Dorsal alopecia in a male crossbred dog

Dorsal alopecia ina male crossbred dog

Author: Ewan Ferguson

Editor: David Lloyd

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Click to reveal the text on this screen

Click the forward arrow to jump to the next screen

History - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

History

•Dorsal alopecia and mild pruritus of 9 monthsduration in a male crossbred dog

•Weight 25 kg

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

History - 2

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

History

•Mild papular rash on dorsum and ventrum.

•Comedones on dorsum and ventrum.

•Ventral coat thin but skin “normal”

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

History - 3

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

History

•Coat has become longer and finer in texture in recentmonths

•Polyuria and polydipsia (3 litres per day) reported

•Good appetite. Poor exercise tolerance

•No previous history of dermatological disease

•2 cats in the house, both healthy

•Diagnosed by the referring veterinarian as flea allergydermatitis

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

History - 4

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

History

•Ectoparasite control

•Dog and both cats treated with fipronil (Frontline Spot-On, Merial) monthly

•Home environment treated annually with pyroxyfenand permethrin spray (Indorex, Virbac)

•No improvement

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

History - 5

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

History

•Pruritus now reported to be controlled with 10 mgprednisolone orally once daily, over the last 4 months

•No hair re-growth seen

•All therapy stopped 2 weeks before referralappointment

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Clinical signs - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\vetExamDogNarrow.jpg$

Signs

$C:\Sonya's RVC Work\Derm cases\images\2_dorsal alopecia_crossbred_sept93\clinical1.jpg$

The ventral abdominal skin

A few scatteredpapules, epidermalcollarettes & crusts ondorsum & ventrum

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Clinical signs - 2

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\vetExamDogNarrow.jpg$

Signs

$C:\Sonya's RVC Work\Derm cases\images\2_dorsal alopecia_crossbred_sept93\clinical2.jpg$

Alopecia & hyperpigmentation in dorsal lumbar region

•No visual evidence ofectoparasitism

•Pendulous abdomen& ventral liver lobespalpably enlarged

•Testes normal onpalpation

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

How would youapproach this case?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Signs

•What are the next steps you would take?

•Make a list of your principle differential diagnoses

•List any samples you would collect

•List any tests you would perform to assist in making adefinitive diagnosis

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\vetExamDogNarrow.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Differentialdiagnoses

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Differentials

•Principle differential diagnoses

•Allergy (fleas, atopy, ?food), Hormonal imbalanceincluding iatrogenic Cushings syndrome, ectoparasiticinfestation, dermatophytosis

•Secondary pyoderma, Malassezia dermatitis

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\vetExamDogNarrow.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Tests - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Tests

•Skin scrapings, tape strips, hair plucks and coatbrushings - no evidence of ectoparasites or fungi

•Fasted blood sample

•Biochemistry: Alkaline phosphatase - 1850 iu/l;Alanine aminotransferase - 170 iu/l; Glucose - 8.4mmol/l; Cholesterol - 9.1 mmol/l

•Haematology: Mild mature neutrophilia &eosinopenia

•Urianalysis: Specific gravity - 1.005; No glycosuria

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

What now?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

•What are the next steps you would take?

•What are now your principle differentialdiagnoses?

•Are there any other samples you would collect?

•List any tests you would perform to assist inmaking a definitive diagnosis

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Tests - 2

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

•Principal differential diagnosis

•Hormonal imbalance particularly natural andiatrogenic Cushings syndrome

•Secondary folliculitis

•Tests

•ACTH response test to provide evidence ofpossible Cushings syndrome and to identifyiatrogenic disease

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Results - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

What is the significance of this test?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Results - 2

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Results - 3

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

What do these tests tell us?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

What is yourdiagnosis?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

•Do the investigations permit a definitive diagnosis?

•List any additional investigations which you think mayneed to be done

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Tests - 3

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Tests

•Radiography

•Mass suspected in the left adrenal region

•Ultrasonography

•Hypoechoic foci in the liver suggestive ofmetastases

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

How would you dealwith this case?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

Therapy

•What is your prognosis?

•How will you advise the owner?

•What treatment would you consider?

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Diagnosis

Therapy

•Hyperadrenocorticism resulting from adrenalneoplasia

•Likely metastasis

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Prognosis

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

Notes

•Prognosis is guarded

•Surgery is not indicated in view of likely metastasis

•Medical management with trilstane (Vetoryl,Arnolds) recommended

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Conclusion

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

Notes

The owner requestedeuthanasia. At postmortem examination anadrenal neoplasm andmultifocal metastaseswere demonstrated.

The adrenal tumour canbe seen in the centre ofthe photograph, thekidney is on the left side

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Review

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

Notes

•If you would like to review this case, please use thenavigation buttons below

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$