Skin Diseases of the Dog and Cat 3rd Edition
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CONTENTS
v
Preface xi
Acknowledgements xiii
Treatment recommendations and professional responsibilities xv
CHAPTER 1 BASICS 1
Terminology used in the description of dermatological lesions 1
Dermatological sampling techniques 8
Dermatological history and physical exam 12
CHAPTER 2 PRURITIC DERMATOSES 13
Acral lick dermatitis (acral lick granulomas) 13
Behavioural dermatoses 15
Atopic dermatitis in dogs 18
Malassezia dermatitis (cutaneous yeast infection) 30
Urticaria (hives) 33
Anal sac disease (anal sac impaction, sacculitis or abscessation) 34
Contact dermatitis (irritant contact dermatitis, allergic contact dermatitis) 36
Epitheliotrophic lymphoma (mycosis fungoides, cutaneous
T-cell lymphoma, Sézary’s syndrome) 38
Feline hypersensitivity dermatitis (feline allergic dermatitis, feline atopic
dermatitis) 41
Feline Demodex gatoi infestation 48
Notoedric mange 49
Cheyletiella mite infestation 50
Fleas and flea allergic dermatitis (flea bite hypersensitivity) 52
Sarcoptic mange 56
Harvest mite infestation (trombiculiasis, chiggers) 59
Pediculosis (lice) 61
Neurogenic dermatoses (including feline orofacial pain syndrome,
trigeminal neuropathy, feline idiopathic ulcerative dermatosis,
syringomyelia, sensory neuropathy and tail dock neuroma) 63
vi C on t e n t s
CHAPTER 3 CRUSTING DERMATOSES 65
General approach to papules, pustules and crusts 65
Surface and superficial pyoderma 65
Canine acne (chin and muzzle folliculitis and furunculosis) 75
Feline acne 77
Fly and mosquito bite dermatitis 79
Pemphigus foliaceus 81
Trichophyton mentagrophytes dermatophytosis 85
Idiopathic ear margin vasculitis
(proliferative thrombovascular necrosis of the pinna) 85
Solar dermatitis (actinic keratosis) 87
Feline squamous cell carcinoma in situ 89
Facial dermatitis of Persian and Himalayan cats 90
Feline thymoma-associated dermatosis 91
CHAPTER 4 ALOPECIC DERMATOSES 93
Non-pruritic alopecia 93
Alopecia X 95
Cyclical flank alopecia (seasonal flank alopecia, flank alopecia, recurrent
flank alopecia) 97
Telogen and anagen defluxion 99
Hypothyroidism 100
Hyperadrenocorticism in dogs and cats (Cushing’s disease) 104
Feline paraneoplastic alopecia 110
Acquired pattern alopecia (pattern baldness, follicular miniaturisation) 111
Black hair follicular dysplasia 112
Colour-dilution alopecia (colour-mutant alopecia, blue Doberman or blue
dog syndrome) 113
Dermatophytosis 115
Feline demodicosis 121
Canine demodicosis 122
Alopecia areata 126
Tail gland hyperplasia (stud tail) 127
Injection site alopecia 128
Postclipping alopecia 130
Topical corticosteroid reaction 131
CHAPTER 5 DERMATOSES OF ABNORMAL KERATINISATION 133
Topical therapies for seborrhoea 133
General approach to keratinisation disorders 133
Ichthyosis 134
Sebaceous adenitis 135
C on t e n t s vii
Zinc-responsive dermatosis 137
Leishmaniasis 139
Exfoliative cutaneous lupus erythematosus of the German Short-haired
Pointer 144
Vitamin A-responsive dermatosis 145
Idiopathic keratinisation defects (primary seborrhoea) 146
Canine ear margin seborrhoea 150
Nasal and digital hyperkeratosis 151
Callus formation 152
Schnauzer comedo syndrome 154
Cutaneous horn 155
Spiculosis 156
CHAPTER 6 ULCERATIVE DERMATOSES 157
General approach to ulcerative dermatoses 157
Feline idiopathic ulcerative dermatitis 157
Feline cutaneous herpesvirus and calicivirus infections 159
Feline cowpox infection 160
Pemphigus vulgaris 162
Bullous pemphigoid 163
Mucous membrane pemphigoid 164
Mucocutaneous pyoderma 165
Epidermolysis bullosa acquisita 167
Vasculopathy of Greyhounds (cutaneous and renal glomerular
vasculopathy, Alabama rot, Greenetrack’s disease) 168
Vesicular cutaneous lupus erythematosus of the Shetland Sheepdog
and Collie 170
Systemic lupus erythematosus 171
