10. Dermatology Flashcards
What 3 things make an ectoparasite ‘important’
Clinical importance
Zoonotic importance
Economic importance
Which 3 types of parasites are found on the skin surface of the host
Fleas
Lice
Surface mites
Name the main surface mites found on the following species: cattle, sheep and horse
Cattle: Chorioptes bovis, Psoroptes
Sheep: Psoroptes ovis, Chorioptes bovis
Horse: Chorioptes equi, Psoroptes spp, Neotrombicula spp (harvest mite)
Name the main surface mites found on the following species: dogs/cats and rabbits (3 for each)
Dogs/cats: Ootodectes (ears), Cheyletiella (fur mite), Neotrombicula (harvest mite)
Rabbits: Cheyletiella, Leporacus gibbus, Psoroptes cuniculi (painful!!)
What 2 types of parasites are found below the skin surface
Burrowing mites
Demodex
What burrowing mites are found on the following species: dog, guinea pig and birds
Dog: Sarcoptes scabei
Guinea pig: Trixacarus
Birds: Knemidocoptes
Which 3 animals are demodex most likely to affect
Dog, hamster and sometimes cats
what is the importance of ticks
Affect many species
Vectors of disease
heavy infestation can be debilitating
Tick granuloma if mouthparts are retained
What is the importance of cutaneous myiasis
Sheep and rabbits
‘Blowfly strike’ is potentially fatal
Larvae feed on host tissue - major welfare problem
What 3 parasites are unlikely to be detected on the host (live In the environment)
Midges e.g. Culicoides spp. => sweet itch and vectors of disease
Nuisance flies => irritants, transmit disease and skin disease
Dermanyssus gallinae (Poultry red mite) => zoonotic
Name 3 places where bacteria can come from to cause skin disease - and give examples
Present on normal skin => ‘endogenous infection” - Dermatophilus congolensis
From the environment - Mycobacteria from soil
From other animals - Treponema funiculi infection from rabbit
State 6 reasons why bacterial skin disease occurs
- Normal protective mechanisms of the skin are compromised
- Mechanical damage
- Immunocompromise
- Defects in skin barrier function
- Changes to the skin microclimate e.g. warm/moist
- Dysbiosis - imbalance of microbes of the skin
3 portals of entry for bacteria to cause skin disease
Via follicles
Direct entry through damaged skin
Haematogenous spread (rare)
Name 3 reasons why bacterial skin disease manifestation varies
Depth of infection
Type of inflammatory response
Lesion distribution and severity
Name 5 clinical manifestations of bacterial skin disease
- Surface pyoderma
- Superficial pyoderma
- Deep pyoderma
- Bacterial granulomatous dermatitis
- Skin lesions secondary to systemic bacterial infections or infections with toxin-producing bacteria
What is surface pyoderma and give 3 examples
When bacteria multiply on skin surface only
Example: canine intertrigo (skin fold pyoderma), acute moist dermatitis, bacterial overgrowth syndrome
What is superficial pyoderma and give 6 examples
Infection within the epidermis or hair follicles
1. Greasy pig disease - Staphylococcus hyicus
2. Bacterial folliculitis
3. Impetigo
4. Exfoliative superficial pyoderma
5. Dermatophilosis (rain scald)
6. Fleece rot (Pseudomonas in sheep)
What is deep pyoderma and give 3 examples
Infection outside epidermis or hair follicle epithelium due to furunculosis, penetrating wounds or sepsis
1. Furunculosis
2. Abscesses
3. Cellulitis
What is bacterial granulomatous dermatitis and give 2 types and causative agents
Mycobacterial (pyo)granulomas caused by traumatic implantation of saprotrophic organisms
1. Non-filamenous bacterial granulomas e.g. staph, strep and actinobacillus => lesions contain small yellow granules
2. Filamenous bacterial granulomas e.g. Actinomyces, Nocardia => lesions are nodular masses which may involve bone
3 common diagnostics tests to diagnose bacterial skin disease
Cytology
Culture
Histopathology with skin biopsy
3 broad principals of treating bacterial skin disease
Kill the organism
Enhance body’s defences
Address underlying cause
Should you use systemic antibiotics for bacterial skin disease
Avoid if possible
Use topical antibacterials when possible
Systemic antibiotics should only be used for deep infections
3 classifications of dermatophytes
Geophilic - adapted for the environment
Zoophilic - adapted for mammals
Anthropophillic - adapted for man
Stages of infection of dermatophytosis
Skin micro trauma and damage
Inoculation and germination of infective arthroscopes
Germ tube penetrate stratum corner
Growth of fungal hyphae
Lesions
Which 2 species of fungi most commonly cause dermatophytosis
Microsporum spp.
