BSAVA MANUAL OF CANINE AND FELINE DERMATOLOGY.

306 Pages·2021·32.377 MB·English

by  H. JACKSON

BSAVA Manual of
Canine and Feline
Dermatology
fourth edition
Edited by
Hilary Jackson and Rosanna Marsella
1155330033__DDeerrmm 44ee ccoovveerr TTHHIISS OONNEE..iinndddd 11 1177//0088//22002211 1155::4411
BSAVA Manual of
Canine and Feline
Dermatology
fourth edition
Editors:
Hilary A. Jackson
ARPS BVM&S DVD DipACVD DipECVD MRCVS
RCVS Recognized Specialist in Veterinary Dermatology
The Dermatology Referral Service,
528 Paisley Road West, Glasgow G51 1RN, UK
Rosanna Marsella
DVM DVD DipACVD
Department of Small Animal Clinical Sciences, University of Florida,
Gainesville, FL 32610, USA
Published by:
British Small Animal Veterinary Association
Woodrow House, 1 Telford Way,
Waterwells Business Park, Quedgeley,
Gloucester GL2 2AB
A Company Limited by Guarantee in England
Registered Company No. 2837793
Registered as a Charity
Copyright © 2021 BSAVA
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in form or by any
means, electronic, mechanical, photocopying, recording or otherwise without prior written permission of the copyright holder.
The drawings in Figures 1.2, 1.5, 1.8, 1.10, 1.12, 5.4, 5.6, 5.9, 5.11, 5.13, 5.16, 5.18, 5.20, 5.22 and 5.24 were drawn by
S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
A catalogue record for this book is available from the British Library.
ISBN 978-1-910443-80-4
The publishers, editors and contributors cannot take responsibility for information provided on dosages and methods of
application of drugs mentioned or referred to in this publication. Details of this kind must be verified in each case by individual
users from up to date literature published by the manufacturers or suppliers of those drugs. Veterinary surgeons are reminded
that in each case they must follow all appropriate national legislation and regulations (for example, in the United Kingdom, the
prescribing cascade) from time to time in force.
Printed in the UK by Cambrian Printers Ltd., Pontllanfraith NP12 2YA
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BSAVA Manual of Canine and Feline Dermatology, fourth edition. Edited by Hilary Jackson and Rosanna Marsella. ©BSAVA 2021
Titles in the BSAVA Manuals series
Manual of Avian Practice: A Foundation Manual
Manual of Backyard Poultry Medicine and Surgery
Manual of Canine & Feline Abdominal Imaging
Manual of Canine & Feline Abdominal Surgery
Manual of Canine & Feline Advanced Veterinary Nursing
Manual of Canine & Feline Anaesthesia and Analgesia
Manual of Canine & Feline Behavioural Medicine
Manual of Canine & Feline Cardiorespiratory Medicine
Manual of Canine & Feline Clinical Pathology
Manual of Canine & Feline Dentistry and Oral Surgery
Manual of Canine & Feline Dermatology
Manual of Canine & Feline Emergency and Critical Care
Manual of Canine & Feline Endocrinology
Manual of Canine & Feline Endoscopy and Endosurgery
Manual of Canine & Feline Fracture Repair and Management
Manual of Canine & Feline Gastroenterology
Manual of Canine & Feline Haematology and Transfusion Medicine
Manual of Canine & Feline Head, Neck and Thoracic Surgery
Manual of Canine & Feline Musculoskeletal Disorders
Manual of Canine & Feline Musculoskeletal Imaging
Manual of Canine & Feline Nephrology and Urology
Manual of Canine & Feline Neurology
Manual of Canine & Feline Oncology
Manual of Canine & Feline Ophthalmology
Manual of Canine & Feline Radiography and Radiology: A Foundation Manual
Manual of Canine & Feline Rehabilitation, Supportive and Palliative Care: Case Studies in Patient
Management
Manual of Canine & Feline Reproduction and Neonatology
Manual of Canine & Feline Shelter Medicine: Principles of Health and Welfare in a Multi-animal Environment
Manual of Canine & Feline Surgical Principles: A Foundation Manual
Manual of Canine & Feline Thoracic Imaging
Manual of Canine & Feline Ultrasonography
Manual of Canine & Feline Wound Management and Reconstruction
Manual of Canine Practice: A Foundation Manual
Manual of Exotic Pet and Wildlife Nursing
Manual of Exotic Pets: A Foundation Manual
Manual of Feline Practice: A Foundation Manual
Manual of Ornamental Fish
Manual of Practical Animal Care
