Mystery Itchy Pet Cases
World Small Animal Veterinary Association World Congress Proceedings, 2007
S. Bettenay1; M. Burrows2; P. Ihrke3; R. Mueller4; L. Vogelnest5
1Tierdermatologie Oberhaching, Germany; 2Murdoch University, Western Australia; 3University of California, Davis, USA; 4Ludwig Maximilian University, Munich, Germany; 5University of Sydney, Australia

Case One

 Animal

 Age: 5yr

 Breed: Pomeranian

 Sex: MN

 Relevant clinical history: Healthy dog apart from skin.

 Relevant dermatologic history: Constant pruritus (for 5 years) and persistent extensive truncal hair loss (for 2 years). Hind-leg scratching towards lateral thorax; some tummy dragging; no biting, licking or nibbling.

 Previous tests: Total T4 (10 months ago) < 5nmol/L (on prednisolone up until few days previously). Repeat T4 6wks after thyroxine supplementation 23nmol/L. Skin biopsies: atrophic dermatopathy.

 Response or failure to previous treatments: No response to prednisolone (unknown dose), thyroxine 20mcg/kg bid x 8 months; or melatonin 3mg bid x 8wks.

 Dermatologic findings: Extensive alopecia and hyperpigmentation of trunk almost completely ventrally, residual haired areas on the mid-line dorsally and on the mid-ventral neck; normal thick coat legs, head. Few tiny papules on ventral abdomen; mild generalised scaling; numerous comedones focally (ventral neck, some areas on lateral trunk).

 Note: Also mild ataxia all 4 limbs, hypermetria of forelimbs evident on clinical exam.

List 3 differential diagnoses:

1.  ________

2.  ________

3.  ________

List further tests you would like the results for: _______________________________

Discussion: _______________________________

Diagnosis: _______________________________

Case Two

 Animal

 Age: 11yr

 Breed: Border Collie

 Sex: FN

 Relevant clinical history: Healthy apart from 2 years of severe skin disease.

 Relevant dermatologic history: Non-seasonal dermatitis and itch x 2years; no problems prior to 9 years of age. 3 other dogs with no skin problems. Began with itch on lower back, progressing to generalised. Itch currently severe and constant: general scratching (especially neck, back and ears), head shaking, biting of legs, feet, and belly. Otherwise well, good appetite, perhaps increased thirst. She is reluctant to walk when skin flaring.

 Previous tests: Total T4 (11nmol/L); skin scrapings (negative twice).

 Response or failure to previous treatments: Antibiotics (no apparent response), prednisolone (significant improvement when continuing on higher doses; last 5 months ago), herbal and natural products (oils, Missing Link®). No flea control currently (previously Advantage on all dogs--no apparent response). Friskies shampoo 2-3 x weekly helps a little.

 Dermatologic findings: Generalised papular dermatitis, with focal areas of brown adherent scaling to crusting, malodour, moderate erythema, and patchy hair loss affecting back, legs, and ventral neck most severely; moderate hyperkeratosis of the foot pads, moderate interdigital redness. Large amounts ceruminous discharge in both ear canals.

List 3 differential diagnoses:

1.  ________

2.  ________

3.  ________

List further tests you would like the results for: _______________________________

Discussion: _______________________________

Diagnosis: _______________________________

Case Three

 Animal

 Age: 12 months

 Breed: Doberman

 Sex: Male castrated

 Relevant clinical history: Acute onset of skin disease with increasing lethargy and anorexia.

 Relevant dermatologic history: Since two weeks erythema and crusting, beginning on the face and rapidly spreading.

 Previous tests: Not performed.

 Response or failure to previous treatments: 5 days of clavulanic acid/amoxicillin at 12.5 mg/kg twice daily and subsequently 5 days of enrofloxacin at 5 mg/kg once daily did not improve the dog at all.

 Dermatologic findings: Severe generalized erythema, erosions, ulceration and crusting most prominent on the pinnae, muzzle and lips. Ulcerations of the oral cavity and sloughing foot pads.

List 3 differential diagnoses:

1.  ________

2.  ________

3.  ________

List further tests you would like the results for: _______________________________

Discussion: _______________________________

Diagnosis: _______________________________

Case Four

 Animal

 Age: 8 years

 Breed: Collie

 Sex: Male castrated

 Relevant clinical history: Castrated 4 years ago, one testicle descended, one cryptorchid.

 Relevant dermatologic history: Since surgery four years ago alopecia and hyperpigmentation, in the last 4 months lethargy, pruritus and intermittent lameness.

 Previous tests: Laparotomy 4 months ago with no pathologic findings, 4 weeks ago serum biochemistry panel: ALP 645 U/L (<225), ALT 139 (<91), Harnstoff 14 mmol/L (3-8.3), Creatinine 118 mcmol/L (32-117).

 Response or failure to previous treatments: A glucocorticoid injection 2 months ago did not change anything.

 Dermatologic findings: Alopecia, hyperpigmentation and erythema focally on the neck, ventral abdomen and inguinal area.

List 3 differential diagnoses:

1.  ________

2.  ________

3.  ________

List further tests you would like the results for: _______________________________

Discussion: _______________________________

Diagnosis: _______________________________


Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Sonya Bettenay, BVSc (Hons), FACVSc, DECVD
Tierdermatologie Oberhaching
Germany

Ralf S. Mueller, DACVD, FACVSc, DECVD, FAAAAI
Ludwig Maximilian University Munich
Germany

Linda Vogelnest, BVSc (Hons), MACVSc, FACVSc (Dermatology)
University of Sydney


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