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Feline Dermatoses Flashcards

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1
Q

What is preauricular alopecia? What is the significance?

A
  • Alopecia that is normal and located in the preauricular area in cats
  • Very noticeable in black cats
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2
Q

Describe the appearance and distribution of lentigines?

A
  • Pigmented macules or patches on orange cats due to increased melanocytes and melanin
  • Nasal planum, eyelids, lips, gingiva, pinnae
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3
Q

Significance of lentigines?

A
  • Coalesce and increase with age

- Benign!

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4
Q

How common are feline dermatoses relative to canine?

A
  • Less common
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5
Q

How common is true folliculitis (pyoderma) and secondary infections (yeast dermatitis) in cats?

A
  • Less common
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6
Q

Are historical details and location of pruritus as consistent with felines?

A
  • No
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7
Q

What are reaction patterns?

A
  • Reactions that commonly develop secondary to an antigenic stimulus from either allergies or ectoparasites
  • Can also be seen with infectious caues such as ringworm though
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8
Q

What is the systematic diagnostic approach to cats?

A
  • FeLV/FIV status
  • Rule out dermatophytes
  • Rule out flea allergy, etc.
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9
Q

How do cats manifest pruritus?

A
  • Scratching
  • Biting
  • Excessive grooming (hairballs)
  • Hypotrichosis
  • Alopecia
  • Hiding
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10
Q

What virus can be associated with intense pruritus?

A
  • Herpes
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11
Q

What should you check with a non-healing wound in a cat?

A

FeLV/FIV status

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12
Q

What are three feline reaction patterns you should absolutely know?

A
  • Miliary dermatitis
  • Alopecia
  • Eosinophilic granuloma complex
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13
Q

Describe miliary dermatitis

A
  • Small, multifocal crusts
  • Crusted papular eruption
  • Can be focal or generalized
  • Can feel with palpation
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14
Q

Differentials for miliary dermatitis

A
  • Allergies (flea, food, atopy, insect)
  • Ectoparasites (Notoedres, Cheyletiella, D. gatoi)
  • Infectious (Dermatophyte, Pyoderma, Malassezia)
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15
Q

Alopecia appearance with cats

A
  • Bald belly but often no skin lesions
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16
Q

What diagnostic test should you do with “bald belly” in a cat, and what is it telling you?

A
  • Trichogram to determine if hair is falling out or being removed
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17
Q

Dfdx for “bald belly” or alopecia

A
  • Allergy (flea, food, atopy)
  • Ectoparasites (Cheyletiella, D. gatoi)
  • Infectious (dermatophyte)
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18
Q

What is an eosinophilic granuloma complex?

A
  • Eosinophilic infiltrate
  • Antigenic stimuli
  • Hypersensitivity reaction
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19
Q

What are common underlying causes for eosinophilic granuloma complex (since it’s NOT a diagnosis)?

A
  • Allergies, hypersensitivities, and ectoparasites are common underlying causes
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20
Q

What are the three syndromes associated with eosinophilic granuloma complex?

A
  • Indolent ulcer
  • Eosinophilic plaque
  • Eosinophilic granuloma
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21
Q

Describe an eosinophilic plaque?

A
  • Alopecic
  • Erythematous raised plaques, erosions, or ulceration**
  • Pruritic
  • Abdomen and thighs
  • often moist and oozing
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22
Q

Describe an indolent ulcer

A
  • Rodent ulcer
  • Upper lip
  • Unilateral or bilateral
  • Non-painful
  • Can become disfiguring
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23
Q

What are four types of eosinophilic granulomas

A
  • Linear granuloma
  • Oral granuloma
  • Interdigital granuloma
  • Pouty lip or fat chin syndrome
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24
Q

Location of eosinophilic granulomas?