Manual of Practical Veterinary Nursing
Manual of Practical Veterinary Welfare
Manual of Psittacine Birds
Manual of Rabbit Medicine
Manual of Rabbit Surgery, Dentistry and Imaging
Manual of Raptors, Pigeons and Passerine Birds
Manual of Reptiles
Manual of Rodents and Ferrets
Manual of Small Animal Practice Management and Development
Manual of Wildlife Casualties
For further information on these and all BSAVA publications, please visit our website: www.bsava.com
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Contents
List of contributors v
Foreword vii
Preface viii
Structure and function of the skin 1
1
Eva Espadale and Domenico Santoro
History, examination and initial evaluation 13
2
Kerstin Bergvall
Core investigation and laboratory techniques 24
3
Sue Paterson
Cytology 32
4
Francesco Albanese
Dermatopathology 41
5
David H. Shearer
An approach to pruritus 49
6
Kathy C. Tater
Ectoparasite infestation – clinical presentation 55
7
Cathy F. Curtis
Ectoparasite infestation – treatment and prophylaxis 70
8
Lluís Ferrer
Atopic dermatitis and food-responsive dermatosis 76
9
Ralf S. Mueller
Management of pruritus and atopic dermatitis 82
10
Patrick Hensel
Allergy testing and allergen-specific immunotherapy – a practical approach 88
11
Dawn Logas and Patrick Hensel
An approach to scaling 93
12
Karen L. Campbell
An approach to papules and pustules 102
13
Rosanna Marsella
An approach to erosions and ulcerations 106
14
Manolis N. Saridomichelakis
An approach to nodules and draining sinus tracts 113
15
David H. Shearer and Jane M. Dobson
An approach to disorders of pigmentation 119
16
Zeineb Alhaidari
An approach to focal and multifocal alopecia 125
17
Dunbar Gram and Megan Boyd
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An approach to canine symmetrical alopecia and management 129
18
Manon Paradis
An approach to otitis 143
19
Emmanuel Bensignor
Management of otitis 150
20
Peter J. Forsythe
An approach to superficial and deep pyoderma 159
21
Daniel O. Morris and Anette Loeffler
Management of superficial and deep pyoderma 167
22
Anette Loeffler and Daniel O. Morris
An approach to feline-specific conditions 176
23
Mandy Burrows
Management of feline-specific conditions 183
24
Alison Diesel
Dermatophytosis 188
25
Karen A. Moriello
Malassezia dermatitis 196
26
Tim Nuttall
Topical treatments 203
27
Carly Mason and Darren Berger
Autoimmune and immune-mediated skin disease 210
28
Hilary A. Jackson
Management of autoimmune and immune-mediated skin diseases 218
29
Hilary A. Jackson and Katharine F. Lunn
Subcutaneous, deep and systemic infections 226
30
Cecilia Friberg
Nutrients and the skin 240
31
Rebecca Ricci and Carla Dedola
Actinic (solar) dermatoses 249
32
Mandy Burrows
Regional dermatoses 256
33
Domenico Santoro and Natalie Barnard
Neoplastic and paraneoplastic syndromes affecting the skin 268
34
Jane M. Dobson and David H. Shearer
Index 281
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Contributors
Francesco Albanese Carla Dedola
DVM DVM DipECVD
Private Veterinary Analysis Laboratory Mylav, Clinica Città di Sassari,
Milan, Italy Via Alghero 43, 07100 Sassari, Italy
Zeineb Alhaidari Alison Diesel
DVM DipECVD DVM DipACVD
Clinique Vétérinaire, Texas A&M University College of Veterinary Medicine
Cidex 248, RN 85, F-06330, and Biomedical Sciences,
Roquefort-les-Pins, France College Station, TX 77843, USA
Natalie Barnard Jane M. Dobson
BVetMed CertVD DipECVD MRCVS MA BVetMed DVetMed DipECVIM-CA(Oncology) FRCVS
EBVS® Specialist in Veterinary Dermatology, RCVS European and RCVS Recognized Specialist in
Recognized Specialist in Veterinary Dermatology Veterinary Oncology
Highcroft Veterinary Referrals, Department of Veterinary Medicine,
615 Wells Road, Whitchurch, University of Cambridge, Madingley Road,
Bristol BS14 9BE, UK Cambridge CB3 0ES, UK
Emmanuel Bensignor Eva Espadale Reballi
DrVet DipECVD DESV(Dermatology) DVM DipECVD MRCVS
Registered Specialist in Veterinary Dermatology EBVS® Specialist in Veterinary Dermatology, RCVS
Oniris Nantes Veterinary School and Veterinary Recognized Specialist in Veterinary Dermatology
Dermatology Referral Service, Rutland House Referrals,
75003 Paris, 35510 Rennes-Cesson and Abbotsfield House, 4 Abbotsfield Road,
