Page 1443 - Clinical Small Animal Internal Medicine

157 Approach to the Patient with Dermatologic Disease 1381

Table 157.1 (Continued) The presence of systemic signs and the pet’s general
VetBooks.ir Breed Disease health should be addressed, such as water intake, appe-
tite, vomiting, diarrhea, frequency/number of bowel
Shih tzu Atopic dermatitis movements, changes in urination, respiratory changes,
lethargy, and body condition changes. General informa-
Demodicosis tion about the patient’s environment and geographic
Traction alopecia
Siamese cat Epidermolysis bullosa location needs to be considered. Certain diseases are
endemic in various regions such as blastomycosis in the
Food hypersensitivity
Hypotrichosis Mississippi, Missouri and Ohio river valleys or coccidioi-
Periocular leukotrichia domycosis in the southwestern portion of the United
Psychogenic alopecia States. For the same reason, travel history should also be
Vitiligo obtained. It is pertinent to ask if other animals in the
Siberian husky Atopic dermatitis home or the owners themselves are affected. If so, conta-
Discoid lupus erythematosus gious and zoonotic diseases need to be considered.
Eosinophilic furunculosis Other medical problems, vaccine history, lists of previ-
Eosinophilic granuloma
Follicular dysplasia ous and current treatments and medications, including
Idiopathic onychodystrophy topical therapy, flea control products and frequency of
Postclipping alopecia administration, need to be addressed, including the
Uveodermatologic syndrome responses to these therapies. Reviewing previous medi-
Zinc‐responsive dermatosis cal records can be particularly helpful regarding medica-
Silky terrier Color dilution alopecia tion history, as often owners find it difficult to remember
Follicular dysplasia all the previous medications, including the ones the
Vaccine‐induced vasculitis
Sphynx cat Urticaria pigmentosa patient may be currently taking. Asking owners to bring
these medications to the initial consultation can also be
Staffordshire Atopic dermatitis helpful in this regard. Any previous medical records
bull terrier Canine flank alopecia should be reviewed to help track episodes of recurrence
Demodicosis
Pedal folliculitis and furunculosis (is there a seasonality?) and progression of the skin dis-
Pattern alopecia ease, verify client observations, and identify past and
Vizsla Sebaceous adenitis current medications, including dose and duration. The
Weimaraner Canine acne response to various treatments can also be extremely
Color dilution alopecia helpful in the identification of underlying disease pro-
Immunodeficiency (commonly IgG) cesses. For example, a patient that presents on high doses
Mast cell tumor of glucocorticoids for suspected allergic dermatitis that
Melanoma is still markedly pruritic needs to be evaluated for sar-
Pattern alopecia coptic mange and/or undergo a treatment trial for this
Sterile granuloma pyogranuloma syndrome
West Atopic dermatitis disease if the mites cannot be found, as allergic patients
tend to be glucocorticoid responsive. When presented
Highland Demodicosis
white terrier Epidermal dysplasia with a patient that is on an appropriate dose and dura-
Food hypersensitivity tion of antibiotic therapy for superficial pyoderma and is
Ichthyosis not responding, a skin culture needs to be performed.
Malassezia dermatitis Finally, a complete dietary history including vitamins,
Seborrhea, primary herbs, and other supplements should be taken. This will
Wheaten Atopic dermatitis be useful if a food elimination trial needs to be performed
terrier Cutaneous asthenia as well as to assess if the diet is complete and balanced.
Ichthyosis
Whippet ABCB1 gene mutation Poor diets can lead to keratinization disorders, poor
haircoat quality, and zinc‐responsive dermatosis.
Color dilution alopecia
Pattern alopecia
Solar dermatitis
Yorkshire Color dilution alopecia Physical Examination
terrier Demodicosis
Dermatophytosis
Follicular dysplasia The patient’s weight, rectal temperature, and pulse
Melanoderma and alopecia should be obtained by the veterinary technician or assis-
Pinnal alopecia tant before or during review of the patient history. Every
Traction alopecia patient examination should be approached in a system-
Vaccine‐induced alopecia (rabies)
atic fashion to ensure a thorough PE. Avoid focusing