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SA dermatology Flashcards

1
Q

what is the most common feline infection?

A

cat bite abscesses

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2
Q

what are some common pitfalls in dermatology?

A

disregarding history
failure to appreciate clinical signs
errors when taking diagnostic samples, allergy testing, interpreting results and therapy

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3
Q

what is the most important things to ask the owner for during history taking?

A

their chief complaint

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4
Q

why is it important to ask the owner for their chief complaint?

A

narrows the differential list (such as is it pruritic or not)
builds vet-client bond
gives the reason they are presenting

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5
Q

what signalment should be collected?

A

age, breed, sex
coat colour
weight (change)
affected relatives

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6
Q

with regards to when the disease started, what information is it important to collect?

A

age at which it started

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7
Q

what a classical conditions seen in very young dogs (<1 year)?

A

parasites
congenital
food-induced atopic dermatitis

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8
Q

what a classical conditions seen in adult dogs?

A

immune mediated
endocrine
food-induced atopic dermatitis

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9
Q

what a classical conditions seen in elderly dogs?

A

neoplastic
metabolic
food-induced atopic dermatitis

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10
Q

what breed of dog is predisposed to getting atopic dermatitis?

A

West Highland White terriers

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11
Q

what should be obtained in a general history?

A 
behaviour
appetite/thirst
vomiting/diarrhoea
stools
sneezing
seasonal history
drug history
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12
Q

what three things need to be determined in a dermatological history?

A

onset
duration
progression

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13
Q

with regards to onset, what can the causes of dermatological issues be split into?

A

chronic and acute

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14
Q

what are some chronic causes of skin problems?

A

allergy
metabolic
endocrine
neoplastic

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15
Q

what are some acute causes of skin problems?

A

parasites
infectious
immune-mediated
hypersensitivity

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16
Q

what are the three ways duration of a dermatology issue can be split?

A

waxing/waning
progressive
intermittent

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17
Q

what are some causes of skin disease that waxes/wanes?

A

allergic

immune-mediated

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18
Q

what are some causes of skin disease that are progressive?

A

metabolic
endocrine
neoplastic

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19
Q

what are some causes of skin disease that are intermittent?

A

parasites

infections

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20
Q

what is the saying to determine whether pruritus is a primary sign?

A

is it a rash that itches or an itch that rashes

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21
Q

what scale is used as a subjective measure of pruritus?

A

visual analogie scale

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22
Q

what is it important to find out about previous/current treatments?

A

what’s the animals response to it was
adverse effects
compliance - animal/owner
dose and duration

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23
Q

what is it important to find out about flea prevention?

A

products used
frequency of use
last application
other in contact animals

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24
Q

what should be asked about when taking a diet history?

A

proteins/carbs in the usual diet
treats and table scraps
edible toys
flavoured vitamins/medications

