Unit 1: Canine Pyoderma

Question 1

What is the major organism associated with canine pyoderma?

Answer 1

Staphylococcus pseudintermedius

Question 2

What organism is this?

Answer 2

Staph pseudintermedius

Question 3

What are the 8 primary diseases that predispose dogs to pyoderma?

Answer 3

1. Allergic hypersensitivity
2. Endocrinopathies
3. Demodicosis
4. Ectodermal dysplasias
5. Follicular dysplasias
6. Keratinization disorders
7. Neoplastic disease
8. Immunosuppressive therapy

Question 4

What is the clinical presentation of pyoderma in dogs?

Answer 4

Patchy, moth-eaten hair coat (folliculitis), pustules, papules, epidermal collarette

Question 5

What are hot spots?

Answer 5

Sudden areas of deep pyoderma that need systemic treatment;

usually due to fleas

Question 6

What happens with the seborrheic form of pyoderma?

Answer 6

Skin is turning over quickly and there is overproduction of keratin debris;

Crusting, dry, scaly; wants to hyperpigment and almost looks like lichenification

Question 7

Where does mucocutaneous pyoderma manifest?

Answer 7

Periocular, nasal planum, perioral, perianal, preputial, around foot pads

Question 8

Mucocutaneous pyoderma is the #1 DDx for _____.

Answer 8

discoid lupus

Question 9

How can you differentiate between mucocutaneous pyoderma and DLE?

Answer 9

See cocci and treat and goes away = pyoderma

Does not go away = consider biopsy for DLE

Question 10

T/F: Chin pyoderma is a true bacterial infection

Answer 10

False

Question 11

What is chin pyoderma?

Answer 11

Combo of lifestyle, ingrown hairs, ruptured hair follicles, etc.

Question 12

What dogs get chin pyoderma?

Answer 12

Short haired bristly dogs (i.e. Vizslas)

Question 13

What is the treatment length for superficial pyoderma?

Answer 13

21 days or 1 week past clinical resolution

Question 14

What is the treatment length for deep pyoderma?

Answer 14

6 weeks or 2 weeks past clinical resolution

Question 15

What are the 3 R’s of pyoderma?

Answer 15

Relapse, recurrence, resistance

Question 16

What is recurrence?

Answer 16

Failure to address underlying cause

Question 17

What is resistance?

Answer 17

Failure to resolve with appropriate therapy

Question 18

What is methicillin resistance?

Answer 18

Most important antimicrobial resistance of staph spp, carried by the mecA gene which encodes for an altered penicillin binding protein

Question 19

What drugs are affected by methicillin resistance?

Answer 19

All B-lactams (penicillins, cephalosporins, carbapenems, monobactams)

Question 20

What is the drug of choice for pyoderma?

Answer 20

Cephalexin

Question 21

What drug is good for abscesses in pyoderma?

Answer 21

clindamycin

Question 22

What potentiated drug can be used that has broad spectrum activity?

Answer 22

Amoxicillin + calvulanic acid

Question 23

What 3rd generation cephalosporin is good for when there may be compliance issues?

Answer 23

Cefpodoxime - only given SID

Question 24

What 3rd generation cephalosporin is an injectable that is good for low compliance or the angry kitties?

Answer 24

cefovecin (convenia)

Question 25

What are the 2nd tier drugs and when do we use them?

Answer 25

Only use when indicated by the C&S: Clindamycin, tetracyclines, FQs, chloramphenicol, potentiated sulfas, aminoglycosides, rifampin

Question 26

The tetracyclines are bacterio\_\_\_\_\_.

Answer 26

static

Question 27

The FQs are bacteri\_\_\_\_\_.

Answer 27

cidal

Question 28

Where do FQs concentrate?

Answer 28

in WBCs

Question 29

Chloramphenicol is bacterio\_\_\_\_.

Answer 29

static

Question 30

FQs are _____ dependent.

Answer 30

concentration

Question 31

Chloramphenicol is _____ dependent.

Answer 31

time

Question 32

How often is Chloramphenicol given and what can it cause in SA?

Answer 32

TID; can cause reversible bone marrow suppression

Question 33

The potentiated sulfas are bacterio\_\_\_\_\_.

Answer 33

cidal

Question 34

Why should we be cautious when using potentiated sulfas and in what breed is this the worst?

Answer 34

They have the most adverse effects of any drug; DO NOT use in Dobermans

Question 35

Aminoglycosides are bacterio\_\_\_\_\_ and _____ dependent.

Answer 35

cidal, concentration

Question 36

What are the adverse effects of the aminoglycosides?

Answer 36

Nephrotoxicity and ototixicity

Question 37

Rifampin is bacteri\_\_\_\_\_.

Answer 37

cidal/static

Question 38

What is the main adverse effect of the potentiated sulfas?

Answer 38

Keratoconjunctivitis sicca

Question 39

What is the main adverse effect of the aminoglycosides?

Answer 39

Nephrotoxicity

Question 40

What is the go-to topical agent for pyoderma?

Answer 40

Chlorhexidine

Question 41

Chlorhexidine is synergistic with \_\_\_\_\_.

Answer 41

azoles

Question 42

How does benzoyl peroxide work?

Answer 42

By lysis/oxidative burst; it is bactericidal

Question 43

What is the downside to benzoyl peroxide?

Answer 43

It is drying, irritating, and bleaching

Question 44

Benzoyl peroxide is not a good long-term option for _____ patients.

Answer 44

atopic

Question 45

What is similar to benzoyl peroxide but less effective?

Answer 45

ethyl lactate

Question 46

What are the downsides to using boric acid/acetic acid combos?

Answer 46

It is astringent (drying), causes skin irritation, and has questionable efficacy

Question 47

What topical is used for highly resistant bacteria?

Answer 47

Sodium hypochlorite (bleach)

Question 48

What topical is labor intensive and mimics oxidative burst?

Answer 48

hypochlorous acid

Question 49

What is mupirocin good for?

Answer 49

G+ bacteria; has good wound penetration

Question 50

What is SSD good for?

Answer 50

G-; enhances epithelialization