Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Seborrhea In Dogs ______Management in Shelters ______and Foster Homes

Karen Moriello, DVM, DACVD ______Clinical Professor of Dermatology University of Wisconsin-Madison ______Madison Wisconsin, USA ______

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‘Seborrhea’- term is obsolete ______

Correct term: cornification defect ______Excessive scales (flakes, ‘dandruff’) with or without oily skin and hair. ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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‘Seborrhea’ is…. ______• Clinical description, not a diagnosis ______• Disruption in production epidermal cells and • Causes ______• Primary-Hereditary-noted early in life, life long • Secondary-acquired, occurs as a result of other diseases, ______temporary • Most common in dogs ______

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Odor and scales that do not wash off… ______

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Practical Anatomy ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Cornification ______

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Importance of Epidermal Barrier ______• Prevents excessive water loss from skin ______• Prevents loss of other bodily fluids • Protects against UV damage ______• Protects against trauma • Part of the body’s immune system ______• Prevents against infection and invasion of micro-organisms ______

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Pathogenesis of Clinical Signs ______• Accumulations of scale and crust because of shortened ______epidermal cell turnover ______• Irritation, inflammation, pruritus and odor develop because of changes in the composition of surface oils ______

• Frequent bacterial and yeast overgrowth/infections ______often with pruritus due to changes in the skin flora

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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‘Seborrhea sicca’-dry ______‘Seborrhea oleosa’-greasy ______• Clinical descriptors • Not a specific disease ______• Only of importance when determining topical therapy • Avoid use of these terms!!!! ______

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Primary Cornification Defect ______• Hereditary with breed predisposition or random genetic ______abnormality • Noted early in life for many conditions ______• Manage, not cure • Diagnose via ruling out other causes ______

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Primary Breed Predisposition ______• Primary cornification disorder ______• West Highland white terrier, cocker spaniel, basset hound, Doberman pincher, , English springer spaniel, Irish setter, Labrador retriever ______• Vitamin A-most notably cocker spaniel • Zinc responsive ______• Alaskan malamute, Siberian husky, Samoyed, Pharaoh hound • Epidermal dysplasia-West Highland white terrier ______• -golden retrievers, Jack Russell terrier, Norfolk terrier, American bull dog ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Primary Cornification ______

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Severe Odor ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Vitamin A ______

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Zinc ______

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Ichthyosis ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Really, really big scales ______

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Localized Disease ______

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Localized Disease ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Localized Disease ______

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Secondary Cornification ______

• Secondary to ANY disease that affects the skin ______• Parasites • External ______• Internal • Infections ______• Allergies • General illness ______• Chronic nutritional deficiencies ______

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Secondary to ______bacterial pyoderma ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Secondary to parasites…. ______

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Secondary to yeast overgrowth ______

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Common problem in allergic dogs.. ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Common in dogs with medical illnesses.. ______

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Common Scenario ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Spending Money Wisely ______

• Consider global health of dog and address issues ______• Vaccination • Nutrition ______• Endo-parasite control • Assume seborrhea is secondary, until proven otherwise ______• Ectoparasite control • Skin cytology for bacterial or/yeast overgrowth ______

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What does this ‘look like’? ______• Intake: vaccinations, standard deworming, appropriate diet and adequate feeding ______• Flea control/contagious parasite treatment q 2 weeks for 6 weeks ______• In house diagnostics • Hair trichogram to look for ______• Skin cytology for yeast • Wood’s lamp-high risk of false positives ______• Bacterial overgrowth is common, at least treat topically ______

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Other Diagnostics ______

• If animal is otherwise healthy, routine laboratory work is ______rarely helpful • Allergy work up? ______• Thyroid function tests? • Adrenal function tests? ______• Skin biopsy indications ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Diagnosis Via Biopsy ______

• Vitamin A responsive skin disease ______• Zinc responsive skin disease • Medical conditions-cutaneous lymphoma ______• Sebaceous adenitis • Lichenoid psoriasiform dermatitis of springer spaniels ______• Nasal parakeratosis-when ruling out from immune mediated • Maybe helpful in ichyosis, primary cornification diseases.. ______

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Lichenoid psoriasiform dermatitis ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Bathing and Grooming ______

• Always indicated ______• Cannot over bathe the dog ______

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Topical Therapy-What You Need ______• ONE cleansing shampoo • One combined antibacterial/antifungal shampoo ______• One combination tar and sulfur or salicylic acid shampoo • One good degreasing shampoo ______• Benzoyl peroxide (degreasing and antimicrobial) • One moisturizing product ______• 50% propylene glycol • Commercial product ______• One non-irritating ear cleaner ______

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Shampoo Therapy Simplified ______

• Step 1: Instill ear cleaner ______• Step 2: Bathe dog in a cleansing shampoo to remove debris • Apply pre-diluted shampoo (1:2 - 1:4), wash, rinse ______• Step 3: Alternate bathing with antimicrobial shampoo and anti-seborrheic shampoo ______• Apply pre-diluted shampoo (1:2 - 1:4), wash, rinse • Rinse again and again ______• Step 4: Finish cleaning ears ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Seborrheic Otitis ______

• Increased ear secretions ______• Ceruminous otitis leads to bacterial overgrowth and chronic inflammation and ODOR ______• Treat microbial overgrowth • Clean ears at every bath ______• Topical ear steroids maybe very helpful • 1:1 dilution of propylene glycol and 2mg/kg of dexamethasone ______

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How Often??? ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Nasal and Digital Hyperkeratosis ______

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Ear Margin Hyperkeratosis ______

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Medical Treatment? ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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What Foster Families Can Do ______• Dog with chronic seborrheic otitis ______• Important to determine if medical or surgical • 30 day treatment period needs to be done in a home ______• 1 mg/kg orally once daily for 15-30 days ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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For example….. ______

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Dog that needs temporary intensive ______bathing to achieve remission ______

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Or this….. Do not squeeze! ______

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Stopping the Scales, Greasiness and Odor of Seborrhea in Shelter and Foster Home Dogs May 21, 2015

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Transitioning to a Permanent Home ______

• Information on what best controls the odor and scale ______• What’s the most you have to do and when? • What are the early signs of a relapse? ______• What products work? Or what products are irritating? • Information on all diagnostic testing ______• Is problem secondary? • If secondary what does new primary care veterinarian need to ______pursue? ______

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______www.vetmed.wisc.edu

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