Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

Non-Invasive Paraclinical Diagnosis of Hepatocutaneous Syndrome in a Dog

A 14-year-old, female spayed Bichon Maltese with no other known previous pathologies was presented for dermatological examination after being referred from a private clinic with the suspicion of generalized, treatment-resistant demodicosis. Upon presentation and clinical examination, multiple deep skin scrapings were performed, returning negative parasitological results. Complete blood count and serum biochemistry revealed mild hepatic damage. Abdominal ultrasound revealed an abnormal echostructure of the liver displaying a honeycomb or Swiss cheese-like pattern, reported as pathognomonic for hepatocutaneous syndrome. The owner declined any further paraclinical examination, including skin biopsy and histopathological examination, requesting a treatment protocol that could be pursued at home, considering the age of the dog and its reactive behavior during the examination. The present case report highlights a non-invasive method of diagnosing the hepatocutaneous syndrome in a dog by clinical examination, routine blood testing, and ultrasound assessment of the abdomen, in the absence of the possibility of doing a histopathological diagnosis.

Clinical Guidelines for the Use of Antipruritic Drugs in the Control of the Most Frequent Pruritic Skin Diseases in Dogs

Pruritus is a common clinical sign in many skin disorders and is currently the main complaint in canine dermatology. Pruritic skin diseases can affect the quality of life of dogs and their owners. Several families of antipruritic drugs are available to help control pruritus in dogs. The aim of this review is to help practitioners select the most appropriate symptomatic treatment in the most frequent situations of dermatological pruritus in dogs. The molecules reviewed here are systemic and topical glucocorticoids, antihistamines, ciclosporin, oclacitinib and lokivetmab. A level of evidence (1, 2 or 3) has been established according to a detailed algorithm for each individual study in the literature published between 1990 and March 2021. The guidelines result from evidence grading using the strength of recommendation taxonomy (SoRT) and clinical recommendations using a thorough methodology.