Week 1 - Ectoparasite Control & Self Trauma

Question 1

What are the objectives of FAD control?

Answer 1

Kill adult fleas
Prevent re-infestation
Reduce the environmental reservoir of fleas

Question 2

How long does it take until adult fleas will lay eggs and what products are good for preventing this?

Answer 2

36 hours

Nitenpyram - 100% effective within 3 hours dog & cat
Spinosad - similar effectiveness within 4 hours but also has persistance for 3 weeks. - do not give with ivermectin!

Question 3

What chemical is often given with an adulticide that has activity against other parasites? E.g. advocate, trifexis

Answer 3

Trifexis = spinosad + milbemycin
Advocate = Imidacloprid + milbemycin

Question 4

What treatments are available for the treatment of mange?

Answer 4

Sarcoptes :
Selamectin
Imidacloprid + moxidectin
Amitraz wash

Demodex:
Licenced - imidacloprid/moxidectin (not effective?), amitraz, non licensed = ivermectin, milbemycin

Question 5

Name some species/breed toxicity issues one should be aware of when prescribing ectoparaciticides.

Answer 5

Ivermectin - Collies, Old English Sheep Dogs / type breeds

Pyrethroids - Cats!

Question 6

What drugs are used in the treatment of ectoparacites for large animals?

Answer 6

Macrocyclic lactones/Avermectins
Pyrethroids
Organophosphates

Question 7

What fungal treatment is licenced for use in LAs?

Answer 7

Enilconazole

Question 8

What tests can be used to test for ectoparacites in general practice?

Answer 8

Scin scrapes, coat brushings, hair plucks, tape strips.

Question 9

What test could be used for a pustule or other inflammatory skin disease?

Answer 9

Culture and smears for cytology. This could be obtained via an FNA for example.

Question 10

What can be concluded if sarcoptes mites are not found?

Answer 10

This is not enough to rule out scabies. Sarcoptes mites do not need to be present in large numbers in order to cause intense pruritis, if this disease is suspected it should always be treated as if it were present.

Question 11

What is the distinction between primary and secondary lesions?

Answer 11

Primary: develop as a direct result of the disease process
Secondary: Evolve from a primary or develop as a consequence of the patients own actions

Question 12

Animals often wont exhibit itching within the time-frame of a consult, what things may help refine the problem of self trauma?

Answer 12

Check reflexes, can stimulate itch by scratching a pruritic area. There may be other evidence of self-trauma e.g. broken hair shafts, secondary lesions caused by the patient.

Question 13

What are the common causes of pruritis?

Answer 13

Parasitic Disease!
Microbial overgrowth/infection
Hypersensitivity disorders (e.g. FAD, atopic dermatitis, food hypersensitivity)

Question 14

What is the difference between the types of mange that cats and dogs get?

Answer 14

Cats dont often get sarcoptic mange. However, they can get demodecosis, cheletiellosis and trombiculiasis.

Question 15

What is the harvest mite season?

Answer 15

July-September/October

Question 16

What are some typical clinical signs/findings seen with chielytiellosis?

Answer 16

Eggs cemented to hair shafts. Lots of scaling - ‘walking dandruff’

Question 17

What should the owner be warned of with demodex infection and what drug should one avoid with this disease?

Answer 17

Can take a very long time to resolve, minimum 12 weeks!

AVOID GLUCOCORTICOIDS!!

Question 18

What is a typical distribution of self trauma for FAD?

Answer 18

The caudal body area, often around the lumbo-sacral region of the animal.

Question 19

What is the difference between urticaria and angioedema?

Answer 19

Urticaria = multiple wheals - superficial
Angioedema = marked sqt oedema - deep

Question 20

What is the main effector cell that causes urticaria/angioedema?

Answer 20

Mast cell

Question 21

What is the treatment for pruritis caused by food hypersensitivity?

Answer 21

allergen avoidance
treatment of secondary complications
GCs only if allergen avoidance is not possible

Question 22

Describe the pathophysiology of canine atopic demratitis.

Answer 22

The pathophysiology of this disease is highly complex. Often it involves a weakness in the skin barrier, this can lead to microbial overgrowth, IgE sensitisation to allergens and inflammation. These all result in pruritis which can also lead back to self-trauma and skin barrier compromise, exacerbating the existing signs.

Question 23

What other disease is often seen with atopic dermatitis?

Answer 23

Ear infection (S. psuedintermedius/ Malassezia pachydermatis)

Question 24

How is atopic dermatis diagnosed? Does allergy testing help?

Answer 24

Rule out other causes of pruritic skin disease. allergy testing is not diagnostic - it can only help with designing an immunotherapy protocol.

Question 25

Give examples of two scaling diseases, their diagnosis and treatments?

Answer 25

Spaniel seborrhoea - dx with biopsy and rule out other causes. Tx - shampoo, retinoids (care)

Sebaceous adenitis - inflammatory destruction of sebaceous gland. Dx - same as above. Tx - shampoo, cyclosporin (expensive), retinoids (care)

Question 26

What are the reasons for crusting?

Answer 26

Epidermal inflammation resulting in a severe oedematous response or marked cellular recruitment.

triggers include:

• physical damage
• infection
• infestation

Question 27

What findings are seen with superficial necrolytic dermatitis?

Answer 27

Hepatic disease/pancreatic glucagonoma.

Bile acids and ultrasonography of the liver/abdomen

Crusting, ulcerative disease often affecting footpads, extremities and periorificial skin.

Sparse mononuclear cell infiltrate.

Question 28

What is a classical reason for crusting in frieshan cows?

Answer 28

Genetic zinc absorbing deficiency (or something like that)

Question 29

What things might contribute to the development of pyoderma?

Answer 29

Things that affect the skin barrier, e.g. parasites, allergies, but also endocrinopathies and metabolic/nutrtional problems.

Question 30

In what type of pyoderma are glucocorticoids very much contraindicated?

Answer 30

Deep pyoderma!

Question 31

What are the different classifications of dermatitis?

Answer 31

Surface:

• Hot spot
• Intertrigo (folds)
• Mucocutaneous
• Bacterial overgrowth

Superficial

• Impetigo
• Folliculitis

Deep

• Furunculosis
• Acne
• Bacterial granuloma

Question 32

What are the tx options for the different pyoderma types?

Answer 32

Surface:

• Topical antibacterial
• Anti-inflammatory
• Tx/correction of underlying factors

Superficial:
-Empirical tx for S. psuedintermedius (can easily check for cocci vs. rods with cytology)

Deep:
-Always base on c&s where possible, can base on cytology results whilst waiting for c&s.

Question 33

Why is compliance often an issue when treating pyoderma and how can this be worked around?

Answer 33

Pyoderma often requires very long term use of antimicrobials. It is therefore important to educate the client on compliance issues.

Question 34

In what instance of pyoderma is systemic therapy contraindicated and why?

Answer 34

When there are likely to be biofilm producing bacteria. The MIC for antibiotics that have to get through biofilm can be 400x that of the bacteria cultured in the lab!