Hair Loss in Cats

Cat Hair Loss – Overview

  • “Alopecia” is the medical term for hair loss
  • Hair loss is a common problem in cats
  • Characterized by a complete or partial lack of hair in areas where it is present normally
  • Pattern of hair loss–varied or symmetrical

Signalment/Description of Pet

Species

  • Cats

Mean Age and Range

  • Cancer-related hair loss (alopecia)–generally recognized in older cats

Signs/Observed Changes in the Pet

  • Hair loss; pattern of hair loss varies—may be localized or widespread
  • Skin itself may appear normal or may be abnormal (such as redness; multiple, pinpoint bumps or scabs; or loss of superficial layers of the skin [known as ulceration])
  • Other signs depend on the underlying cause of hair loss

Causes

  • Nervous system or behavioral disorders—compulsive disorder, in which the cat overgrooms, with resulting hair loss
  • Hormonal disorders—sex hormone hair loss (alopecia); excessive levels of thyroid hormone (known as “hyperthyroidism”); increased levels of steroids produced by the adrenal glands (known as “hyperadrenocorticism” or “Cushing’s syndrome”); diabetes mellitus (“sugar diabetes”)
  • Immune-mediated disorders—skin allergies (known as “allergic dermatitis”); specific condition characterized by multiple patches of hair loss (known as “alopecia areata”); other disorders
  • Parasites—demodectic mange (known as “demodicosis”); itchy skin disease caused by infestation with Cheyletiella, a type of mite (condition known as “cheyletiellosis” or “walking dandruff”
  • Fungal infection—ringworm (known as “dermatophytosis”)
  • Physiologic or metabolic disorder—condition characterized by multiple areas of hair loss with reddened skin, scales (accumulations of surface skin cells, such as seen in dandruff), and signs of itchiness (known as “pruritus”) with inflammation of the sebaceous glands, the glands that produce oils in the hair coat (condition known as “sebaceous adenitis”)
  • Cancer or cancer-related hair loss
  • Unknown cause (so-called “idiopathic disease”)
  • Inherited hair loss
  • Injection-site reaction, leading to hair loss
  • Effects of medications–steroids
  • Viral infection–feline lukemia virus (FeLV) and feline immunodeficiency virus (FIV) associated diseases

Risk Factors

  • FeLV infection and FIV infection—for demodectic mange (demodicosis)

Treatment

Health Care

  • Treatment is limited for many of the disorders that cause hair loss (alopecia)
  • Behavioral modification or use of a “T-shirt” on the cat may protect the hair coat and help prevent excessive self-grooming
  • Shampoo and treatment applied directly to the skin may relieve secondary problems, such as increased thickness of the outer, keratinized layer of the skin (known as “hyperkeratosis”) in sebaceous adenitis (condition with hair loss, reddened skin, scales, and inflammation of the oil-secreting sebaceous glands); dried discharge on the surface of the skin lesion (known as a “crust”) in demodectic mange (demodicosis); secondary bacterial infections; and malodor for greasy conditions

Diet

  • Removal of an offending dietary item and use of a restricted ingredient diet may alleviate signs of food allergy (such as hair loss, scratching at skin)

Surgery

  • Biopsy of a tumor or the skin may be indicated in the diagnostic workup for some causes of hair loss (alopecia)
  • Excessive levels of steroids produced by the adrenal glands (hyperadrenocorticism or Cushing’s syndrome)—surgical removal of the adrenal gland
  • Surgical removal of skin cancer or tumors

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.