44000 Nantes, France Saint Helens WA9 4HU, UK
Darren Berger Lluís Ferrer
DVM DipACVD DVM PhD DipECVD
Iowa State University, Veterinary School,
College of Veterinary Medicine, Universitat Autonoma de Barcelona,
1809 S Riverside Drive, Ames IA 50011, USA Barcelona, Spain
Kerstin Bergvall Peter J. Forsythe
DVM DipECVD BVM&S DVD MRCVS
Department of Clinical Sciences, The Dermatology Referral Service,
University of Agriculture, Uppsala, Sweden 528 Paisley Road West,
Glasgow G51 1RN, UK
Megan Boyd
DVM DipACVD Cecilia Friberg
Animal Dermatology Center, DVM DipACVD DipECVD
Studio City, CA 91361, USA Evidensia Södra Djursjukhuset Kungens Kurva,
Månskärsvägen 13, 14175 Kungens Kurva,
Mandy Burrows
Stockholm, Sweden
BSc BVMS MANZCVS FANZCVS
Registered Specialist in Veterinary Dermatology Dunbar Gram
Animal Dermatology Clinic Perth, School of Veterinary DVM DipACVD MRCVS
Medicine, Murdoch University, 6150 Western Australia Department of Small Animal Clinical Sciences,
University of Florida,
Karen L. Campbell
Gainesville, FL 32610, USA
DVM MS DipACVIM DipACVD
MU Veterinary Health Center at Wentzville, Patrick Hensel
College of Veterinary Medicine, University of Missouri,
Dr.med.vet DipACVD DipECVD(Dermatologie)
1092 Wentzville Parkway, MO 63385, USA EBVS® Specialist in Veterinary Dermatology
Fachtierarzt für Allergien, Haut- und Ohrenerkrankungen
Cathy F. Curtis
Tierdermatologie Basel, Emil Frey-Strasse 127,
BVetMed DVD MRCVS
CH-4142 Münchenstein, Switzerland
RCVS Recognized Specialist in Veterinary Dermatology
Skin Specialist Vet Service,
Rooftops, Spring View Road, Ware,
Hertfordshire SG12 9LB, UK
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Hilary A. Jackson Tim Nuttall
ARPS BVM&S DVD DipACVD DipECVD MRCVS BSc BVSc CertVD PhD CBiol MRSB MRCVS
RCVS Recognized Specialist in Veterinary Dermatology RCVS Recognized Specialist in Veterinary Dermatology
The Dermatology Referral Service, Royal (Dick) School of Veterinary Studies,
528 Paisley Road West, University of Edinburgh, Easter Bush Campus,
Glasgow G51 1RN, UK Roslin EH25 9RG, UK
Anette Loeffler Manon Paradis
PhD DVD DipECVD FHEA MRCVS DVM MVSc DipACVD
Royal Veterinary College, Professor Emeritus
Hawkshead Lane, Hatfield, Department of Clinical Sciences,
North Mymms, Hertfordshire AL9 7TA, UK Faculty of Veterinary Medicine, University of Montreal,
CP 5000, St-Hyacinthe,
Dawn Logas
Québec J2S 7C6, Canada
DVM DipACVD
Veterinary Dermatology Center Sue Paterson
Maitland, FL 32751, USA MA VetMB DVD DipECVD FRCVS
RCVS and European Specialist in Veterinary Dermatology
Katharine F. Lunn
Virtual Vet Derms Telemedicine Service,
BVMS MS PhD DipACVIM MRCVS Kendal, UK
Department of Clinical Sciences,
NC State University College of Veterinary Medicine, Rebecca Ricci
1052 William Moore Drive, Raleigh, NC 27607, USA DVM PhD
European Specialist in Veterinary and
Rosanna Marsella
Comparative Nutrition
DVM DVD DipACVD Department of Animal Medicine, Production and Health,
Department of Small Animal Clinical Sciences
University of Padua, Agripolis, viale dell’Università 16,
University of Florida,
35020 Legnaro (PD), Italy
Gainesville, FL 32610, USA
Domenico Santoro
Carly Mason
DVM MS DrSc PhD DipACVD DipECVD DipACVM(Bacteriology/
BVSc CertVD DipECVD MRCVS Mycology & Immunology)
Guide Dogs UK, Department of Small Animal Clinical Sciences,
Southeast Region, UK University of Florida, Gainesville, FL 32610, USA
Karen A. Moriello Manolis N. Saridomichelakis
DVM DipACVD DVM PhD DipECVD
School of Veterinary Medicine, Clinic of Medicine, Faculty of Veterinary Science,
University of Wisconsin-Madison, University of Thessaly, Trikalon Str 224, GR-43132,
WI 53706, USA Karditsa, Greece
Daniel O. Morris David H. Shearer
DVM MPH DipACVD BVetMed PhD CertSAD PGCertVetEd FHEA CBiol FRSB DipRCPath
School of Veterinary Medicine, MRCVS
University of Pennsylvania, 3900 Delancey Street, Vetcutis Ltd,
Philadelphia, PA 19104, USA Holly House, Station Road,
Pulham St Mary, Norfolk IP21 4QQ, UK
Ralf S. Mueller
Dr.med.vet DipECVD DipACVD FANZCVS(Dermatology) Kathy C. Tater
Faculty of Veterinary Medicine, DVM MPH DipACVD
Ludwig-Maximilians University Munich, Veterinary Information Network,
Veterinarstrasse 13, 80539 Munich, Germany Davis, CA 95616, USA
