Canine pododermatitis and idiopathic disease

Ultrasonographic findings may be useful for differentiating interdigital abscesses secondary to migrating grass awns and interdigital furunculosis in dogs

Grass awn migration and furunculosis are common diseases in dogs that can lead to interdigital subcutaneous lesions with a similar clinical presentation, and occasionally similar ultrasonographic images, but different treatments are required. This retrospective, multicentric, analytical study aimed to determine whether epidemiological, clinical, and ultrasonographic features could be used to differentiate interdigital furunculosis and abscesses secondary to migrating grass awns. Fifty-nine dogs that underwent interdigital ultrasonography were included (interdigital furunculosis [IDF], n = 27; interdigital abscess secondary to a migrating grass awn [IAGA], n = 32). Ultrasonographic images were reviewed by two observers blinded to the diagnosis, who graded nine qualitative and four quantitative parameters for each patient. In both groups, pruritus/licking (IDF 74%, IAGA 70%), a discharging interdigital wound (63% for each group), and thoracic limb involvement (IDF 88%, IAGA 75%) were common features. On ultrasound, a subcutaneous multilinear hyperechoic main element was identified in most dogs (IDF 85%, IAGA 100%). The ability to display this element in a single plane (P < 0.01), the absence of additional hyperechoic linear elements in different planes (P < 0.01), and a surrounding hypoechoic halo (P < 0.05) were significantly more common in dogs with interdigital abscesses secondary to migrating grass awns. A cut-off value of 0.83 cm for the length of the main multilinear element provided a sensitivity of 91% and a specificity of 87% in the diagnosis of a migrating grass awn. Findings supported prioritizing a differential diagnosis of interdigital abscesses secondary to grass awns in dogs with these ultrasonographic characteristics.

Dermatological Problems of Brachycephalic Dogs

Brachycephalic dogs are not only affected by brachycephalic obstructive airway syndrome (BOAS), but are also frequently referred to veterinary dermatologists for skin conditions, with English bulldogs and pugs particularly over-represented. Some skin diseases, such as skin fold dermatitis, are directly associated with the abnormal anatomic conformation of brachycephalic dogs, while for others, such as atopic dermatitis and viral pigmented plaques, there is an underlying genetic basis or a general predisposition. Anatomic alterations associated with brachycephaly, leading to fold formation of the skin and stenosis of the ear canal, together with primary immunodeficiencies described in some breeds, favor the development of pyoderma, Malassezia dermatitis, and otitis externa/media. In addition, the frequently neglected but often lifelong dermatological problems of brachycephalic dogs are an important consideration when discussing genetic and medical conditions affecting the welfare of those dogs. Here we review the current state of knowledge concerning dermatological problems in brachycephalic dogs and combine it with clinical experience in the management of these challenging disorders.

A retrospective case series of the postoperative outcome for 30 dogs with inflammatory interdigital nodules, surgically treated with carbon dioxide laser and a nonantimicrobial wound-healing protocol

BACKGROUND

Inflammatory interdigital nodules (IIN) affecting the paws of dogs is a multifactorial and painful condition. Surgery using carbon dioxide (CO ₂ ) laser has been shown to be helpful in the management.

HYPOTHESIS/OBJECTIVES

To assess a postoperative treatment protocol without use of antibiotics following CO₂ laser surgery for IIN treatment.

ANIMALS

Forty-seven paws, in 30 client-owned dogs, with IINs affecting the interdigital web between the 4th and 5th digits of the forepaws, surgically treated using CO₂ laser, were included.

MATERIALS AND METHODS

Medical records were reviewed for demographic details, medication use and wound healing using a set wound care protocol. Time to resolution of the surgical wounds and the postoperative outcome were assessed.

RESULTS

The mean healing time was 34 days. Resolution was seen in 42 of 47 paws with complications in five paws (11%), including development of new fistulae or nonhealing granulation tissue. Surgery was repeated in those five cases. Relapse occurred during the follow-up period of five-19 months in six paws (13%).

CONCLUSIONS AND CLINICAL RELEVANCE

This study shows that surgical treatment with CO₂ laser for interdigital nodules is successful in most cases. The postoperative outcome using a wound-healing protocol avoiding use of antimicrobials can be used without compromising patient care whilst following antimicrobial stewardship guidelines.

