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Mystery dermatology cases: A potpourri of interesting cases (Proceedings)

October 1, 2008
Christine Rees, DVM, DACVD

Chili has had hair loss along the neck and ventrum for the last six months.

MYSTERY CASE #1: Chili

Signalment: 4 year old, male castrated, dachshund

History: Chili has had hair loss along the neck and ventrum for the last six months. The hair loss started as a spot on the right shoulder and has since spread to the areas seen today. The hair loss extends from the ventral area (including the neck and chest extending into the inguinal area) and thins out along the lateral sides of the dog. The hair loss on the tops of the ears has a circular pattern and does not appear pruritic. This dog has been drinking and urinating more lately.

Physical Examination: T= 102 degrees F, P= 72 bpm, R= 40 bpm, weight= 12 pounds

Chili appeared bright, alert and responsive during her examination. The body condition score of 8 out of 10. There was moderate tartar buildup her teeth.

Chili's hair coat is dry to the touch with scale and hair loss along ventrum, along neck and right shoulder and on tops of the ears. There is hair loss along right lateral aspect of the tail. Chili does not seem pruritic at this time.

Differential Diagnoses:

Diagnostic Tests:

Diagnosis:

Treatment:

Follow-up/Comments:

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MYSTERY CASE #2: Bailey

Signalment: 3 month old, female, Chihuahua

History: Two month history of pruritus of both ears, a swollen vagina and swollen anal area. Bailey has been treated for coccidian with Albon and was diagnosed with a Staphylococcal infection of ears was treated with Amoxicillin by the referring DVM. The owner thought that Bailey had a reaction to the Amoxicillin that was given several weeks ago and the dog's antibiotic was switched to Clindamycin about 3 weeks ago. At the same time as starting the Clindamycin, Bailey was started on prednisone and diphenhydramine for the pruritus. When trying to wean the dog off the prednisone, the symptoms returned and Bailey was referred. The dog is on every other day prednisone and according to the owner Bailey is a 10 out 10 pruritic (scale of 0 to 10 with 10 being the most severe or keeping the owner up at night).

Physical Examination:T= 101.8 degrees F, P= 158 bpm, R= 44 bpm, Weight= 2.2 pounds.

Bailey is bright and alert. Both ears are erythematous and have severe crusting along the margins. An area of alopecia was present on the left shoulder area. The anal and vaginal areas were erythematous and swollen.

Differential Diagnoses:

Diagnostic Tests:

Diagnosis:

Treatment:

Follow-up/Comments:

MYSTERY CASE #3: Nikita

Signalment: 12 year old, FS, Shepherd mix.

History: Nikita has a 3 month history of a swollen right foot. The toenail was torn and had a secondary infection. Previous treatments included clavamox and baytril orally. Initially, some response was noted to antibiotics alone but the second course of antibiotics has not been helpful in resolving the dermatitis. Radiographs of the foot revealed no boney involvement.

Physical examination: T= 101.8 degrees F, P= 80 bpm R= 40 bpm,

weight= 88.5 pounds

Several abnormalities were noted on physical examination. A 1 cm diameter raised nodule was present above the left eye. The right ear had some crusts and erythema. The right front foot was swollen with a red/black color to it on the dorsum. On the ventral surface of the right front foot, it was moist, oozing and had a purulent discharge. The rest of the feet were slightly erythematous. The chin had some alopecia and erythema. The prescapular lymph nodes were slightly enlarged.

Differential Diagnoses:

Diagnostic Tests:

Diagnosis:

Treatment:

Comments/Follow-up:

MYSTERY CASE #4: Bob

Signalment: 3 year old, castrated male, DSH

History: Two month history of facial pruritus. This cat is current on his vaccinations and lives with one other cat. The other cat recently has started to excessively groom himself.

Physical examination: T= 102 degrees F, P= 110 bpm, R= purring, Wt= 9 pounds

The only abnormality on physical examination was some alopecia and excoriations of the face. The rest of the body appeared normal.

Differential Diagnoses:

Diagnostic Tests:

Diagnosis:

Treatment:

Follow-up/Comments:

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