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Foreword
I was delighted and honoured both as a Past President of the BSAVA and as a Board
Certified Veterinary Dermatologist to be asked to write the Foreword and contribute to the
fourth edition of the BSAVA Manual of Canine and Feline Dermatology.
The last edition of the BSAVA Manual of Canine and Feline Dermatology was published in
2012 and, whilst at the time it provided an excellent reference source for a wide range of
small animal dermatological conditions, the rapid advances in both the diagnosis and
therapy of dermatological diseases have meant that this new edition has been completely
updated to provide a go-to resource for busy primary care veterinary surgeons, nurses and
veterinary students.
The editors, Hilary Jackson and Rosanna Marsella, must be congratulated for harnessing the
combined expertise of a wide range of key opinion leaders within the global veterinary
dermatology community, as well as contributing their own not inconsiderable wealth of
knowledge to this new edition.
The initial chapters on the structure and function of the skin, together with a systematic
approach to the investigation of skin disease, provide a firm initial grounding in dermatology.
Subsequent chapters on clinical presentations, such as pruritus, scaling, papules and
pustules, pigmentation and alopecia, form the main body of the text, which allows the time-
pressed clinician to quickly access the appropriate information to help them identify and
manage problems. Additional chapters focus on specific conditions such as otitis externa
and media, and new to this edition are several excellent chapters dedicated to feline skin
disease. The abundance of high-quality photographs of clinical signs, parasites and cytology
are welcome, and the use of tables detailing differential diagnoses, together with clinical
decision-making flow charts all enhance the usefulness of this text.
There is no doubt that this Manual should be on the bookshelf of every small animal clinic
and veterinary hospital as an invaluable resource for veterinary professionals.
Sue Paterson
MA VetMB DVD DipECVD FRCVS
Director Virtual Vet Derms
BSAVA President 2019–20
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Preface
Skin and ear diseases represent common problems in general practice. With many diseases,
the cutaneous lesions have a similar appearance and thus it is important to embrace a
logical approach when investigating a dermatological case, recognizing the importance of
history and becoming familiar with the various point-of-care tests that can be used to inform
therapeutic decisions. As the response to treatment largely depends on the correct
identification of the primary disease, a systematic step-by-step approach is critical. The
purpose of the BSAVA Manual of Canine and Feline Dermatology is to be an easy-to-read
resource focused on the clinically relevant aspects of dermatological diseases.
This new edition retains the popular format from the third edition. The initial chapters review
the basic structure and function of the skin and discuss a logical approach to history taking
and the core investigative tests that can be performed. New to this edition is a separate
chapter on skin cytology, which features many excellent images illustrating the cytology of
common skin conditions that we hope will be useful to practitioners.
The introductory section is followed by chapters focused on a problem-oriented approach to
common dermatological conditions. Here we have expanded the information on the
approach and management of certain commonly seen conditions such as pyoderma, ear
disease and atopic dermatitis. New to this edition is a chapter dedicated to the indications
for allergy testing and the use of allergen-specific immunotherapy. There are also two
separate chapters addressing feline dermatological conditions because, as we all know, cats
are not small dogs.
The development and availability of new therapeutic options for pruritus warrants a
standalone chapter in this new edition, alongside a separate chapter discussing the
advantages and disadvantages of immunosuppressive therapy for autoimmune and immune-
mediated diseases.
