Parasitic skin disease Flashcards

1
Q

Insects we’re concerned about?

A
  • FLEAS - Ctenocephalides felis (teno cepha lideesssssss)
  • Ctenocephalides canis (MOST COMMON ON DOGS AND CATS)
  • Spillpsyllus cuniculi
  • LICE
  • INSECT BITE HYPERSENSITIVITIES
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2
Q

Discuss flea allergic dermatitis?

A
  • Most common skin disease of dogs and cats in the world
  • Zoonotic!
  • Pruritic dermatosis
    • Pruritus associated with hypersensitivity to salivary proteins of flea (Type I or Type IV)
    • Leads to self trauma by pet
  • Infestation vs hypersensitivity
    • Other pets may be infested but show no clinical signs (cats infested but not itch very much)
    • Client communication important
    • Important animal can be infesrted with fleas without itching
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3
Q

What is this a classic pattern of?

A

Clinical signs of FAD in the dog

Distibution of this problem is classic: Caudal and dorsal

Other clinical signs include:

  • Scratching
  • Biting skin
  • Jumping up suddenly
  • Excess licking/over grooming
  • Results in secondary changes:
  • Alopecia
  • Skin inflammation +/- skin infection
  • Crusting
  • Lichenification
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4
Q

Environmental atopy generally feet and face.

A
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5
Q

Clinical signs of FAD in cat -variable presentations include?

A
  1. Miliary dermatitis (tiny crusty scabs over body)
  2. Alopecia - due to overgrooming
  3. Eosinophilic granuloma complex lesions (seen in pic) (eosinophilic plaques, eosinophilic granulomas (including ‘fat chins’), indolent (‘rodent’) ulcers)
  4. Head & neck pruritus

NB These are cutaneous reaction patterns - occur for many reasons in the cat, eg FAD, food-induced or environmental-induced atopic dermatitis. Remember to rule out fleas early on when you see any of these presentations!

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6
Q

What should the clinical approach to FAD in dog or cat be?

A
  • Thorough history-taking (has it got parasites has it got allergy has it got infection?)
  • Observation of clinical signs
  • Consider differential diagnoses
    • Other ectoparasites eg scabies, cheyletiellosis, (Otodectes? Lice?)
    • Atopy to environmental or dietary allergens (food allergy, cutaneous adverse food reaction)
    • Microbial infections – bacteria, Malassezia
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7
Q

What diagnostic techniques can be used to identify flea infestation?

A

Demonstration of fleas/flea faeces

  • Flea comb
  • Vigorous coat brushing – examine debris on moistened paper –> red/brown tinge
  • Microscopy of flea dirt collected on combing or tape strip
  • Knock down flea spray (eg permethrin on dogs) to kill fleas quickly for demonstration?
  • Examine faeces for tape worm segments? If dog has tapeworm likely to have fleas as well!
  • (Dipylidium caninum)

But

  • False negatives common
  • Cats may remove all evidence of fleas from their coat, particularly if flea allergic
  • Therefore failure to detect fleas, i.e. negative finding, is unreliable!
  • NB Frequently, owners are convinced their pet doesn’t have fleas à communication challenge!
  • Because it is a type 1 hypersensitivity and Intradermal allergy test can be done

Response to Therapy

  • This is the best method of diagnosis
  • Range of effective and ineffective products – chose an effective one!
  • Diagnosis is confirmed by response to thorough flea control trial
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8
Q

What advice re flea control would you give to:

The owner of a 5 year old labrador which receives twice weekly bathing for Malassezia dermatitis. The owner also wishes to treat ticks?

A

Sarolaner, alfaxolaner, flurolaner any of the isoxazalines

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9
Q

What advice re flea control would you give to:

The owner of cat in a multicat household with flea allergic dermatitis?

A

IGR, Imidacloprid, flumethrin, spinosad and isoxasoline, selamectin and sarolaner

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10
Q

What advice re flea control would you give to:

The owner of a cat with ear mite (Otodectes) and flea infestations?