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25
why is important to find out the products used for flea treatment?
they are often effective against other parasites so can to reduce the differential diagnosis list
26
on a dermatological examination what need to be assessed in detail?
``` mucocutaneous junctions and MM hair coat skin claws, pads, nail beds ear pinnae and canals ```
27
how many layers does the epidermis have?
four
28
what is found in the dermis of skin?
blood vessels/nerves hair follicles sebaceous glands sweat glands
29
what are some examples of primary lesions?
``` papules pustules pigmented macules papular-macular rash alopecia erythematous plaques ```
30
what is a plaque?
lots of pustules joined together
31
what are some examples of secondary lesions?
``` lichenification thin skin crusts and erosion excoriation epidermal collarettes scale ulcer comedones ```
32
what do epidermal collarettes happen secondary to?
pustules
33
what is the difference between erosion and ulcers?
erosion - loss of epidermis above the basement membrane | ulcers - loss of epidermis through the basement membrane (bleeding)
34
describe how a papule evolves
papule to pustule to crust to epidermal collarette to pigmented macules
35
what does bilateral symmetrical distribution of lesions suggest?
an inside-out disease
36
what does an irregular distributions of lesions suggest?
an outside-in disease
37
what should be assessed on coat examination?
``` change in colour change in texture ease of epilation broken hairs follicular casts ```
38
what 4 points must be described for each lesion?
configuration morphology distribution evolution
39
what are the three key facts that should be known at the end of the dermatology consult?
age of onset presence/absence of primary pruritus distribution/types of lesions
40
what are the major presenting signs of dermatological problems?
``` pruritus alopecia crusting scale nodules ```
41
what is the unique ways of presenting skin disease in cats?
feline cutaneous reaction patterns
42
what are the four feline cutaneous reaction patterns?
military dermatitis eosinophilic granuloma complex head and neck pruritus symmetrical alopecia
43
what are the types of eosinophilic granuloma complexes?
eosinophilic granuloma indolent ulcer eosinophilic plaques
44
what are some parasites that will cause pruritus in cats?
``` Cheyletiella Felicola subrostratus Notoedres cati Sarcoptes scabei fleas Neotrombicula Demodex gatoi ```
45
what are two infections that can cause pruritus in cats?
superficial bacterial pyoderma | Malassezia dermatitis
46
what must be considered when attempting to diagnose ectoparasites?
where they are found in the skin
47
how can ectoparasites found on the skin surface be sampled?
brushing, wet paper test, sellotape impression
48
how can ectoparasites found in the shallow surface in the epidermis be sampled?
superficial skin scrapes
49
how can ectoparasites found in deeper skin be sampled?
deep skin scrapes hair plucks biopsy
50
is Demodex gatoi contagious?
yes
51
what are the clinical signs of Demodex gatoi?
pruritus | head, neck and truncal alopecia
52
how can Demodex gatoi be diagnosed?
tape cytology | skin scrapes have very poor sensitivity for this
53
how can Demodex gatoi be treated?
selamectin fluralaner lime sulphur dip (treat all in contact cats)
54
where does Notoedres cati initially infect?
head and ears but can spread to rest of the body as it becomes more chronic
55
how can Notoedres cati be differentiated from sarcoptic mange?
Notoedres is smaller and has a dorsal anus
56
what parasite can cause alopecia?
Demodex cati
57
what infections can cause alopecia?
superficial bacterial pyoderma | dermatophytosis
58
what endocrine disorder can cause alopecia?
spontaneous/iatrogenic hyperadrenocorticism
59
where on the body is Demodex cati found?
eyelids, periocular, head, neck
60
Demodex cati is a commensal, what are some issues that could cause it to become a problem?
immunosuppression FIV/FeLV diabetes squamous cell carcinoma
61
what are the clinical signs of Demodex cati?
comedones, alopecia, erythema, crusts, scale, variable pruritus, secondary infection
62
what can be used to treat Demodex cati?
isoxazolines | lime sulfur dips
63
how is Demodex cati diagnosed?
deep skin scrape - sedation/analgesia required
64
what should be seen after a deep skin scrape?
blood/haemorrhage confirms the scrape is deep enough
65
what is paraneoplastic alopecia of cats associated with?
pancreatic or bile duct tumours
66
where is alopecia seen in paraneoplastic alopecia cats?
ventral body, neck, chin, body, inner legs, feet, nasal plant, footpads
67
how is the skin of paraneoplastic alopecia cats described?
thin and shiny
68
describe the process of skin biopsy
place punch firmly on the skin and twist 180 degrees and push
69
what parasites will cause scaling and greasy cats?
Cheyletiella Felicola subrostratus Notoedres cati Sarcoptes scabei
70
other than parasites what conditions can cause scaling/greasy disease in cats?
neoplasia keratinisation disorders infections
71
what is the main neoplasia causing greasy/scaly cats?
thymoma
72
what are the clinical signs f thymoma induced exfoliative dermatitis?
diffuse, non-pruritic erythema and exfoliation possible alopecia respiratory compromise - problems
73
how can thymoma induced exfoliative dermatitis be diagnosed?
biopsy (skin) | chest radiograph
74
what can be used to treat thymoma induced exfoliative dermatitis?
``` immunomodulatory drugs (prednisolone) surgery ```
75
what cat breed is predisposed to idiopathic facial dermatitis?
Persian
76
what are the clinical signs of idiopathic facial dermatitis?
tightly adherence greasy black scales | pruritus
77
what can be used to treat idiopathic facial dermatitis?
reduce inflammation - cyclosporin remove grease - keratolytic shampoos anti-yeast therapy
78
feline acne is a common keratinisation disorder, what are the clinical signs?
can be asymptomatic | dark, waxy scales and comedones
79
what can be used to treat feline acne?
topical antiseptics anti-keratinolytics good hygiene/washing
80
what breeds of cat are predisposed to Malassezia dermatitis?
Devon rex Sphinx Persian
81
what are the possible clinical signs of Malassezia dermatitis?
seborrhoeic dermatitis otitis keratinisation disorder
82
what viral infections of cats can cause crusts?
pox virus herpesvirus calicivirus
83
what cats is cow pox mainly seen in?
rural male cats that hunt
84
what happens in most cases of cow pox in cats?
spontaneous resolution if around 4 weeks
85
when may spontaneous resolution of cow pox in cats not occur?
in immunocompromised cats
86
what should not be used to treat cow pox in cats?
corticosteroids - fatal
87
what can be used to treat cow pox?
supportive therapy - fluids, appetite stimulation, tube feeding (can't kill the virus) manage secondary infection and respiratory disease
88
where is feline herpes virus lesions normally seen?
eyes and nose (butterfly pattern)
89
what can trigger feline herpes virus?
stress and glucocorticoids
90
what areas of the skin is mosquito bite hypersensitivity usually found?
nose, ears and feet (where skin is thin and hair is sparse)
91
what are some clinical signs of mosquito-bite hypersensitivity?
papules - develop into crusts alopecia, depigmentation and ulcers peripheral lymphadenomegaly
