Canine Pododermatitis Flashcards
Demodiocosis of paws
Can be in adult dogs > 4 years Commonly misdiagnosed as allergies Not usually pruritic Hyperpigmentation Comedones Nodules, hemorrhagic draining lesions of paws
Possible Causes
Infectious Parasites Immunologic Metabolic Neoplasticism Genetic/familial Foreign body/acquired
Deep Pyoderma of Paws
Looks very similar to Demodicosis
Two conditions likely to be seen together
Nodules, Fistula, recurrent draining tracts
Plucking hairs/skin scraping
Bacterial cultures/MIC
Multiple paws and interdigital spaces affected, body usually not involved
May be underlying caused by underlying allergic dermatitis
Idiopathic form - Great Danes, Mastiff
Treatment: Systemic AB from culture 4- 8 weeks
Manage underlying conditions
Avoid steroids
Malazssezia yeast
Very common cause of pododermatitis
Common inhabitant of skin that can become pathogens
Yeast causes reaction in the skin resulting in lichenification, hyperpigmentation, foul odor, marked pruritic, crusting, erythema
Always secondary to other conditions - usually atopy
Cytology is diagnostic
Staph colonization common
Treatment: Treat underlying atopy
oral Ketoconazole, oral Fluconazole, Topical antifungals: Miconazole in topicals, Climbazole in topicals, Ketoconazole in topicals
Pemphigus Foliaceus
Crusting primarily of paw pads, dorsal muzzle, planum nasals, pinnae, periorbital areas
Cytology: pustule contents, lifted crust - intact neutrophils, acantholytic cells without bacteria (look like fried eggs); NO BACTERIA (unlike pyoderma)
Histo: acantholytic cells
Average age: 4 years
Differential: Bacterial folliculitis
Non-pruritic
Papules and pustules
Cracked paw pads
Treatment:
Prednisone (high doses) with azathiprine
Monitor CBC, chem weekly
Atopy affecting paws
Sometimes only paw involvement
Can cause pruritic of paws, face, axillae, ears or flanks, groin, perineum
Erythema, variable alopecia, lichenification, excoriation
Age of onset - 6 months - 6 years
Skin scraping to rule out Demodex
Cytology for secondary pyoderma, malassezia
Treatment: Intradermal allergy testing for formulation therapy
Allergen specific immunotherapy
Treat secondary infections
Oral antihistamines, oral steroids, oral cyclosporine, Topicals to manage epidermal barrier abnormalities
Vasculitis affecting paws
Lesions on tips of tails, paw pads, pinnae
Surface crusting, ulceration, SQ swelling
Paw lesions very subtle
Pinnae lesions most obvious
Nail beds can be affected, shedding of multiple nails
Rabies vax or other vax have been implicated for lesions of alopecia
Skin biopsy required for diagnosis
Treatment (slow to resolve):
Pentoxifylline, Steroids oral and topical, Tacrolimus topical, Omega 3 FA
Superficial Necrolytic Dermatitis
Hepatocutaneous Syndrome
Dogs with chronic liver failure or glucagon secreting pancreatic tumors
Skin lesions first signs
Metabolic changes noted later on bloodwork
Amino acid deficiency
Crusting, ulcerative lesions in groin, perioral, paw pads (severe lesions)
Paw pads cracks, hyperkeratosis, lameness
Skin biopsy and liver ultrasound showing Swiss cheese pattern- diagnosis
Poor prognosis
IV amino acid therapy prn- weekly to monthly (central line slow infusion)
Oral amino acid supplements, egg yolks, zinc supplements
Steroids can be deadly!
IM specialist for consult
Usually older dogs
Nail Bed Squamous Cell Carcinoma
Usually solitary, may affect multiple digits
Lameness, digital swelling, deformity or loss of the nail
Digital swelling of P3
Bone lysis on radiographs
Usually Age > 7 years
Lg breeds predisposed - Lab, Std Poodle, Rott, Giant Schnauzers
Treatment: Amputation of P3 is curative
Epitheliotropic Lymphoma
Often confused with pyoderma, allergy, hypothyroidism, or autoimmune disease.
Scale, erythema, slightly raised erythematous plaques.
Diffuse depigmentation of foot pads, lips, eyelids, nasal planum (classic signs)
Older dogs > 8 years Prognosis if guarded to poor Treatment: Some will respond to prednisone for awhile CCNU (Lomustine) Palliative only
Referral to Oncologist
Familial Paw Pad Hyperkeratosis
Rare defect of keratinization
Restricted to paw pads x 4
Thick, keratin proliferation, horns, fronds, thick hard pads.
Cracks in pads cause lameness
Claws in abnormal curved patterns
Changes start @ 4 - 6 months, cont through life
Breeds: Lab, Golden, Dogue de Bordeaux, Irish terrier, Kerry blue terrier
Treatment: Daily foot soaks in 50% propylene glycol
Daily oral acid retain (Soriatane) may help
Dremel PRN off keratin under sedation q 3 - 5 months
Interdigital Follicular Cysts
Follicular cysts develop on plantar or palmar surface of canine paw
Recurrent nodules that are erythematous, ulcerate, drain
Dog licks at affected areas- cause recurrent interdigital disease
usually in front paws in lateral interdigital spaces
Failure to respond to AB
Start 1 - 3 years of age
Treatment with appropriate AB, CO2 laser ablation of cysts