  • Compulsive disorder—amitriptyline as well as other behavior-modifying medications
  • Hormonal hair loss (alopecia) in males—testosterone supplementation
  • Skin allergy (allergic dermatitis)—antihistamines, steroids, “allergy shots” (known as “hyposensitization vaccine”); medications to control parasites on the skin
  • Excessive levels of thyroid hormone (hyperthyroidism)—medications given by mouth, such as methimazole (Tapazole), or radioactive iodine therapy
  • Diabetes mellitus (“sugar diabetes”)—regulation of glucose levels with insulin
  • Excessive levels of steroids produced by the adrenal glands (hyperadrenocorticism or Cushing’s syndrome)—surgery; no known effective medical therapy
  • Cancer-related hair loss (alopecia)—no therapy for many types of cancer-related hair loss; disease often fatal
  • Epitheliotropic lymphoma (type of cancer in the skin characterized by the presence of abnormal lymphocytes; a lymphocyte is a type of white blood cell, formed in lymphatic tissue throughout the body)—retinoids (isotretinoin), steroids, interferon, cyclosporine, lomustine
  • Sebaceous adenitis (condition with hair loss, reddened skin, scales, and inflammation of the oil-secreting sebaceous glands)—retinoids, steroids, cyclosporine
  • Squamous cell carcinoma (type of skin cancer)—retinoids (applied to skin directly [topical] and administered by mouth [oral]), topical imiquimod cream
  • Alopecia areata (specific condition involving multiple patches of hair loss)—no therapy; possibly counterirritants
  • Demodectic mange (demodicosis)—lime sulfur dips at weekly intervals for 4–6 dips
  • Cheyletiellosis—medications applied to the skin to kill the Cheyletiella mite (medications known as “topical parasiticides”)
  • Ringworm (dermatophytosis)—griseofulvin, itraconazole, terbinafine

Follow-Up Care

Patient Monitoring

  • Determined by specific diagnosis

Preventions and Avoidance

  • Determined by specific diagnosis

Possible Complications

  • Determined by specific diagnosis

Expected Course and Prognosis

  • Determined by specific diagnosis

Key Points

  • “Alopecia” is the medical term for hair loss
  • Hair loss is a common problem in cats
  • Pattern of hair loss varies–may be localized or widespread
  • Skin itself may appear normal or may be normal

Pigment Loss

Loss of Pigment in Dogs & Cats

Overview

  • Disease or cosmetic condition involving loss of pigmentation of the skin and/or hair coat either by lack of pigmentation or by melanocyte damage; “melanocytes” are cells that produce pigment in the skin or hair
  • Normal pigment in the skin and hair coat is melanin
  • “Leukotrichia” is the medical term of whitening of the hair, without indication of location of the whitened hairs
  • “Poliosis” is the medical term of whitening of the hair on the head and/or face
  • “Leukoderma” is the medical term of whitening of the skin

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Breed Predilections

  • Mucocutaneous pyoderma (bacterial skin infection involving areas of the lips, eyelids, nostrils)—German shepherd dogs
  • Systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs) and discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face)—collies, Shetland sheepdogs, German shepherd dogs
  • Pemphigus foliaceous (auto-immune disease involving the skin, characterized by inflammation with crusting and lesions containing pus)—chow chows, Akitas
  • Uveodermatologic syndrome (a rare syndrome in which the pet has inflammation in the front part of the eye, including the iris [condition known as “anterior uveitis”] and coexistent inflammation of the skin [known as “dermatitis”], characterized by loss of pigment in the skin of the nose and lips)—Akitas, Samoyeds, Siberian huskies
  • Vitiligo (condition characterized by symmetrical lack of pigment in the skin and white hair coat, especially involving the face and nose) in dogs—Belgian Tervuren, German shepherd dogs, Doberman pinschers, rottweilers, German shorthaired pointer, Old English sheepdog, and dachshund
  • Seasonal nasal hypopigmentation (loss of pigment in the tough, hairless skin of the nose [known as the “nasal planum”] that occurs seasonally)—Siberian huskies, Alaskan malamutes, yellow Labrador retrievers, and golden retrievers
  • Proliferative arteritis of the nasal philtrum (inflammation of the arteries of the nasal philtrum, the juncture between the sides of the upper lip extending to the nose)—Saint Bernards, giant schnauzers
  • Vitiligo in cats–Siamese
  • Periocular leukotrichia (whitening of the hair coat around the eyes) in cats–Siamese
  • Chediak-Higashi syndrome (an inherited disorder that affects many tissues in the body; causes lack of pigment in the skin and eyes)–Persian

Mean Age and Range

  • Vitiligo (condition characterized by symmetrical lack of pigment in the skin and white hair coat, especially involving the face and nose) in dogs—usually less than 3 years of age
  • Epitholiotropic lymphoma (a type of skin cancer; also known as “mycosis fungoides”)—typically dogs over 10 years of age

Predominant Sex

  • Discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face)—may occur more often in females than in males
  • Vitiligo in Siamese cats—females