92
what type of disease is feline pemphigus foliaceus?
auto-immune
93
where on the body is feline pemphigus foliaceus usually seen?
head, ears, nipples and feet
94
what are the clinical signs of plasma cell pododermatitis?
soft swollen pads with scaling ulceration can have gingival stomatitis or nasal lesions
95
what is used to diagnose commensal skin infections?
cytology
96
why can culture be used to diagnose commensal organisms?
they are present on skin whether there is disease or not
97
what is the most common commensal bacteria that causes skin disease?
Staphylococcus pseudintermedius
98
what is the most common commensal fungi that causes skin disease?
Malassezia pachydermatis
99
how are pathogenic skin infections diagnosed?
culture
100
what is the name for a bacterial skin infection?
bacterial pyoderma
101
what are some common causes of secondary bacterial pyoderma?
``` allergy ectoparasites self trauma immune deficiency (endocrinopathy) keratinisation defects ```
102
what are some bacteria that can cause bacterial pyoderma other than S. pseudintermedius?
S. aureus S. schleiferei S. canis
103
what are the three depths that bacterial pyoderma can be classified to?
surface superficial deep
104
what layer is surface bacterial pyoderma found on?
superficial epidermis
105
where in the skin is superficial bacterial pyoderma found?
epidermis and hair follicles
106
where in the skin is deep bacterial pyoderma found?
epidermis, hair follicles, dermis, subcutaneous fat
107
what causes surface bacterial pyoderma?
overgrowth of bacteria (not infection!!)
108
what are the three clinical presentations of surface overgrowth?
hotspots skin fold pyoderma bacterial overgrowth
109
what breeds of dog are predisposed to hotspots?
densely coated breeds - Rottweilers, golden retrievers...
110
where are hotspot lesions usually seen?
cheek, neck and rump
111
how are hotspot lesions described?
well demarcated flat eroded moist lesions with erythematous halo
112
why do hotspot lesions develop so quickly?
due to self trauma because of pruritus and pain
113
what can be done to treat hotspots?
clip, clean, topical antiseptic/antimicrobials
114
what is another name for hotspots?
pyotraumatic dermatitis
115
what is the name for skin fold dermatitis?
intertrigo
116
what causes intertrigo?
compromised barrier due to friction, altered micro-climate, loss of normal ventilation and accumulation of fluids
117
what is done to treat skin fold dermatitis?
topical antiseptics and antimicrobials clean areas treat underlying cause
118
where on the body us bacterial overgrowth usually seen?
ventral trunk and interdigital spaces
119
what type of discharge does Malassezia overgrowth produce?
brown and greasy
120
what types of lesions are acetate tape strips used for?
dry, erythematous, scales and alopecic skin
121
where is superficial dermatitis usually found?
hair follicles
122
what are the primary lesions of a superficial folliculitis?
follicular papule and pustules
123
what is the most common bacteria causing superficial folliculitis?
S. pseudintermedius
124
what are the clinical signs of superficial pyoderma?
``` erythema follicular papules/pustules crusts epidermal collarettes erosion hyper pigmented macules ```
125
what clinical sign is seen in short coated puppies with superficial pyoderma?
moth eaten appearance | annular macule of alopecia
126
what is the name given when follicles rupture due to deep pyoderma?
folliculitis and furunculosis
127
what are the clinical signs of deep pyoderma?
heat, swelling, erythema, furuncles, nodules, bull, plaques, sinus tracts, ulcer, exudation, crusts more systemic signs - fever, pain, lymphadenopathy
128
with regards to deep pyoderma, what type of exudate is usually seen?
haemorrhagic to Haemonchus-purulent
129
what are the methods of sampling that can be used for cytology?
direct impression smear cotton swab smear adhesive tape strip fine needle aspirate
130
what are the two key findings on cytology of pyoderma?
degenerative neutrophils and intracellular bacteria
131
what are the key morphological features of degenerative neutrophils?
lose cytoplasmic outline light pink staining nucleus streaming
132
when should culture and susceptibility be performed?
``` recurrent/chronic infections poor response to therapy rod shaped or unusual organisms on cytology degenerative neutrophils but absence of bacteria on cytology deep infections non-healing wounds post-op or nosocomial infections life threatening infections ```
133
what is the culturing technique for superficial infections?
rupture/sample intact lesion if present | sample erosion under a crust or collarette
134
what is the gold standard for culturing technique for deep infections?
use a fresh tissue biopsy
135
other than a fresh tissue biopsy what can be used to culture deep infections?
rupture of intact lesions and swab
136
what should be used to treat all bacterial pyodermas? and why?
topical therapy - less antimicrobials needed
137
what should be used as the first line of treatment for Malassezia dermatitis?
chlorhexidine shampoos
138
what is pruritus?
the unpleasant sensation that elects the desire or reflex to scratch, rub, lick, chew or roll
139
how does pruritus manifest in cats?
reaction patterns | behavioural changes
140
what are the 4 reaction patterns of cats?
alopecia head and neck pruritus military eczema eosinophilic granuloma complex
141
in cases where owners don't realise/deny their dog is itchy, what can be looked at to confirm if they are or not?
feel for broken hairs | look for saliva stained paws (brown discolouration)
142
what tests can be done to identify pruritus?
trichography | cytology
143
what is trichography?
examination of hair plucks
144
what is examined during trichography?
stage of growth structure of melanosomes pathological changes attached/associated organisms and parasites
145
what structures can pathological changes be looked for during trichography?
bulb shaft tip external surface
146
what can be seen associated with the hair during trichography?
Demodex mites | dermatophytosis
147
how can cytology be used to confirm the presence of pruritus?
during licking/chewing oropharyngeal bacteria will be deposited on the skin, these can then be identified
148
what oropharyngeal bacteria is looked for to confirm the presence of saliva on the skin?
Conchiformibius
149
when using assessment charts for pruritus, what must be told to the owner before they give their grade of pruritus?
what grade the pruritus was previously - can tell whether it has improved or not
150
what are some superficial skin infections that cause pruritus?
superficial bacterial pyoderma | Malassezia dermatitis
151
name some ectoparasites that can cause pruritus
``` Sarcoptes scabei Notedres cati Demodex gatoi flea Cheyletiella Neotrombicula autumnalis lice Otodectes cyanotis ```
152
what allergies can cause pruritus?
flea allergy cutaneous adverse food reaction atopic dermatitis feline atopic skin syndrome
153
name two immune mediated/auto-immune diseases that can cause pruritus
Pemphigus foliaceus | sebaceous adenitis
154
what are some viral disease that may cause pruritus?
cow pox feline herpes virus FeLV/FIV
155
how does superficial pyoderma present?
spots, crusts and patchy hairloss
156
what areas is superficial pyoderma most common in?
