MOTIVATION Our deepest fear is not that we

MOTIVATION “Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure…” -Marianne Williamson

DERMATOLOGY NOT DONE YET!

OTITIS EXTERNA An acute or chronic inflammatory disease of the external ear canal � Clinical signs: › › › Head rubbing or shaking Ear scratching Head tilt – with the affected ear tilted down Malodorous otic discharge (brown, greenish-yellow) Lichenification, hyperpigmentation, crusts, erythema and excoriations may be present › Aural hematoma

OTITIS EXTERNA NOTE THE EXCESS BROWN EXUDATE ERYTHEMA, HYPERPIGMENTATION, LICHENIFICATION AURAL HEMATOMA

OTITIS EXTERNA � PREDISPOSING FACTORS: › Conformation �Heavy, pendulous ears �Stenotic ear canals �Ear hair › Excessive moisture �Frequent bathing or swimming › Hypersensitivities �Food allergy, atopy

OTITIS EXTERNA DIAGNOSIS: › Otoscopic exam › Clinical signs › Cytology, ear smear Yeast, bacteria, cerumen, skin cells

OTITIS EXTERNA MALASSEZZIA OTITIS Malassezzia resemble footprints, bowling pins, or snowmen

OTITIS EXTERNA BACTERIAL OTITIS ROD-SHAPED BACTERIA AND A SKIN CELL

OTITIS EXTERNA � TREATMENT › Always treat the underlying condition if present › Topical meds instilled daily �Antibacterial, antifungal, or combination products often with steroids (otomax, tresaderm, baytril otic) �Cleaning ears during treatment › Surgical intervention may be required �Aural hematoma �Chronic conditions (Total Ear Canal Ablation)

ANAL SAC DISEASE The anal sacs are located between the muscle layers of the anus at the 4 and 8 o’clock positions. Each sac connects to the surface through a narrow duct. Sebaceous glands produce a foul-smelling oily, brown fluid. The sacs are naturally expressed during defecation, but can sometimes overfill.

ANAL SAC DISEASE

ANAL SAC DISEASE � IMPACTION › When the sacs overfill, the water can be reabsorbed, and the material dries out. �Sacs become a source of discomfort for the dog and are difficult to express at this time. › Impaction can lead to abscessation and rupture. � Clinical signs include: scooting rear end across the floor, painful defecation, tail chasing, perianal erythema, and/or swelling

ANAL SAC DISEASE

ANAL SAC DISEASE � DIAGNOSIS › Palpation (rectally or externally) › Clinical signs � TREATMENT › Express contents › Flush sac › Instill antibiotic ointment › Oral antibiotics, anti-inflammatories › Surgery?

ANAL SAC DISEASE WEARING GLOVES, GENTLY MILK THE GLANDS IN AN UPWARD MOTION TO EXPRESS.

TUMORS OF THE SKIN Tumors are a new growth of tissue characterized by progressive, uncontrolled proliferation of cells. Benign vs. Malignant Localized vs. Invasive Adenoma/Carcinoma vs. Sarcomas

BENIGN TUMORS OF THE SKIN HISTIOCYTOMA: small, button-like tumors that are usually pink, hairless, and raised. They are rapidly growing Common locations include the pinnae, head, and legs

BENIGN TUMORS OF THE SKIN HISTIOCYTOMA › Occurs almost exclusively in young dogs <4 yrs old DIAGNOSIS › Appearance › biopsy TREATMENT › These tumors may spontaneously regress, but surgical excision is the treatment of choice ROUND CELL TUMOR

BENIGN TUMORS OF THE SKIN LIPOMA: tumor of the subcutaneous adipocytes (fat cells) that are typically freely movable and wellcircumscribed › Common in older, female, obese dogs DIAGNOSIS: › Biopsy › Fine needle aspirate

BENIGN TUMORS OF THE SKIN LIPOMA › TREATMENT: Surgical excision Benign neglect lipocytes

BENIGN TUMORS OF THE SKIN � PAPILLOMAS: wart-like growths that develop as smooth, white/pink/pigmented, elevated lesions in the oral cavity (oral papillomatosis) or on the skin (cutaneous papillomas) › These growths are caused by a papillomavirus

BENIGN TUMORS OF THE SKIN � PAPILLOMAS › DIAGNOSIS: �Appearance �Biopsy › TREATMENT �Usually spontaneous regression �Autogenous vaccine

BENIGN TUMORS OF THE SKIN � SEBACEOUS GLAND CYSTS: Slow growing, encapuslated, round, and exude a gray, cheeselike material. Caused by degenerative changes in the glandular area surrounding the follicle. › Common in cocker spaniels � DIAGNOSIS �Contents of the cyst �histology � TREATMENT › Surgical removal of entire encapsulated cyst

BENIGN TUMORS OF THE SKIN SEBACEOUS CYSTS

MALIGNANT SKIN TUMORS � FELINE VACCINE-INDUCED FIBROSARCOMAS: rapidly developing, highly invasive, malignant tumors that occur at the site of vaccination ~4 -6 weeks later. › VACCINES MOST COMMONLY IMPLICATED ARE THOSE WITH ADJUVANTS (substance that enhances the immune response by increasing the stability of a vaccine in the body) SUCH AS Fe. LV AND RABIES

MALIGNANT SKIN TUMORS VACCINEASSOCIATED SARCOMAS › DIAGNOSIS: Biopsy of fine needle aspirate Physical exam findings Swelling in area of recent vaccination Rapidly growing firm elongated mass

MALIGNANT SKIN TUMORS � VACCINE-ASSOCIATED SARCOMAS › TREATMENT �Radical surgical excision which may involve limb amputation is the treatment of choice › CLIENT INFORMATION �Poor prognosis if not detected early and treated aggressively �Inflammatory lumps may do develop after vaccines but usually disappear within 1 -2 weeks

MALIGNANT SKIN TUMORS FELINE VACCINE-ASSOCIATED SARCOMAS

MALIGNANT SKIN TUMORS MAST CELL TUMORS: firm nodules on the skin that may be ulcerated or edematous. Mast cells contain histamine and heparin

MALIGNANT SKIN TUMORS FINE NEEDLE ASPIRATE OF MAST CELL TUMOR; NOTE THE NUMER

MALIGNANT SKIN TUMORS IN CATS, MAST CELL TUMORS ARE USUALLY BENIGN AND MAY SPONTA

MALIGNANT SKIN TUMORS � MAST CELL TUMOR › TREATMENT �Chemotherapy �Radiation therapy �BENADRYL �H 2 blockers to treat gastric ulceration and irritation › PROGNOSIS �Depends on biopsy “grading” results

MALIGNANT SKIN TUMORS � MELANOMA (Benign or Malignant) › BENIGN: small, slow growing, hairless, pigmented › MALIGNANT: large, dome-shaped sessile +/pigmentation �Ex: Tumors of the oral cavity and digits �Poor prognosis �Metastasize readily �Recurrence after surgery is common

MALIGNANT SKIN TUMORS TREATMENT INVOLVES SURGICAL REMOVAL AND POSSIBLY TREATME