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Seborrhea In Dogs
Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Seborrhea In Dogs ___________________________________ Management in Shelters and Foster Homes ___________________________________ ___________________________________ Karen Moriello, DVM, DACVD Clinical Professor of Dermatology ___________________________________ University of Wisconsin-Madison Madison Wisconsin, USA ___________________________________ ___________________________________ ___________________________________ ‘Seborrhea’- term is obsolete Correct term: cornification defect ___________________________________ Excessive scales (flakes, ‘dandruff’) with or without oily skin and hair. ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 3 1 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ‘Seborrhea’ is…. • Clinical description, not a diagnosis ___________________________________ • Disruption in production epidermal cells and ___________________________________ • Causes • Primary-Hereditary-noted early in life, life long ___________________________________ • Secondary-acquired, occurs as a result of other diseases, temporary • Most common in dogs ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 4 ___________________________________ ___________________________________ Odor and scales that do not wash off… ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 5 ___________________________________ ___________________________________ Practical Anatomy ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ www.google. images Advancing animal and human health with science and compassion 6 2 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Cornification ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 7 ___________________________________ ___________________________________ Importance of Epidermal Barrier • Prevents excessive water loss from skin ___________________________________ • Prevents loss of other bodily fluids ___________________________________ • Protects against UV damage • Protects against trauma ___________________________________ • Part of the body’s immune system • Prevents against infection and invasion of micro-organisms ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 8 ___________________________________ ___________________________________ Pathogenesis of Clinical Signs • Accumulations of scale and crust because of shortened ___________________________________ epidermal cell turnover ___________________________________ • Irritation, inflammation, pruritus and odor develop because of changes in the composition of surface oils ___________________________________ • Frequent bacterial and yeast overgrowth/infections ___________________________________ often with pruritus due to changes in the skin flora ___________________________________ Advancing animal and human health with science and compassion 9 3 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ‘Seborrhea sicca’-dry ‘Seborrhea oleosa’-greasy ___________________________________ • Clinical descriptors ___________________________________ • Not a specific disease • Only of importance when determining topical therapy ___________________________________ • Avoid use of these terms!!!! ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 10 ___________________________________ ___________________________________ Primary Cornification Defect • Hereditary with breed predisposition or random genetic ___________________________________ abnormality • Noted early in life for many conditions ___________________________________ • Manage, not cure • Diagnose via ruling out other causes ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 11 ___________________________________ ___________________________________ Primary Breed Predisposition • Primary cornification disorder ___________________________________ • West Highland white terrier, cocker spaniel, basset hound, Doberman pincher, German shepherd, English springer spaniel, Irish setter, Labrador retriever ___________________________________ • Vitamin A-most notably cocker spaniel • Zinc responsive ___________________________________ • Alaskan malamute, Siberian husky, Samoyed, Pharaoh hound • Epidermal dysplasia-West Highland white terrier ___________________________________ • Ichthyosis-golden retrievers, Jack Russell terrier, Norfolk terrier, American bull dog ___________________________________ Advancing animal and human health with science and compassion 12 4 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 13 ___________________________________ ___________________________________ Primary Cornification ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 14 ___________________________________ ___________________________________ Severe Odor ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 15 5 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Vitamin A ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 16 ___________________________________ ___________________________________ Zinc ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 17 ___________________________________ ___________________________________ Ichthyosis ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 18 6 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Really, really big scales ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 19 ___________________________________ ___________________________________ Localized Disease ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 20 ___________________________________ ___________________________________ Localized Disease ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 21 7 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Localized Disease ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 22 ___________________________________ Secondary Cornification ___________________________________ • Secondary to ANY disease that affects the skin ___________________________________ • Parasites ___________________________________ • External • Internal • Infections ___________________________________ • Allergies • General illness ___________________________________ • Chronic nutritional deficiencies ___________________________________ Advancing animal and human health with science and compassion 23 ___________________________________ ___________________________________ Secondary to bacterial pyoderma ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 24 8 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Secondary to parasites…. ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 25 ___________________________________ ___________________________________ Secondary to yeast overgrowth ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 26 ___________________________________ ___________________________________ Common problem in allergic dogs.. ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 27 9 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ Common in dogs with medical illnesses.. ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 28 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 29 ___________________________________ Common Scenario ITCH ___________________________________ ___________________________________ ___________________________________ ___________________________________ INFECTION ___________________________________ ___________________________________ 10 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ Spending Money Wisely ___________________________________ • Consider global health of dog and address issues ___________________________________ • Vaccination ___________________________________ • Nutrition • Endo-parasite control ___________________________________ • Assume seborrhea is secondary, until proven otherwise • Ectoparasite control ___________________________________ • Skin cytology for bacterial or/yeast overgrowth ___________________________________ Advancing animal and human health with science and compassion 31 ___________________________________ ___________________________________ What does this ‘look like’? • Intake: vaccinations, standard deworming, appropriate diet ___________________________________ and adequate feeding • Flea control/contagious parasite treatment q 2 weeks for 6 ___________________________________ weeks • In house diagnostics ___________________________________ • Hair trichogram to look for demodicosis • Skin cytology for yeast ___________________________________ • Wood’s lamp-high risk of false positives • Bacterial overgrowth is common, at least treat topically ___________________________________ Advancing animal and human health with science and compassion 32 ___________________________________ ___________________________________ Other Diagnostics • If animal is otherwise healthy, routine laboratory work is ___________________________________ rarely helpful • Allergy work up? ___________________________________ • Thyroid function tests? • Adrenal function tests? ___________________________________ • Skin biopsy indications ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 33 11 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 34 ___________________________________ ___________________________________ Diagnosis Via Biopsy • Vitamin A responsive skin disease ___________________________________ • Zinc responsive skin disease ___________________________________ • Medical conditions-cutaneous lymphoma • Sebaceous adenitis ___________________________________ • Lichenoid psoriasiform dermatitis of springer spaniels • Nasal parakeratosis-when ruling out from immune mediated ___________________________________ • Maybe helpful in ichyosis, primary cornification diseases.. ___________________________________ Advancing animal and human health with science and compassion 35 ___________________________________ ___________________________________ Lichenoid psoriasiform dermatitis ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 36 12 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Bathing and Grooming • Always indicated ___________________________________ • Cannot over bathe the dog ___________________________________ ___________________________________ ___________________________________ ___________________________________ Google images Advancing animal and human health with science and compassion 37 ___________________________________ Topical Therapy-What You Need ___________________________________ • ONE cleansing shampoo ___________________________________ • One combined antibacterial/antifungal shampoo • One combination tar and sulfur or salicylic acid shampoo ___________________________________ • One good degreasing shampoo • Benzoyl peroxide (degreasing and antimicrobial) ___________________________________ • One moisturizing product • 50% propylene glycol ___________________________________ • Commercial product • One non-irritating ear cleaner ___________________________________ Advancing animal and human health with science and compassion 38 ___________________________________ ___________________________________ Shampoo Therapy Simplified • Step 1: Instill ear cleaner ___________________________________ • Step 2: Bathe dog in a cleansing shampoo to remove debris ___________________________________ • Apply pre-diluted shampoo (1:2 - 1:4), wash, rinse • Step 3: Alternate bathing with antimicrobial shampoo and anti-seborrheic shampoo ___________________________________ • Apply pre-diluted shampoo (1:2 - 1:4), wash, rinse • Rinse again and again ___________________________________ • Step 4: Finish cleaning ears ___________________________________ Advancing animal and human health with science and compassion 39 13 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Seborrheic Otitis • Increased ear secretions ___________________________________ • Ceruminous otitis leads to bacterial overgrowth and chronic inflammation and ODOR ___________________________________ • Treat microbial overgrowth • Clean ears at every bath ___________________________________ • Topical ear steroids maybe very helpful ___________________________________ • 1:1 dilution of propylene glycol and 2mg/kg of dexamethasone ___________________________________ Advancing animal and human health with science and compassion 40 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 41 ___________________________________ ___________________________________ How Often??? ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 42 14 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ Nasal and Digital Hyperkeratosis ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 43 ___________________________________ ___________________________________ Ear Margin Hyperkeratosis ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 44 ___________________________________ ___________________________________ Medical Treatment? ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 45 15 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 46 ___________________________________ ___________________________________ What Foster Families Can Do • Dog with chronic seborrheic otitis ___________________________________ • Important to determine if medical or surgical • 30 day treatment period needs to be done in a home ___________________________________ • 1 mg/kg orally once daily for 15-30 days ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 47 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 48 16 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ ___________________________________ For example….. ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 49 ___________________________________ ___________________________________ Dog that needs temporary intensive bathing to achieve remission ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 50 ___________________________________ ___________________________________ Or this….. Do not squeeze! ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 51 17 Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015 ___________________________________ Transitioning to a Permanent Home • Information on what best controls the odor and scale ___________________________________ ___________________________________ • What’s the most you have to do and when? ___________________________________ • What are the early signs of a relapse? • What products work? Or what products are irritating? ___________________________________ • Information on all diagnostic testing • Is problem secondary? ___________________________________ • If secondary what does new primary care veterinarian need to pursue? ___________________________________ Advancing animal and human health with science and compassion 52 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ www.vetmed.wisc.edu ___________________________________ ___________________________________ Advancing animal and human health with science and compassion 53 18