folded (intertrignous) areas | naturally alopecic skin
157
what are the clinical signs of Malassezia dermatitis?
erythema pruritus malodor dark coloured exudate
158
what breeds are predisposed to Malassezia dermatitis?
bassets | rex cats
159
what is the scientific name for fleas?
Ctenocephalides felis
160
what must happen for a flea to lay eggs?
they must have a blood meal
161
what is a crucial step in the control of fleas?
stopping them before they have their blood meal
162
how do fleas cause pruritus?
annoyance | flea allergic dermatitis (type I and Iv hypersensitivity)
163
what are the primary clinical signs of fleas?
pruritus papules erythema
164
what cutaneous reaction patterns are seen in cats with fleas?
all four cutaneous reaction patterns
165
what are the secondary clinical signs of fleas?
excoriation alopecia crusts pyoderma signs
166
what areas of a dogs body are fleas seen on?
caudodorsal and ventral abdomen
167
what are the ways in which fleas can be diagnosed?
direct observation wet paper test coat brushing/sellotapes
168
how can fleas be treated/controlled?
adulticides to all animals environmental control - cleaning, environmental sprays... anti-pruritic therapy if required
169
what causes sarcoptic mange?
Sarcoptes scabei
170
what animals is sarcoptic mange most commonly seen in?
immunosuppressed dogs and cats
171
how long is the lifecycle of Sarcoptes scabei?
3 weeks
172
how does sarcoptic mange first present?
as a pruritic disease that then progresses to crust formation
173
what type of reaction do sarcoptic mites cause?
a type I hypersensitivity
174
how long after initial infestation does pruritus begin in sarcoptic mange?
3-4 weeks
175
where are female Sarcoptes scabei found?
tunnels in the stratum corneum
176
where on the body is carcoptic mange usually seen?
ears, ventral neck, elbows and hock
177
what are the primary clinical signs of sarcoptic mange?
severe pruritus papules erythema
178
what are the secondary clinical signs of sarcoptic mange?
excoriation alopecia crusts pyoderma signs
179
what can be used to diagnose sarcoptic mange?
skin scrapes test treatment - most common serology (variable sensitivity)
180
what type of skin scrub is done for sarcoptic mange?
superficial scrape on papules or crusted area
181
what are common topical/oral therapies for treating sarcoptic mange?
moxidectin, selemectin, isoxazolines | anti-pruritic initially
182
what breeds are predisposed to Demodex injai?
terriers
183
what are the clinical signs of Demodex injai?
greasiness, truncal pruritus, alopecia | secondary bacterial infection
184
where does Demodex injai live?
deep in follicles and sebaceous glands
185
how is Demodex injai diagnosed?
deep skin scrapings and biopsy
186
what are Neotrombicula autumnalis also known as?
harvest mites
187
what do harvest mites look like on the skin?
orange dots
188
what season is Neotrombicula autumnalis seen?
June to September
189
how can harvest mites be treated?
avoidance is best!! | fipronil spray on legs
190
how many legs does the larvae of harvest mites have?
6
191
what are ear mites called?
Otodectes cyanotis
192
how can Otodectes cyanosis be diagnosed?
direct observation of photophobic mites | ear wax examination
193
what drug must not be put in the ear to treat Otodectes cyanotis?
fipronil
194
what are the clinical signs of Cheyletiella?
scaling affecting the trunk and sometimes the head Miliary dermatitis in cats variable pruritus
195
how can Cheyletiella be diagnosed?
coat brushing | skin scrapes of scaly areas
196
is Cheyletiella zoonotic?
yes
197
what are the three types of lice found in dogs?
Felicola subrostratus Trichodectes canis Linognathus setosus
198
what are the clinical signs of lice?
alopecia scale and excoriation anaemia in severely effected puppies
199
what are some examples of hypersensitivity reactions?
atopic dermatitis - food and environmental inspect bite contact
200
what are the characteristic features of Pemphigus foliaceus?
sterile pustules/crusts affecting the face, nose and feet
201
why can obtaining clinical history of dermatological disease in cats be challenging?
they have a solitary nature and are secretive so clinical signs may go unnoticed
202
what 4 broad things can trigger feline allergy?
food allergens flea allergens intrinsic allergens (self-proteins) extrinsic allergens
203
what factors can contribute to feline allergy?
``` skin barrier dysfunction immune dysregulation allergen sensitisation environmental factors stress microbes ```
204
how can food allergens manifest in cats?
allergic skin disease (with/without GI disease)
205
how can flea allergens manifest in cats?
allergic skin disease
206
what can intrinsic and extrinsic allergens manifest as in cats?
asthma or allergic skin disease
207
define feline atopic syndrome (FAS)
allergic disease associated with environmental allegens, food allergy and asthma that may be associated with IgE antibodies
208
define feline atopic skin syndrome (FASS)
inflammatory and pruritic dermatitis involving a spectrum of non-specific cutaneous reaction patterns that may be associated with IgE to environmental allergens
209
what can mimic or contribute to feline atopic skin syndrome?
food or flea allergies
210
define feline food allergy (FFA)
any disease (including FASS) attributable to immunological reactivity to ingested food
211
what does the inflammatory response of FAS involve?
eosinophils and lymphocytes
212
what does extrinsic disease of FAS involve?
IgE and is demonstrable
213
what is the typical history of a cat with FASS?
young age of onset (6 months to 3 years) presence of pruritus absence of contagion response to corticosteroids
214
what is a major characteristic of FASS lesions?
they are pruritic
215
what are the primary lesions of FASS?
erythematous papules and patches
216
what are the secondary lesions of FASS?
excoriations lichenification hyperpigmentation
217
where on the body are lesions of FASS usually distributed?
feet, eyes, ears, chin, tail base
218
what other diseases/problems must be eliminated before diagnosing a cat with FASS?
fleas, parasites, infections and food allergy
219
how can pruritus be confirmed in cats?
``` linear excoriations short/spikey hairs fur balls and hair in faeces hair in gingival sulci/tongue clumps of hair in cats environment trichogram ```
220
what are the 4 cutaneous reaction patterns?
self induced alopecia head/neck pruritus military dermatitis eosinophilic granuloma complex
221
what are the 3 eosinophilic granuloma complexes?
eosinophilic plaque eosinophilic granuloma indolent ulcer
222
what does the skin of self-induced alopecia in cats look like?
non-inflamed and normal with hair removed
223
where will self-induced alopecia be seen?
areas that cat can scratch - ventral abdomen, lateral throat, caudal thight
224
non-pruritic self-induced alopecia is uncommon, what could cause this?
pain and anxiety
225
what are the parasitic differentials for self-induced alopecia?
``` Cheyletiellosis Trombiculosis Otoacariasis Pediculosis Demodex gatoi ```
226
what are the parasitic differentials for head and neck pruritus?
otoacariasis trombiculosis notoedric and sarcoptic mange
227
what are the microbial infections that could lead to head and neck pruritus?
bacterial infection Malassezia dermatitis dermatophytosis
228