Fluorescence Biomodulation for Canine Interdigital Furunculosis: Updates for Once-Weekly Schedule

Interdigital furunculosis is a common multifactorial, inflammatory disease of the canine interdigital skin in which lesions commonly become secondarily infected. Fluorescence biomodulation (FBM) administered twice weekly has shown to effectively control clinical manifestation as adjunct therapy to systemic antibiotic. Since twice weekly regimen could be unaffordable for some pet owners, the aim of this study was to evaluate the effect of once weekly application of FBM in combination with systemic antibiotic on clinical manifestations of canine interdigital pyoderma, comparing the results to those present in literature. Twelve dogs diagnosed with interdigital pyoderma received antibiotic plus once weekly FBM application. Dogs were scored until complete healing based on global lesion score and neutrophil engulfing bacterial score. The results obtained demonstrated that once weekly application of FBM exerts the same beneficial effect on interdigital furunculosis healing as per twice weekly, indicating that once weekly regimen is well tolerated and is yielding similar results to twice weekly applications.

Current Applications and Future Perspectives of Fluorescence Light Energy Biomodulation in Veterinary Medicine

The purpose of this review is to determine the state of the art of the mode of action and potential applications of fluorescence photobiomodulation in veterinary medicine. After a summary of the assets that have led the translation of such light-based therapies from bench side into clinical use, recent advances in canine dermatology using this brand-new approach are presented, and future scenarios where this type of care may provide benefits over the current standard care are highlighted.

The Effectiveness of Fluorescent Light Energy as Adjunct Therapy in Canine Deep Pyoderma: A Randomized Clinical Trial

A single centre, single-blinded, prospective, randomized, controlled clinical study was conducted to evaluate the effectiveness of twice weekly fluorescent light energy therapy (Phovia™) as adjunct to systemic antibiotics in the management of deep pyoderma in dogs. Dogs with clinical lesions consistent with deep pyoderma, positive bacterial culture, and showing neutrophil engulfing bacteria at cytology were included in the study. Assessments were undertaken weekly for 8 weeks and every 2 weeks thereafter until 12 weeks after enrolment. At each visit, lesions were scored and cytology was conducted to determine a neutrophil engulfing bacteria score. All dogs (Groups A and B) were treated with systemic antibiotic twice daily, and Group B received additionally Phovia twice weekly. Median treatment duration was 11.7 weeks for Group A and 5.7 weeks for Group B. After 8 weeks of treatment, the percentage of dogs that achieved clinical resolution was 35.0% and 88.0% for Groups A and B, respectively. Lesion scores showed highly statistically significant difference in favour of Group B from week 3 to 8, and neutrophil engulfing bacteria scores showed statistical difference from week 2 onwards in favour of Group B. These results indicate that Phovia, when used as an adjunct to systemic antibiotics, can accelerate time to clinical resolution in cases of canine deep pyoderma.

Fluorescence biomodulation in the management of canine interdigital pyoderma cases: a prospective, single-blinded, randomized and controlled clinical study

BACKGROUND

Interdigital pyoderma is a common multifactorial, inflammatory disease of the canine interdigital skin. Lesions commonly become infected secondarily. In addition to management of the underlying cause, management of the chronic inflammatory changes in the interdigital skin created by secondary infection and by the release of keratin into deep tissues is required. Fluorescence biomodulation appears to modulate the inflammatory process in dermatological disorders and has shown promise in preliminary studies evaluating its use in superficial and deep pyoderma in dogs.

HYPOTHESIS/OBJECTIVES

To evaluate the effect of a fluorescence biomodulation (FB) system used in conjunction with systemic antibiotic on clinical manifestations of canine interdigital pyoderma (CIP), compared to dogs treated with antibiotic alone.

ANIMALS

Thirty-six dogs diagnosed with CIP.

METHODS AND MATERIALS

Dogs were randomly allocated to treatment groups of either antibiotic alone (Group A) or antibiotic plus twice-weekly FB application (Group B). Dogs were scored over a 12 week period on the basis of two measured parameters: a global lesion score composed of four different lesions types and neutrophil engulfing bacterial scores.

RESULTS

A statistically significant decrease was seen by Week 3 in both measured parameters for Group B compared to Group A. The mean time-to-resolution of lesions was 4.3 weeks in Group B and 10.4 weeks in Group A.

CONCLUSION AND CLINICAL IMPORTANCE

The FB system shows promise as an adjunct therapy to systemic antibiotic use in the management of CIP.