A
  • Caudal aspect of rear legs, chin, axilla
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25
Clinical signs of most eosinophilic granulomas?
- Usually asymptomatic
26
Describe linear granulomas (appearance, location, pruritic or not)?
- Linear conformation - Yellow or pink nodules - Caudal thighs, chin, axilla - Not pruritic - Discovered incidentally
27
Describe oral granuloma appearance, and where do they show up?***
- Hard or soft palate - Tongue - Nodular looking thing
28
Describe interdigital granuloma
- Can be asymptomatic or clinical | - Nodular or ulcerative masses in-between the digits
29
Rule outs for feline allergy?
- Flea - Food - Atopy - Insect
30
What is the most common allergy in cats?
- Flea allergy
31
Seasonality of flea allergy in cats?
- Can be seasonal or non-seasonal
32
Clinical signs of FAD?
- Any eosinophilic granuloma complex lesions - Itching - OVergrooming
33
Which flea causes FAD in cats?
- Ctenocephalides felis
34
Can flea allergy happen even if: Cat is indoor or outdoor? No fleas seen? Flea control?
- YeS
35
Pathogenesis of FAD
- Antigen in saliva - Type I and IV - Hypersensitivities
36
Diagnosis of flea allergies in cats
- Flea comb may or may not be helpful (negative doesn't rule it out) - Fecal (tapeworms support) - Response to therapy (treat secondary infections; capstar trial every other day for 30 days; or bravecto) - Rule it out in every pruritic cat
37
Treatment for flea allergy
- Strict, year-round flea control - Topical adulticide (Bravecto or Revolution) - Flea control for all in-contact animals (Revolution) - +/- treat environment (Lufenuron; environmental treatment)
38
What is the second most common allergy in cats?
- Food allergy
39
Reaction patterns possible with food allergy
- Any - Any eosinophilic granuloma complex lesions - Recurring otitis
40
Seasonality of food allergy in cats
- Non-seasonal
41
Age of cat with food allergy
- Often <1 year
42
Distribution of pruritus in cats with Food allergy
- Head and neck pruritus common
43
Concurrent signs with food allergy in cats
- 10-30% have concurrent GI signs
44
Which proteins are cats allergic to most commonly?
- Chicken - Beef - Dairy - Fish
45
Pathogenesis of food allergy in cats
- Largely unknown | - Allergen in most cases is a protein
46
Diagnosis of food allergy in cats
- Food trial (novel protein vs hydrolyzed diet) - 6-8 week minimum - STRICT - At the end, challenge with original diet - Treat with any secondary infections
47
Serum allergy tests for food allergy
- Not reliable
48
Which diets are appropriate for a food trial?
- RC rabbit - RC ultamino - RC HP
49
Seasonality of feline atopy
- Seasonal or non-seasonal pruritus
50
Reaction patterns possible with feline atopy
- Any reaction pattern | - Any eosinophilic granuloma complex lesiosn can be seen
51
Pathogenesis of atopy in cats
- Inhaled and cutaneously absorbed allergens | - Type I hypersensitivity
52
How to diagnose atopy in cats?
- Rule out flea and food allergies first (Bravecto or Revolution or advantage multi every 2 weeks for 3 consecutive treatments) - treat for ectoparasites - Diagnose infections - Atopica trial
53
Treatment for atopy
- Antihistamiens - Glucocorticoids - Atopica - Allergy specific immunotherapy - Bathing? - Free fatty acids?
54
Antihistamines for cats with Atopy
- Chlorpheniramine (mediocre) - Amitriptyline (also psychotropic) - Cetirizine (Zyrtec)
55
Atopica trial for cats with atopy
- Cyclosporine | - Approved for use in cats
56
What needs to be done before atopica trial in cats?
- Baseline bloodwork - FeLV/FIV - Dermatophyte culture!
57
Steroids for atopy in cats
- Prednisolone EVERY other day | - maybe more effective in ats?
58
