Exam 2 Handout Flashcards
Food Allergy
Avoid in food, supplements, chews, preventatives
-Beef
-Dairy
-Chicken
-Eggs
-Turkey
Topical Therapy
-Skin and Ears
-Active ingredients should be used to guide treatment not brand names
-80% secondary infections with endocrine and allergies Staph and Malassezia
Oatmeal lotion/conditioner
-Soothing agent
-Helps restore the epidermal skin barrier function
-Magic leave on: added 2% zinc gluconate to prevent infections. Can be used as bath or leave on lotion
Genesis Spray (Virbac)
-Denatured alcohol (will not sting) with Triamcinolone
-Treats itch and bacteria and yeast
-Apply every 12 hours
-Too frequent can lead to skin thinning
Antibiotics
-Good skin antibiotics start with “C”
-MARSA - Fluoroquinolones or too much steroids or Apoquel
Clindamycin
-Best safest for dogs
-can help prevent MRSA
Cefpodoxime
-Excellent daily
-Very few side effects
-Expensive for big dogs
-Ideal for small dogs and cats
Cephalexin
-The most common
-Must be every 8-12 hours
-If combined with ketoconazole = vomit
Convenia
-Cephalosporin 3rd generation
-Expensive in big dogs
-Must be repeated in 2 weeks to achieve total of 3-4 weeks
-Very good option for cats and small dogs
Trimethoprim sulfamethoxazole
-Potent broad spectrum
-Every 12 hours
-WBC suppression or drug reactions side effects
-Hard to administer to cats (very bitter)
Chloramphenicol
-Potent antibiotic
-Used for MRSA infections
-Most dogs develop tremors, lathery after 2 weeks
-Often combined with a second antibiotic to prevent resistance
Rifampin
-Potent antibiotic
-Used for MRSA infections
-Can cause severe life threatening hepatitis
-Often combined with a second antibiotic
Mupiricin Ointment
-More effective for Staph/MRSA than other
-Used into-nasal therapy for humans
-Very safe
DMSO + enrofloxacin +/- Dex SP
-High concentration solution that penetrates the skin 1/2 inch
-Smells and tastes like garlic, wear gloves
-Great option for aural lick granulomas and interdigital bullae
Doxycycline
-Used to reduce inflammation associated with Lupus or other auto immune disease (and COVID)
-Inhibits TNF and Proteases
-Not effective for Staph pyoderma
Azithromycin
-May be helpful in reducing or preventing the papillomas and gingival hyperplasia triggered by cyclosporine
Cytopoint
-Blocks only IL-31
-Very safe
-Almost no adverse effects
-Fails if the patient has infection and cytopoint is not fresh
-Can control purity’s for 1-6 months
Environmental allergies
Failure reasons
1. Patient has infection
2. Cytopoint not fresh
3. Temperature sensitive or incorrect diagnosis
-Does not work well for food allergies, otitis, aural lick granuloma
Steroids
Dexamethasone
-Seemingly fewer side effects than prednisolone
-Injectable Dex SP for cats
-Dex SP added to trizEDTA and DMSO for topical therapy combined with enrofloxacin
-Long term cats every 2-3 days
-Long term dogs Sat+Sund
Isoxazoline
-Safest and best class of PARASITICIDES
-Treatment of choice for Demodicosis
-Treatment of choice for insect allergies (mosquito, mites, fleas)
Ear Disease
Otitis
-Always secondary to an underlying problem (allergy or endocrine or Sarcoptiform mites)
3 step treatment & Prevention
-Purulent discharge = pseudomonas, proteus, staph and possibly yeast. Starting and stopping treatment = problem
Malassezia
Antifungal
What antifungal makes cats vomit?
Which is the best antifungal for dermatophytes?
Ketoconazole
-Longest lasting
-Cephalexin combination = vomit in dogs
-Makes cats vomit
-Best option for dogs
-Every day for 30-90 days safe
-Can be used as pulse therapy
Terbinafine
-Best for dermatophytes and cats
-Genetic of Lamisil
-Topical or oral
- Less liver and metabolic issues than ketoconazole
-Every 12-24 hours
-Pulse therapy not effective
Itrazonazol (Virbac)
-Feline oral liquid designed to treat dermatophytosis
-Safe and easy to administer
-3 months treatment
Fluconazole
-Can replace Terbinafine but often more expensive
How should Atopy be treated?
-Pollen avoidance
-Antihistamines
-Cytopoint
-Allergy Vaccine
Antihistamines & “Itch control”
Which is the best option for cats?
Which are OTC, Rx?
Ceterizine
-Human adult Zyrtec
-Can be given every morning or every 12 hours OTC
Flexofenadine
-Generic Allegra
Diphenhydramine
-High dose generic Benadryl OTC
-Alternative includes
-Sleep promotion
Hydroxyzine & Chlorpheniramine (Rx)
Chlorpheniramine
-Best for cats
-Can be added for dogs’ promotion of sleep
Dextromethorphan - Cough tabs
-Active ingredient in NyQuil
-Promotes sleep
Apoquel
-“itch” control
Fluoxetine and Gabapentin
-OCD or neurologic triggers for itch
-Relatively safe
-Useful for aural lick granulomas
Tramadol and other opiates can cause pruritus in some dogs 10%
Cyclosporine
Apoquel
-Blocks IL-31 and many other cytokines
-IL-2, TNF, EPO
-Causes immune suppression
-Risk: cancer, demodex, MRSA, Pneumonia
-10% tumor risk in dogs
Steroids and Apoquel are the only drugs that can cause Demodicosis
-True potent immune-suppressive medication
Vitamin A + B3 + Omega 3 + Melatonin
Auto immune disease
-Treatment for autoimmune skin disease
-Process of normalizing the skin and glands and modulating and suppressing
+Baths
+Doxycycline/tetracycline
+Tacrolimus
+Topical steroids
+Atopica
+/-Apoquel
+/- Oral Steroids
+/-Azithiaprine
+/- Chlorambucil, lomustine, dapsone, mycophenolate mofetil, etc.
High dose Vit A
Follicular cast, Sebaceous Adenines treatment
-Poodles, doodles, Cocker
-Best, safest therapy
-Helps normalize the skin and ear glands and epidermal turnover time
Niacinamide (B3)
-Increases skin blood flow
-Beneficial for vasculitis, blood vessels, autoimmune disorders
-Lupus/Pemphigus
-Dachsund ear-margin dermatitis
-SLO
-Good for skin glands and hair follicles
Melatonin
-Safe treatment
-Hyperadrenocortisim Cushing’s
-Alopecia disorder like follicular dysplasia/arrest
-Improves cognitive function and makes geriatric small-breed dogs feel 2-3 years younger
CATS
Goal
-Cheapest, faster, longest lasting, fewest interventions that the cat can tolerate
-EDUCATE the owner that chronic diseases are chronic life long
Problems
-50% treatment problems due to cat refusing the treatment or the owner compliance is low
Best Antibiotic
Convenia
-Cephalosporin 3rd generation
Malassezia
-Due to diabetes or hyperthyroidism
Extremely sensitive with ears
-Wax and dirt do not clean unless bothering the cat
Demodex gatoi
-10% of cases in TN
-Isoxyliznes effective but at higher doses than dogs
Honey
-Can put meds into it and let cat lick it off the paw
Steroids
-Cats can tolerate long term better than dogs
-High dose Depomedrol/Vetalog = diabetes and heart failure 10-20% risk
Atopica/Cyclavance (cyclosporine)
-Most inflammatory diseases in cats are lymphocytic, plasmacytic, eosinophilic immune response
-Safest and best long-term treatment
-90% effective