Superficial necrolytic dermatitis (diabetic dermatopathy, hepatocutaneous
syndrome, necrolytic migratory erythema and metabolic
epidermal necrosis) 174
German Shepherd dog pyoderma 177
Decubital ulcers (pressure sores) 179
Mucocutaneous lupus erythematosus 180
Vasculitis and vasculopathy 182
Erythema multiforme complex 185
CHAPTER 7 DRAINING TRACTS 189
General approach to draining tracts 189
Pansteatitis (yellow fat disease) 189
Feline mycobacterial infections 190
Postgrooming furunculosis 193
Deep pyoderma (furunculosis) 195
viii C on t e n t s
Canine mycobacteriosis (canine leproid granuloma and opportunistic
[atypical] mycobacterial infections) 198
Nocardiosis/Actinomycosis 200
Sporotrichosis 202
Blastomycosis 204
Saprophytic deep fungal infections (eumycotic mycetoma, chromomycosis
[phaeohyphomycosis and chromoblastomycosis], hyalohyphomycosis,
zygomycosis) 206
Sterile nodular panniculitis 207
Dermoid sinus 209
Perianal fistulae (anal furunculosis) 211
Metatarsal fistulation 212
CHAPTER 8 DISEASES OF THE PAWS AND NAILS 215
General approach to paws and nails 215
Interdigital cysts and furunculosis 216
Neoplasia of the nailbeds and feet 219
Calcinosis circumscripta 220
Vasculitis of the footpads 221
Symmetrical lupoid onychitis (onychodystrophy) 222
Feline plasma cell pododermatitis 225
Footpad corns (keratomas) 226
CHAPTER 9 NASAL DERMATOSES 227
General approach to nasal dermatoses 227
Nasal arteritis 228
Discoid lupus erythematosus 229
CHAPTER 10 JUVENILE DERMATOSES 231
General approach to juvenile dermatoses 231
Juvenile cellulitis (puppy strangles) 232
Shar Pei mucinosis 233
Epidermolysis bullosa – hereditary 234
Ehlers–Danlos syndrome 235
Congenital alopecias 236
Ectodermal dysplasia 236
Black hair follicular dysplasia 236
Colour dilution alopecia 237
Pattern alopecia of Spaniels 237
Pattern baldness (follicular miniaturisation) 237
Canine familial dermatomyositis (ischaemic dermatopathy/vasculitis) 238
Canine congenital endocrinopathies (pituitary dwarfism) 240
Acral mutilation syndrome 242
C on t e n t s ix
CHAPTER 11 NODULAR DERMATOSES 243
General approach to nodular dermatoses 243
Sterile granuloma/pyogranuloma 243
Dermatophyte kerions 245
Histiocytic neoplasia 246
Canine eosinophilic granuloma 249
Sebaceous gland tumours – benign 250
Follicular and apocrine cysts 251
Viral papillomatosis – canine 252
Viral papillomatosis – feline 255
Feline eosinophilic granuloma complex 256
Cryptococcosis 259
CHAPTER 12 DISEASES OF ABNORMAL PIGMENTATION 261
General approach to abnormal pigmentation 261
Vitiligo 262
Uveodermatological syndrome (Vogt–Koyanagi–Harada-like
[VKH-like] syndrome) 264
Lentigenes 266
CHAPTER 13 OTITIS 267
General approach to otitis 267
Otitis externa 267
Otic foreign body 276
Feline aural polyps 277
Feline cystomatosis 279
Ear mites (Otodectes cynotis infestation) 280
Pseudomonas otitis 281
Primary secretory otitis media 283
Otitis media 284
Otitis interna 287
Appendix: Immunosuppressive drug therapy table 289
Index 291
PREFACE
xi
A Colour Handbook of Skin Diseases of the Dog and new conditions, development of new approaches to
Cat was first published in 1998. It was one of the management and effective new treatment options. In
first books to bring key information about skin this third edition, we have completely revised and
diseases to first-opinion clinicians in an easy to updated the chapters while retaining the problem-
use problem-orientated format. By 2009 the huge based approach. We hope that this new edition will
growth in knowledge about skin conditions neces- continue to provide key information about the diag-
sitated an updated and almost completely rewritten nosis and management of skin conditions in a format
second edition. Subsequent exponential growth in that is easily accessible to busy clinicians.
