Weird case

RE: Weird case

Miriam Lodewyks — Fri, 31 Mar 2017 13:20:30 GMT

Being in the UK, I too would be thinking "Ectoparasites with secondary pyoderma".

Would start with Bravecto and Cephalosporin.

Also interested to know what you find and how things go, so please keep us posted?

RE: Weird case

Anthony Todd — Wed, 29 Mar 2017 19:20:50 GMT

[quote user="Tomás Basto"]One more thing. Whats your oppinion on steroids???[/quote]

No way, no way.

Didn't realise you were around leishmaniasis...... whole new ballgame"

RE: Weird case

Tomas B — Wed, 29 Mar 2017 17:22:48 GMT

Thank you for all the feedback. Here in north Portugal leishmânia is something very very common.

I will also use fluoralaner (im a bit scared with ivermectin in shepperds, even the German ones.).

The dog is untouchable so even if i want a skin scrape and citology (apposition or tape) i cant do it. So, sedation and lets get the complete package ;)

First, fluoralaner and clorhexidine baths, see the improvement, then cepha..

But, even being the mites secondary to the infection, do you guys think is just a deep pyoderma? The anorexia, nasal hiperqueratosis, nail bed infection and lameness???

One more thing. Whats your oppinion on steroids???

thank you all

RE: Weird case

Bob Russell — Wed, 29 Mar 2017 17:15:54 GMT

In the UK I would be looking at sarcoptic mange as my first 'educated' guess! Sound parasite control should always be the first target with these cases. All the antibiotics in the world will not cure a dog with fox mange!

I bore people with 'common things happen commonly' so parasite control with something to improve immediate comfort then see what happens. Happily use chlorhexidine washes short term to give further relief. Skin scrapings are cheap and easily done in house but I have been hunting for over 30 years looking for my first sarcoptes mite on a scraping. Loads of demodex though!!

Not being familiar with clinical cases of Leishmaniasis I will follow the thread with interest!

RE: Weird case

Anthony Todd — Wed, 29 Mar 2017 16:21:43 GMT

[quote user="Kate Richardson"]but if you just want to try treatment first, I would go with 3 weeks of antibiotics (my preference would be cephalexin 20-30mg/kg BID) and then ressess. You might want to use an antibacterial/antifungal shampoo 2-3 times a week as well, but you may need to clip the dog fully for this to give maximum effect. [/quote]

Sensible thing would be as above. there's an obvious pyoderma and there may be ectoparasites.

Treat for both which is pretty well all you can do anyway.

Biopsy is only going to confirm what we can see and/or you have described and is very unlikely to give you any other information. It will cost more than the treatment you will be using [and sooner the better]. Delays the start of treatment too.

Total clip is a good idea too.

RE: Weird case

Rob Loxley — Wed, 29 Mar 2017 13:40:36 GMT

[quote user="Tomás Basto"]My approach will be : sedation, skin biopsy, skin citology, and clip and clean the affected areas.[/quote]

Don't forget parasite control, particularly demodex and sarcoptes I'd want to positively exclude

RE: Weird case

Rob Loxley — Wed, 29 Mar 2017 13:30:46 GMT

[quote user="Tomás Basto"]ive read that enro is also good for deep pyoderma[/quote]

but should we be using fluoroquinolones first line, without any good reason to think simpler antibiotics wouldn't work?

RE: Weird case

Tomas B — Wed, 29 Mar 2017 12:52:36 GMT

I will do cepha, but ive read that enro is also good for deep pyoderma. Have you tried Pradofloxacine (Veraflox)?????

RE: Weird case

Tomas B — Wed, 29 Mar 2017 12:35:38 GMT

The owner says its pruritic.

My approach will be : sedation, skin biopsy, skin citology, and clip and clean the affected areas.

This German Shepperd's pyoderma are frequent, but with associated lameness and loss of weight?

I have a colleague who told me that she had a case like this, it came as negative to leishmania and she did a skin bipsy and had amastigotes of the leishmania parasite..

RE: Weird case

Kate Richardson — Wed, 29 Mar 2017 12:20:16 GMT

Hi Tomas

It may not be weird, it could be quite simply a generalised chronic pyoderma. Does his owner say he isn't pruritic or is that your assessment? Any external parasites such as fleas?

How you proceed depends on what his owners want's obviously you could do skin scrapes, surface cytology, culture of any pustules, possibly even skin biopsy, but if you just want to try treatment first, I would go with 3 weeks of antibiotics (my preference would be cephalexin 20-30mg/kg BID) and then ressess. You might want to use an antibacterial/antifungal shampoo 2-3 times a week as well, but you may need to clip the dog fully for this to give maximum effect.