Trichophyton spp.
Clinical features of dermatophytosis
Zoonotic
Infection of hair/surface keratin
Folliculitis => alopecia
Variable pruritus
Adherent scale
Haired skin almost always affected
Lesions normally asymmetric
4 uncommon presentations of dermatophytosis
- Furunculosis
- Fungal kerion
- Pseudomycetoma
- Onychomycosis (claw disease)
5 methods of diagnosis of dermatophytosis
- Direct examination of hairs/scales
- Wood’s lamp
- Fungal culture
- Fungal PCR
- Skin biopsy => histopathology
Pathogenesis of Malassezia infection
Host factors - skin folds, other skin diseases, systemic disease leads to
Increased Malassezia numbers, decreased species diversity => Dysbiosis
OR
Shift towards a more pathogenic strain
Clinical presentation of a Malassezia infection
Pruritis
Erythema, grease, scale, crust
Malodourous
Ears - erythropoietin-ceruminous otitis - rarely purulent
Diagnosis of a Malassezia infection (3 steps)
- Identify appropriate lesions
- Identify Malassezia at these sites with cytology
- Assess response to anti-fungal therapy
Why viral skin diseases are so important
Many are NOTIFIABLE
General clinical signs of vesicular disease (type of viral skin disease)
Vesicles and erosions on non-haired skin mostly
Can lead to shed hooves and horns
Name 5 notifiable vesicular diseases
- Foot and Mouth
- Vesicular Stomatitis
- Swine vesicular disease
- Bluetongue virus
- Rinderpest
General characteristics of Papilloma viruses (viral skin disease)
Warts (papillomas)
Enter via micro abrasions
Rarely undergo malignant transformation => squamous cell carcinomas
Which papilloma virus affects cattle and how does it transmit
Bovine papilloma virus
Indirect transmission
Which 2 papilloma viruses affects horses and how does it transmit
- Bovine papilloma virus
- Equine papilloma virus
Transmits via flies and tack
Which papilloma virus affects dogs
Canine papilloma virus
General feature of Pox viruses (viral skin disease)
Macules, papules, vesicles, pustules, crust
Name pox viruses affecting the following species: cow, cat, horse, pigs, sheep/goats, rabbits
Identify which ones are notifiable
Cattle: cowpox (rare) and lumpy skin disease (NOTIFIABLE)
Cats: cowpox
Horses: horsepox
Pigs: swinepox
Sheep/goats: sheep pox and goat pox (both NOTIFIABLE)
Rabbits: myxomatosis
Give 3 examples of parapoxviruses
- Contagious pustular dermatitis (Off)
- Pseudocowpox
- Bovine papular stomatitis
What type of virus causes Post-weaning Multisystemic Wasting Disease (PMWD)/ Porcine Dermatitis Nephropathy Syndrome (PDNS)
Circovirus
Differential diagnosis for classic and African swine fever (NOTIFIABLE)
what type of virus causes Psittacine beak and feather disease
Circovirus
What type of virus causes Boarder disease in sheep
Pestivirus
2 routes of diagnosis of a viral skin disease
- Detection of the actual virus/viral antigen/ nucleic acid
- Diagnostic serology - detection of antibodies to the virus
What type of disease is Leishmaniasis, what is it caused by and how is it spread
Protozoal skin disease
Caused by Leishmania spp.
