Life long disease

ongoing management

tailored treatment

6mo to 3 years

insidious onset ( gradual) 

waxing and waning course

avoid breeding

suggests parasitic or infectious

- fleas, sarcoptes, cheyletiella

- dermatophytosis

suggest AD

- spring-summer

- winter exacerbationss

- 70-80% start or become non seasonal

also

fleas

trombicula

environmental changes?

seasonal foods?

pruritus 

erythema

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flexor surfaces- carpus, tarsus, elbow, hock

also: conjuctivities, rhinitis, Otitis, GIT signs

match exposure

macular papular erythema

macular papular erythema

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treat other contagious parasites with an effective product for 4-6 weeks to kill newly hatched larvae, clean bedding, equipment etc. may need to treat environment. 

excoriation

alopecia

hyperpigmentation

lichenification

common

 surface superficial are very pruritic but are always secondary to an underlying cause. 

Malassezia dermatitis/otitis

normal commensal where?

treatment?

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normal commensal of ears, feet and muco cutaneous junctions, has an underlying disease. 

Treatment with chlorhexidine/miconazole shampoo, and or ropical miconazole is usually effective. may need systemic treatment with itraconazole. 

- other hypersensitivity

- ectoparasites or endo: sarcoptes, demodex, trombicula, otodectes

- skin and ear infections: staph pyoderma, malassezia

- other: pemphigous foliaceous, keratinastion disorders

coat brushings

skin scrapes

hair plucks

cytology: tape strips, impression smears

histopathology

trial therapy

IgG Elisa- but cross reacts with house dust mites

pinneal margin involvement, lat surfaces

can be pruritic with minimal alopecia

similar body sites to AD

older animals

insidious course but poor response to chemo. 

diffuse or localised erythema and scaling, plaques, ulcers. 

Neuropathic pruritus 

psychological pruritus

anxiety, stress?

Chiari malformation and syringomyelia in CKCS

acral mutilation- spaniels

can see air scratching, severe mutilation, follow nerves

Pustular and crusting immune mediated conditions

- often itchy

c.s very similar to AD

macular papular dermatitis

atypical lesion distribution- perianal, hind limbs, dorso-lumbar

- poor response to glucocorticoids and ciclosporin

wider age range

six weeks minimum

- acute disease responds quickly

- chronic takes longer

proteins hydrolysed into peptide fragments

pruritus meant to be reduced

 do not have intact AB binding site- so dont get allergy. But doesnt work all the time. 

Trees: feb to april

Grasses: June to August

Flowering plants: July to October

Parasites: fleas, otodectes, trombicula, sarcoptes

Hypersensitivity: flea allergic dermatitis, Atopic, adverse food reaction

Infectious: bacteria or malassezia, cowpox ( local)

Misc: acral lick dermatitis and other behavioural/neurological causes

most common infest tailhead, rump, dorsum, ventral abdomen and flanks. 

- anaemia possible in young animals

- treat animal with on -animal adulticide and the environment with a combined larvicide/insect growth regulator. vacuuming will stimulate the pupae to hatch

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Trombicula: adults living in thick vegetation- infest in late summer and autumn. can use long acting products such as fipronil applied to feet and ventral body every 7-14 days can be effective. 

Demodicosis: usually assoc. with erythema, papsules, alopecia. short bodied D. gatoi is contagious in cats

Free-living Pelodera nematodes or Hookworm larvae can cause severe dermatitis of the feet and ventral body where hygeine is poor. 

1. Atopic dermatitis and adverse food reactions

2. Allergic and irritant contact dermatitis 

involve abnormalities in skin barrier function, altered skin inflammation and allergies. 

- Most cases of AD are assoc with environment allergens such as house dust mites, epidermals, insects, pollens. 

- WHWT are predisposed

- stress and anxiety often act as flare factors 

CS: 

pruritis- erythema, saliva stains

chronic inflamm with hair loss

1. eliminate other causes of pruritus

2. control infection

3. 6-8 week food trial( home cooked or commerical, single protein diet, novel and water. Hydrolysed diets may help. expensive and animals may still react to product. 

4. Clear written instructions, follow up and good communication are important in maintaining compliance. 

5. relapse after challenge with the usual diet is necessary to confirm. once diagnosed, the owners add one ingredient at a time to ID offending items to then avoid. 

ALLERGY TESTING:

- intradermal allergen tests

- only to ID allergens for avoidance

- not to confirm atopic dermatitis

chronic self trauma to the ranial and lateral aspects of the distal limbs. 

- most involve longstanding deep bacterial folliculitis, lichenification and scarring, 

- might need behavioural therapy and mood regulators and might need laser therapy for lesions.