Friday, September 10, 2010
Diabetes management
Sushil Kumar Paudel Hi! Dear Vets, Sorry for long Gap! today i want to open floor to discuss about the management Of diabetic(DM) animal(esp. Dog and Cat), can we discuss about the best way to get ideal glucose curve in short period of time? ( I am extremely sorry, if already discussed)
Friday, August 20, 2010
Canine Dermatology Update
Swarupmay Majumdar Moderation hereby acknowledge all the guests at canine dermatolgy update that the event is now declared closed. we are planning to bring it alive same time next year. We also plan to bring canine cardiology in next event
April 13 at 12:04pm
Sumit Virmani 35 days old Daschund male.
Patchy alopecia on back & ventral side, which is progressing, as per the owner.
No itching, no observable change in skin tone.
Swarupmay Majumdar Canine dermatology update is getting closed by tonight. Most members did not participate as they were not able to log in. Most others were not able to do because they are preoccupied. How about extending the update for one more week? your feedback please.
Sumit Virmani Patchy alopecia with itching in a month old Daschund?
Most likely diagnosis ? Infection / allergy ?
Saurabh Saxena Malassezia dermatitis is almost always associated with an underlying cause like atopy, endocrinopathy, food allergy etc. For mild cases only, topical therapy with ketoconazole + chlorhexidine shampoo, every 3 days, is sufficient. I also use vinegar, mixed in water, to spray after every bath; gives good results.
Swarupmay Majumdar Bilaterally symmetric lesions are typically caused by internal disease such ashypothyroidism, hyperadrenocorticism, or pemphigus foliaceus. Allergies may also present with bilaterally symmetric symptoms.
Joseph Cyrus Not necessarily; FBA or FAD is also symmetric in most cases!April 10 at 7:13pm
Swarupmay Majumdar Localized problems may be due to infectious organisms that gained entry at a certain siteand spread only locally such as atypical mycobacterial or fungal infections. Neoplastic disease is commonly localized, atleast initially. Generalized disorders are more commonly dueto hypersensitivities or systemic conditions, such as endocrine disorders and immune-mediated or metabolic skin diseases.
Swarupmay Majumdar Some antibiotics, such as trimethoprim-sulfonamide combination, will affect blood concentrations of thyroxin. Others, such as cephalosporins may affect the glucose readings of some urine test strips.
Swarupmay Majumdar In case of chronic otitis externa, the differential diagnosis may include : Atopy, adverse food reaction, parasites, polyps. Secondary infections are common and can also occur with primary endocrine diseas like hypothyroidism.
Swarupmay Majumdar If cutaneous signs have been present for yearswithout the development of concurrent systemic signs, endocrine disorders are unlikely.
Swarupmay Majumdar If pruritus was the first initial sign and lesions occurredlater, then atopy or food-adverse reaction are most likely. Pruritus with lesions, that occur at approximately the same time, may be due to a wide variety of causes.
Swarupmay Majumdar Synthetic Levothyroxine at 0.02mg, is the drug of choice for canine hypothyridism.
Swarupmay Majumdar Ketokonazole is also used in Canine Hyperadrenocorticism at 10mg/kg sid po or once in 48 hrs. It may be required to be increases to 15mg/kg po sid or 48 hrly in case the Cortisol levels still remain above resting level.
Swarupmay Majumdar Ketokonazole works very well in acidic gastic environments. So H2 blockers or antacids are better not used simultaneously.
Swarupmay Majumdar Granulomatous Panuveitis, depigmentation hair and Skin ( vitiligo) are seen in a condition called VKH- vogt-Koyamagi Harad like syndrome. They are symmetrical and mostly on head region and appear acutely.
Swarupmay Majumdar iN case of food allergy , commercial hypoallergenic diets are likely to be effective in 80% cases. The food brand change (usual from one to another) doesnot always reduce allergy and same food in future may also not cause allergy.
Swarupmay Majumdar in any cases of Seborrhea, corticosteroids are contraindicated for long time use, as they can cause a decrease in sebum production and increase scales production.
Gautam Unny When the skin does not heal and there is a recurrence of skin trouble, poor skin coat, hair loss at areas of friction, slow regrowth of hair, rat tailed appearance do think of the thyroid. Also there seems to be a correlation between adult onset demodicosis and hypothyroidism. T3 has little significance in dogs. Estimation of free T4 is the most reiable indicator of the thyroid. Human thyroid drugs can be used. A clinical response trial of thyroid hormone too, can be tried for 3 months where there is a deep suspision of the disease but testing is not possible.
Swarupmay Majumdar I have found Immumod very effective in cases of reccurent pyoderma, abcess, digital abcess, and many other cases. (Thanks to Dr Gautam Unny for sharing this information on SAVIN)
Swarupmay Majumdar It is better to use immunostimulants or immuno modulators than using immuno supressants. I sometimes feel why everytime we chose a steroid for all skin problem! We need to search for immunomodualtors, immunostimulator and non steroids.
Swarupmay Majumdar Ketokonazole is very effective even when used wkly 2 consecutive days for 4 wks instead of daily dosing. I mean sunday -monday.. wait .. sunday monday
Swarupmay Majumdar Methyl prednisolone( depromedrol) or Triamcelolone( vetlog) is not effective at all in any cases of atopy. But we still keep using them.