Signs/Observed Changes in the Pet

  • White hair (known as “leukotrichia”)
  • Partial or total lack of pigment in the skin (known as “leukoderma”)
  • Lightening of the pigment in the skin, often seen as a “graying” or “browning” of previously pigmented areas
  • Reddening of the skin (known as “erythema”)
  • Loss of the top surface of the skin (known as “erosion” or “ulceration,” based on depth of tissue loss)

Causes

  • Mucocutaneous pyoderma (bacterial skin infection involving areas of the lips, eyelids, nostrils)
  • Systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs)
  • Discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face)
  • Pemphigus foliaceous (auto-immune disease involving the skin, characterized by inflammation with crusting and lesions containing pus)
  • Pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)
  • Uveodermatologic syndrome (a rare syndrome in which the pet has inflammation in the front part of the eye, including the iris [anterior uveitis] and coexistent inflammation of the skin [dermatitis], characterized by loss of pigment in the skin of the nose and lips)
  • Contact hypersensitivity (increased sensitivity or reaction in the skin to the presence of a foreign agent that comes in contact with the skin)
  • Vitiligo (condition characterized by symmetrical lack of pigment in the skin and white hair coat, especially involving the face and nose)
  • Seasonal nasal depigmentation (loss of pigment in the tough, hairless skin of the nose [known as the “nasal planum”] that occurs seasonally)
  • Albinism (inherited disorders characterized by lack of pigment in the skin, hair, and/or eyes, due to abnormal production of melanin)
  • Schnauzer gliding syndrom (young, gray miniature schnauzers develop golden hair color, primarily in the body)
  • Hormonal disorders
  • Drug reaction
  • Erythema multiforme (skin disorder caused by reaction of medications, infections, or other diseases)
  • Proliferative arteritis of the nasal philtrum (inflammation of the arteries of the nasal philtrum, the juncture between the sides of the upper lip extending to the nose)
  • Loss of pigment in the skin and/or hair following skin inflammation
  • Dermatophytosis (fungal infection on the surface of the skin)

Risk Factors

  • Sun exposure—systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face), and pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)

Treatment

Health Care

  • Outpatient, except for systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), erythema multiforme (skin disorder caused by reaction to medications, infections, or other diseases), and lymphoma of the skin (a type of skin cancer), when severe multiple organ dysfunction is present
  • Reduce exposure to sunlight—systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face) and pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)
  • Replace plastic or rubber dishes—particularly if roughened edges cause abrasions
  • Application of water-resistant sun-block ointments or gels (with a SPF UVA and UVB greater than 30) to depigmented areas
  • Vitiligo and nasal depigmentation–no treatment

Activity

  • Restrict outdoor activity to minimize exposure to sunlight—systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face) and pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)

Surgery

  • Skin biopsy

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.

  • Vary based on underlying cause
  • Systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs)—immunosuppressive therapy with steroids (such as prednisolone or dexamethasone) and chemotherapy drugs (such as azathioprine [dogs] or chlorambucil [cats])
  • Tetracycline and niacinamide—to treat pemphigus erythematosis (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus) and discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face) in dogs
  • Medications to decrease the immune response (known as “immunosuppressive therapy”)—to treat systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), pemphigus foliaceous (auto-immune disease involving the skin, characterized by inflammation with crusting and lesions containing pus), pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)
  • Cyclosporine to decrease the immune response in auto-immune disorders
  • Steroids applied to the skin directly (known as “topical steroids”)
  • Tacrolimus, 0.1% gel or pimecrolimus 1% cream applied daily to lesions in combination with or to replace steroids
  • Imiquimod 5% cream for actinic keratosis (a precancerous skin condition caused by sun exposure)
  • Antibiotics–trimethoprim-sulfadiazine, cephalexin, or amoxicillin-clavulanate; effective in some cats
  • Antibiotics for bacterial skin infection (known as “pyoderma”)
  • Chlorambucil, a chemoterapeutic drug
  • Medications to treat fungal infections (known as “antifungal drugs”) to treat dermatophytosis (fungal infection on the surface of the skin)

Follow-Up Care

Patient Monitoring

  • Varies with specific disease and treatment prescribed

Preventions and Avoidance

  • Restrict outdoor activity to minimize exposure to sunlight—systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs), discoid lupus erythematosus (auto-immune disease involving the skin only, usually the face) and pemphigus erythematosus (auto-immune disease involving the skin of the face and ears, characterized by reddening of the skin [erythema] and lesions containing pus)