A

Selamectin, Imidacloprid and moxidectin, sarolaner

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11
Q

What advice re flea control would you give to:

The owner of a 5 week old kitten with fleas?

A

Firponil spray (only thing licensed in that age)

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12
Q

Outline the lifecycle of a cat flea?

A

Series of moults before they become a pupae

Can take up to 140 days for a pupae to hatch to an adult flea

Pupae uneffected by ectoparitisde so need something to kill them in environment such as permethrin in environment as they hatch out

  • Flea life cycle usually complete in 3 to 4 weeks but may be as short as 2 weeks or as slow as 6 months, depending on environmental conditions
  • Remember the ‘pupal window’…nothing kills the pupae so need to kill emergent adults before they bite – environmental control essential! May take 3 months+ before fleas fully eliminated
  • ensure your client is aware of this
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13
Q

Outline the actions of different flea treatments?

A
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14
Q

Name an insect growth regulator available in an injectable form for cats and an oral form for dogs. Does this product also act as an adulticide?

A

Lufenuron available as tablet in dogs injection for cats lasts 6 months (no adulticide action)

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15
Q

Name a spot-on product where the pro-drug is activated by the parasite only?

A

Indoxocarb

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16
Q

Name a spot-on product that kills fleas and sarcoptic mange but has no action against demodicosis?

A

Selamectin

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17
Q

Name a flea adulticide that will not lose its efficacy with repeated bathing?

A

Spinosad and isoxasalines

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18
Q

Name a very short-acting (24h) knock-down adulticide?

A

Nitenpyram

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19
Q

Name an oral product that is active against fleas and ticks (and likely demodicosis –off label) and lasts for 3 months?

A

Flurolaner

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20
Q

Name lice that infect cats and dogs?

A

Louse infestation ‘pediculosis’

Dogs

  • Trichodectes canis (biting louse) If chewing biting louse on dog it will be this
  • Linognathus setosus (sucking louse)

Cats

  • Felicola subrostratus
21
Q

Name some particulars of lice?

A
  • Host specific
  • No risk to owners
  • Surface parasites, may move quickly
  • Operculate eggs ‘nits’ attached to hairs
  • Life cycle lasts approx 3 weeks
  • Adults can only survive off host for 3 days
  • Nits can cause indirect infestation from bedding and blankets, especially if large numbers of dogs
22
Q

What are the clinical signs of lice?

A
  • Often asymptomatic – may see poor coat, scaling, papules, crusts, variable pruritus
  • Heavy infestation can cause anaemia and lethargy
  • Infestation may reflect poor hygiene/nutrition/immunity
  • Pediculosis (infestation with lice) suspected in this puppy – how will you diagnose it?
23
Q

How are lice diagnosed?

A
  • Demonstration of lice/eggs with magnifying glass or under microscope
  • Combing
  • Unstained acetate tape strip
  • Hair plucking? Need to pluck the right hair!
24
Q

How is a lice infestation treated?

A

Relatively easy to treat as life-cycle entirely on host

  • Many flea adulticides effective (eg imidacloprid, fipronil, selamectin, permethrin)
  • Treat in-contacts also
  • Environmental cleaning recommended
25
Q

What is seen here and what is the treatment?

A

Insect bite hypersensitivity

Treatment

  • Avoid outdoors especially dawn and dusk
  • Use insect repellents (seresto collar = flumethrin and imidaclopid)
  • Symptomatic treatment e.g. glucocorticoids, antihistamines
26
Q

What is this?

A

Trichodectes canis

27
Q

What is this?

A

Demodex canis

28
Q

What is this?

A

Sarcoptes scabei

29
Q

What is this?

A

Eggs: operculate eggs are lice so no operculation here so cheyletiella mite eggs are seen

30
Q

What is this?

A

Cheyletiella (heart shaped)

31
Q

What is this?

A

Trombicular (harvest mite)

32
Q

Name arachnids that can bother animals?