what neurological disease can cause head and neck pruritus?
oro-facial pain syndrome
229
how does miliary dermatitis present?
multiple crusted papules on the dorsum of a cat (also seen on caudomedial thighs and ventral abdomen)
230
what are the parasitic differentials for miliary dermatitis?
``` cheyletellosis pediculosis otoacariasis neotrombiculosis endoparasites ```
231
what are two differentials for miliary dermatitis that aren't microbial infections or parasites?
drug reactions | fatty acid/dietary deficiency
232
where are eosinophilic plaques usually seen?
abdominal/inguinal skin, interdigital skin, neck, thighs
233
what is the clinical presentation of eosinophilic plaques?
highly pruritic | raised, alopecic, erythematous eroded to ulcerated plaques
234
how do eosinophilic granulomas present?
variably pruritic alopecic raised plaques/nodules intact skin to eroded/ulcerated - central white accumulations
235
are indolent ulcers pruritic or painful?
neither pruritic or painful
236
describe the appearance of indolent ulcers
well circumscribed, red/brown ulcer with raised border
237
where are indolent ulcers always seen?
upper lip
238
what are some possible infectious differentials for eosinophilic granuloma complexes?
``` deep bacterial infection deep mycosis dermatophytic granuloma cowpox cutaneous herpes ```
239
what are some non-infectious differentials for eosinophilic granuloma complexes?
neoplasia foreign bodies genetics sterile granulomatous disease
240
what is the name of the criteria used to diagnose FASS?
Favrots criteria
241
what are some common diagnostic tests used to rule out differentials for FASS?
``` impressions smear cytology flea combing scale examination skin scrapings trichography trial treatment biopsy ```
242
how long are flea treatment trials run for?
6-8 weeks
243
what other differentials can be ruled out with careful selections of flea treatment trials?
Demodex | other parasites
244
what are the criteria for flea treatment trials?
adulticide with rapid kill speed insect growth regulator with residual action safe and easy to administer treat all at home contacts
245
how long should an elimination diet for suspect food induced FAS be run?
8-12 weeks
246
what are the two options for elimination diets?
novel home cooked diet | commercial novel hydrolysed or single protein diet
247
what are the recommended treatments for FAS?
systemic glucocorticoids | ciclosporin
248
what are the 4 treatment groups for multimodal management of FASS?
skin barrier care anti-inflammatory and immunomodulators allergen avoidance control flare factors
249
what can be used for skin barrier care in the multimodal management of FASS?
essential fatty acids topical lipid complexes moisturising shampoos
250
what is allergen specific immunotherapy used for?
reduce flares associated with exposure to environmental allergens
251
when should symptomatic treatment of FASS be started?
at the beginning of the diagnostic trial
252
what are some anti-inflammatories/immunomodulators that can be used in FASS cases?
prednisolone methylprednisolone dexamethasone (these are glucocorticoids)
253
what are some patient factors that treatment needs to be tailored for?
severity of disease general health status home environment predisposition to microbial infections
254
what is a particular side effect in cats of long term glucocorticoid administration?
diabetes mellitus
255
what are the most common adverse effects of cyclosporin administration?
GI signs | weight loss
256
when are antihistamines usually used for FASS?
early/mid disease due to the limited benefits of them in cats
257
what is alopecia?
the loss of or absence of hair
258
what are the two types of alopecia?
spontaneous | self-induced
259
how can the absence of pruritus in alopecic patients be confirmed?
feel of coat (rough/smooth) saliva stains cytology for Conchiformibius trichograms
260
what are some symmetrical alopecias?
``` follicular dysplasia canine recurrent flank alopecia colour dilution alopecia hyperadrenocorticism hypothyroidism pattern alopecia sebaceous alopecia ```
261
what needs to be found out about the character of the alopecia?
whether it is partial or complete | if it is in regular or irregular patches
262
what is the most common cause of bacterial folliculitis?
Staphylococcus pseudintermedius
263
how is the alopecia associated with bacterial folliculitis distributed?
focal to multifocal patches
264
what clinical signs if bacterial folliculitis associated with?
``` pruritus alopecia scale (epidermal collarettes) crusts deep infection (nodule swelling) ```
265
what can be done to diagnose bacterial folliculitis?
impression smear cytology
266
what is the most common cause of ringworm in cats/dogs?
Microsporum canis
267
what is ringworm also known as?
dermatophytosis
268
what animals is ringworm most commonly seen in?
young or immunocompromised animals
269
what breed of acts are predisposed to ringworm?
Persian
270
what are possible formats for dermatophytosis?
bedding grooming equipment collars/leads any surface
271
what are the clinical signs of ringworm?
multifocal circular patches that often have hyperpigmentation follicular casts
272
where on the body is dermatophytosis often found?
head, ears and chin
273
how can dermatophytosis be diagnosed?
``` Mackenzie (toothbrush) sample woods lamp exam trichography in house DTM external lab fungal culture ```
274
how is a woods lamp examination carried out?
warm lamp for 5-10 minutes and expose hair for 3-5 minutes | apple green fluorescence of hair if dermatophytosis is present
275
what is looked for on a trichograph to confirm dermatophytosis?
arthrospores (soap bubbles) surrounding hair shaft and hyphae within the hair
276
what is a Mackenzie (toothbrush) sample?
use a cheap toothbrush with nylon bristles brush effected areas of the animal submit the toothbrush to the lab or inoculate onto fungal culture medium
277
what can be done to treat dermatophytosis?
topical treatment - chlorhexidine/miconazole shampoo, lime sulphur dip, enilconazole (dogs)
278
why does dermatophytosis need to be treated?
to decrease contamination and environmental spread (disease revolves spontaneously within 12-20 weeks)
279
why is clipping for treatment of dermatophytosis controversial?
it can cause microtrauma which can the further increase infection
280
how often does chlorhexidine/miconazole shampoo for dermatophytosis need to be used?
2-3 times a week
281
how often does lime sulphur dip for dermatophytosis need to be used?
once a week
282
how often does enilconazole for dermatophytosis need to be used?
every 4 days
283
how long is Mycosporum canis viable for in the environment?
up to 18 months
284
what can be done to decrease the environmental contamination of ringworm?
isolate the animal to 1 room (with non-porous surfaces) destroy/disinfect bedding protective clothing daily vacuuming/disinfectant (sodium hypochlorite - bleach)
285
what two drugs are used systemically to treat dermatophytosis?
itraconazole | ketoconazole
286
how is the treatment success of dermatophytosis monitored?
fungal culture every 2 weeks using the Mackenzie test
287
what is pseudomycetoma also known as?
nodular dermatophytosis
288
what breed of cats are predisposed to pseudomycetoma?
Persian
289
what is pseudomycetoma?
