Page 1460 - Clinical Small Animal Internal Medicine

1398 Section 12 Skin and Ear Diseases

allow more prolonged effect, and newer formulations antiseborrheic agents, astringents, anti–inflammatory,
VetBooks.ir such as microemulsion sprays which can work well on antimicrobial, and antiparasitic ingredients. Some ani-
mals may not allow their application. Alcohol‐containing
large body surfaces without the need for baths. The active
ingredients in rinses may vary but they often include
particularly in acute inflamed skin disorders.
moisturizers, antiseborrheic agents, and antimicrobials. sprays, which are meant to quickly dry, may be irritating,
Lotions Mousses
Lotions are often used for their cooling, antipruritic, Mousses are a new form of topical therapy in veterinary
antimicrobial, and drying effects, depending on their medicine and provide an easy and pleasant way for pet
inactive agents such as water, alcohol and propylene owners to deliver active ingredients to haired and non-
glycol, and their anti–inflammatory, antipruritic, and haired skin. The product must be applied directly to the
antimicrobial active ingredients. They are usually rec- skin in order to be effective. Mousses may contain anti-
ommended for a determined period of time but may also pruritic, antimicrobial, and antiseborrheic agents.
be used for maintenance.
Spot‐On Solutions
Creams and Ointments Spot‐on formulations include flea and tick preventatives,
Creams and ointments lubricate the skin, facilitate hydra- fatty acids, ceramides and keratolytic or antiseborrheic
tion of the stratum corneum, help prevent water loss, and agents. These formulations are usually lipophilic with
form a protective covering increasing the penetration of large molecular weights which slow dermal absorption,
active ingredients. However, these formulations are con- lower systemic bioavailability, and provide a large area of
traindicated in exudative areas. They may contain water‐ distribution.
washable bases such as polyethylene glycol or hydrophobic
oils such as mineral oil. The main disadvantages of these Wipes
products include their somewhat difficult application to Medicated wipes are very useful for treatment of inter-
hairy skin, their occlusive properties which can potentially triginous areas such as the interdigital, perianal, perivul-
lead to folliculitis, and they can be greasy and messy (oint- var, facial, and tail skinfolds. They contain antimicrobials
ments). Also, their use is limited to localized and small or antiseptics and can be used for prevention and treat-
areas such as the paws, elbows, and nose. They are also ment of bacterial and yeast skin infections. Alcohol‐
often used in ears. Most commonly, these formulations containing wipes may be irritating, particularly in acute
contain antimicrobials, anti–inflammatory, antipruritic, inflamed skin disorders.
keratolytic, and ultraviolet (UV) radiation‐blocking
agents. Creams are white and nongreasy and contain pre- Ear Cleaner Solutions
servatives to protect against growth of bacteria and fungi. Ear cleaners can be used for the treatment of ear
Ointments are oil based or emulsions of oil and water infections, on a maintenance regimen to help prevent
droplets that do not dissipate well when applied to the infections, and after bathing or swimming to keep the
skin. They are greasy and clear and do not require pre- ear canals dry. Ear cleaners are often used in conjunction
servatives. Ointments are selected when increased absorp- with topical antibiotics, antifungals, and/or glucocorti-
tion, hydration, and occlusion are required. coids. The frequency of cleaning varies from once daily
to once weekly according to the needs of each patient. It
Gels is important to demonstrate the cleaning technique to
Gels do not have a sticky residue and are not messy, com- pet owners to improve compliance and efficacy.
pared to creams and ointments. Most commonly, they The choice of cleaner depends on the condition of the
contain anti–inflammatory, antimicrobial, and keratolytic ears. Ceruminolytic agents help remove dry waxy mate-
agents in combination with other inactive agents such as rial by dissolving cerumen and include propylene glycol,
propylene glycol and carboxypolymethylene. They are mineral and vegetable oils, essential oils, glycerine, and
mostly used for localized treatment or small skin areas. xylene. Astringents work as drying agents, reducing
humidity and helping prevent maceration. They are indi-
Sprays cated for moist ears and include isopropanol, boric acid,
Sprays can be very useful and convenient for the treat- benzoic acid, salicylic acid, acetic acid, and aluminum
ment of large body areas when frequent baths are not acetate. Drying agents are typically used after debris or
possible and can also complement the use of medicated exudate has been removed from the ear canals with a
shampoos. They may also facilitate treatment of difficult ceruminolytic agent. Surfactants emulsify debris and are
areas such as perianal areas and the interdigital aspects good for removing tightly adhered debris and include
of paws. Sprays may contain emollients, moisturizers, docusate, calcium sulphosuccinate, and sodium lauryl