Transmitted by blood-sucking sandflies
Zoonotic
Name 6 triggers for allergic skin disease
- Environmental allergens
- Food
- Ectoparasites
- Contact allergens
- Microorganisms
- Drugs
Which hypersensitivity is most commonly associated with allergic skin disease
Type 1
But others can be involved
Environmental atopic dermatitis - dogs
Which type of adaptive immune response is associated with chronic or acute lesions
Acute - lymphocytes follow TH2 pathway => IgE = Type 1 hypersensitivity
Chronic - more complex, TH1, TH2 and other T cell responses
Pathogenesis of environmental atopic dermatitis in dogs (2 ways)
- Aberrations in the skin barrier
- Dysregulation of microbiome
What 2 phases are required for a type 1 hypersensitivity reaction
Sensitisation phase
Provocation/re-exposure phase
Clinical features of environmental atopic dermatitis in dogs
Breed predisposition
age of onset - 6months-3 years
Highly heritable
Seasonal/non-seasonal
Relapsing pruritus
Responsive to glucocorticoids
Clinical signs of food-induced atopic dermatitis
Age of onset <1 year
Response to glucocorticoids variable
GI signs
Non seasonal
2 types of feline atopic syndrome
Feline atopic skin syndrome (FASS)
Feline food allergy (FFA)
What are the 4 cutaneous skin reaction patterns in cats
- Face, head, neck pruritus (FHN)
- Self induced alopecia (SIA)
- Miliary dermatitis (MD)
- Eosinophilic granuloma complex (EGC)
Equine atopic dermatitis - what type of allergen
Environmental
Often co-existing with insect bite hypersensitivity
3 types of ectoparasite allergies
- Flea allergic dermatitis
- Insect bite hypersensitivity - Culicoides spp, mosquitos
- Mite hypersensitivity - Psoroptes, Sarcoptes
What are the predominant hypersensitivity types in Cutaneous Immune-Mediated Diseases (CIMDs)
Type II - antibodies
Type III - immune-complex disease
Type IV - T cells
3 types of cutaneous immune-mediated disease affecting the epidermis
- Pemphigus foliaceus
- Facial cutaneous lupus erythematosus
- Vitiligo
Name the target, immune mechanism, presentation and main differential diagnosis for pemphigus foliaceus
Target = desmosomal proteins in the upper epidermis
Immune mechanism = antibody (Type II)
Presentation = pustules rapidly developing into crusts, leaving erosions
Main d/d = superficial pyoderma (pustle doesn’t form around a single follicle in pemphigus foliaceus)
Name the target, immune mechanism, presentation and main differential diagnosis for facial cutaneous lupus erythematosus
Target = epithelial cells
Immune mechanism = T cells (Type IV)
Presentation = damaged epithelium with ulceration and depigmentation due to bystanding melanocytes being affected
Main d/d - Mucocutaneous pyoderma and Epitheliotrophi lymphoma
Name the target, immune mechanism, presentation and main differential diagnosis for vitiligo
Target = melanocytes
Immune mechanism = Antibodies and T cells (type II and IV)
Presentation = removal of pigment from epithelium, minimal inflammation
Main d/d = any inflammatory disease causing depigmentation
What are the 5 dermal targets for Cutaneous Immune-Mediated Diseases
- Isthmus of the hair follicle
- Hair bulb
- Sebaceous glands
- Dermal blood vessels
- Anchoring fibrils
3 types of cutaneous immune-mediated disease affecting the dermis
- Sebaceous adenitis
- Vasculitis
- Panniculitis
Name the target, immune mechanism, presentation and main differential diagnosis for sebaceous adenitis
Target = sebaceous glands
Immune mechanism = T cells (Type IV)
Presentation = Gland is destroyed, broken hair, scale and alopecia
Main d/d = superficial pyoderma, dermatophytosis and other scaling diseases
Name the target, immune mechanism, presentation and main differential diagnosis for vasculitis
Target = dermal blood vessels
Immune mechanism = antibodies and antibody immune complexes (Type II and III)
Presentation = tissue death and hair loss in the area supplied by the blood vessel
Main d/d = causes of alopecia, tumours, trauma
Name the target, immune mechanism, presentation and main differential diagnosis for panniculitis
Target = subcuticular fat
Immune mechanism = unclear
Presentation = soft, fluctuating nodules that may rupture
Main d/d = Tumours, deep infections
What 4 conditions are sterile pyogranulomatous dermatitis and panniculitis (SPDP) seen with
