Is it atopic dermatits?

Re: Is it atopic dermatits?

Francisco Gomez — Mon, 06 Oct 2014 12:27:41 GMT

[quote user="Ruta"]

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With those eyes, the first thing that comes to my mind is Sarcoptes. Have u asked the owners if they have any lesions ??

Sure pure hypoT dogs aren't meant to each. But the very nature of the disease is thought to predispose them to pyodermas.

... and pyodermas are itchy

Re: Is it atopic dermatits?

listhestar — Sat, 04 Oct 2014 21:16:40 GMT

Well I would start with total t4 first - if normal then rules out hypothyroidism. Otherwise I think the panel covers tt4, tsh and thyroglobulin antibodies.

I tend to use z/d or another hydrolysed diet - response within 6 weeks. Explain clearly as I once had a client shred chicken in a blender to go on top of the z/d (obvious I wasn't clear enough, the owner rationalised that it was 'only tiny pieces'). Be aware of dental chews, flavoured toothpastes etc!

Good luck

Lisa

Re: Is it atopic dermatits?

Ruta — Thu, 02 Oct 2014 18:48:26 GMT

Here is my patient.

Re: Is it atopic dermatits?

Anthony Todd — Thu, 02 Oct 2014 17:56:21 GMT

Just a few thoughts:

Would it be fair to say that pure hypothyroids never itch?

Would it be fair to say that demodecosis is easy to confirm on deep scrape, fresh lesion? [should be easy round the eye?]

Does atopy ever involve the pinna as opposed to the external canal? [Martin?]

"all coat full of dandruff, the hairs is falling down"

Are the owners bathing the dog in something irritant?

Scabby ear edges are almost typical of scabies though.....

Re: Is it atopic dermatits?

Ruta — Thu, 02 Oct 2014 15:41:46 GMT

Yes, I mean scabs, Martin. :)

Re: Is it atopic dermatits?

Martin Atkinson — Thu, 02 Oct 2014 15:32:48 GMT

I presume you mean scabs not 'scabies' on the ears otherwise you may already have your diagnosis!

Atopy is usually seasonal so you really need to get them to be more specific with their history. Also it will usually be progressive involving the pinna, feet/carpus/tarsus, inguinal, axilla and belly (although not necessarily in that order), it is not usually generalised unless you have a secondary bacterial or malassezia dermatitis on top. It is a diagnosis of elimination and even if it is nailed on atopy often the other factors mentioned are major contributors to the overall picture. If it is generalised demodex you should pick it up easily on a correctly performed scrape.

Given the odd behaviour and eyes you need to do a a full blood and dermatology work-up as suggested but if there is not a diagnosis from that, and even before, I would hit it with Malaseb shampoo, Omega 6 supplement and a hypoallergenic diet (I would start with an exclusion diet before a hydrolysed diet) and see what happens. A food allergy should start to improve within 3 weeks, rarely more than 6, then you could try a dietary challenge. You may then not have to bring in the big guns of immuno-suppressant drugs but you MUST make a diagnosis or at least eliminate the other suggested possibilities before you do.

Re: Is it atopic dermatits?

Ruta — Thu, 02 Oct 2014 15:00:54 GMT

Thanks, I didn't think about tape strip, it could be a good idea. I have a few questions, just make it clear - what is poss thyroid panel? T3, T4 and free T4? And how should I do diet trial? With Hill's Z/D?

Re: Is it atopic dermatits?

Ruta — Thu, 02 Oct 2014 15:00:53 GMT

Re: Is it atopic dermatits?

listhestar — Thu, 02 Oct 2014 13:53:25 GMT

I would do a full skin work up- scrape, tape strip, hair pluck for fungal culture. Demodex is tricky at times to diagnose and sometimes will only show up in a skin biopsy, either way demodex in an older animal would still warrant further investigation. I would also possibly suggest a biochemistry and haematological panel and poss thyroid panel. The strange behaviour could be a porto systemic shunt and the skin could be related to it. Have you done a diet trial?

Just my thoughts, I am in no means a specialists so others may have better ideas.

Lisa