I’ve come across a couple of cases of Sarcoptes this winter. Both cases were young dogs with intense pruritus – one on his face and the other around the triceps region.
Although both owners were rather sceptical, both dogs responded very rapidly to therapy with imidacloprid/moxidectin (Advocate, Bayer).
In our neck of the woods, I tend to try trial therapies first as we have a high urban fox population, but perform ELISA blood tests for Sarcoptes in dog cases with persistent signs.
I occasionally do skin scrapes but rarely, if ever, find mites!
Quiet, lethargic, not eating very much and just generally a bit slow? It’s worthwhile tapping the abdomen.
I saw a golden retriever presenting in just this way, just as surgery was about to close on Christmas Eve. On examination she was a bit pale but not particularly tachycardic, although her abdomen felt distended.
A quick needle tap sadly revealed the presence of free blood. However haematology showed a significant reticulocytosis consistent with the bleed occurring 2-3 days previously (the owner did point out that, in fact, she had started to perk up that morning).
Our next step will be some imaging to see what the spleen looks like and whether we can consider surgery – hopefully with a favourable outcome. Fingers crossed.
Dr Lisa Powell from the University of Minnesota’s College of Veterinary Medicine describes how to perform an abdominocentesis (peritoneal tap) – the procedure used to obtain free abdominal fluid.
An interdigital cyst in the paw of an English bull terrier – image by Nottingham Vet School (CC BY-NC-SA 2.0) via Flickr.
I recently saw a very large, and very friendly bull mastiff that presented with what appeared to be typical interdigital cysts. These had been chronically recurrent and previous histopathology indicated a pyogranulomatous reaction.
However his lesions responded poorly to three weeks’ of cephalexin antibiotic therapy and, in fact, he developed several lesions on his other feet.
Cytology revealed mild bacterial colonisation, and it occurred to me this might be an immune-mediated reaction (his blood work and TSH/T4 were all within normal limits) – and, hey presto, we got a rapid clinical response to steroids.
In spite of being under control he has also developed an acute erythematous otitis externa, so I think a food trial is my next line. Watch this space…
Greenish purulent discharge accompanied by crusting, erythema and punctuate ulcerations in a crossbreed affected by Pseudomonas aeruginosa otitis externa, secondary to an adverse drug eruption. Image source: Veterinary Times 45.01 (Jan 6, 2014) – “Otitis: a diagnostic approach” by Filippo De Bellis.
I suspect we have all come across that tricky Pseudomonas otitis case that just seem to refuse to completely respond to antibiotic therapy in spite of extensive investigation for underlying causes.
I had just one such case recently that, in spite of culture and sensitivity, blood work, skin biopsy, extensive flushing, lack of response to licensed products (and so on), just refused to respond.
A quick look through one of my trusty text books* suggested Ticarcillin.
Ticarcillin potentiated with calvulanic acid (Timentin) is an extended spectrum penicillin that often has good activity against Pseudomonas. The 100mg/ml antibiotic solution can be applied directly to the ear canal as a drop.
The case I’m treating has responded really well.
* Reference: Hill, P.B. (2002) Small Animal Dermatology: a practical guide to the diagnosis and management of skin diseases in dogs and cats. Butterworth-Heinemann. London.
Last Saturday I had a “walk in” – a very cute spaniel that was limping slightly and had a cut pad. The owner thought she might have trodden on something.
A good palpation didn’t seem to suggest the presence of any foreign body and the dog was very stoical. My previous experiences suggest any foreign material produces a lot of pain that is exacerbated by palpation – sometimes with dramatic effect!
However, the insistence of the owner made me look closer and I could just see a glint of a firm object deeply embedded in the pad. A pair of rat toothed forceps later and I extracted a 5mm slither of glass from the pad.
The result was a happy dog and owner, but oh – I could so easily have sent that poor dog away!
The homeless come with a certain stigma – particularly those with pets at their side.
Should we be concerned for the welfare of those animals, whose owners cannot afford to feed themselves so surely cannot adequately care for a companion?
Of course we should.
However, instead of claiming these pets should be removed from their owners, Ruby Shorrock (a fourth year vet student at the University of Glasgow) took a different approach.
