Exam 2 from notes Flashcards
Pyodermas are usually a primary clinical manifestation (T or F)
F: usually secondary to an underlying problem
What are some conditions that are predisposing to pyoderma?
environmental factors, allergies, endocrine, nutrition, immunologic, keratin defects, parasites, anatomic defects, prior therapy
What does pyoderma actually mean?
pus in the skin
In a clinical setting a purulent lesion may not always be present macroscopically with a pyoderma (T or F)
T: so a pyoderma may not be associated with pus-producing lesions
What is the most common pathogen in canine pyoderma?
Staph pseudintermidius (S. intermedius)
What organisms might be seen as secondary invaders with pyoderma?
gram neg like proteus, pseudomonas, and E. coli
Besides S. intermedius what other pathogens are found in some cases of pyoderma?
S. aureus and S. schleiferi
What do S. intermedius, S. aureus, and S. schleiferi produce and what does it do?
beta lactamase, destroys penicillin, amoxicillin, and ampicillin
Which antibiotics should you not use empirically with canine pyoderma?
penicillin, amoxicillin, ampicillin, streptomycin, and tetracycline
Which classification scheme for pyoderma is therapy usually based on?
the depth of infection
What is a surface pyoderma and what are some examples?
only involves superficial layers of the epidermis
seen in pyotraumatic dermatitis (hot spots) and skin fold pyodermas
What is a superficial pyoderma and what are some examples?
bacterial infection of epidermis/ hair follicles
seen in impetigo and bacterial folliculitis
What is a deep pyoderma and what are some examples?
infection of tissues deeper than hair follicles
seen in acne, nasal and interdigital pyoderma
What is pyotraumatic dermatitis? (other names for it)
acute moist dermatitis or hot spots
What breeds are most susceptible to hot spots?
st bernards and golden retrievers
any with long thick coats that can trap moisture
What is the etiology of pyotraumatic dermatitis?
underlying problem -> dog licks and scratches -> moisture and self inflicted maceration and erosion of stratum corneum -> secondary bacterial infection
Hot spots are self induced (T or F)
T they are self inflicted and lead to secondary infections
What are some clinical signs of pyotraumatic dermatitis?
erythema, erosion, edema and serous-purulent exudate
exudate forms a yellow to brown crust
lesions are painful and well demarcated
You perform a cytological exam on a dog with pyotraumatic dermatitis. What do you find?
cocci and degenerated neutrophils
How would you treat pyotraumatic dermatitis?
remove hair -> clean with dilute chlorhex -> dry with astringent -> mild use antibiotic cream, severe use oral pred, generalized infection use systemic antibiotics
It’s most important to treat the lesions of pyotraumatic dermatitis (T or F)
F: treating the underlying disease will reduce recurrences
Why are skin folds predisposed to pyodermas?
areas of friction, poor air circulation, accumulate moisture
What is characteristic of skin fold pyodermas?
exudative, odiferous, erythematous lesions
What are the 4 kinds of skin fold pyodermas?
lip fold, facial fold, vulvar fold, tail fold
What breeds are prone to lip fold pyodermas?
cockers, springers, setters and st bernards
What is the main client complaint with lip fold pyodermas?
severe halitosis (doggy breath)
What might offer a permanent cure for lip fold, facial fold, and vulvar fold pyodermas?
surgical ablation (cheiloplasty, episioplasty)
Where do you see facial fold pyoderma and in what breeds?
folds between eyes and nose in brachycephalic breeds
What problems are commonly concurrent with facial fold pyodermas?
corneal abrasions and ulcerations
What dogs are often seen with vulvar fold pyodermas?
obese females spayed before first estrus, vulvas recessed
What are the common signs of vulvar fold pyodermas?
excessive licking, foul odor, painful urination, pervulvar erosions and ulcerations, secondary UTI
Tail fold pyodermas are seen in breeds with fluffy tails and are easy to treat medically (T or F)
super False, seen in corkscrew tails and difficult to treat, usually require surgical amputation or reconstruction
What are other names for impetigo?
superficial pustular dermatitis or puppy pyoderma
What is impetigo?
subcorneal pustules in sparsely haired skin in dogs <1 yr, infection is just below the stratum corneum
What are clinical signs of impetigo?
asymptomatic pustules, papules, honey colored crusts, collarettes, and sometimes pruritus
Impetigo can be seen in healthy dogs without any known associated condition or it can be associated with parasites, nutrition, environment, and viral infections (T or F)
All of this is true!
