You would think that skin problems occur more frequently in the summer, as dogs with atopy may be suffering with the tree, weed and grass pollens and even house dust mites are more common during the humid months of July, August and September. However, there are still problems such as flea allergy dermatitis that can be seen more frequently in the winter, particularly if flea control is not optimal. Here is a video interview with well know vet (and Veterinary Dermatologist) of “Animal Hospital” fame, David Grant, discussing this and other skin problems encountered during the winter. Particularly exciting is the mention of a once a month oral treatment for fleas that kills all fleas within 2 hours. Please ring the surgery for more details.

There was a special presentation on the Friday evening on an exciting new oral preparation for the control of fleas. Comfortis, has been used in the United States for the last 3 years and has recently been launched here. USA Veterinary Dermatologist, Craig Griffin, gave us a very interesting presentation on his experience using this new drug in the treatment of flea allergy and other itchy skin conditions in dogs. Comfortis is a tablet that given every 4 weeks and starts killing fleas within half an hour and within 4 hours all fleas are dead. It is particularly useful in dogs which need to be shampooed regularly or swim, where topical treatments may not work well. It would also appear that this product works very well at further reducing itch in animals which have been on topical flea control, so it would appear it has great uses for the control of fleas in allergic dogs and the management of allergic skin disease.

The theme for the rest of the weekend is therapeutics and I am enjoying listening to world famous Dermatologists such as Craig Griffin from the USA and one of the UK’s renowned internal medicine experts, Ian Ramsay from Glasgow Veterinary School, with some very thought provoking information on the treatment of such diseases as demodectic mange,on the use of steroids in practice and on the treatment of of Immune mediated skin disorders, Atopic Dermatitis and Cushings Disease. I’m sure I will come back to the practice with information that will help me serve my clients and their animals better.

I am currently taking part in clinical trials of a new topical treatment for otitis for a leading veterinary pharmaceutical company.  During this period I can offer examinations, and in- depth work up of your dog’s ear infection and treatment for no charge.  Certain criteria have to be met before inclusion in this clinical trial.  The dog must not be on any treatment with anti-inflammatory drugs, must not have been treated with any topical ear preparation for at least 2 weeks and owners must be prepared to come to the surgery at  a time requested by me, as each consultation  will take approximately one hour  to perform the examinations, take samples and dispense medications and deal with the paperwork.  The drug being trialled is already proven to be effective for the treatment of bacterial and fungal ear infections -  the purpose of this trial is to compare its efficacy with another leading proven  otitis treatment and I will be blinded as to which one of the treatments your dog will be receiving.   After the initial consultation, re-examinations have to be performed around day 14, 28 and 60 post-treatment.  As well as not being charged for treatment, owners who complete the trial will be given a £40 credit on their practice account. If your dog is suffering with otitis and fits the above criteria phone our surgery on 0116 2388100

On 6th and 7th November I attended the annual autumn meeting of the BVDSG.

The theme for the weekend was Oncology  and delegates were given the latest information on common skin tumours such as Mast Cell Tumours and Squamous Cell Carcinoma and the rarer ones such as the lymphoid  and histiocytic tumours. 

One of the most common skin tumours we  see is the Mast Cell Tumour and a lot of research has been done on this neoplasm, which can look just about like any other skin tumour.  The current textbooks which most vets have are now out of date regarding the management of mast cell tumours.  Because this tumour has such a wide ranging array of appearances it is recommend that ALL skin tumours should be examined  cytologically.  The procedure, called a fine needle aspirate is easy to perform inthe consulting room and the characteristic mast cells are , in the vast majority of cases, easy to identify.  Early diagnosis is very important as some Mast Cell Tumours are malignant and aggressive.

The majority of mast cell tumours are benign, but they should be removed and sent off to the lab for histopathological grading and staging should be made by examining draining lymph nodes etc.   Some mast cell tumours are so large at the time of diagnosis that they are unable to be removed surgically and there have been some excting developments with new targeted drug therapies. For the last year there has been a drug available from France  called Masivet  (mastinib) which works best on the 30% cases which have a specific mutation but can work on other cases.   A a similar drug, called Palladia (toceranib) has just been released in the UK with  promising results.  Both drugs are licensed for non-resectable tumours.  Annual costs for a Labdrador would be in the region of £4000 with Masivet and around £3600 with Palladia.  Treatment is what is termed cytostatic (rather than cytotoxix) so may only work if the drug is continued indefinitely, but there are reported cases where the tumour has not returned when the drug is stopped.   Further research on both these new drugs is still ongoing.

