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Blackwell s Five-Minute Veterinary Consult Clinical Companion Small Animal Dermatology Second Edition
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Blackwell s Five-Minute Veterinary Consult Clinical Companion Small Animal Dermatology Second Edition Karen Helton Rhodes, DVM Diplomate, American College of Veterinary Dermatology Riverdale Veterinary Dermatology Riverdale, New Jersey and Alexander H. Werner, VMD Diplomate, American College of Veterinary Dermatology Animal Dermatology Center Studio City, California A John Wiley & Sons, Inc., Publication
This edition first published 2011 2011 by Blackwell Publishing Ltd. Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell s publishing program has been merged with Wiley s global Scientific, Technical and Medical business to form Wiley-Blackwell. Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 2121 State Avenue, Ames, Iowa 50014-8300, USA The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 9600 Garsington Road, Oxford, OX4 2DQ, UK For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell. Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Blackwell Publishing, provided that the base fee is paid directly to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payments has been arranged. The fee codes for users of the Transactional Reporting Service are ISBN-13: 978-0-8138-1596-1/2011. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Disclaimer The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Rhodes, Karen Helton. Blackwell s five-minute veterinary consult clinical companion. Small animal dermatology / Karen Helton Rhodes and Alexander H. Werner. 2nd ed. p. ; cm. Other title: Five-minute veterinary consult clinical companion Other title: Small animal dermatology Rev. ed. of: The five minute veterinary consult clinical companion : small animal dermatology / Karen Helton Rhodes. c2002. Includes bibliographical references and index. ISBN 978-0-8138-1596-1 (pbk. : alk. paper) 1. Dogs Diseases Handbooks, manuals, etc. 2. Cats Diseases Handbooks, manuals, etc. 3. Exotic animals Diseases Handbooks, manuals, etc. 4. Veterinary dermatology Handbooks, manuals, etc. I. Werner, Alexander H. II. Rhodes, Karen Helton. Five minute veterinary consult clinical companion. III. Title. IV. Title: Five-minute veterinary consult clinical companion. V. Title: Small animal dermatology. [DNLM: 1. Dog Diseases Handbooks. 2. Skin Diseases veterinary Handbooks. 3. Cat Diseases Handbooks. SF 992.S55] SF992.S55R46 2011 636.089 65 dc22 2010026561 A catalogue record for this book is available from the British Library. Set in 10.5/13 pt Berkeley by Toppan Best-set Premedia Limited 1 2011
This text is dedicated to: Steven, as an expression of gratitude for his continued support in every endeavor. Cameron, may she continue to explore her talent and mastery of the written expression. My parents, Anne and Bill, in appreciation for the gift of an education. And, as always to Authur I. Hurvitz who, even in his absence, continues to be my mentor, friend, and muse. Karen Helton Rhodes To Rita Werner, our family s first author, who always believed in me, and to my mentors who believe in me still. To my siblings who always had faith in me, and to Mike who has faith in me still. And to my children, Jacob and Gregory, who will have faith in me again when they are no longer teenagers. Alexander H. Werner
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Contents Preface...................................................x Acknowledgments......................................... xi section 1 Basics chapter 1 Lesion Description/Terminology................................ 4 chapter 2 Practical Cytology......................................... 17 chapter 3 Diagnostic Culture and Identification (Bacterial and Fungal)......... 27 chapter 4 Obtaining a Diagnostic Biopsy............................... 36 chapter 5 Lesional and Regional Differentials............................ 44 chapter 6 Zoonosis................................................ 88 section 2 Allergic and Hypersensitivity Dermatitis chapter 7 Atopic Dermatitis......................................... 94 chapter 8 Contact Dermatitis....................................... 104 chapter 9 Eosinophilic Granuloma Complex............................ 110 chapter 10 Food Adverse Reactions................................... 