A

SURFACE MITES

  • Cheyletiella (dogs, cats and rabbits and very contagious , 3 week lifecycle can survive off host 3-6 weeks)
  • Otodectes
  • Neotrombicula
  • Sarcoptes (can take 2 months for itch to stop once treatment has started)

DEEP MITES

  • Demodex

TICKS

33
Q

Discuss the surface mite cheylietella?

A
  • Causes cheyletiellosis in dogs, cats, rabbits – highly contagious
  • Mite lives on skin surface
  • Life cycle takes
  • 3-4 weeks
  • May survive off host
  • 5-6 weeks
  • Zoonotic! Humans often affected, with pruritic papules on arms, legs, trunk

Clinical signs

  • Pruritus and scaling, especially dorsal trunk – ‘walking dandruff’
  • D/d: flea infestation, scabies, atopy
34
Q

What can manage cheyletiellosis in cats and dogs?

A
  • Often difficult to eradicate as can survive off host
  • Currently no licensed products but effective acaricides include:

TOPICAL

  • Fipronil (spot-on or spray) every 3-4 weeks
  • Selenium sulphide shampoo – weekly
  • (Amitraz every 2 weeks x 3 – rarely used. Not cats)

SYSTEMIC

  • Selamectin spot-on at 2-4 week intervals
  • Isoxazolines? Anecdotal reports

And remember to treat the environment….

  • Treat environment with a household flea spray to kill mites off host
  • Contaminated materials must be burnt, steam cleaned or chemically treated (eg disinfectant)
35
Q

What is this and what are the clinical signs of an infestation?

A

Signs of hypersensitivity

  • Ear irritation
  • Head shaking
  • Excessive ear wax
  • Occasional irritation of face or body

Diagnosis

  • Visualise ear mites by otoscopy
  • Detect ear mites/eggs in cerumen
36
Q

How can you treat and prevent otodectes cynotis infection?

A

Treatment and prevention

  • TOPICAL THERAPY, in ears Acaricidal ear drops at least twice daily for three weeks, as eggs resistant
  • Surolan and Canaural licensed but contain no anthelmintic! Questionable antibiotic stewardship…
  • Consider compliance of frequent application

SYSTEMIC THERAPY preferential to the above as it isn’t over use of the above which contain antibiotics

  • eg selamectin, moxidectin spot-ons
  • sarolaner – licensed
  • Note regular ear cleaning important to remove excess cerumen
  • Need to treat in-contacts
37
Q

What is this and what are the clinical signs of infestation?

A

Sarcoptes scabiei var. canis

  • Small burrowing mite
  • Life cycle complete in 3 weeks
  • Causes sarcoptic mange (scabies) in dogs and foxes
  • Highly contagious
  • Hypersensitivity to mites may develop
  • Zoonotic! Human involvement can occur especially if close contact (bed sharing with dogs!)

Clinical Signs

  • Intensely pruritic !! No response to steroids
  • 80% show positive pinnal-pedal scratch reflex
  • Papules and crusts esp pinnal margins, elbows, hocks, sternum, but other areas may be affected
38
Q

How do you diagnose Sarcoptes scabiei var. canis?

A

Diagnosis

History

  • Acute-onset intense pruritus is suggestive
  • May be unresponsive to prednisolone – NB!

Skin scrapings

  • Take multiple skin scrapes (minimum of 6) as difficult to detect (only 50% sensitivity!!)
  • Choose primary lesions (crusted papules) in affected areas, avoiding secondary changes
  • Look for mites, eggs and even mite faeces
  • Use liquid paraffin and cover slip

Serology

  • Elisa test available – detects anti-Sarcoptes IgGHighly sensitive and specific
  • But can have false positive due to cross-reaction with antibodies to house dust mites in environmental atopic dogs
  • Occasional false negatives
  • NB Seroconversion takes 3-4 weeks so false negatives are possible if sampled too early

Therapeutic Trial

  • Can be used to aid diagnosis particularly if no mites detected – if you suspect sarcoptic mange, treat it!
  • Also helps distinguish from atopic dermatitis (can get false positives on serology in dogs sensitised to housedust mites as a cross reactivity)
39
Q

What are the topical and systemic treatments for sarcoptes?

