Page 640 - Small Animal Clinical Nutrition 5th Edition

662 Small Animal Clinical Nutrition

Assess the Food and Feeding Method
The dog had been fed a dry commercial food formulated for puppies for the first 10 months of life and several different dry dog
VetBooks.ir foods formulated for adult maintenance for the next three years.

Therapy Including Feeding Plan
Based on the age at onset, breed, diagnostic results and a lack of response to various therapies, a tentative diagnosis of acrodermati-
tis of bull terriers was made.

Questions
1. What nutritional therapy should be recommended for this dog?
2. What other information should the owner be given regarding this disease and the prognosis for the dog?

Answers and Discussion
1. Acrodermatitis develops in bull terriers shortly after birth and
is associated with defects in zinc absorption and metabolism.
Cutaneous and systemic clinical signs resemble severe zinc
deficiency with growth retardation, gastrointestinal disease,
chronic bacterial infections and progressive, erythematous,
exfoliative, papular to pustular dermatitis of the distal extrem-
ities and skin surrounding the mucocutaneous junctions.
Surface crusts usually contain numerous bacteria and yeast
organisms.
Supplementation of the food with oral or intravenous zinc
usually fails to ameliorate clinical signs. Treatment with sys-
temic antimicrobials, especially for secondary superficial yeast
infections, may result in marked improvement, although sys-
temic and cutaneous infections recur. This dog was treated
with a zinc methionine supplement (50 mg once daily) and
oral cephalexin (250 mg b.i.d.) for secondary pyoderma.
2. Acrodermatitis is an inherited, autosomal recessive metabolic
disease reported to occur in bull terriers in the United States,
Canada and the United Kingdom.This bitch had already been
spayed but further breeding of this dog’s parents should be dis-
couraged. The condition has been termed lethal acrodermati-
tis because homozygously affected dogs rarely live beyond 18
months of age. Some of the apparently normal littermates may
develop zinc-responsive dermatitis. Owners of affected dogs
Figure 1. A four-year-old bull terrier with thick crusts in the inner usually complain that their pets have skin disease, stunting,
pinna at the ear canal entrance. difficulty with eating and large, splayed, painful feet. Ulcerated
and thick, crusted lesions are prominent on the muzzle and
ears. Abnormal keratinization of the footpads, severe nail dys-
trophy and paronychia are also common. Prognosis is guarded
to poor for severely affected dogs.
Progress Notes
After eight weeks of therapy, the crusting shown in the pictures
had decreased about 30%. At that point, the dog was lost to fur-
ther evaluation.

Bibliography
Jezyk PF, Haskins ME, Mackay-Smith MA, et al. Lethal acro-
dermatitis in bull terriers. Journal of the American Veterinary
Medical Association 1986; 188: 833-839.
McEwan NA. Confirmation and investigation of lethal acroder-
matitis of bull terriers in Britain. In: Ihrke PJ, Mason IS, White
SD, eds. Advances in Veterinary Dermatology, vol. 2. New York,
Figure 2. The same dog with hyperkeratosis of the footpads. NY: Pergamon Press, 1993; 151-156.