We are immensely grateful to all our authors for taking the time to share their expertise and
knowledge in this new edition of the BSAVA Manual of Canine and Feline Dermatology. It is
truly an international effort.
We would also like to thank the BSAVA Publications Team for all their patience and hard work
pulling together this Manual during the COVID-19 pandemic.
We hope that you find this a useful edition to your practice library and that it proves a
practical companion in your day-to-day practice.
Hilary Jackson
Rosanna Marsella
July 2021
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Chapter 1
Structure and function
of the skin
Eva Espadale and Domenico Santoro
The skin is the largest organ of the body and it is involved The epidermis
in a wide array of functions fundamental for homeostasis
(Figure 1.1). Beyond acting as a physical barrier against The outermost layer of the skin, or epidermis, is a stratified
external insults, the skin is also important as a thermo­ squamous epithelium overlying the basement membrane.
regulatory, sensory and immunological organ. Further ­ The latter provides firm attachment of the epidermis to the
more, because of the different regional requirements of dermis and allows the selective passage of molecules and
this organ (e.g. ears, eyelids, lips, prepuce, nasal planum, cells between the two structures (see ‘Basement mem­
footpads and claws), the skin has acquired specialized brane zone’ below). The epidermis typically comprises four
structures and functions. A consideration of these topics is layers (Figure 1.2) that, from inner to outer, are:
beyond the scope of this chapter and the reader is referred
to the relevant chapters later in the Manual. This chapter is • Basal layer (stratum basale, SB)
mainly focused on providing a basic understanding of the • Spinous layer (stratum spinosum, SS)
structure and function of the skin and its role in the body’s • Granular layer (stratum granulosum, SG)
immune defence. • Horny layer (stratum corneum, SC).
Mammalian skin is mainly composed of three layers –
the epidermis, dermis and subcutis. These layers have In some body regions (such as the nasal planum and
different functions and will be treated separately in footpads), a fifth layer may be present. This is known as
this chapter. the clear layer or stratum lucidum or stratum conjunctum.
Each layer is composed of a single or few rows of cells,
depending on the anatomical site. In general, the epi der mis
of cats and dogs is thin (two to three nucleated cell
layers, not counting the horny layer) in areas of haired
Function Activities
skin, ranging from 0.1 to 0.5 mm in thickness. The epidermis
Barrier Controls loss of water, electrolytes and other is thinnest on the abdomen, while the thickest epider ­
molecules mis is found on the footpads and nasal planum, where it
Excludes chemical, physical and
may measure 1.5 mm.
microbiological agents
The keratinocyte is the principal cell of the epidermis
Sensation Heat, cold, pain, itch, pressure
(approximately 85% of epidermal cell populations). The
Thermor egulation Insulation (hair coat), regulation of cytoskeleton of the keratinocyte is composed of actin
cutaneous blood supply, sweat gland filaments, keratin intermediate filaments and microtubules,
function
which provide its structural strength. Keratin intermediate
Secretion Epitrichial (apocrine), atrichial (eccrine) and filaments are formed by bundles of keratin monomers
sebaceous glands typical of keratinized epithelia and highly abundant in the
Synthesis Vitamin D epidermis. In mammalian epidermis, type I (acidic) keratins
and type II (neutral–basic) keratins form heterodimers via
Motion/shape Flexibility, elasticity and toughness
disulphide bonds. Specific keratins are found more promi­
Storage Electrolytes, water, vitamins, fat,
nently in various layers of the epidermis or in specific
carbohydrates, proteins, etc.
anatomical sites. For example, keratin 5 (K5) and K14 are
Indicator General health, internal disease, physical and
mainly expressed in proliferating (basal) keratinocytes,
sexual identity
whereas K1 and K10 are mainly expressed in differentiated
Immune regulation Keratinocytes, Langerhans’s cells, keratinocytes, and K16 in highly proliferative epithelia such
lymphocytes
as palmoplantar epidermis or injured or stressed epithelia.
Antimicrobial action Lipids, organic acids, lysozymes, host In the epidermis, the keratinocytes are joined together
defence peptides by several structures: desmosomes, tight junctions,
Pigmentation Prevents damage from solar radiation, and Adherens junctions and gap junctions. In addition, modified
oxidation desmosomes including hemidesmosomes and corneo des ­
mosomes may be present. Desmosomes are composed of
1.1 Skin activities associated with homeostasis.
transmembrane proteins (desmogleins and desmocollins)
BSAVA Manual of Canine and Feline Dermatology, fourth edition. Edited by Hilary Jackson and Rosanna Marsella. ©BSAVA 2021 1
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