Today's Veterinary Practice

JAN-FEB 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 46 CE: CANINE ATOPIC DERMATITIS S pseudintermedius-associated pyoderma in dogs has increased interest in targeted topical antimicrobial therapy with chlorhexidine shampoos and sprays. 11 More severe or generalized cases of pyoderma may require first-line systemic antimicrobials ( BOX 3 ); bacterial culture and susceptibility testing may be needed in cases of recurrent pyoderma. 12 For Malassezia dermatitis, there is evidence for use of topical miconazole/chlorhexidine shampoo treatment (Malaseb, bayerdvm.com ; twice a week for 3 weeks) and, in severe cases, systemic treatments with azole derivatives ( BOX 3 ). Many drug interactions exist with use of azole drugs, especially with ketoconazole. 13 Frequent use of systematic antimicrobials (antibiotics and antifungals) is not recommended because it is likely associated with increased prevalence of drug resistance. BOX 3 Systemic Antimicrobial Options for Severe Skin Infection Pyoderma Cephalexin, cefadroxil 15-30 mg/kg PO q12h Cefpodoxime 5-10 mg/kg PO q24h Clindamycin 5.5-11 mg/kg PO q12h Lincomycin 15-25 mg/kg PO q12h Malassezia dermatitis Ketoconazole 5-10 mg/kg q24h Itraconazole 5 mg/kg q24h for 3 weeks Terbinafine 30 mg/kg q24h for 3 weeks FIGURE 4. A 6-year-old mixed-breed dog with CAD and flea allergy dermatitis with severe pruritus and secondary bacterial infection at initial presentation (A, C). After failed allergen-specific immunotherapy, treating fleas and resolving secondary infection, the dog's allergies became well controlled with frequent medicated baths and lokivetmab, anti–canine IL-31 monoclonal antibody (B, D). A C B D

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