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Dorsal alopecia in a male crossbred dog

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Presentation on theme: "Dorsal alopecia in a male crossbred dog"— Presentation transcript:

1 Dorsal alopecia in a male crossbred dog
Author: Ewan Ferguson Editor: David Lloyd © European Society of Veterinary Dermatology

2 History - 1 Dorsal alopecia and mild pruritus of 9 months duration in a male crossbred dog Weight 25 kg Click to reveal the text on this screen Click the forward arrow to jump to the next screen History

3 History - 2 Mild papular rash on dorsum and ventrum.
Comedones on dorsum and ventrum. Ventral coat thin but skin “normal” History

4 History - 3 Coat has become longer and finer in texture in recent months Polyuria and polydipsia (3 litres per day) reported Good appetite. Poor exercise tolerance No previous history of dermatological disease 2 cats in the house, both healthy Diagnosed by the referring veterinarian as flea allergy dermatitis History

5 History - 4 Ectoparasite control
Dog and both cats treated with fipronil (Frontline Spot-On, Merial) monthly Home environment treated annually with pyroxyfen and permethrin spray (Indorex, Virbac) No improvement History

6 History - 5 Pruritus now reported to be controlled with 10 mg prednisolone orally once daily, over the last 4 months No hair re-growth seen All therapy stopped 2 weeks before referral appointment History

7 Clinical signs - 1 The ventral abdominal skin
A few scattered papules, epidermal collarettes & crusts on dorsum & ventrum Signs

8 Clinical signs - 2 Alopecia & hyperpigmentation in dorsal lumbar region No visual evidence of ectoparasitism Pendulous abdomen & ventral liver lobes palpably enlarged Testes normal on palpation Signs

9 How would you approach this case?
What are the next steps you would take? Make a list of your principle differential diagnoses List any samples you would collect List any tests you would perform to assist in making a definitive diagnosis Signs

10 Differential diagnoses
Principle differential diagnoses Allergy (fleas, atopy, ?food), Hormonal imbalance including iatrogenic Cushings syndrome, ectoparasitic infestation, dermatophytosis Secondary pyoderma, Malassezia dermatitis Differentials

11 Tests - 1 Skin scrapings, tape strips, hair plucks and coat brushings - no evidence of ectoparasites or fungi Fasted blood sample Biochemistry: Alkaline phosphatase iu/l; Alanine aminotransferase iu/l; Glucose mmol/l; Cholesterol mmol/l Haematology: Mild mature neutrophilia & eosinopenia Urianalysis: Specific gravity ; No glycosuria Tests

12 What now? What are the next steps you would take?
What are now your principle differential diagnoses? Are there any other samples you would collect? List any tests you would perform to assist in making a definitive diagnosis Tests

13 Tests - 2 Principal differential diagnosis Tests
Hormonal imbalance particularly natural and iatrogenic Cushings syndrome Secondary folliculitis Tests ACTH response test to provide evidence of possible Cushings syndrome and to identify iatrogenic disease Tests

14 Results - 1 What is the significance of this test? Tests

15 Results - 2 Tests

16 Results - 3 What do these tests tell us? Tests

17 What is your diagnosis? Do the investigations permit a definitive diagnosis? List any additional investigations which you think may need to be done Tests

18 Tests - 3 Radiography Ultrasonography
Mass suspected in the left adrenal region Ultrasonography Hypoechoic foci in the liver suggestive of metastases Tests

19 How would you deal with this case?
What is your prognosis? How will you advise the owner? What treatment would you consider? Therapy

20 Diagnosis Hyperadrenocorticism resulting from adrenal neoplasia
Likely metastasis Therapy

21 Prognosis Prognosis is guarded
Surgery is not indicated in view of likely metastasis Medical management with trilstane (Vetoryl, Arnolds) recommended Notes

22 Conclusion The owner requested euthanasia. At post mortem examination an adrenal neoplasm and multifocal metastases were demonstrated. The adrenal tumour can be seen in the centre of the photograph, the kidney is on the left side Notes

23 Review If you would like to review this case, please use the navigation buttons below Notes

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