treatment options in sebaceous adenitis

RE: treatment options in sebaceous adenitis

emma o'connor — Fri, 08 Feb 2019 12:06:30 GMT

[quote user="Beats"]ciclosporin takes 6 to 8 weeks to reach maximum effect and is only treatment demonstrated to lead to regeneration of sebaceous glands. If the cost isn't a concern I'd use this first-line.[/quote]

Has been on this for nearly 2 years now!! recent biopsies showing no signs of regeneration of the glands. I have had a reply from Aiden Foster in Langford and he suggests if no regeneration by now unlikely to be any more response.

My plan is to go with the topicals as localised lesions at present and if this doesn't help will try oral vitamin A. The latter does worry me regarding the development of KCS as a potential side effect.

Will try and remember to update the forum in a few weeks time!

RE: treatment options in sebaceous adenitis

Liz Barton — Thu, 07 Feb 2019 14:26:13 GMT

[quote user="Beats"]The suggestions of olive oil, propylene glycol 50%, phytospingosine or ceramide shampoos and propylene glocol/coconut oil all sound quite a lot of work. Would Douxo seb mousse / spot-on, with just weekly shampooing be achievable?[/quote]

We had a case of an akita riddled with it. Weekly baths by our nurses worked brilliantly (the owner struggled). I can't remember the exact shampoo, but it was a moisturising one. I think it was on cyclosporin too, but I wasn't involved with the derm side. I just corrected it's GDV.

Interesting back story - it was brought in as a stray OOH by the police with a GDV. Entire body looked horrific and was covered in scale and alopecia. We decompressed, treated shock and were considering having to euthanise, but kept pushing the rather useless bobby to go back to where he found it and knock on some doors. His colleague who was a much brighter spark eventually went and did it. Turns out the dog was owned by a wealthy family, insured to the hilt. They'd gone out for the evening and the dog had obviously wandered off as it didn't feel right with it's stomach twisted! The policeman had driven past and picked it up, not bothering to stop and ask any questions locally. The owners had it under regular supervision by a local dermatologist, but treatment was obviously not optimal(!).

Turns out it did have an ID chip, which hadn't registered due to the thickness of scaling all along it's dorsum (it's entire body actually). We could read it after several shampoos!

So we did the surgery, and they became loyal clients. It's skin was better than ever after a new treatment plan was put in place. Despite being an akita and pretty grumpy, we all grew very fond of the dog and it's lovely owners. It became a bit of a celebrity!

RE: treatment options in sebaceous adenitis

Beats — Thu, 07 Feb 2019 12:03:08 GMT

would love to hear how you get on.

According to Skin diseases of the dog and cat, 3rd edition, 2019 by Heinrich, Eisenschenk, Harvey and Nuttall, pp. 135-137:

ciclosporin takes 6 to 8 weeks to reach maximum effect and is only treatment demonstrated to lead to regeneration of sebaceous glands. If the cost isn't a concern I'd use this first-line.

i get the impression that treatment needs tailored to signs dog showing given large range of clinical presentations. I suspect the douxo spot-on could be a useful part of treatment for isolated area on head perhaps.

RE: treatment options in sebaceous adenitis

emma o'connor — Thu, 07 Feb 2019 09:31:05 GMT

cost is not an issue as good level of insurance cover. I think we may have dropped the cyclosporin too quickly previously by the sound of it. Back on once daily for the last 6 weeks though. The general trunk is looking fabulous compared to the initial presentation, its just the head lesions that are bothering the client. I will look into the propolyne glycol 50% and the douxo spot on as this may be a good option.

RE: treatment options in sebaceous adenitis

Beats — Wed, 06 Feb 2019 23:08:58 GMT

[quote user="emma o'connor"]tetracycline/niacinamide[/quote]

I have never seen diagnosed sebaceous adenitis, but I can confirm that I have never had any success with tetracycline/nicotinamide (case numbers less than 5, and none in the last decade).

There was an elegant BSAVA podcast in last 3 years or so from Danny Scott (legend) detailing the odd historical rise of "tetracycline/nicotinamide-responsive-dermatoses", in spite of everything he did seem to use it and have seen success, sufficiently that I parked it as a maybe consider again (albeit with a lot of skepticism) treatment option? I'd consider this.

Did the ciclosporin go from 7 days a week to 3.5 days a week suddenly? I'd consider if decide to start again to wean more gradually by dropping a day a week every month once in remission (no guarantee that will be any more successful though!

[quote user="emma o'connor"]I don't believe it is bothering the dog much but the owner is worried.[/quote]

If it's non-pruritic, then perhaps not so improtant to treat?

Might be worth considering easier applied topicals if previous regimen too hard for client or alternative topicals if not convicned previous ones worked.

Aim is apparently removing scale and then infusing moisture into skin and coat. The suggestions of olive oil, propylene glycol 50%, phytospingosine or ceramide shampoos and propylene glocol/coconut oil all sound quite a lot of work. Would Douxo seb mousse / spot-on, with just weekly shampooing be achievable? Is the cost a concern, if so then I guess can't get much cheaper than vegetable cooking oil (my wife used to use it on the babies, so I'm sure its fine... probably gets bit messy mixed with hairy areas though).