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MOD > The approach to pruritus > Flashcards

The approach to pruritus Flashcards

1
Q

What is pruritus?

A

Unpleasant sensation that elicits the desire or reflex to scratch

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2
Q

How does pruritus manifest in dogs?

A

*Scratching
*Rubbing (along furniture)
*Chewing
*Licking: often not perceived as pruritus by owners
*Rolling
*Temperament changes

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3
Q

How does pruritus manifest in cats?

A

*Scratching
*Chewing
*Licking
*May be secretive and not noticed by owners

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4
Q

What are common differentials of pruritus?

A

*Hypersensitivity reactions (allergic skin disease + parasite hypersensitivity)
*Microbial infections
Less common differentials =
-Epitheliotrophic lymphoma
-Pemphigus foliaceus
-demodicosis
-dermatophytosis

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5
Q

What are the different parasitic infestations?

A

*Sarcoptic mange
*Cheyletiellosis
*Pediculosis (lice)
*Trombiculiasis (Harvest mites)
*Flea infestation
*Notoedric mange
*Hookworm dermatitis

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6
Q

How would you differentiate the different diseases?

A

*History
*Dermatological examination
*Diagnostic tests

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7
Q

Where does atopic dermtaitis affect?

A

Muzzle
Eyes
Ears
Paws
Ventral aspect

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8
Q

Where does sarcoptic mange affect?

A

Ear margins
Ventral aspect

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9
Q

Where does cheyletiellosis + pediculosis affect?

A

Dorsum

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10
Q

Where does pemphigus foliaceus affect?

A

Nose
Eyes
Ears
Whole body

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11
Q

Where does Epitheliotropic lymphoma affect?

A

Muzzle
Whole body

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12
Q

Why are cytology tests important?

A

-very important to rule out secondary microbial overgrowth or infection (indicated in most cases)
*Direct/indirect impression smear
*Acetate tape impression (stained)

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13
Q

How would you identify parasitic disease?

A

*Coat brushing and wet paper test
*Acetate tape impression (unstained)
*Skin scraping
*Hair plucks and trichography

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14
Q

When would you use skin biopsy?

A

to rule out less common differentials for pruritus; Pemphigus foliaceus, Epitheliotropic Lymphoma

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15
Q

What cats are more at risk of fleas?

A

*Outdoor cats
*Multi-cat household

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16
Q

What is flea allergy commonly seen with in dogs?

A

Canine Atopic Dermatitis

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17
Q

What are the primary and secondary lesions caused by fleas?

A

Primary lesions
*Pruritus
*Papules
*Erythema

Secondary lesions
*Crusted excoriations
*Alopecia
*+/- bacterial pyoderma
signs

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18
Q

What is the typical distribution of fleas?

A

Caudodorsum (+ventral abdomen in dogs)

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19
Q

What diagnostic tests can be taken to identify fleas?

A

*Direct observation
*Wet paper test
*Coat brushings: direct microscopy may reveal coiled faeces
*Serology/intradermal allergy testing: limited usefulness
*Treatment trial

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20
Q

What is the most common flea in the UK?

A

Ctenocephalides felis

21
Q

How are fleas transmitted?

A

*Direct zoonosis
*Bartonella henselae
*Dipylidium caninum

22
Q

What and where are the primary + secondary lesions of sarcoptic mange?

A

Primary lesions
*Pruritus - severe
*Papules
*Erythema

Secondary lesions
*Excoriation
*Alopecia
*Crusts
*Pyoderma signs
Distribution =
*Pinnal margins, elbows, hocks
*Becomes more generalised with time

23
Q

What are diagnostic tests for sarcoptic mange?

A

*Pinnal-pedal reflex: often present but unreliable
*Superficial skin scrapes: high specificity (100%) & low sensitivity (50%)
*IgG serology: variable sensitivity and susceptibility, cross reaction with
house-dust mites!
*Treatment trial: often chosen above others as most reliable

24
Q

What is the main sarcoptes found in dogs?

A

Sarcoptes scabei var canis

25
Q

What is the feline form of sarcoptic mange?

A

Notoedres cati

26
Q

Where do female sarcoptes lay their eggs?

A

Tunnel into stratum corneum

27
Q

What is a common treatment for sarcoptic mange?

A

*Common topical and oral treatments are effective
*Anti-pruritic therapy often needed to control severe pruritus

28
Q

What is the distribution of harvest mites (Trombicula)?

A

Henry’s pocket - pinnae
Ventrum - nipples
Between footpads

29
Q

What are common treatments for harvest mites?

A

*Larval forms temporarily parasitise animals to feed then return to environment
*Avoidance is best policy as killing following feeding fails to address irritation
*Fipronil spray for the legs (not licenced)
*Isoxazolines?
*Prednisolone as before to control pruritus and inflammation

30
Q

What is the ear mite?

A

Otodectes Cynotis

31
Q

What is the distribution of the ear mite?

A

Usually in the ear
But can leave canal and affect head/tail

32
Q

What is the treatment of otodectes?

A

Spot-on /oral therapies
+Topical

33
Q

What diagnostic tests can be done for otodectes?

A

*Direct observation of mites using otoscope (photophobic)
*Unstained ear wax examination (mount in liquid paraffin)

34
Q

What are the most common species of cheyletiellosis?

A

Cheyletiella yasguri
C. blakei
C. parasitivorax

35
Q

What is the distribution of cheyletiella?

A

Dorsal trunk
Rarely head

36
Q

What diagnostic tests can be done for cheyletiella?

A

*Coat brushings: walking dandruff
*Superficial skin scraping from scaly areas
*Faecal flotation may be used in cats where excessive grooming present

37
Q

What is the treatment for cheyletiella?

A

*No licenced therapy
*Fipronil spray or spot-on selamectin
effective

38
Q

What are common chewing lice?

A

Felicola subrostratus
Trichodectes canis

39
Q

What is a common sucking louse?

A

Linognathus setosus

40
Q

What is the normal distribution of lice? (Pediculosis)

A

Dorsum

41
Q

How can you diagnose lice?

A

Coat brushings - lice seen under microscope + eggs

42
Q

What animals are affected by epitheliotropic lymphoma?

A

*Disease of older animals (very rarely seen in
young animals)
*Lesions before pruritus

43
Q

What is the distribution of epitheliotropic lymphoma?

A

Anywhere on body
Often mucocutaneous junction

44
Q

How is Epitheliotropic lymphoma diagnosed?

A

*Skin biopsy & histopathology

45
Q

What is the primary lesion of demodex?

A

Alopecia

46
Q

What are clinical features of demodex gatoi?

A

*Contagious (unlike all other forms of demodicosis)
*Pruritus often seen (but not in all animals)
*Self-induced alopecia ± excoriation (anywhere)

47
Q

How is demodex diagnosed?

A

*Surface dwelling mites so skin scrapes have very poor sensitivity
*Tape impression more useful
*Faecal floatation has been used successfully

48
Q

What is the treatment of demodex gatoi?

A

*Selamectin/sarolaner spot-on combo (Stronghold Plus)
*Fluralaner (Bravecto)
*Lime sulphur dip (weekly until 2 negative samples)
*Treat in contact cats and investigate potential immunosuppressive disease

49
Q

What species are predisposed to demodex injai?

A

Terriers - Border, Welsh, Norfolk, WHWT

MOD (103 decks)

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