ABSTRACT OF THE WEEK

Veterinary dermatology
Volume 27 | Issue 5 (October 2016)

Retrospective analysis of cutaneous lesions in 23 canine and 17 feline cases of coccidioidomycosis seen in Arizona, USA (2009-2015).

Vet Dermatol. October 2016;27(5):346-e87.

Diana M Simões¹, Sharon M Dial², Kimberly S Coyner³, Anthea E Schick⁴, Thomas P Lewis 2nd⁵

¹ Dermatology for Animals, 106 East Campbell Avenue, Campbell, CA 95008, USA. drdmsimoes@gmail.com.; ² Veterinary Diagnostic Laboratory, The University of Arizona, 2831 N. Freeway Road, Tucson, AZ 85705, USA.; ³ Dermatology Clinic for Animals, 5608 South Durango Street, Tacoma, WA 98409, USA.; ⁴ Dermatology for Animals, 22595 North Scottsdale Road #110, Scottsdale, AZ 85255, USA.; ⁵ Dermatology for Animals, 86 West Juniper Avenue, Gilbert, AZ 85233, USA.

Abstract

BACKGROUND:Coccidioidomycosis is a fungal disease caused by the dimorphic saprophytic fungus Coccidioides immitis or C. posadasii. Primary pulmonary infection can disseminate to cutaneous and subcutaneous tissues, or less commonly direct cutaneous inoculation may occur.

HYPOTHESIS/OBJECTIVES:To characterize the historical, clinical, diagnostic and treatment findings in dogs and cats with cutaneous manifestation of coccidioidomycosis.

ANIMALS:Twenty three dogs and seventeen cats diagnosed between 2009 and 2015 in Arizona, USA.

METHODS:Retrospective review of medical records from dogs and cats from an endemic area with a confirmed diagnosis via histopathology, cytology and/or culture, and skin lesions.

RESULTS:Age of affected dogs ranged from 14 weeks to 13 years (median = 7 years), whereas cats ranged from 3 to 17 years (median = 9 years). Subcutaneous nodules were the most common lesions in both species. Lesions were distributed widely and not often found over sites of bone infection. In 75% of dogs and 54.5% of cats with cutaneous lesions there were clinical signs of systemic illness, supporting the diagnosis of cutaneous disseminated disease. Four dogs and four cats had localized lesions with no systemic illness, consistent with possible primary cutaneous infection. The most common mode of diagnosis was cytology identification in both species. Fluconazole was the most commonly prescribed antifungal drug.

CONCLUSIONS AND CLINICAL IMPORTANCE:Coccidioidomycosis is the most common mycosis of dogs and cats in endemic regions and cutaneous signs of the disease may be an initial presenting complaint. This study identified a variety of cutaneous manifestations of the disease in dogs and cats and should be recognized by clinicians.

Companion Notes

Retrospective report on cutaneous lesions due to coccidioidomycosis in 23 dogs and 17 cats

Study design

- study population: 40 animals with skin lesions due to coccidioidomycosis

- 27 animals seen at University of Arizona from 12/1/09-11/1/15

- 13 animals seen at clinics located in surrounding counties

(Pima, Maricopa and Navajo)

- diagnosis confirmed via histopathology, cytology and/or culture

- procedure: records retrospectively reviewed

Results

- history & signalment

- in the 23 dogs

- median age: 7 years of age with a range of 14 weeks to 13 years

- pit bull terrier dog and crosses, most common breed, 6

- median weight: 18 kg with a range of 3-43 kg

- cats

- median age: 9 years of age with a range 3-17 years

- sex:F, 12 cases (all neutered)

- median weight: 4.7 kg with a range of 2.7-6.5 kg

- indoor/outdoor status known in 7 cats; 6 were indoor only cats

- clinical signs (subcutaneous nodules most common lesion in both species)

- in the 23 dogs

- lesions included the following:

- nodules, 14

- nodules with draining tracts, 6

- ulcerated nodules, 2

- active hemorrhage from lesions, 2

- regional lymphadenomegaly, 2

- alopecia, scarring and induration with draining tracts, 1

- lesion location varied widely

(not often found over sites of bone infection)

- trunk (thorax, abdomen, axillae), 8

- distal extremities, 6

(digital, interdigital, carpal and tarsal region)

- neck, 4

- stifle, 3

- proximal extremities (lateral and medial thigh region), 3

- testicular/scrotal region, 3

- face/head, 3

- elbow, 1

- in the cats (11 of the 15 cats had focal dermatological lesions)

- lesions included the following:

- closed nodules, 12 cases

- open nodules with draining tracts, 4

- ulceration, 2

- alopecia, scarring and induration with draining tracts, 1

- papules and pustules, 1

- regional lymphadenopathy, bruising and excoriation, several cats

- lesion location varied widely

- thorax, abdomen, axillae, 8

- digital, interdigital, carpal and tarsal regions, 5

- face/head, 3 (2 had lesions localized to tongue and ear)