subcutaneous form of dermatophytosis that is usually accompanied by typical dermatophyte signs
290
what should be avoided with cats that have pseudomycetoma?
abdominal surgery as it can introduce disease into the cavity
291
what is a common parasite that causes spontaneous alopecia?
Demodex mites
292
what are the common types of Demodex mites?
Demodex canis Demodex injai Demodex cati
293
what animals are effected by canine demodicosis?
young and immunocomprosied dogs
294
what are the clinical signs of alopecia associated with demodicosis?
``` alopecia scaling blue-grey hyperpigmentation comedones follicular casts ```
295
how can demodicosis be diagnosed?
clinical appearance | skin scrape, hair plucks, biopsy
296
what are the three main diseases that cause follicular casts?
demodicosis dermatophytosis sebaceous adenitis
297
what should happen when you do a hair pluck for demodex?
demoted should fall off the hair bulb
298
what should always be done when comedones are present?
skin scrapes
299
what needs to be identified in adult onset demodicosis?
the underlying disease
300
what are some underlying disease that may lead to adult onset demodicosis?
``` hyperadrenocorticism hypothyroidism diabetes mellitus systemic neoplasia immunosuppressive therapy FIV/FeLV ```
301
what is used to treat adult onset demdodicosis?
clip long hair and bathe treat secondary bacterial pyoderma treat underlying immunosuppression amitraz and isoxazolines
302
what is done as a precautionary measure for bitches that have had demodicosis?
spey them - demodicosis often comes back during pregnancy
303
what is sebaceous adenitis?
an uncommon cause of alopecia that leads to subtle loss of truncal hair that then becomes more generalised
304
what is dermatomyositis?
rare cause of alopecia resulting in the loss of air from the face and boney prominences
305
how should a vesicle be biopsies?
cut out the entire vesicle
306
when sending a suspect tumour biopsy away for analysis, what should it be packaged in? and why?
half in formalin - histopathology | half in sterile saline - tissue culture
307
what are the three main stages of the hair growth cycle?
anagen catagen telogen
308
what is anagen?
the growing phase of the hair cycle
309
what is catagen?
the transition phase of the hair cycle with regression if the lower part of the hair follicle
310
what is telogen?
resting stage of the hair cycle
311
what is exogen?
the release and shedding of the hair
312
what is kenogen?
refers to empty hair follicles
313
what stage of the hair cycle are the majority of follicles in with animals with primary alopecia?
telogen
314
what can cause hair cycle arrest?
``` endocrinopathies anagen/telogen deflux paraneoplastic alopecia alopecia X cyclic flank alopecia post-clipping alopecia injection alopecia ```
315
what endocrinopathies can cause hair cycle arrest?
hyperadrenocorticism hypothyroidism hyperoestrogenism sex cell alopecias
316
what are the clinical features of endocrinpathies?
``` symmetrical to generalised alopecia dull and dry coat comedones hyperpigmentation atrophic skin poor wound healing poor hair growth ```
317
why does the coat appear dull and dry with endocrinopathies?
the diseases effect the sebaceous glands
318
what two effects do glucocorticoids have on the skin?
catabolic and antimitotic
319
the antimitotic effect of glucocorticoids means there is decreased mitoses of the skin, what does this cause?
thinning delayed wound healing pilosebaceous atrophy
320
what do glucocorticoid inhibit the proliferation/production of at the skin?
fibroblast proliferation | collagen and matrix substance production
321
what does the inhibition of fibroblast proliferation and collagen/matrix substance production result in?
thinning | fragile vessels
322
what stages of the hair cycle do glucocorticoid accelerate?
anagen and catagen (meaning all the follicles are in the telogen phase)
323
what are the typical clinical signs of hyperadrenocorticism?
``` truncal alopecia comedones skin atrophy and striae prominent blood vessels calcinosis cutis ```
324
what are striae?
wrinkles
325
what is calcinosis cutis?
inorganic, insoluble mineral salts are deposited on the dermis/subcutis
326
how does calcinosis cutis appear?
crusting and haemorrhage
327
how does feline hyperadrenocortism compare to canine?
feline is less common but more severe
328
what is the main clinical sign of feline hyperadrenocorticism?
skin fragility (severe)
329
what disease is feline hyperadrenocroticism often seen concurrently with?
diabete mellitus
330
what is the general effect of thyroid hormones on the skin?
stimulate cytoplasmic protein synthesis and increase tissue oxygen consumption
331
what are the 4 specific effects of thyroid hormones on the skin?
initiate anagen phase and wound healing decrease cell apoptosis (prolong anagen) promote matrix cell proliferation support development of lymphoid tissue, neutrophilic function and lymphocyte funtion
332
if there hypothyroidism, what happens to the hair cycle?
anagen is not stimulated so majority of hair cells are in telogen (resting)
333
what are the clinical signs of hypothyroidism?
``` truncal/extremity alopecia dull hair coat myxoedema weight gain lethargy heat seeking ```
334
what does myxoedema cause?
tragic facial expression
335
what animals is hyperestrogenism most common in?
intact males
336
why is hyperestrogenism most common in intact males?
due to functional testicular neoplasia - Sertoli cell tumour
337
what is the effect of oestrogen's on the hair cycle?
initiate and promote catagen by induction of apoptosis | inhibition of anagen onset - longer telogen phase
338
what are the clinical signs of Sertoli cell tumours?
testicular masses (not always obvious) pendulous prepuce linear preputial erythema feminisation
339
how can Sertoli cell tumours usually be cured?
neutering - don't normally metastasise
340
what is telogen defluxion?
a sudden loss of hair as the hairs synchronise into telogen
341
when does telogen deflexion occur?
1-3 months post-stressful event (pregnancy, severe illness, shock, surgery)
342
what is anagen defluxion?
sudden loss of hair due to damage of the growing hair/follicle
343
what may cause anagen defluxion?
chemotherapy | severe illness
344
what are the clinical signs of anagen defluxion?
patchy to complete hair loss (fractured/distorted hair) | loss of whiskers
345
what are some causes of feline paraneoplastic alopecia?
pancreatic/bile duct carcinomas neuroendocrine pancreatic tumour hepatosplenic plasma cell tumour
346
where do feline paraneoplastic alopecias usually cause hair loss?
ventrum and legs
347
how does the skin of patients with feline paraneoplastic alopecia appear?
shiny and translucent (not fragile)
348
what breeds are predisposed to alopecia X?
plush coated - Pomeranians, Chow chows...
349
what are the clinical signs of alopecia X?
dull dry coat - hair loss in frictional areas truncal alopecia and hyperpigmentation dog otherwise well
350
how does alopecia X progress?
starts with loss of primary hairs (puppy coat) then later there is complete alopecia and hyperpigmentation
351
how is alopecia X diagnosed?
by exclusion - rule out endocrinopathies, sex hormones and take biopsy
352
how can alopecia X be treated?
``` none that is always effective neutering males (deploring implant) melatonin ```
353