What is the best treatment for mild impetigo?
none, it’s often self limiting or just needs topical therapy
What is superficial bacterial folliculitis?
an infection in but not beyond the hair follicle
What are the clinical signs of folliculitis?
papules, pustules, erythema, collarettes, circumscribed alopecia, varied pruritus
How is folliculitis usually distributed on the body?
truncal, ventral abdomen
What usually causes folliculitis?
mainly infiltrating neutrophils that release pruritogenic proteases
Superficial bacterial folliculitis is usually a primary disease (T of F)
dude that’s false
Superficial bacterial folliculitis never reoccurs (T or F)
also false, it often reoccurs
How are the underlying diseases of folliculitis classified?
pruritic (the itch that rashes) or non-pruritic (the rash that itches)
What are the most common DDx for bacterial folliculitis?
demodicosis, dermatophytosis, and pemphigus
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Phoebe made this card just for you!
…….with her butt
How can you diagnose bacterial folliculitis?
history, skin scrapings to rule out parasites, rule out ringworm with culture, cytology, response to therapy
What is the rule of thumb for treating bacterial folliculitis?
use the right antibiotic at the right dose 1wk past resolution of lesions
What is deep pyoderma (canine acne)?
deep folliculitis and furunculosis (inflammation with ruptured hair follicle)
What breeds are usually seen with canine acne?
short coated breeds
What are the clinical signs of deep pyodermas?
papules, nodules, hemorrhagic bulla on chin and lips. Can erode or ulcerate and draining tracts may form with ruptured hair follicle that have serous sanguinate exudate.
What are the kinds of deep pyoderma?
canine acne, nasal pyoderma, interdigital pyoderma, generalized, deep hot spots
Where are nasal pyodermas located?
dorsal muzzle and around nostrils
What breeds are predisposed to nasal pyodermas?
shepherds, collies, pointers, hunting dogs
What is the main differential for nasal pyodermas?
dermatophytosis
How do you treat deep pyodermas?
systemic antibiotics two weeks past clinical cure
What is a main clinical sign in interdigital pyoderma?
comedones that may become inflamed and rupture
Which deep pyodermas are seen in any age or sex?
interdigital and generalized
What areas are lesions seen in with generalized deep pyoderma?
anywhere but often rump, thighs, chest, and legs
What diagnostic should you do on all deep pyoderma cases?
bacterial culture and sensitivity
What breed often gets deep hot spots?
golden retriever
How can you distinguish a deep hot spot from a regular hot spot?
deep feel thicker and when squeezed you see draining tracts with sanguinous purulent exudate. They don’t respond to routine therapy.
Use a bactericidal drug with recurrent pyodermas (T or F)
T use this instead of bacteriostatic
How should you use medicated shampoos?
massage them in to the skin for 10 minutes
How is the duration of therapy different for superficial and deep pyodermas?
superficial: 1 wk after clinical signs resolve
deep: 2 wks after clinical signs resolve
What cases should bacterins be used in treatment?
if they respond to long term antibiotic therapy but relapse shortly after the therapy is stopped
Immunomodulators will cure an existent bacterial infection (T or F)
False, they will not you must use antibiotics concurrently
What are the number 1 and number 2 underlying primary problems with pyodermas?
1) allergic 2) endocrinopathies
What are some antibiotic options for treating canine pyoderma?
erythromycin, clindamycin, penicillinase-resistant penicillins, TMPS, cephalexin, clavamox, convenia, enrofloxacin, marbofloxacin
What is the theory for why cats are less likely to develop skin infections?
staph species adhere poorly to feline corneocytes
Compare abscesses to cellulitis.
abscess: focal accumulation of pus
cllulitis: diffuse dermal and SQ infection
What cats are predisposed to abscesses and cellulitis?
intact males
How would you treat feline abscesses or cellulitis?
drain and clean
systemic antibiotics for 2 wks, treat 1 wk past clinical signs
What antibiotics can you use to treat feline abscesses?
penicillin, ampicillin, amoxicillin, clavamox, and cephalexin
What organisms are isolated from feline abscesses?
anaerobes, P. multocida, beta hemolytic streptococci, staph, clostridium, and E. coli
What is the definition of atopy?
an inherited predisposition to develop IgE antibodies to environmental allergens
Atopic dermatitis is a type II hypersensitivity (T or F)
False it is type I (IgE mediated)
What cells does IgE fix to in atopic dermatitis?
mast cells and basophils
What role does IL4 play in atopic dermatitis?