Squamous  Cell Carcinoma  a common tumour seen both in cats and dogs,  usually in unpigmented skin and is commonly the result of ultraviolet light  damage from the sun, but there is  now increasing interest in the role of papillomaviruses in the pathogenesis of these tumours.   It is important that cats with white ears/unpigmented noses are kept out of the sun, particularly in the middle of the day.and the same can be said with white dogs such as English Bull Terriers or  Dalmations.   Owners should also consider use of sun blocks  and sun blocking suits available for small children!

Following on from a report in the Leicester Mercury 2-3 weeks ago about a surge in canine  scabies cases in the Market Harborough area, I have seen 3 cases in quick succession in the LFE and Beaumont Leys areas of Leicester

Hair loss and erythema  and a papular rash on inside of hock.

The disease of caused by the mite Sarcoptes scabiei and symptoms of itchy skin particularly on the limbs, flanks and the ears (many dogs have crusty ear rims which produces the “pinnal scratch reflex” which is supicious although not completely diagnostic of scabies- rubbing the edge of the ear flap induces scratching by the hind legs).   Itchy dog skin  can develop some time after intial infestation as the dog develops a hypersensitivity to the mite.  Self trauma can make the skin look much worse and this particular dog was chewing at its limbs as well as scratching its ears.  As the clinical  signs are due to a hypersensitivity to the mites, which burrow in the top layers of the epidermis of the skin, it can be difficult to find them on skin scrapings.  In this particular case I took several scrapings and found no mites, but was lucky enough to find one slide with 3 sarcoptes eggs, which confirmed the diagnosis.  There is now a very reliable blood test that can confirm diagnosis by measuring antibodies to the mite, but will only give positive results if the dog has been infested for at least 4 weeks.  If a case is supected  before this time and mites can’t be found,  it is common to try a therapeutic trial with a good miticide.

Similar lesions on the Front Leg

Scabies is very contagious and can spread by direct contact with an affected animal or also picking the mites from the ground where other affected animals have laid.  Foxes are a major carrier of this mite and are suspected of being responsible for a large number of cases that we are now seeing.

Canine scabies is a major differential when seeing a dog with itchy skin and when considering possible allergies and therapeutic trials are aften done when investigating a case.

Below are photos of the offending mite and its eggs as seen when recoverd from the skin by a skin scraping.

I am currently treating a dog with a skin infection in its feet caused by the bacteria staphylococcus pseudintermedius. Nothing unusual about that – this bacteria accounts for the vast majority of bacterial skin infections in dogs. This staph lives as a commensal bacteria in the nose and around the mouth and anus. It causes infection in the skin when there is a problem with normal skin defence mechanisms such as seen with with parasite infestations, allergies, hormonal problems such as hypothyroidism or immunosuppresion caused by severe internal disease.  This poor dog must have a problem which has allowed the bacterium to infect the skin and this is currently being investigated. However this case is further complicated by the discovery, from performing bacteriology on a skin biopsy, that the infection is caused by a multiple antibiotic-resistant strain of staphylococcus pseudintermedius or Methacillin Resistant Staphylococcus Pseudintermedius – MRSP

These resistant strains of staphylococcus, as with MRSA seen in human medicine, are becoming more common and their continued advance is going to make it more difficult in future for veterinary surgeons to treat skin and soft tissue infections. In fact, one speaker at the recent ESVD conference in Italy stated that in 10 years time we could be faced with very real problems in treating bacterial skin infecions in dogs because of these mutiple antibiotic resistant strains.

The particular strain of MSRP cultured from my recent case is only sensitive to two extremely expensive and difficult to administer antibiotics, both of which have some nasty possible side effects.
It is the responsibility of our profession to use antibiotics sensibly as it the overuse of antibiotics that has lead to this situation occuring.

For further information on MRSP click on  www.wormsandgermsblog.com/uploads/file/JSW-MA2%20MRSP%20-%20Owner.pdf

I am one of many UK  veterinary dermatologists and one of 496 veterinary dermatologists worlwide to attend the annual congress of the  European Society Of Veterinary Dermatology and European College of Veterinary Dermatology.

This year the event is the beautiful historic city of Florence, Italy

At the Palazzo Degli Affari.

Today, as well as lectures on fungal skin infections and Leishmaniasis (a very nasty disease that your dog could contact if taken to southern Europe) , zoonotic skin infections  and human atopic dermatitis attended today, I also had a look around the many stands at the congress belonging to pharmaceutical and other companies with products relevant to the field of Veterinary Dermatology

Karl Storz Video Otoscopy Stand- ESVD Conference

Bayer Pharmaceuticals Stand

After attending congress I took a late afternoon stroll to see some of the sites of Florence.

Ponte Vecchio over the River Arno

Palazzo Vechio  Florence Town Hall