what word would be used to describe the disease of alopecia X?
cosmetic
354
with recurrent flank alopecia, where is hairloss mainly seen?
flanks in the thoracolumbar area that can be unilateral
355
what are the clinical signs of recurrent flank alopecia?
``` hyper pigmented skin partial to complete alopecia coat colour change flank alopecia dog otherwise well - cosmetic condition ```
356
what is recurrent flank alopecia linked to?
reduction in day length, follicular atrophy, dysplasia
357
what can be used to treat recurrent flank alopecia?
melatonin
358
what drugs can cause injection site alopecia?
glucocorticoids vaccines antibiotics
359
what are some hair synthesis defects?
congenital alopecia follicular dysplasias pattern alopecia sebaceous adenitis
360
what are some defects that are associated with congenital alopecia?
adnexal, epidermal, dental and nail defects
361
what are some breeds that are predisposed to follicular dysplasia?
Irish water spaniel Portuguese water dogs airedale
362
what are the clinical signs of follicular dysplasia?
hair that is present at birth but alopecia develops when the hair starts to cycle shaft fractures
363
what breed is bald thigh syndrome seen in?
greyhounds/sighthounds
364
what are the clinical signs of bald thigh syndrome?
bilateral hair loss on the caudal and lateral thighs (may extend to distal hind legs, ventral abdomen and chest)
365
when in life is pattern alopecia seen?
later - elderly dogs
366
where on the body is pattern alopecia usually seen?
pre/post auricular, ventral neck, ventrum, caudal thighs
367
what breeds can be effected by pattern alopecia?
Yorkshire terrier, dachshund, greyhound, chihuahua
368
what causes black hair follicular dysplasia?
genetic defects in melanisation causing a defect in pigmentation and hair formation
369
how does black hair follicular dysplasia progress?
animal born normal but by 4 weeks the black hairs have become dull and may have fractured or been lost bacterial infection can occur
370
what causes colour dilution alopecia?
one or more genetic defects in melanisation
371
what are the clinical signs of colour dilution alopecia?
``` hair fragility melanin clumping (macromelanosomes) hair fracture/loss scaling possible bacterial folliculitis ```
372
how can hair synthesis defects be diagnosed?
history - breed, distribution, coat colour trichogram skin biopsy
373
what can be done to treat hair synthesis defects?
``` avoid coat damage high quality nutrition gentle anti-scaling shampoos prevent secondary infection sun protection ```
374
what is a nodule?
a circumscribed solid elevation greater than 1cm in diameter that usually extends into deep layers of skin
375
what do nodules usually result from?
infiltration of inflammatory cells, neoplastic cells, deposition of fibrin/crystals
376
when looking at the clinical presentation of nodules, wha should be described?
``` location on body number size behaviour clinical features ```
377
what are some possible clinical features of nodules?
``` warm painful hard/soft/elastic/fixed/moveable alopecia ulcerated hyper/hypopigmented ```
378
after describing the clinical presentations of nodules, what should be done?
cytology - FNA, apposition
379
after cytology and histology, what further diagnostic tests can be done on nodules?
``` immunohistochemistry PCR biochemistry urinalysis serology ```
380
what are some examples of foreign bodies that can cause nodules?
plant material grass awns embedded insect mouthparts suture material
381
what are some endogenous materials that can cause a nodular reaction?
hair, sebum, keratin calcium salts tyrosine crystals
382
what are common causes of abscesses that cause nodules?
penetrating wounds, bites and foreign bodies
383
what are some examples of filamentous bacteria that cause abscesses?
Actinomyces Nocardia Actinobacillus
384
what are the clinical signs of filamentous bacteria nodules?
ulcerated nodules/abscesses with draining tracts and cellulitis serosanguineous exudate possible systemic signs - pyrexia, depression...
385
how can filamentous bacteria nodules be diagnosed?
cytology (special stains) histology (special stains) culture (can take weeks)
386
how can filamentous bacteria nodules be treated?
surgical drainage and antimicrobial therapy
387
what are the two main presentations of nodules caused by mycobacteria?
canine leproid granuloma | feline leprosy syndrome
388
what are the clinical signs of mycobacterial nodules?
single/multiple, firm, well circumscribed nodules in skin/subcutis
389
how does canine leproid granuloma progress?
self-limiting (usually)
390
how does feline leprosy syndrome progress?
progressive and occasionally aggressive clinical course
391
how can mycobacteria nodular diseases be diagnosed?
cytology histology PCR
392
why is culturing of mycobacteria nodular disease not generally carried out?
they are extremely fastidious and generally uncultivatable
393
how can nodular disease caused by mycobacterium be treated?
long courses (often life long) of antibacterials
394
what can atypical mycobacterium cause?
granulomatous panniculitis
395
describe the gross appearance of granulomatous panniculitis
single/multiple nodules, plaques, macule and diffuse swelling
396
where is granulomatous panniculitis most commonly seen on the animal?
inguinal fat pad tail base flank
397
how can nodular disease caused by atypical mycobacteria be treated?
antibiotic treatment | surgical intervention
398
what are the clinical signs of nodular mycobacterial disease caused by M. tuberculosis complex?
firm ulcerative nodules non-healing wounds and draining tracts tick yellow green fluid
399
in what animals is nodular mycobacterial disease caused by M. tuberculosis complex most common? where on the body is it seen?
male outdoor cats on the face, extremities, tail base and perineum
400
how can nodular mycobacterial disease caused by M. tuberculosis complex be diagnosed?
cytology histology culture PCR
401
how is nodular mycobacterial disease caused by M. tuberculosis complex treated?
notifiable disease - owner may need to be screened for TB euthanasia often common multidrug treatment
402
what are the two types of dermatophyte infections causing nodular lesions?
dermatophytic pseudomycetoma | kerion - nodular dermatophytosis
403
how does dermatophytic pseudomycetoma present clinically?
a deep dermal/subcutaneous infection painless single/multifocal ulcerated dermal nodules with yellow granular discharge
404
where on the body is dermatophytic pseudomycetoma most commonly seen?
neck, dorsal, tail flanks and limbs
405
how can dermatophytic pseudomycetoma be treated?
systemic antifungals such as itraconazole and terbinafine
406
what animals is dermatophytic pseudomycetoma seen in?
cats - Persians
407
what animals is nodular dermatophytosis seen in?
dogs
408
describe the appearance of nodular dermatophytosis
single/multiple erythematous, alopecic, exudative nodules
409
where on the body is nodular dermatophytosis seen?
head, neck and limbs
410
how can nodular dermatophytosis be treated?
systemic antifingals - itraconazole and ketoconazole
411
what can lead to subcutaneous fungal nodules?
traumatic implant of saprophytic organisms on soil and vegetation
412
what animals is disseminated saprophytic subcutaneous fungal infections seen in?
immunocompromised animals
413
what is a mycetoma?