Th2 lymphocytes make it and it signals B cells to produce IgE
What are the main two routes that sensitizing allergens enter the animal?
inhaled or penetrate the skin
What role do langerhans cells play in atopic dermatitis?
langerhans have IgE receptors -> IgE binds -> allergen binds to IgE -> present allergen to Th2 lympho -> they secrete IL4 and 5
Hair is a major epidermal antigen (T or F)
False-erific! dander and dried saliva are
Pruritus is the initial sign in atopic dermatitis (T or F)
True!
What 6 factors predispose atopic dogs to staph secondary pyoderma?
1) keratinocytes bind more staph
2) stratum corneum has less ceramides
3) skin is inflamed and warm
4) increased skin moisture
5) increased sebaceous nutrients for staph
6) excoriation damages barrier
What is the difference between seborrhea oleosa and seborrhea sicca? Which is more common with atopic dermatitis?
oleosa is associated with excessive sebum secretion, and is more common with AD
Treating the secondary problems will improve an animal’s allergic condition (T or F)
True!
Where is pruritus localized in atopic dermatitis?
face, axillae, ventrum, lateral thorax and feet
What is the main differential for atopic dermatitis?
sarcoptic mange
Atopic dermatitis is controllable, but not curable (T or F)
True!
Antihistamines are antagonized by fatty acids (T or F)
FALSE they work synergistically
In feline AD what is the most common non seasonal allergen?
house dust mites
Feline AD can mimic what disorder?
psychogenic alopecia (self inflicted and non inflammatory)
Do cats with AD always present with pruritus?
No and yes, owner often won’t notice pruritus and won’t report it but the cat usually has been itchy
Why are cats brought in early in the course of AD?
they will often self mutilate when severely pruritic
Non-inflammatory alopecia in cats is often Cushing’s (T or F)
So FALSE! it’s very rare in cats, self induced is more likely
What sort of trial should you perform first with non-seasonal pruritus?
food elimination trial
Skin tests have many problems in cats (T or F)
oh yeah it’s True, stress affects the response and they are very difficult to interpret
Glucocorticoids are the main therapy for AD in cats (T or F)
you know it’s True!
What’s the greatest concern with glucocorticoids in cats?
developing diabetes mellitus
Who is more likely to get food allergy? cats or dogs
kitty cats
Which type of hypersensitivity is food allergy?
most likely type I, but also type III and type IV
What are the top allergens for dogs and cats in food allergy?
beef, dairy, wheat, fish
Switching brands is an effective way to manage food allergies (T or F)
all the false, usually have similar ingredients so you won’t fix anything
At what age of onset should you suspect food allergy?
under 1 year
Fleas will get you if no dogs or cats are around (T or F)
True and gross
Flea allergy is common in warm tropical climates (T or F)
True!
What is the most common flea of dogs and cats?
Ctenocephalides felis
Can fleas survive freezing?
nope, thankfully
What does flea saliva contain?
anticoagulants and pruritogenic enzymes
What type of hypersensitivity is flea allergy?
Type I or IV, usually see both at once
What three things favor developing flea allergy?
intermittent exposure, exposure late in life, AD
What is the distribution of flea allergy lesions in dogs?
dorsal lumbar sacral, base of tail, medial hind limbs, abdomen, inguinal
Interdermal testing can diagnose flea allergy (T or F)
True, some false negatives but it’s a better test for this than with other allergies
What flea control are cats sensitive to?
pyrethrins and permethrin
What do pyrethrins kill?
adult fleas and larvae
How does imidacloprid work?
blocks Ach receptors
What does fipronil kill?
fleas and ticks
What does S-methoprene do?
prevents eggs and larva from developing
Demodex canis is a normal inhabitantof hair follicles and sebaceous glands (T or F)
True
What needs to happen for demodex canis to cause disease?
immunodysfunction of the host lets the parasite run wild
Follicular demodicosis is usually pruritic (T or F)
False, unless secondary pyoderma
What is the prognosis for the different onsets and types of demodicosis?
adult onset of any kind is guarded
juvenile localized is very good
juvenile generalized is ok