Swarupmay Majumdar Fatty acids as anti inflamatory agents in atopic dermatitis can help you in 20% cases.
But if employed with some antihistaminics they are working well
Swarupmay Majumdar Levamisole can be used thrice a week subcut for any bad cases of demodecosis. Levamisole works as an immunomodulator and can help
Swarupmay Majumdar Ketokonazole is know to be hepatotoxic, but toxicity is not so common. In any case it is better to use some liver protectant simmultaneously. It is also absorbed well when the food is rich in Fatty acid or fat.
Swarupmay Majumdar In severe cases of skin infections and abcess, Amoxycllin- clav is better used every 8 hrs. They actually work better when given thrice a day.
Swarupmay Majumdar Sometimes, you may find Amoxy-clav showing resistance in ABS, but still then you can continue using them sucessfully. So even though culture says Amoxy-clav may not work, but in real you can use it sucessfully.
Swarupmay Majumdar Clemastine can be very affective in controlling allergy in cats. It is not veryu effective in dogs and usually not used. It does not have tendency to cause drowsiness
Gautam Unny for scabies try psorinum 30 ( made from mites), for general poor skin use sulphur 200 once a week, for moist exzema use graphitis 30, for non healing skin lesions use ferrumphos 6x.
Ashwin Nambiar Drs, what systemic treatment do you use for Malassezia? Drugs other than ketoconazole?
Saurabh Saxena for chronic mixed skin infection wid itching ,alopecia generalised,i use liq gentian violet mix wid benzyl benzoate cream .before applying this ,i scrub whole body wid hard tooth brush and then apply this mixture.time consuming but very good results..use elizabetan collar or sedate it becoz it shd not be allowed to lick ..
Gautam Unny a very useful trick i use in stubborn chronic demodicosis is to mix amitraz 12.5% in liquid paraffin and apply locally. it has very good effects. i use 2 ml ridd in 30 ml of light pafaffin oil
Cyril Roy How true is the statement that ivermectin is resistance free?
In canada there is a big problem of dermatological problems in fish. Fish farming is a big industry in Canada to feed the big appettite of United States of America and also Canada itself. Most of the dematological problems are caused by sea lice, and also i t...hink some kind of mange. Ivermectin has been regularly used to reduce this infection with good effect(population level eradication programs). But lately there has been severe reports of resistance.
I am writing this because, when i was doing some practice, i always thought ivermectin is resistance free. But now i am hearing that resistance is possible. Hope this is useful...
But we also have to understand that always population level treatment has the high risk of inducing resistance than individual animal treatment. So the risk may be low.
Swarupmay Majumdar Cypermetrin is not recommended in pups and dogs below 6 months. Avoid using CISAFLUX,Furfree,Softas in pups. This is s common tosee many vets prescribe Cisaflux in pups, it not safe and not recommended.
Swarupmay Majumdar Fipronil , Immidacloprid are well absorbed when there is natural oil on Skin. When we plan using Advantix,advantage or protector, it is better not to give bath atleast 7 days before and after applicatioins. See The results yourself.
Swarupmay Majumdar Cats are much more likely to respond to
antihistamines than dogs. However, administering oral medication on a
long-term basis may be challenging in this species.
Gautam Unny ivermectin is very safe if given at the righ dose. it does not cause any hepatic toxicity as commonly thought but instead is a potent neuro toxin in the high doses. there is no need to space ivermectin at weekly intervals.
it can be given daily at around 300micrograms/kg for as long a year for chronic mange. i have been... using it at these dosages and have found no deleterious effects whatsoever.
to prevent drug resistance to ivermectin, please use it only where fully warrented and avoid using as a routine dewormer, thiough it is both a endo and ecto parasiticide
Swarupmay Majumdar
Hierarchy of Skin antibiotics ( most effective to least effective) with dossage:
* cephalexin 20-30mg/kg bid po
*Amoxy-clav 13.75mg/kg po bid
*Enrofloxacin 5mg/Kg sid po
*Chloramphenicol 5mg/kg po bid
*lincomycin 10-20mg/kg bid
*Trimethoprim-sulph 15-30mg bid
*clindamycin 10-20mg/kg bid po
Efficacy of cephalexin is around 95%, Amoxy clav , enrofloxacin and Chloramphenicol around 75% ( all against Staph. intermedius). Sulpha has variable results.
Gautam Unny would request all attending to accept one major case, study it and summarize it. Please tell us which case you wish to take on. I could take Cushing's syndrome.
Swarupmay Majumdar No no, there is no real sessions. its just a week dedicated to veterinary dermatology for small animals. Memebers should try to emphasize more on dermatology cases, updates, latest drugs, review, suggestions etc. it will happen all on the forum and will be great if all participate actively.
@ Dr Cyril: Can you Give us ...updates on recent trends in veterinary dermatology, equine no issue.
@ DrAnoop: can you update us on recent drugs, or any other you feel comfortable.
@Dr Fajiriyanti: can you update on endocrine related dermatology?
@dr Darsh mapatuna: Immuno dermatology- can u pl update?
Cyril Roy What will be time in canada? Afternoon i suppose..
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