Miscellaneous

Question 1

describe symmetric lupoid onychitis/symmetric lupoid onychodystrophy (SLO)

Answer 1

1. history of acute paw licking, pain, lameness, and nail sloughing
   -MULTIPLE nails and multiple paws affected
2. separation of nail plate from nail bed prior to sloughing
   -exposure of vascular nail bed = super sensitive and patients do NOT want you to look at their toes
3. secondary infections possible
4. cause and pathogenesis unknown
   -young to middle-aged dogs
   -GSDs, gordon setters, bearded collies predisposed
5. NO SYSTEMIC SIGNS or other skin symptoms/lesions
6. all nails may slough over a period of time (weeks) and then grow back short, misshapen, brittle, discolored

Question 2

describe diagnosis of SLO

Answer 2

1. histopathology (nail bed biopsy or digit amputation): lichenoid interface dermatitis
   -rarely done though because history and presentation are usually characteristic and the wave-like nature of the disease means you could get a nondiagnostic biopsy
   -but not currently considered an autoimmune disease despite lichenoid resembling lupus
2. diagnosis:
   -history
   -CLINICAL SIGNS
   -cytology: secondary infections uncommon but are possible so take care of them if present
   -histopathology
3. differentials: none really, clinical presentation is extremely unique
   -considered an immune-mediated disease with a genetic background

Question 3

describe treatment of SLO

Answer 3

1. glucocorticoids (initially)
2. essential fatty acids (long-term)
3. cyclosporine, tetracycline/niacinimide, pentoxifylline (immunomodulation)
4. topical antiseptic footbaths in case of secondary infections

(sedate and pull loose nails, shorten and drimmel nails throughout treatment)

Question 4

describe feline plasma cell pododermatitis

Answer 4

1. rare in cats
   -no age, breed, or sex predilection
2. cause and pathogenesis unknown
3. plasmacytic inflammatory disease of footpads +/- hypergammaglobulinemia
4. starts with swelling of one or multiple foot pads, may lead to ulceration and lameness
   -marked swelling of metatarsal/metacarpal footpads (pillow foot)
   -may stay localized to one foot (harder to be sure of diagnosis) or spread to all feet
   -once ulceration, hemorrhage, and tissue prolapse - irreversible and requires surgical removal of pawpad

Question 5

describe diagnosis of feline plasma cell pododermatitis

Answer 5

1. history
2. CLINICAL SIGNS
3. cytology
4. histopathology
5. differentials: none really, clinical presentation is extremely unique

Question 6

describe treatment for feline plasma cell pododermatitis

Answer 6

1. immunosuppression: steroids, cyclosporine
2. doxycycline
3. surgery: refractory cases
4. spontaneous remission possible

Question 7

describe perianal fistula

Answer 7

1. chronic, often progressive, idiopathic inflammatory condition most commonly seen in middle-aged GSDs
   -draining tracts/fistula, ulcers, fibrosis, purulent discharge around anus
   -inflammation can lead to secondary anal sac impaction at beginning of disease (present for repeated anal sac expressions)
2. debilitating for patients and owners with partially grave impacts on life
   -in pain every time you need to use the bathroom = poor quality of life
3. histopathology is unspecific: mixed inflammation, furunculosis, and sinus tracts (draining tract with an epithelial lining)
   -biopsies are rarely done
4. differentials: none really, clinical presentation is extremely unique
   -anal sac impaction, infection, and rupture usually heal after rupture, while PAF does not heal

Question 8

describe diagnosis and treatment of perianal fistula

Answer 8

1. diagnosis:
   -history
   -CLINICAL SIGNS
   -cytology: secondary bacterial infections very common
   -histopathology: if worried about secondary cancer due to chronic inflammation
2. treatment:
   -cyclosporine
   -topical tacrolimus (can sting on open wounds so not used early in the treatment process)
   -maybe oclacitinib
   -glucocorticoids: may or may not work
   -antimicrobial therapy as needed
   -stool softeners as needed
3. prognosis:
   -variable
   -mild cases have a different prognosis than severe cases
   -some patients respond minimally to any therapy