Being homeless can be extremely isolating and lonely. For some of these people, their dog is their only companion, and can often be the only thing keeping them going. A dog can also provide a connection to home, and so the reluctance to give them up is understandable.
Despite this, many shelters refuse to accommodate dogs and so the help available can become increasingly restricted for homeless dog owners.
In light of this, Ruby founded Trusty Paws, a non-profit organisation that hosts free clinics and provides preventative care for hounds belonging to the homeless. The clinics involve a free health check (a clinical examination performed by veterinary students, supervised by a qualified vet), microchipping, flea and worming treatment and vaccinations. Dog food packages and other supplies such as leads and dog coats are also given out at the clinics.
Trusty Paws: a vaccination clinic for dogs belonging to the homeless, run by fourth year vet students at the University of Glasgow.
There have been three Trusty Paws clinics in Glasgow so far, with several grateful clients being able to benefit from the supplies donated and the services provided by the students. Everyone involved is delighted with how the clinics have been received.
Plans for 2015 include registering as a formal charity and organising public fundraisers. The Trusty Paws team also intends to tackle the problem of local shelters and hostels not allowing dogs.
Trusty Paws relies entirely on donations and sponsorship and the response to requests for both has been exceptional. The concept has really taken off and looks to gain popularity and success in the future.
The work of Trusty Paws is a fantastic way of not only actively ensuring quality care for homeless pets, but also raising awareness within the community to tackle public perception. If these misconceptions can be eliminated, others will be willing to accept that pets are a huge part of the lives of homeless people too and, perhaps, be encouraged to help the situation instead of avoiding eye contact with that person sitting in a doorway on a rainy evening.
Pyometra in a dog, seen during surgery. The uterus is distended with pus. Image by Joel Mills [GFDL, CC-BY-SA-3.0 or CC-BY-SA-2.5-2.0-1.0], via Wikimedia CommonsLast week I removed one of the largest, most pus-filled uteri from a large breed dog that I have ever seen.
I’m a bit long in the tooth now, but I still found the whole procedure a bit scary given the size and vascularity of the uterus – and this made me reflect on the benefits of early neutering.
We routinely spay bitches in our practice from five months of age with minimal long-term complications, and it’s so much easier.
I am aware that recent research indicates early neutering may have some long-term implications in certain breeds, but the procedure is so much safer in young dogs, and anything that prevents them developing pyometra in later life has got to be an advantage.
In our practice, the preferred way to induce vomiting after ingestion of poisons (most commonly raisins, chocolate and rat poison) is subcutaneous apomorphine.
If a strong acid or alkali has been ingested, this is contraindicated. This also seems to occur most commonly out of hours for some strange reason.
We give 30μg/kg SC and wait for the desired effect, which works very well and usually results in a peaceful night’s sleep for all concerned.
This line always makes me think of the James Herriot books – and I recently thought of this when I had a poor cavalier King Charles that presented with a colon impacted with numerous shards of cooked lamb bones.
The poor chap was in quite a bit of discomfort and was straining without any production. It took ages to flush out his colon and, to be honest, more than one attempt.
Eventually some warm soapy water and repeated flushing with a cut dog-urinary catheter did the trick and he’s now feeling much better.
Sarcoptes scabei – a parasitic arthropod that burrows into skin and causes scabies. Image by Kalumet. Licensed under CC BY-SA 3.0 via Wikimedia Commons.
Have you ever had an atopic dog that’s really well managed but suddenly flares, becomes very pruritic and seems to stop responding to therapy? I had one such case just a couple of months ago.
Skin scrapes did not reveal the presence of any ectoparasites and cytology was pretty unexciting (a bit of bacterial colonisation but otherwise unremarkable).
However, noticing the pruritus to be primarily around the head, ears and ventral abdomen tipped me off to think about Sarcoptes scabei – particularly as we have a very prolific and confident urban fox population in our practice area.
A serum sample was duly sent off and – lo and behold – proved positive for Sarcoptes antibodies.
The client then confessed to missing “a dose” of Advocate but, upon reapplication, management was readily restored.
