Approach to SA Pruritus

Question 1

Pruritis definition

Answer 1

Unpleasant sensation that evokes the desire to scratch

Question 2

What to do if suspect fleas

Answer 2

Fine-toothed comb to isolate ADULTS and FECES
Adulticide + Treat the ENVIRONMENT!!!

Question 3

What does sarcoptes scabiei var. canis look lile

Answer 3

Papulo-crusted lesions on ear pinnae. Severe pruritus with acute onset

Question 4

Dx of Sacroptes

Answer 4

Superficial skin scraping (few mites, attention to eggs and fecal pellets)
Elisa for Sarcoptes-specific IgE: seroconversion in 5 weeks…

Question 5

What doe cheyletiella spp look lile

Answer 5

dry exfoliation mainly dorsal, progressiv itching severity

Question 6

Dx cheyletiella spp

Answer 6

Adhesive tape test, combing => microscopic examination: adults, eggs, stool examination (adults/eggs ingested during grooming)

Question 7

DX Demodex

Answer 7

Deep skin scraping, skin biopsy (rare, Shar-Pei)

Question 8

Group of medications used to deal with ectoparasites

Answer 8

ISOXAZOLINE
Afoxolaner (Nexgard, Nexgard Spectra)

Question 9

Drugs used to control pruritus

Answer 9

Oclacitinib 0.4-0.6 mg/kg BID for 7-10 days (Apoquel)
Prednisolone 0.5 mg/kg BID for 7-10 days (SE)

Question 10

How to diagnose an adverse reaction to food

Answer 10

Elimination diet trial

Question 11

Duration of elimination diet trial

Answer 11

MINIMUM 8 WEEKS

Question 12

How to confirm dx after eliminiation diet trail

Answer 12

Notice if pruritus flares back testing the previous diet’s ingredients, together or one by one
Keeping the elimination diet as a base we introduce a new ingredient every 2 weeks
Start with proteins, then carbohydrates, then treats

Question 13

What is the most frequent pruritic disease

Answer 13

Atopic dermatitis

Question 14

Dx Atopic dermatitis

Answer 14

Animals with perennial pruritus not responding to the elimination diet trial
Animals with proved seasonality of pruritus and skin lesions

Question 15

Is allergy testing indicated for dx of atopic dermatitis

Answer 15

No

Question 16

When is allergy testing indicated

Answer 16

To identify the allergens responsible of the symptoms

Question 17

Name of immune mediated skin disease

Answer 17

PEMPHIGUS FOLIACEOUS

Question 18

C/S of Pemphigus Foliaceous

Answer 18

Generally older animals >7 years
Symmetric bilateral lesions, head, face and ears in 80% of cases
Large pustules spanning multiple follicular units
Pustules/crusts on the concave aspect of the pinna

Question 19

What do I expect to see on cytology for Pemphigus Foliaceous

Answer 19

neutrophils (non degenerate), acantholytic cells, eosinophils

Question 20

Dx for Pemphigus Foliaceous

Answer 20

Skin biopsy

Question 21

Name of neoplastic skin disease

Answer 21

Epitheliotropic T cell Lymphoma

Question 22

C/S of Epitheliotropic T cell lymphoma

Answer 22

Old animals >10 years
No previous history of pruritus
Exfoliative erythroderma, white Adherent scales
Depigmentation of labial phyltrum

Question 23

What is the most frequent allergy for cats

Answer 23

Flea Allergy

Question 24

Most common food allergy in cats

Answer 24

Beef and Fish

Question 25

What breed of cat is predisposed to having an adverse reaction to food

Answer 25

Siamese

Question 26

What is Feline Atopic Skin Syndrome

Answer 26

Seasonal only in 10-20% of patients
No particular lesions or localizations
Allergy towards molds, mites, epithelia

Question 27

Cat breed predisposed to to Feline Atopic Skin Syndrome

Answer 27

Abyssinian predisposed

Question 28

Dx of self inflicted alopecia

Answer 28

trichoscopic examination
roots in anagen, broken tips

Question 29

Drugs to give itchy cat

Answer 29

Ciclosporin 7 mg/kg (FIV-FelV e Toxo negative)
Glucocorticoids (topical or systemic)

Question 30

Do I control symptoms before,during or after diagnostic trial

Answer 30

DURING