125 section 3 Endocrine Dermatoses chapter 11 Canine Hyperadrenocorticism............................... 132 chapter 12 Feline Hyperadrenocorticism/Skin Fragility Syndrome............. 142 chapter 13 Hypothyroidism......................................... 147 chapter 14 Noninflammatory Alopecia................................. 159 section 4 Immunologic and Autoimmune Disorders chapter 15 Canine Familial Dermatomyositis............................ 172 chapter 16 Discoid (Cutaneous) and Systemic Lupus Erythematosus.......... 179 chapter 17 Drug Eruption, Erythema Multiforme, and Toxic Epidermal Necrolysis...................................... 188 chapter 18 Granulomatous Sebaceous Adenitis.......................... 193 chapter 19 Panniculitis............................................. 197 vii
viii CONTENTS chapter 20 Pemphigus Complex and Bullous Pemphigoid.................. 203 chapter 21 Sterile Nodular Granulomatous Dermatoses.................... 232 chapter 22 Uveodermatologic Syndrome............................... 242 chapter 23 Vasculitis............................................... 247 section 5 Infectious Dermatoses chapter 24 Bacterial Folliculitis and Emerging Resistant Pyoderma............ 256 chapter 25 Dermatophytosis......................................... 275 chapter 26 Intermediate and Deep Mycosis............................. 283 chapter 27 Leishmaniasis: Protozoan Dermatitis.......................... 294 chapter 28 Malassezia Dermatitis..................................... 298 chapter 29 Mycobacterial Infections................................... 305 chapter 30 Nocardiosis............................................. 313 chapter 31 Viral Dermatoses........................................ 317 section 6 Neoplasias, Cutaneous/Paraneoplastic Dermatoses chapter 32 Actinic Dermatoses....................................... 324 chapter 33 Canine Pre- and Paraneoplastic Syndromes.................... 338 chapter 34 Common Skin and Hair Follicle Tumors....................... 351 chapter 35 Epitheliotropic Lymphoma................................. 363 chapter 36 Feline Paraneoplastic Syndromes............................ 375 chapter 37 Histiocytosis............................................ 381 chapter 38 Mast Cell Tumors........................................ 388 section 7 Parasitic Disorders chapter 39 Biting and Stinging Insects................................. 398 chapter 40 Demodicosis (Canine and Feline)............................ 413 chapter 41 Sarcoptid Mites (Sarcoptes, Cheyletiella, Notoedres, and Otodectes).......................................... 426 section 8 Selected Topics chapter 42 Acne, Canine and Feline................................... 434 chapter 43 Anal Sac Disorders/Perineal Fistulas.......................... 437 chapter 44 Behavioral or Self-Injurious Dermatoses....................... 443 chapter 45 Disorders of Keratinization................................. 459 chapter 46 Otitis Externa, Media, and Interna........................... 486 chapter 47 Pododermatitis and Claw Disorders.......................... 515 chapter 48 Superficial Necrolytic Dermatitis (Hepatocutaneous Syndrome)...... 527
CONTENTS ix section 9 Exotic Pet Dermatology chapter 49 Ferret................................................. 536 chapter 50 Guinea Pig............................................. 545 chapter 51 Hamster............................................... 551 chapter 52 Hedgehog............................................. 553 chapter 53 Mouse/Rat............................................. 556 chapter 54 Rabbit................................................. 558 appendixes appendix A Clinical Management of Pruritic Inflammatory Skin Disease........ 568 appendix B Canine Genodermatoses/Breed-Predisposition Dermatoses......... 575 appendix C Drug Formulary......................................... 586 appendix D Client Education Handouts (also available on companion CD)...... 684 Allergic Dermatitis, Canine & Feline.......................... 685 Allergy Vaccine: Hyposensitization (General Information).......... 687 Antihistamine/Antipruritic Therapy........................... 690 Bacterial Infections....................................... 692 Bloodwork Monitoring.................................... 695 Chemotherapy/Immunosuppressive Therapy.................... 696 Contact Dermatitis....................................... 