- Pancreatic neoplasia
- Pancreatitis
- Polyarthritis
- Systemic lupus erythematosus
Apart from the skin, what other areas of the body can vasculitis affect
Kidneys, joints and eyes
How to accurately diagnose CIMDs
Exclusion of differential diagnoses
conformation of correct histopathological pattern
General approach to investigating cause of skin disease
Signalment
History
Differential diagnoses
Initial diagnostic tests
Diagnosis
Further investigations
Trial therapy
What aspects of signalment are important when investigating skin disease
Age - Immature, young, old
Sex - entire male/female
Breed - predispositions
Important things to ask about the history of patient when investigating skin disease
Any underlying systemic disease
Systemic disease which may affect diagnostic or treatment plans
Drug history
Important aspects of lifestyle/management when investigating skin disease
Housed/stabled
If not housed, nature of environment
Any recent introductions to the group of animals
Contact with other species
Do they hunt
Key questions to ask when obtaining a dermatological history
Details of in-contact animals and people
Past dermatological history
Onset of current problem - when, nature of lesion, area affected, pruritus, seasonality
What are the common tests and what are they used for in common dermatological conditions
Coat comb - surface parasites/fleas
Acetate tape strip unstained - surface parasites
Superficial skin scrape - surface parasites
Deep skin scrape - deep parasites
Trichogram - parasites of hair shaft, dermatophytes, hair abnormalities
Cytology - bacteria and yeast detection, cell type
Woods lamp - Microsporum canis
Swab for culture - yeast and bacteria
Why biopsy the skin
Establish a diagnosis that cannot be reached through less invasive testing
Rule out certain conditions
Best site to biopsy for alopecia
Across the margin of the alopecic area
Area of maximum hair loss
Normal haired skin
Best site to biopsy for ulcerated skin
Skin just adjacent to the ulcer where the epidermis is still intact
Best site to biopsy for pustules, vesicles or bullae
Remove the whole lesion without disruption
How to prepare the biopsy sample site
Avoid disturbing skin surface
Clip hair, not too short
Do not disturb crusts
Do not scrub the skin
If using local anaesthetic draw a circle around the lesion and infiltrate local into subcutis around edge of the circle
What are the 2 types of biopsy
Punch biopsy
Wedge biopsy - excision or incisional
how to handle biopsy sample for histopathology
10% formalin
Minimum 10x volume of the tissue sample
Is thin sample prevent curling by using stiff card
Special consideration for bacterial and fungal tissue culture
DO NOT use formalin - use sterile saline
Withdraw antibiotics for 5-7 days, topical antimicrobials for 3 days before sampling
How to label sample for the histopathologist
Give brief history
Suspect differential diagnoses
Name the 8 dermatological patterns
- Perivascular dermatitis
- Interface dermatitis
- Vasculitis
- Nodular and or diffuse dermatitis
- Vesicular/pustular dermatitis - intra or subepidermal
- Folliculitis/furunculosis/adenitis
- Panniculitis
- Atrophic dermatosis
Name the features of the perivascular dermatitis pattern and when is it seen
Prominent blood vessels
Leukocytes around vessels
Oedema of the dermis
Examples - Canine atopy, FAD, pyoderma
Name the features of the interface dermatitis pattern and when is it seen
Band-like mononuclear infiltrate crossing dermo-epidermal junction (cell rich or poor)
Pigment incontinence
Hydronic degeneration of basal keratinocytes
+/- apoptosis
Example - immune mediate disease
Name the features of the vasculitis pattern and when is it seen
Inflammation of blood vessels - degeneration of vascular walls with inflammatory cells around
May have micro haemorrhages
+/- panniculitis, dermal necrosis, atrophy of hair follicle
Example - primary or secondary to inflammation, infection, drug reactions, neoplasia or vaccination
Name the features of the nodular/diffuse dermatitis pattern and when is it seen
Convergence of nodules leading to a diffuse pattern
Call type can vary - neutrophils (pyogenic), macrophages (foreign body/mycobacteria), neutrophils and macrophages (fungi), eosinophilic (parasite), lymphocytic (insect bite)