Which insect is most responsible for insect hypersensitivity?
- Mosquitoes
59
Lesions associated with insect hypersensitivity
- Papules, pustules, crusts
60
WHere are lesions associated with insect hypersensitivity?
- Bridge of the nose, outer pinnae, footpads
61
Pruritus associated with insect hypersensitivity?
- Mild to severe pruritus
62
Diagnosis of insect hypersensitivity
- CLinical signs | - Outdoors at dusk
63
Therapy for insect hypersensitivity
- Indoor only - Restrict access to outdoors at dusk - Insect control - Steroids
64
What should you do with pruritic ectoparasites?
- Always consider | - Always rule out
65
Appearance of Notoedric mange in cats
- Rare with endemic foci - Pruritus of head and neck - Crusting of head, ears, feet, perineum
66
How to diagnose Notoedres in cats?
- Superficial scrape
67
Notoedres cati characteristics: Contagious or not? Zoonotic or not?
- Contagious AND zoonotic
68
Etiology and appearance of Cheyletiellosis
- Cheyletiella blakei - Large saddle-shaped with ACCESSORY MOUTH PARTS - Walking Dandruff
69
How common is Cheyletiella?
- Not common anymore
70
Is Cheyletiella contagious? Zoonotic?
- Contagious and zoonotic
71
Treatment of Notoedres
- Treat all in-contact animals - Bravecto - REvolution/Advantage Multi every 2 weeks for 3 consecutive treatments - Lime sulfur - Ivermectin
72
Cheyletiella clinical signs
- Scale along the dorsum - miliary dermatitis - ALopecia (symmetrical) - Pruritus - Asymptomatic carriers are possible too
73
Diagnosis of Cheyletiella
- Not always easy - SUperficial skin scrape - Acetate tape prep - Fecal - Flea comb - vacuum technique (hook up to a vacuum and collect) - Response to treatment***
74
Treatment of Cheyletiella
- All in-contact animals - This mite is easy to treat - Frontline works - Bravecto - Revolution - Advantage Multi - Lime sulfur dips
75
Demodex gatoi
- Refer to notes on feline demodicosis | - Lime sulfur or bravecto?
76
Infectious causes of pruritus
- Dermatophytosis and Pyoderma
77
What must you rule out before using medications like steroids or atopica?
- Need to know if the cat has dermatophytosis | - Refer to notes
78
What are common underlying causes of pyoderma?
- True bacterial folliculitis is uncommon as compared to dogs - Secondary infection to underlying allergies or ectoparasites - Treat/address the same as in dogs
79
How common is psychogenic alopecia?
- Very uncommon | - Most (>80%) have above causes
80
Which breeds are overrepresented with psychogenic alopecia?
- Asian breeds overrepresented
81
Clinical signs of psychogenic alopecia?
- alopecia but no lesions
82
How to diagnose psychogenic alopecia?
- Diagnosis of exclusion by ruling out other potential causes of alopecia
83
Treatment of psychogenic alopecia
- Identify and eliminate possible stressors - Psychotropic medications - Amitriptyiline
84
Otodectes etiology
- Otodectes cynotis
85
Common clinical signs of otodectes?
- Otitis | - Pruritic dermatitis of the head and neck
86
Treatment for superficial mites (Notoedres, Cheyletiella, Otodectes)?
- Bravecto - Revolution - Advantage Multi - Ivermectin - Lime sulfur dips
87
Where does D. gatoi live?
- Stratum corneum
88
Appearance of D. gatoi
- Short, fat bodied mite
89
Is D. gatoi contagious?
- Yes
90
Diagnosis of D. gatoi
- Broad superficial scrapes (tough to find; between shouldre blades; scrape in contact animals) - fecal
91
Treatment trial for D. gatoi
- Lime sulfur dip - At least 6 dips - All in contact animals if improvement is seen
92
Other differentials for cats with skin lesions
- Dermatophytosis - Autoimmune - Neoplasia - Paraneoplastic - Psychogenic
93
Which species of dermatophyte is most common in cats?
- Microsporum canis
94