697 Demodex Mites......................................... 698 Dermatophytosis (Ringworm)............................... 701 Elimination Diet Trial...................................... 703 Granulomatous Sebaceous Adenitis.......................... 705 House Dust Mite: Controlling Exposure....................... 706 Malassezia Dermatitis (Yeast)............................... 708 Mold Allergies: Controlling Exposure......................... 709 Otitis (Ear Disease)....................................... 710 Pemphigus Foliaceus...................................... 712 Scabies................................................ 714 Shampoo Therapy: Instructions.............................. 716 Surgical/Procedure Discharge Instructions...................... 717 Symptoms of Cushing s Syndrome........................... 718 Treatment: Pituitary Cushing s Syndrome...................... 720 Video-Otoscopy for the Surgical Management of Otitis Media and Chronic Otitis Externa................................. 725 Suggested Reading................................................................ 727 Index.......................................................................... 728
Preface I hope you find this new book an informative and vital resource for your clinical practice. The text is not meant to replace the more comprehensive dermatology textbooks available but rather to augment your current library with a quick clinical resource of the more common dermatologic disorders. The second edition is a completely new compilation of information assembled in a slightly different format. We have retained the easy to scan bullet layout although redundancy has been eliminated. Numerous color photographs are still found throughout the text to illustrate the clinical descriptions. The first edition consisted primarily of excerpts drawn from Blackwell s Five -Minute Veterinary Consult: Canine and Feline. Some of those chapters have been retained and updated yet most have been completely replaced, thus making the second edition able to stand as a new text. I think the reader will find the information current and clinically relevant. Client education handouts used daily in my practice, Riverdale Veterinary Dermatology, have been included in the text and on the companion CD in the back of the book. These handouts can be used as is or as a template of information for your own compilation. I hope you find them helpful. I have found that my clients appreciate having information available to take home and read. I wish to thank Wiley -Blackwell, and specifically Erica Judisch, for their enthusiastic support in my decision for a total re -write rather than insisting on an update of the existing text. I welcome and introduce Alexander Werner as a co -author in the compilation of this manuscript. His clinical experience is centered along the western coast of the United States while mine is along the northern and southeastern regions, which allows for a more diverse perspective. Karen Rosenthal continues to author the exotics section in this edition. Her expertise and friendship is, as always, invaluable. I thank both of them for assisting in this project. Karen Helton Rhodes x
Acknowledgments Portions of chapters in the first edition of this book were provided by material contributed to the Five - Minute Veterinary Consult: Canine and Feline by the following authors: Albert H. Ahn Stephen C. Barr Karin M. Beale Ellen N. Behrend Karen L. Campbell Edward G. Clark Ellen C. Codner Paul A. Cuddon Elizabeth A. Curry -Galvin David Duclos Robyn E. Elmslie Carol S. Foil Sharon F. Grace Elizabeth Goldman John G. Gordon Joanne C. Graham W. Dunbar Gram Deborah Greco Jean Swingle Greek Nita Kay Gulbas Steven R. Hansen Keith A. Hnilica Johnny D. Hoskins Richard J. Joseph Robert J. Kemppainen Peter P. Kintzer Karen Ann Kuhl Suzette M. Leclerc Alfred M. Legendre Steven A. Levy Dawn Elaine Logas John MacDonald Kenneth V. Mason xi
xii ACKNOWLEDGMENTS Linda Medleau Linda Messinger Daniel O. Morris K. Marcia Murphy Gary D. Norsworthy James O. Noxon Allan J. Paul Kenneth M. Rassnick Lloyd M. Reedy Keith P. Richter Wayne Stewart Rosenkrantz Karen L. Rosenthal Fred W. Scott Kevin Shanley Francis W. K. Smith Jr. Paul W. Snyder Margaret S. Swartout Sheila M. Torres John W. Tyler Alexander H. Werner J. Paul Woods Karen M. Young Anthony Yu
Blackwell s Five-Minute Veterinary Consult Clinical Companion Small Animal Dermatology Second Edition