Name the features of the Intraepidermal vesicular/pustule dermatitis pattern and when is it seen
Clefting in epidermis => vesicles/pustules
Due to epidermal inflammation, pacantholysis or intracellular oedema
How can the intraepidermal vesicular/pustule dermatitis pattern be further classified
By position - sub corneal, suprabasilar, in follicular externall root sheath
By cellular infiltrate - neutrophils or eosinophils
Name the features of the subepidermal vesicular/pustular dermatitis pattern and when is it seen
Separation of the epidermis from the dermis
Rare
Autoimmune
Thermal burns
Severe dermal oedema
Name the features of the Folliculitis/furunculosis/adenitis pattern and when is it seen
Inflammation affecting different hair follicle structures
Folliculitis = inflamed hair follicle
Furunculosis = deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue
Sebaceous Adenitis = inflammation of sebaceous gland
Name the features of the panniculitis pattern and when is it seen
Inflammation of the subcutaneous adipose tissue
Causes - infectious agent, foreign body, trauma, pancreatic disease, vasculitis
Can be sterile idiopathic
Name the features of the atrophic dermatosis pattern and when is it seen
Atrophy of: epidermis, hair follicles, collagen and sebaceous glands
Various endocrine causes - HAC, hypothyroidism
what are the 3 main causes of pruritus
- hypersensitivity
- parasites
- microbial infections
What is the first step in investigating environmental/food-induced atopy
Exclusion diet trial for 6-8 weeks
what order you you work in when a pruritic animals comes in
Make a ranked d/d list
Investigate parasites and microbial infections first
Then do a diet trial
Then consider environmental atopic dermatitis
What kind of lesions are pustules and papules
Primary lesions
What are the common causes of pustules and papules
Infections - superficial bacterial pyoderma/folliculitis most common
Ectoparasites
Hypersensitivities
what type of lesion is scale
usually secondary lesion
what type of lesion is crust
always secondary lesion
What are the 2 main causes of scale
Hyperkeratosis
Increased or disrupted epidermal turnover
What causes crust
When exudates dry on the skin surface
What are the common bacterial causes of crust/scale
Pyoderma/folliculitis
Dermatophilosis
What are the common fungal causes of crust/scale?
Dermatophytosis
Malassezia
What are the common viral causes of crust/scale
Viral papillomas
Occult sarcoids
Give 3 examples of surface mites which cause scale/crust
Chorioptes
Cheyletiella
Psoroptes
Give 3 examples of burrowing mites which cause scale/crust
Sarcoptes
Trixacarus
Cnemidocoptes
What is a primary keratinisation disorder
Defects in normal keratinisation process
e.g. abnormal formation of keratinocytes or abnormal sebaceous gland function
Name 5 causes of swellings of non-dermatological origins
- hernias
- oedema
- bursitis
- emphysema
- mammary tumour
What are the main 3 categories of skin masses
Inflammatory - infectious/non infectious
Cysts
Neoplasams
Name 4 infectious causes of inflammatory skin masses
- Access/cellulitis
- Furunculosis
- Bacterial granulomas
- Deep/subcutaneous or systemic fungal granuloma
Name 3 bacteria which can cause bacterial granulomas
Actinobacillus
Nocardia
Actinomyces
Name 4 non infectious causes of inflammatory skin masses
- Urticaria, angioedema
- Seroma
- Haematoma
- Other e.g. tick/insect bite granuloma
what can be the causes of urticaria
Allergic (type I or type III)
Non immunological cause
What skin neoplasia is most common in horses
Melanomas - grey horses mostly
What 3 neoplasias are most common in dogs
Lipomas
Sebaceous adenomas
Mast cell tumours
what 4 main things are we looking for in a general clinical exam for an animal with skin masses
Pyrexia
Peripheral lymphadenopathy
Other systemic abnormalities
Non dermatological swelling
What are the 3 methods for taking fine needle aspirate
Needle only with no suction
Continuous suction
Intermittent suction
2 reasons to take a tissue biopsy
Histopathology
Tissue culture
Define primary alopecia
Failure of hair to grow normally
Define secondary alopecia
Hair grows normally but is subsequently lost/damaged
Define true alopecia
Direct damage to hair follicle unit => loss of whole hair follicle unit
Define apparent alopecia
Hair shaft is damaged but not lost from the hair follicle unit
