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Pilonidal Cyst 788.e3

• Antibiotics (e.g., ampicillin 22 mg/kg IV q dysfunction or complications such as severe Technician Tips
6-8h, enrofloxacin 5 mg/kg diluted 1 : 1 in hyperthermia due to hypocalcemic tetany A phosphate enema (Fleet or other brands)
VetBooks.ir 24h in cats]) in cases with history of colonic on the timing and extent of subsequent supplied in a transparent, soft plastic bottle Diseases and Disorders
is formulated as a clear liquid that is usually
have a guarded/poor prognosis, depending
sterile water and given slowly IV q 12h [q
disease and suspicion or evidence of sepsis
treatment.
and is never appropriate for cats or small dogs.
due to translocation of enteric bacteria
(DSS) enemas, products made specifically for
PEARLS & CONSIDERATIONS Many safe alternatives (e.g., docusate sodium
Drug Interactions small animals) are available.
• Sodium bicarbonate is not recommended Comments
(unless severe acidosis develops) because • Hypernatremia lasting more than 12-24 hours SUGGESTED READING
of its hypertonic nature; it may exacerbate needs to be treated as a chronic condition. Stern LA: Hypertonic phosphate enema intoxication
hypokalemia and hypocalcemia and may In such cases, increased serum sodium level in dogs and cats. Vet Med May 27, 2015. http://
cause metabolic alkalosis. requires slow reduction over 48 hours at a veterinarymedicine.dvm360.com/hypertonic-
• Insulin for hyperglycemia is not indicated rate of not more than 0.5 mEq/L/h (p. 1428). phosphate-enema-intoxication-dogs-and-cats/.
because spontaneous resolution is expected. • Avoid administration of phosphate-
containing enemas, especially to small ADDITIONAL SUGGESTED
Possible Complications patients (<10 kg) or patients with severe READINGS
• Hyperthermia due to hypocalcemia-induced obstipation or suspected/known compromise Atkins CE, et al: Clinical, biochemical, acid-base, and
muscle fasciculations of the colonic wall, marginal or compromised electrolyte abnormalities in cats after hypertonic
• Cerebral edema if hypernatremia of > 12-24 renal function, or preexisting hypernatremia, sodium phosphate enema administration. Am J
hours’ duration is corrected overly rapidly hyperphosphatemia, or hypocalcemia. Vet Res 46:4, 1985.
• For injectable calcium, calcium chloride Jorgensen LS, et al: Electrolyte abnormalities induced
Recommended Monitoring is generally not recommended due to its by hypertonic phosphate enemas in two cats. J Am
• Serum electrolyte levels (q 8-12h as needed potentially severe corrosive effects if it leaks Vet Med Assoc 187:12, 1985.
until normal) perivascularly/subcutaneously.
• Acid-base status • Doses for injectable calcium can be listed in RELATED CLIENT EDUCATION
2+
milligrams of elemental calcium (Ca ) or SHEET
PROGNOSIS & OUTCOME in milligrams of compound (e.g., calcium
gluconate, calcium chloride). It is important Human Medications Dangerous for Pets
• Patients treated promptly and thoroughly to be clear which dose is used to avoid AUTHOR: Eric Dunayer, VMD, MS, DABT, DABVT
have a good prognosis; complete recovery overdosing or underdosing. For example, EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
is expected. a 10% calcium chloride (CaCl 2 ) solution
• Patients for whom treatment is delayed has 100 mg/mL calcium chloride, which is
2+
or that develop central nervous system 27.2 mg of Ca /mL CaCl 2 .

Pilonidal Cyst Client Education
Sheet

Clinical Presentation
BASIC INFORMATION • If the cyst is infected and communicates
DISEASE FORMS/SUBTYPES with the spinal canal, clinical signs may be
Definition • Single or multiple dermal draining tracts associated with
Uncommon (usually breed associated), focal, • Subcutaneous cystic mass(es) along the dorsal ○ Myelitis
tubular skin lesion with a cutaneous opening midline ○ Meningomyelitis
extending ventrally from dorsal midline as ○ Encephalitis
a blind sac or possibly connecting to dura HISTORY, CHIEF COMPLAINT ○ Pain and neurologic dysfunction: due to
mater • Opening in the skin on dorsal midline with inflammation or tethering effect of the
hair protruding from the opening sinus on the spinal cord
Synonyms • The chief complaint may be a dorsal
Pilonidal sinus; dermoid sinus or cyst midline mass consisting of concretions of Etiology and Pathophysiology
accumulated hair and sebum matting the Congenital neural tube defect:
Epidemiology opening. • Incomplete separation of the skin and neural
SPECIES, AGE, SEX tube during embryonic development
Young dogs, either sex PHYSICAL EXAM FINDINGS • In some cases, the sinus can reach to the
• Single or multiple openings in the skin level of the dura mater.
GENETICS, BREED PREDISPOSITION along the dorsal midline in the cervical or
• Breed predisposition: Rhodesian ridgeback sacrococcygeal region DIAGNOSIS
is most common. The condition is seen less • Hair protruding from opening
commonly in shih tzu, Yorkshire terrier, • Sinus can be palpated extending through Diagnostic Overview
boxer, chow chow, cocker spaniel, rottweiler, the subcutaneous tissue toward the spine. The diagnosis is fundamentally based on the
English bull terrier, and springer spaniel Often, a cervical sinus is attached to the signalment (breed) and physical exam findings.
dogs. spinous process of C2.
• Thought to be heritable, but the mode of • Lumen may be filled with inspissated sebum Differential Diagnosis
inheritance has yet to be determined. and hair. • Sebaceous cyst

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