veterinary dermatology has led to the discovery of
ACKNOWLEDGEMENTS
xiii
The authors thank all the referring veterinarians and A special thanks to Patrick McKeever DVM,
owners that have entrusted the care of their animals DACVD for invaluable mentorship.
to us so that we could accumulate the knowledge and
experience necessary to write this book.
TREATMENT RECOMMENDATIONS AND
PROFESSIONAL RESPONSIBILITIES xv
Wherever possible, the treatment recommenda- treatment protocols for a particular case, taking into
tions in this book are evidence based, following account the diagnosis, potential for adverse effects,
published data and therapeutic guidelines. Where underlying conditions and any concurrent therapy.
such data are lacking, we have based the recommen- Veterinarians must also be aware of relevant medi-
dations on consensus opinion and personal experi- cines legislation and whether it is legal to administer
ence. The treatment options may include off-label or certain treatments in their country or province of
off-cascade suggestions. The prescribing veterinar- work.
ian has complete responsibility for any decision on
CHAPTER 1
BASICS
1
TERMINOLOGY USED IN THE DESCRIPTION OF DERMATOLOGICAL LESIONS1
Primary lesions
Primary lesions are directly associated with the disease process. They are not necessarily pathognomonic,
but give a valuable clue as to the type of disease process occurring.
1.1A Papules are solid, elevated lesions up to 1 cm in diameter
associated with cell infiltration and/or proliferation, in this
case a mast cell tumour (Fig. 1.1).
1.1B
1.2A A nodule is a solid elevation of the skin >1 cm in diameter,
located primarily in the dermis or subcutis. The nodule
illustrated in Fig. 1.2 is a mast cell tumour on the
abdomen of a dog.
1.2B
1.3A A plaque is a flat, solid, circumscribed, elevated lesion of
>1 cm in diameter, again associated with cell infiltration
and/or proliferation (Fig. 1.3). A plaque may result from
a coalescence of papules. The lesions illustrated are
eosinophilic plaques on a cat.
1.3B
2 Chapter 1
1.4A A pustule is a circumscribed skin lesion containing
purulent material (Fig. 1.4). This consists of degenerate
inflammatory cells (most commonly neutrophils) with or
without microorganisms or other cells (e.g. acanthocytes in
pemphigus foliaceus). Pustules and vesicles rapidly rupture
in dogs and cats to form crusts.
1.4B
1.5A A vesicle is a circumscribed elevation of the skin up
to 1 cm in diameter filled with liquid (clear, serous or
haemorrhagic). A bulla describes the same lesion >1 cm
in diameter. These lesions usually quickly rupture to
leave ulcers and/or crusts. Fig. 1.5 shows vesicles due to
cutaneous mucinosis in a Shar Pei.
1.5B
1.6A A cyst is an enclosed cavity with an epithelial lining that
contains liquid or semi-solid matter. Fig. 1.6 is of multiple
follicular infundibular cysts in a dog.
1.6B
1.7A Macules are flat, non-palpable areas of circumscribed
discoloration up to 1 cm in diameter (Fig. 1.7). Patches are
>1 cm in diameter. Changes can involve increased blood flow
(erythema), extravasated blood (haemorrhagic petechiae
and ecchymoses) or pigment changes. Erythema can be
distinguished from haemorrhage by blanching on digital
pressure or using a glass slide (Diascopy, see page 11).
1.7B
