Page 2719 - Cote clinical veterinary advisor dogs and cats 4th

Draining Tracts, Cutaneous 1413

Draining Tracts, Cutaneous
VetBooks.ir History and physical examination

Impression smear or needle
aspirate for cytologic examination
(Diff-Quik stain)

Neoplastic Inflammatory

Staging and/or No infectious agent Screen for foreign body if Infectious agent
incisional or identified history, exam are consistent identified
excisional biopsy as • Radiograph (e.g., metal,
indicated by signal- bone) +/- contrast/
ment and tumor type fistulogram if radiolucent
• Ultrasound (e.g., grass awn)
Request special Deep tissue biopsy
stains (GMS and for appropriate
acid-fast stains) Surgical exploration/ culture and susceptibility
removal if present

No organism identified Organism identified Organism not cultured Organism cultured

Deep tissue biopsy for Deep tissue biopsy Rebiopsy and culture, Treat appropriately,
histopathology with with appropriate or treat empirically, based on susceptibility
special stains, culture and susceptibility based on suspected results
bacterial, fungal, and organism seen
mycobacterial culture cytologically

Organism not cultured Organism cultured Organism not cultured Organism cultured

Sterile process. Treat appropriately, Rebiopsy and culture, Treat appropriately,
Consider anti- based on susceptibility or treat empirically, based on susceptibility
inflammatory or results based on suspected results
immunosuppressive organism seen
treatment, based on cytologically
histopathologic Clinical
results Algorithms

GMS, Gömöri methenamine silver.
(Reproduced from the third edition in unabridged form)
THIRD EDITION AUTHOR: Andrew Lowe, DVM, MSc, DACVD
THIRD EDITION EDITOR: Manon Paradis, DVM, MVSc, DACVD

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