Reaction pattern seen with M. canis?
- Miliary dermatitis
95
How to diagnose pyoderma and malassezia in cats?
- Cytology
96
Treatment for pyoderma in cats
- Topicals - Oral abx like cephalosporins - Injectable Convenia
97
Treatment for Malassezia in cats
- Topicals | - Oral antifungals (fluconazole, terbinafine)
98
Treatment of psychogenic alopecia
- Identify and limit stress | - Behavior modifying drugs
99
Diagnostic approach to pruritic cat: Step 1
- Derm data base for EVERY case - Fungal culture (+treat for dermatophyte) - SKin scrape (+ treat for mites) - SKin cytology (bacteria or yeast treat secondary infections; eosinophils work up for allergy)
100
Diagnostic approach to pruritic cat: Step 2
- Rule out FAD and ectoparasites - Strict flea control (Bravecto; Revolution/Advantage Multi trial every 2 weeks for three treatments) - Treat the itch (steroids, antihistamines)
101
Diagnostic approach to pruritic cat: Step 3
- Food trial - Atopica trial - Lime sulfur dip trial
102
Step 4: if no response to food trial
Long term steroids? Atopica? Allergy desensitization therapy? Lime sulfur trial to rule out demodex gatoi?
103
If response to Atopica?
- Continue long-term and reduce to every other day - Monitor bloodwork every 6-12 months to ensure drug safety - Consider allergy desensitization therapy (allergy shots?)
104
Anti-inflammatory doses of prednisolone in the dog?
- 0.5-1 mg/kg/day
105
Immunosuppressive doses of prednisolone in the dog
- 2 mg/kg/day
106
Dexamethasone doses
- I think you divide by 10
107
Short acting steroids for cats
- Prednisolone (goal is taper to every other day) | - Dexamethasone (taper to 2x a week)
108
Long acting steroids - use?
- Try to avoid - Depomedrol every 3 months - Triamcinolone acetonide give every 3 months
109
What do you need before starting steroids?
- Basic bloodwork - FeLV/FIV - Dermatophyte culture - Auscult chest?
110
Serious side effects of glucorticoids?
- Skin fragility syndrome - Medial curling of Pinnae (depomedrol) - Congestive heart failure - Diabetes mellitus
111
Do cats tend to get primary or secondary scaling?
- Secondary much more common
112
Is dry or greasy seborrhea more common in cats?
- Cats tend to get seborrhea sicca
113
What is most common cause of scaling?
- Secondary to miliary dermatitis
114
Dfdx for miliary dermatitis
- Flea allergy - Others - Dermatophytosis - Cheyletiellosis - Pyoderma - Pemphigus foliaceus
115
other secondary causes of scaling
- Fleas - Cheyletiellosis - Demodicosis - Pediculosis
116
Endocrine causes of scaling
- Hyperthyroidism | - Diabetes mellitus
117
What is feline acne?
- Focal primary follicular keratinization disorder | - Idiopathic
118
Clinical signs of feline acne
- Comedones - Papules, pustules - Crusting - Nodules
119
Diagnosis of feline acne
- Derm database - Scrape - Cytology - +/- culture and sensitivity
120
Treatment of feline acne
- Treat any complicating factors like bacteria (mupirocin and oral antibiotics) - Symptomatic therapy for underlying keratinization disorder (Keratolytic/keratoplastic like benzoyl peroxide)
121
How common is plasma cell pododermatitis?
- NOt at all | - Rare
122
Clinical signs of plasma cell pododermatitis?
- Soft painless swelling of metacarpal/tarsal footpads - White cross-hatches - +/- ulcerate
123
Causes of plasma cell pododermatitis
- Unknown - Maybe immune-mediated? - ~50% are FIV positive
124
Treatment of plasma cell pododermatitis?
- Spontaneous regression - Doxycycline - Immunosupression - Food trial - Change in kitty litter? - Surgery
125
Diagnosis of idiopathic seborrhea
- Cytology and biopsy
126
Treatment of seborrhea
- Difficult to manage | - SYmptomatic therapy

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