Low-level laser therapy: Case-control study in dogs with sterile pyogranulomatous pododermatitis

AIM

Low-level laser therapy (LLLT) is a therapeutic photobiostimulation with properties in reducing swelling, inflammation, and promoting tissue healing. The objective of this pilot study was to evaluate LLLT in sterile pyogranulomatous pododermatitis in five dogs.

MATERIALS AND METHODS

In each dog, one lesion was designated as the control (treated with a 0.0584% hydrocortisone aceponate spray), and one or more other lesions were treated with a gallium aluminum arsenide-laser, daily for 5 days. Lesions were scored before treatment (D0), at the end (D4), 16 days after the last laser treatment (D20), and after 2 months (D65).

RESULTS

Comparing the treated lesion group with the control lesion group, the clinical score was similar at D0, whereas there was a statistically significant difference at D4 and D20; in the treated group over time, there was a statistically significant improvement between D0, D4, and D20. Lesion recurrence was absent in more than 50% of the treated lesions at D65. No adverse reactions were reported.

CONCLUSION

Given the positive results of this first clinical study, it would be interesting to extend the study to confirm the validity of this type of therapy in sterile pyogranulomatous pododermatitis in the dog.

Recognizing pyoderma: more difficult than it may seem

Although bacterial pyoderma is among the most commonly encountered dermatologic conditions in dogs, some cases present diagnostic challenges even to experienced clinicians. This article presents several unusual manifestations of pyoderma, including bullous impetigo, superficial spreading pyoderma, mucocutaneous pyoderma, and post-grooming furunculosis. Conditions mimicking pyoderma, including juvenile cellulitis, immunomodulatory-responsive lymphocytic-plasmacytic pododermatitis, and pemphigus foliaceus are also described. Diagnostic techniques used for diagnosing and characterizing pyoderma are also discussed.

Fusion Podoplasty for the Management of Chronic Pedal Conditions in Seven Dogs and One Cat

Eight animals underwent fusion podoplasties for the treatment of chronic interdigital furunculosis (n=3), ectrodactyly (n=1), digit abnormalities associated with tendonectomy (n=1), redundant indertigital skin (n=1), conformational deformity (n=1), and necrotizing fasciitis of the paw (n=1). Median duration of bandaging was 14 days, and median duration of hospitalization was 5 days. Four dogs had dehiscence, which occurred at a mean time of 11 days after surgery. Clinical abnormalities necessitating podoplasty resolved in six animals and improved in two. Six animals had normal ambulation and two dogs had slight weight-bearing lameness after a median follow-up time of 29 mo. Fusion podoplasty may be recommended as a salvage procedure for the treatment of various chronic pedal diseases in dogs and cats.

Computed tomographic, magnetic resonance imaging, and cross-sectional anatomic features of the manus in cadavers of dogs without forelimb disease

OBJECTIVE-To provide a detailed description of cross-sectional anatomic structures of the manus in canine cadavers in association with corresponding features in computed tomographic (CT) and magnetic resonance (MR) images. SAMPLE POPULATION-7 cadavers of adult large-breed-type dogs (weight range, 25 to 30 kg) without forelimb disease. PROCEDURES-Forelimbs were removed from the cadavers within 4 hours after euthanasia and frozen. The right forelimbs of 3 cadavers were cut into 4-mm sections by use of a band saw; 1 limb each was sectioned in the transverse, dorsal, or sagittal plane. Sections were cleaned and then photographed. After thawing, transverse CT images of the right forelimbs of 3 additional cadavers were obtained, and the right forelimb of a seventh cadaver underwent MR imaging in the transverse, sagittal, and dorsal planes. The evaluated regions extended from the digits to the carpus. Features in CT and MR images that corresponded to clinically important anatomic structures in tissue sections were identified. RESULTS-For most of the anatomic structures evident in tissue sections, corresponding CT and MR imaging features were identified. Osseous and musculotendinous structures of the manus were readily detected in CT and MR images, whereas vascular structures were only rarely identified by use of the imaging techniques. CONCLUSIONS AND CLINICAL RELEVANCE-Results of the detailed assessment of anatomic structures of the canine manus in association with corresponding features in CT and MR images will facilitate detection of pathological conditions and be beneficial in planning surgical procedures for diseases of the manus in dogs.