Hair cropped short
3 main mechanisms of primary alopecia
Lack of stimulation of anagen (growth) phase
Elongation of the telogen (resting) phase
Abnormal growth factors
Name 4 main causes of alopecia
Congenital alopecia (rare)
Hair follicle inflammation (most common)
Hair cycle abnormalities
Hair morphological abnormalities
Which species are ringworm most common in
Cattle, horses, cats and hedgehogs
What are the common causes of alopecia in immature animals
Infections (demodicosis, dermatophytosis, superficial pyoderma)
Congenital alopecia
What are the common causes of alopecia in middle-aged/older animals
Endocrinopathies
Neoplasia
demodicosis
What conditions in entire females can cause alopecia
ovarian neoplasia
What conditions in entire males can cause alopecia
Sertoli cell tumour => oestrogen production => hair loss
When can alopecia be normal
Sphinx cats
Flank scent glands on hamsters
Normal coat shedding
How to differentiate between true and apparent alopcia
Trichogram
can see the broken distal tips of the hair suggesting apparent alopecia
Name 3 initial tests to narrow down differentials for alopecia
Skin scrape
Dermatophyte investigations - woods lamp, direct microscopy
Trichograms
Name some further tests for alopecia
Cytology - pyoderma
Endocrine function tests
Skin biopsies
Name the 4 aspects of multimodal therapy for atopic dermatitis
- control of inflammation and pruritus
- allergen avoidance and allergen-specific immunotherapy
- improving skin barrier
- control of the flare factors
What are the 4 main classes of drugs used to control inflammation and pruritus
- Glucocorticoids
- Oclacitnib (apoquel)
- Lokivetmab (cytopoint)
- Cyclosporin
What tests can be used to identify non dietary allergens
Intraderamal testing
IgE serology
Give 3 things used to help improve the skin barrier
Moisturisers
Oral/topical essential fatty acids
Essential oils
Name 3 methods to control flare factors of atopic dermatitis
Controlling microbial populations
Good ectoparasite control
Avoid overheating of the skin
Name the 4 aspects of therapy for autoimmune disease
Induction
Titration
Maintenance
Monitoring
Explain the process of the induction step in autoimmune therapy
Rapid control of lesions
Systemic treatment usually with glucocorticoids at immunosuppressive doses
Continue until most lesions healed and no new lesions for 2 weeks
Which glucocorticoids are commonly used to treat autoimmune diseases
Prednisolone in dogs and cats
Dexamethasone or prednisolone In horses
Describe the titration step in therapy of autoimmune disease
Tapering down the dose of glucocorticoids to lowest effective dose
Often need adjunctive treatments to keep lesions under control
Name 6 adjunctive treatments used to help reduce dose of glucocorticoids
Azathioprine - not for cats!
Chlorambucil
Mycophenolate mofetil
Ciclosporin - esp for T-cell-mediated diseases
Oclacitinib – emergent information
Gold salts - rare use
Describe the maintenance step in autoimmune therapy
Reduce prednisolone to alternate-day therapy if possible
Aim for maintenance of remission without harmful side effects of medication
Describe the monitoring step of autoimmune therapy
Reexamining and monitoring for lesion control and any side effects of drugs
When would you use topical glucocorticoids for autoimmune disease
local lesions
What are the 6 main aims of dermatologic therapy
- Kill/repel parasites
- control/kill microbial infections
- control inflammation/pruritis
- Moisturise/ improve skin barrier function
- Resolve scale
- treat otitis externa
What 3 agents are used to moisturise/improve the skin barrier
- emollients
- moisturisers
- agents to improve skin barrier function e.g. essential fatty acids
What is the proper name for agents used to control scale
Antiseborrhoeic agents
Name 2 forms of antiseborrhoeic agents (controlling scale)
Keratolytic
Keratoplastic
what do keratoplastic agents do
restore normal epidermal epithelialisation and keratinisation
what to keratolytic agents do
break down keratin
Give 3 examples of keratolytic/keratoplastic agents
- sulphur
- salicylic acid
- ammonium lactate
What are the 2 main groups of drugs used to treat otitis externa
Polypharmacy ear drops/creams (POM-V)
Ear cleaners (non POM-V)
What criteria is used to select which POM-V ear drop is required for otitis externa
