Ulcerative disease

Question 1

what can you see on cytology with ulcers

Answer 1

blood cells
macrophages likely to be present- because dermis exposed

Question 2

what is primary ulceration

Answer 2

Diseases within the skin that result in epidermal loss
due to- bacterial, viral, fungal, immune-mediates, traumatic and idiopathic causes

Question 3

List 3 viral causes of ulceration in cats

Answer 3

Feline herpesvirus infection
Feline calicivirus infection
Feline cowpox infection

Question 4

Name a immune-mediate disease that can cause ulceration in cats

Answer 4

feline plasma cell pododermatitis

Question 5

Name a neoplasm that can cause ulceration in cats

Answer 5

squamous cell carcinoma

Question 6

where are ulcerations likely to occur with feline herpes virus-1

Answer 6

facial lesions make a mask (eyelids, muzzle and nose +/- other parts of body)

Question 7

Describe how to diagnose feline herpes virus-1

Answer 7

Diagnosis on histopathology- eosinophilic +/- neutrophilic inflammation

Question 8

where are ulcers generally seen with calicivirus

Answer 8

ulcers and vesicles on mucous membrane, lips and nose

Question 9

Describe how to treat viral causes (FHV-1 and FCV) of ulcers in cats

Answer 9

supportive care
specific antivirals may be useful in FHV-1- (lysine IS NOT EFFECTIVE)

Question 10

which cats generally affected by cow poxs

Answer 10

hunting cats- often rural setting

Question 11

Descrieb what you see with cow pox in cats

Answer 11

initially= signs usually start around head- crusted ulcer
7-14 days later= secondary papular crusting eruption
spontaneous recovery around 4-5 weeks as long as they have not been given steroids

Question 12

Describe how to diagnose cow poxs

Answer 12

biopsy or PCR

Question 13

Decsribe how to treat cow poxs

Answer 13

NOT GIVE STEROIDS/IMMUNOSUPPRESSANTS
supportive therapy
manage co-morbidities
zoonotic- PPE essential

Question 14

what is the cause of plasma cell pododermatitis

Answer 14

unknown - immune-mediated???
strong relationship to FIV in some studies

Question 15

CLinical signs of plasma cell pododermatitis

Answer 15

soft swollen pads- mushy
some times have oral/nasal lesions

Question 16

Diagnosis of plasma cell pododermatitis

Answer 16

FNA show plasma cells - often scant
Biopsy may be needed to confirm

Question 17

signs of canine cutaneous lupus - FDLE

Answer 17

Nasal planum / nares
Erythema, depigmentation, scaling-> erosions/ulcerations, loss of architecture of nasal planum +/- crusting

Question 18

Treatment of plasma cell pododermatitis

Answer 18

spontaneous regression
prolapsed material= surgical repair
immune-modulation
prognosis god unless underlying disease

Question 19

diagnosis of canine cutaneous lupus- FDLE

Answer 19

histopathology - biopsy

Question 20

signs of cutaneous lupus- MCLE

Answer 20

Perimucosal ulcerated skin lesions / pain on urinating/defaecating
Anus, perigenital region, lips, periocular / symmetrical

Question 21

Treatment of cutaneous lupus

Answer 21

topical- where possible, antiseptics, steroid creams, tacrolimus

systemic- risk of adverse effects- immunosupression - avoid chronic intermittent use of oral ABs

Question 22

signs of mucocutaneous pyoderma

Answer 22

erythema, swellign crusting
ulcers

Question 23

Treatmetn of mucocutaneous pyoderma

Answer 23

ABs and chlorohexidien washes for 3-4 weeks
intermittent topical steroids for long term use

Question 24

Describe Cutaneous epitheliotropic lymphoma

Answer 24

older dog
variable presentation
oral lesions are common
ulcerations
variable response to chemo - can just treat signs of itch

Question 25

What is vasculitis

Answer 25

Immune-mediated damage of cutaneous blood vessels, but systemic involvement needs to be considered

Question 26

what is first affected by vasculitis

Answer 26

pinnae, tail tip, pads and nails

Question 27

Treatment of vasculitis

Answer 27

underlying cause- there are lots Immunosuppressive agents (e.g. steroids) Perfusion enhancing drugs (e.g. propentofylline) Surgery sometimes needed for tail and ear lesions

Question 28

History seen with erythema multiforme

Answer 28

acute onset lots of triggers T-cell mediated attack of keratinocytes leading to cell death Rare to uncommon

Question 29

Diagnosis of erythema multiforme

Answer 29

acute onset - rule out other causes biopsy for definitive diagnosis

Question 30

Treatment for mild erythema multiforme

Answer 30

spontaneous regression possible look for underlying cause- correct it

Question 31

Treatment for extensive erythema multiforme

Answer 31

supportive care and immunosuppressive drugs have a marked risk of secondary bacterial infection

Question 32

How do Decubital ulcers (pressure sores) occur

Answer 32

Result from prolonged application of pressure - Over a boney prominence - Under a bandage - In very heavy or debilitated animals

Question 33

Describe the stages of pressure sores

Answer 33

Stage 1= Redness of the skin, Erosions and possibly ulceration Stage 2= Ulceration into the subcutis Stage 3= Ulceration into underlying tissues Stage 4= Ulceration to level of bone

Question 34

Treatment of pressure sores

Answer 34

prevention is way better treatment= clean, protect (ring bandage), treat infection

Question 35

Describe hat we need to explain to owners about immunosuppression

Answer 35

control- initially complete control then titrate- reduce dose to lowest level maintain monitor- to check for iatrogenic adverse effects

Question 36

what form of immune response do glucocorticoids contrl

Answer 36

humoral immune response

Question 37

what form of immune response does ciclosporin control

Answer 37

cell-mediated immune response

Question 38

what adjuvant drugs can be added to steroids or ciclosporin

Answer 38

azathioprine Chlorambucil

Question 39

what species should azothioprine not be used in

Answer 39

Cats

Question 40

List 3 possible side effects of azathioprine

Answer 40

myelosupression pancreatitis hepatotoxicity

Question 41

List 3 possible side effects of chlorambucil

Answer 41

anorexia v+ D+