pyogranulomatous nodules that contain tissue grains or granules composed of dense colonies of organisms and necrotic debris
414
what two categories of fungi can cause nodular saprophytic subcutaneous fungal infections?
pigmented | unpigmented
415
what is chromomycosis?
a subcutaneous and systemic disease associated with pigmented fungal elements (not grain in tissue)
416
is hyalohyphomycosis a pigmented or unpigmented fungal infection?
unpigmented
417
where is cryptococcus found and what does it most commonly cause?
in the environment causing systemic mycosis in cats
418
how can nodular saprophytic subcutaneous fungal infections be treated?
based on culture systemic antifungals - itraconazole, ketoconazole amphotericin B terbinafine
419
protozoa rarely cause nodular skin lesions, what animals can they cause this in?
immunocompromised
420
what parasite can cause nodular skin lesions?
Dirofilaria repens
421
what is the name of the group of nodular causing disorders caused by inflammation?
histiocytic proliferative disorders
422
what is a histiocyte?
overarching term to describe cells of dendritic cells or macrophage lineage
423
what are the two types of histiocytic proliferative disorders?
neoplastic | reactive
424
why does protective clothing need to be worn when dealing with suspected histiocytic proliferative disorders?
they are zoonotic
425
what are the two types of reactive histiocytic proliferative disorders?
cutaneous histiocytosis | systemic histiocytosis
426
how does cutaneous histiocytosis appear?
multiple cutaneous and subcutaneous nodules up to 4cm in diameter that are non-painful and non-pruritic ulcerations common
427
where on the body does cutaneous histiocytosis usually appear?
face, nose, trunk, extremities
428
how can histiocytic proliferative disorders be treated?
glucocorticoids | ciclosporin
429
describe the prognosis for systemic histiocytic proliferative disorders
guarded
430
are crusts usually a primary or secondary lesion?
secondary
431
where do crusts originate from?
from drying of exudate, serum, pus, blood and squamous corneocytes
432
what is scale?
the presence of flakes of keratin in the hair coat and on the skin
433
what can scale result from?
``` normal skin function (dandruff) abnormal desquamation abnormal cornification inflammation bacterial and fungal enzymatic action ```
434
what are some diseases that can result in primary scale?
``` primary keratinisation disorders primary seborrhoea zinc responsive dermatosis vitamin A responsive dermatosis ear margin seborrhoea ```
435
what are some diseases that can result in secondary scaling?
``` callus hypothyroidism allergy parasites bacterial infection dermatophytosis sebaceous adenitis ```
436
what is done to diagnose a problem when secondary scale seems unlikely?
check parasites check infection biopsy genetic testing
437
what are some non-specific topical treatments for scale?
keratoplastic/keratolytic products - reduce scale production and remove scale moisturising and emollient products - hydrate/moisturise the skin
438
what causes type I zinc-responsive dermatosis?
generally genetically predisposed
439
what causes type II zinc-responsive dermatosis?
nutritional restrictions seen in young rapidly growing dogs
440
what are the main presentations of nail disease?
breakages and losses pus, inflammation, swelling of the nail bed discolouration
441
what are some disease that effect the nails?
symmetrical lupoid onychodystrophy dermatophytosis acute nail trauma neoplasia of the ungual fold
442
what are the clinical sign of symmetrical lupoid onychodystrophy?
``` nail loss nail breakage/splitting nail pain haemorrhage secondary paronychia multiple nails can be effected ```
443
what is onychomadesis?
nail loss
444
what is onychalgia?
nail pain
445
what is onychorrhexis?
nail breakage
446
how does acute nail trauma present?
very painful
447
what is acute nail trauma a sign of in cats?
RTA (check internal injury)
448
what are two neoplasias that can occur on the ungual fold?
squamous cell carcinoma | melanoma
449
what function are anal sacs associated with?
scent marking
450
where are anal sacs found?
paired sacs between the internal and external anal sphincters
451
what is a common problems associated with anal sacs?
impaction
452
what are the clinical signs of impacted anal sacs?
pruritus pain and depression malodour distended sacs
453
what are some primary causes of anal sac impaction?
thick high volume secretios change in muscle tone faecal form - diarrhoea or constipation plugging of ducts
454
what are some secondary causes of anal sac impaction?
bacterial infection (possible abscessation)
455
what are some predisposing factors to impacted anal sacs?
other causes of pruritus (atopic dermatitis, food allergy) | breed
456
what are some differential diagnoses for anal sac impaction?
anal pruritus - food allergy, atopic dermatitis, vulva fold dermatitis, tail fold dermatitis abscessation - tumour, anal furunculosis
457
what are the treatment options for impacted anal sacs?
expression additional fibre in feed - improve faecal consistency flush and pack anal sacculectomy
458
what tumour can be seen within the anal sac?
anal sac adenocarcinoma
459
what type of disease is anal furunculosis?
immune mediated skin disease
460
what breed is predisposed to anal furunculosis?
German shepherds
461
how can anal furunculosis be treated?
immunosuppressive therapy - prednisolone food trials good skin hygiene surgery
462
what is the main differential for canine pododermatitis?
sterile pyogranulomatous pododermatitis
463
what does sterile pyogranulomatous pododermatitis include?
interdigital folliculitis/furunculosis with/without interdigital cysts or nodules
464
what breeds are predisposed to sterile pyogranulomatous pododermatitis?
smooth, short-coated breeds such as staffies
465
what can cause sterile pyogranulomatous pododermatitis?
trauma from the environment/self induced - usually on the front feet as they take more weight
466
describe the pathogenesis of sterile pyogranulomatous pododermatitis
chronic weight bearing and friction on haired skin leads to follicular obstruction, damage and rupture lesions start sterile and quickly progress to having secondary infection due to rupturing of cysts and self trauma reoccurrence leads to increased scar tissue and disease perpetuation
467
where do lesions of sterile pyogranulomatous pododermatitis form?
ventral interdigital surface but then rupture onto the dorsal surface
468
what type of lesions form with sterile pyogranulomatous pododermatitis?
erythema, oedema, comedones, nodules, pustules, ulcers, haemorrhagic bullae, haemorrhagic draining tracts, pyogranulomas and callus formation
469
between what digits does sterile pyogranulomatous pododermatitis often effect?
between digits 3 and 4, and 4 and 5
470
how can sterile pyogranulomatous pododermatitis be diagnosed?
history/clinical exam | consider other differentials and comorbidities - atopic dermatitis, demodicosis
471
how should sterile pyogranulomatous pododermatitis be treated?
``` aggressively at the start to prevent scaring immune-modulation topical antiseptics treat secondary infection restrict activity to smooth surfaces protect paw from trauma using boots ```

MOD (year 3) (45 decks)

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