Organism present
Level of inflammatory activity required
Potential for ototoxicity if tympanic membrane is ruptured
Nature of exudate in the ear
Frequency of application required
give the common glucocorticoids used in ear cleaners in order from low to highest potency
Hydrocortisone
Prednisolone dexamethasone/ betamethasone/ hydrocortisone aceponate
Mometasone
what active ingredients are ototoxic if the tympanic membrane is ruptured
Gentamycin
Polymixin - B
which drug is inactivated if there is pus in the ear
Polymixin B
What agents may non POM-V ear cleaners contain
Cerumenolytics
Surfactants
Astringents
Antimicrobials
Give examples of cerumenolytics
squalene
propylene glycol
glycerine
mineral oils
Name some positives of topical therapy
less concerns about side efects
Direct delivery of the drug
Can achieve higher concentrations of the drug
can target the therapy to the site
Name some disadvantages of topical therapy
Labour intensive
some animals won’t tolerate
Possible toxicity/loss of efficacy if the drug is licked off
For bites and traumatic wounds, if systemically well and not pyrexic, what is the antimicrobial protocol
Topical treatment with 2-4% chlorhexidine
For bites and traumatic wounds, if systemically unwell and pyrexic, what is the antimicrobial protocol
systemic antibacterial based on cytology
What antibacterials would you use for cocci
Clindamycin
Cefalexin
Amoxicillin/clavanulate
Trimethoprim/sulphonamide
what antimicrobials do you use for rods
fluoroquinolone
What topical treatments do you use for surface pyoderma
2-4% chlorhexidine
Fusidic acid +/- glucocorticoids
Silvers sulphadiazine (if rods present)
what antimicrobials do you use for cocci in otitis externa
Florfenicol
Fusidic acid/framycetin
Polymixin B/miconazole
what antimicrobials do you use for rods in otitis externa
Framycetin
Gentamicin
Polymixin B
in horses, what is the antimicrobial protocol for superficial bacterial skin infections
Topical antibiotics
Correct underlying cause
In horses, what is the antimicrobial protocol for deep pyoderma/cellulitis
Systemic antibiotics
Which is the first line antibiotic for cellulitis in horses and what are the alternatives
First = doxycycline
Alternatives = Penicillin and gentamicin
Which is the first line antibiotic for pyoderma in horses and what are the alternatives
First = trimethoprim and sulphadiazine (TMPS)
Alternatives = doxycycline
Name 3 systemic antibiotics that can be used in farm animals for potential bacterial infections
Penicillin, cephalosporins, oxytetracycline
What is the treatment protocol for abscesses in all species apart from rabbits
Avoid antibiotics
Once mature => lance, drain and flush
Give antibiotics if systemically unwell
What is the treatment protocol for abscesses in rabbits
Pus is caseous so can’t lance and drain
Surgical management required
Stages of treatment for dermatophytosis
Identify fungus
Remove infective fungal spores from coat and reduce environmental contamination
+/- systemic therapy
Clean the environment as much as possible
Monitor response to therapy
Name 2 main topical anti fungal rinses
Miconazole
Enilconazole
Name 2 main systemic antifungals
Itraconazole
Ketoconazole - NEVER in cats
What are the issues with itraconazole and ketoconozole
GI upset
Hepatotoxicity
What is the treatment protocol for malassezia infections
Topical antifungals - mainstay of treatment
Systemic is sometimes required but not licensed
what 3 things need to be done in pre hibernation for a tortoise
Starve 3-4 weeks
Bathe daily in warm water
reduce temperatures
3 things to monitor during hibernation to know if something is wrong
Defaecation
Urination
Weight
What 2 diseases are most common in tortoises
Herpes disease
Mycoplasma
what temp should it be to hibernate a tortoise
3-7 degrees
name 3 pro kinetics for rabbit gut stasis
Cisapride
Ranitidine
Metaclopramide
what 2 vaccines do you use in rabbits
Myxomatosis
RHD 1 and 2
What vaccines are needed for ferrets
Canine distemper
Rabies if going out of the country
Name 3 main reasons for lethargy in ferrets
Insulinoma
Lymphoma
Heart disease
name 4 differentials for hair loss in ferrets
Normal moulting
persistent oestrus
hyperadrenocorticism
malnutrition
what is the ferret breeding season
march to September