A

Systemic

  • Selamectin or moxidectin (as moxidectin/imidocloprid) spot-on.
  • Sarolaner (Simparica) An isoxazoline

Topical

  • Amitraz (solution) applied weekly for 4 weeks+

Toxicity concerns for pet and in-contact people and animals – read instructions carefully and ensure client understands and complies

  • Lime sulphur – applied weekly for 4 weeks

Effective & well tolerated but staining & pungent odour

40
Q

How should a sarcoptic mange infestation be managed?

A
  • Zoonotic, as well as contagious to other dogs so avoid contact and decontaminate or destroy items such as bedding, brushes.
  • Treat all in-contact animals with acaricide
  • Environmental - insecticidal spray recommended (e.g. flea spray)
  • Glucocorticoids, eg prednisolone, to help control intense pruritus (pruritus may increase as mites die)
41
Q

Compare sarcoptes and demodex mite infestation?

A
42
Q

Discuss demodex canis?

A
  • A normal inhabitant of canine skin
  • Causes disease in immunocompromised animals
  • Not contagious – passed from dam to offspring in first few days of life
  • Incapable of living off host
  • Excessive multiplication in hair follicles and sebaceous glands –> follicular disease on skin –> folliculitis, alopecia, furunculosis, often with erythema
43
Q

Discuss demodicosis adult and juvenille onset?

A

Juvenile: 1-12mo (esp 3-6mo); usually resolve with sexual maturity if localised

  • Multifactorial disease: affected by genetics, nutrition, stress, breed
  • Avoid breeding from affected individuals
  • Common

Adult-onset: 4yo or more

  • Uncommon
  • usually secondary to immunosuppression – look! (eg hypoT4, HAC, neoplasia)
  • Find cause in 50% cases
  • Prognosis guarded if underlying cause cannot be corrected
44
Q

How can demodicosis be diagnosed?

A

Diagnosis

  • Deep skin scrapes (squeeze before scraping!)
  • +/- biopsy (if skin scarred, Shar Pei). May see mites, folliculitis, furunculosis
  • +/- plucks (esp face and feet)
45
Q

What drugs are effective for canine demodicosis?

A
  • Sarolaner
  • Amitraz (Aludex) (atipam is apparently antidote)
  • 10% Imidacloprid/2.5% moxidectin spot-on (e.g. Advocate)
46
Q

For all cases of demodicosis you should?

A
  • Treat secondary microbial infection, if present
  • Glucocorticoids and oclacitanib contraindicated!
  • Investigate/correct underlying cause, if possible
  • Relapses common – warn owner. Especially at oestrus – neuter when able
  • NB avoid future glucocorticoids/oclacitanib if possible \Immunosuppressive drugs just make it worse
  • Do not breed from affected animals
47
Q

What is this?

A

Feline demodicosis

D. cati (follicular, long and slender mite)

  • Uncommon
  • Parasite in follicles, sebaceous glands
  • –>Localised or generalised disease. +/- waxy otitis externa
  • Causes patchy alopecia, erythema, scale. Also may have comedones and secondary pyoderma
  • Pruritus variable
  • Localised: often head/neck
  • Generalised: usually associated with underlying immunosuppression eg FIV, FeLV, diabetes mellitus – check!
48
Q

What is the treatment for ticks?

A

Treatment

  • Manual removal
  • Acaricides

Permethrin, flumethrin, fipronil, deltamethrin, moxidectin, amitraz

  • New treatments – fluralaner, afoxolaner, sarolaner

Do not necessarily prevent attachment, but ticks die and drop off within 12-48 hours

Repellants

  • Permethrin repels but toxic to cats
  • Imidacloprid/flumethrin collar (Seresto collar) – kills and repels for 8 months
49
Q

Outline tick treatments?

A