- hip, 2

- elbow, 1

- stifle, 1

- medial thigh region, 1

- clinical signs of systemic illness concurrent with cutaneous lesions

- 20 dogs had data on presence of systemic signs at diagnosis described

- 15 of the 20 had signs of systemic illness

- 11 of the 15 dogs presented with multiple signs of illness

- lethargy, 7 dogs

- inappetence, 7

- weight loss, 4

- lameness, 4

- fever, 4

- cough, 4

- epistaxis, 2

- neurological signs (seizures and ataxia), 1

- 11 cats had data on presence of systemic signs at diagnosis described

- 6 had systemic signs

- fever, 4

- lethargy, 3

- weight loss, 2

- lameness, 2

- inappetence, 1

- cough, 1

- sneezing, 1

- decreased jumping ability, 1

- localized skin lesions with no systemic illness

- 4 dogs (on thigh in 2 cases; lateral thorax in 1 and scrotum in 1)

- supporting diagnosis of primary cutaneous infection

- 4 cats had localized lesions

- diagnostic testing

- cytology, most common mode of diagnosis in both species

- positive in 11 of 13 dogs and 10 of 10 cats

- serology for antibodies vs Coccidioides spp, available in 13 dogs and 8 cats

- all were positive for IgG except for 2 dogs

- median in dogs: 1:8

- median in cats: 1:64

- when serology was done 1-3 months after starting antifungal therapy

- median in dogs increased: 1:16

- median in cats decreased: 1:4

- treatment known in 28 cases (all cases but 1 cat received an antifungal drug)

- fluconazole, 26 cases

- including 2 transdermal preparations and at least 16 compounded ones

- ten-fold price increase occurred in the generic drug in ‘13

- median prescribed dosage for dogs: 9.83 mg/kg twice daily

- median prescribed dosage for cats: 9.32 mg/kg twice daily

- outcome (lesion status), available in only 11 cases

(10 cases were still receiving antifungal treatment)

- skin lesions improved clinically, 6 cases

- nodules smaller and draining tracts closed

- skin lesions completely resolved within 3-6 months of starting antifungal, 5

“Regardless of therapeutic approach, over time, nearly all cases required at least 6 months of treatment and most were maintained on longterm antifungal therapy to prevent relapse.”

Article Tools:

Medline

Email to me

Archives Highlights:

Delayed embryonic development or a long sperm survival in two mares-A registration conundrum.
Donor mares were inseminated with semen from one stallion during one oestrous cycle and semen from a different stallion on the subsequent oestrous cycle. Embryo(s) were collected 8?days after ovulation during the second oestrous cycle and transferred into synchronised recipient mares. Genetic testing was performed to determine parentage of the two foals. For both foals, DNA parentage testing excluded the second stallion as the genetic sire and confirmed that the first stallion, whose semen was inseminated on the previous oestrous cycle, was the actual genetic sire.

Approach to dealing with acute heart failure in cats and dogs
The general principles of heart failure management can be applied to a broad range of cardiac diseases; identifying a cardiac cause for the clinical signs is therefore more important than making a definitive diagnosis in the acute phase of heart failure. Nevertheless, there is no ‘one-size-fits-all’ recipe for treatment and the approach needs to be tailored to the individual.

Acute onset of circling and dull mentation in a 1-year-old male neutered domestic shorthair cat.
CNS cuterebriasis represents a neurologic disease more common in cats than dogs, resulting in presentation during summer months with acute onset and often asymmetric, focal or multifocal, intracranial signs preceded by upper respiratory disease.

Role of autopsy imaging in veterinary forensic medicine: experiences in 39 cases.
Among the 39 cases, 28, 6, 3, 1, and 1 involved cats, dogs, rabbits, a ferret, and a pigeon, respectively. The major autopsy imaging (Ai) findings included skull and rib fractures, subcutaneous emphysema, pneumothorax, pneumoperitoneum, diaphragmatic hernia, and abdominal rupture. The leading causes of death, determined comprehensively via Ai and pathological reports and drug test results, included traumatic impact, blood loss, poisoning, suffocation, tension pneumothorax, starvation, and drowning, all of which have been strongly suspected to indicate animal abuse by humans.

A survey of male and female dairy calf care practices and opportunities for change.
The survey had a 7.4% response rate (n = 289/3,924) and was primarily filled out by farm owners (76%). Although colostrum and milk feeding practices were similar between male and female calves, male calves received less milk while still on the dairy farm of origin, compared with females. Male calves were also more likely to be fed a higher proportion of raw, unsalable milk. Female producers and those that kept their male calves beyond 10 days of age had lower odds of using poorer feeding practices for male calves.