Possible Complications

  • Systemic lupus erythematosus (auto-immune disease in which the body attacks its own skin and other organs)—scarring
  • Squamous cell carcinoma ( a type of skin cancer) in cases of sun-damage to the skin, with resulting loss of skin pigment

Expected Course and Prognosis

  • Vary with specific disease

Itchiness in Dogs & Cats

Itchiness in Dogs & Cats – An Overview

  • “Pruritus” is the medical term for itching or itchiness; it is the itching sensation that provokes the desire to scratch, rub, chew or lick
  • Pruritus is an indicator of inflamed skin
  • The term is not a diagnosis but rather is a description of a clinical sign

Species

  • Dogs
  • Cats

Signs/Observed Changes in the Pet

  • Scratching
  • Licking
  • Biting
  • Rubbing
  • Chewing
  • Self-trauma
  • Inflammation of the skin (known as “dermatitis”)
  • Hair loss (known as “alopecia”); hair loss without inflammation may be the only sign in some cats
  • Other signs determined by underlying cause

Causes

  • Parasites—fleas; mites (canine scabies [Sarcoptes], Demodex, ear mites [Otodectes], feline scabies [Notoedres], “walking dandruff” [Cheyletiella], harvest mite or red bud [Trombicula]); lice; rhabditic dermatitis (Pelodera strongyloides); or migration of internal parasites
  • Allergies—parasite allergy; atopy (disease in which the pet is sensitized [or “allergic”] to substances found in the environment [such as pollen] that normally would not cause any health problems); food allergy; contact allergy; drug allergy; allergy to skin bacteria (known as “bacterial hypersensitivity”); allergy to Malassezia (a yeast found on the skin)
  • Bacterial or fungal infections—Staphylococcus (a bacteria) and Malassezia pachydermatis (a yeast or fungus); rarely a dermatophyte (fungus living on the skin, hair, or nails); however, Trichophyton is a dermatophyte that tends to cause more itchy skin disease than the other dermatophytes
  • Miscellaneous—excessive scaling of the skin (known as “seborrhea”); calcium deposits in the skin (known as “calcinosis cutis”); skin tumors or cancer
  • Immune-mediated skin diseases and hormonal skin diseases can be variably itchy
  • Psychological skin diseases may be associated with itchiness

Risk Factors

  • Exposure to other animals with parasites

Treatment

Health Care

  • More than one disease can contribute to itching
  • The use of mechanical restraint (such as an Elizabeth collar) can be a helpful option, but is seldom feasible in long-term treatment
  • Treat for secondary infections, which are common

Diet

  • Depends on underlying cause
  • Usually no change in diet needed, unless suspected food allergey

Medication

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive

Medications Applied to the Skin Directly (Known as “Topical Therapy”)

  • Topical therapy is helpful in mildly itchy pets
  • For localized areas of itchiness or skin inflammation, sprays, lotions and creams are most appropriate
  • If the itching involves many areas or widespread areas, shampoos are the preferred means of application
  • Antibacterial shampoos help control bacterial infections that cause itching; however, some antibacterial shampoos (such as those containing benzoyl peroxide or iodine) can cause increased itching
  • Colloidal oatmeal is common in all forms of topical therapy; its duration of effect usually is less than two days
  • Topical antihistamines may be found alone or in combination with other ingredients; they may not have a beneficial effect
  • Topical anesthetics may offer only a very short duration of effect
  • Antimicrobial shampoos help control bacterial infections that cause itching; however, some contain ingredients (such as benzoyl peroxide or iodine) that can increase itchiness through excessive drying
  • Lime sulfur (which has a bad odor and can stain) can decrease itching, while also having anti-parasitic, antibacterial, and antifungal properties
  • Topical steroids probably are the most useful topical medications; hydrocortisone is the mildest and most common topical steroid; stronger steroids (such as betamethasone) may be more effective and are more expensive; a triamcinolone-containing prescription spray (Genesis® Topical Spray, Virbac) is effective in decreasing itchiness (pruritus)
  • Some topical steroid medications also contain ingredients (such as alcohol), which can aggravate already irritated skin
  • In some pets, the application of any substance, including water (especially warm water), can result in an increased level of itchiness; however, cool water often is soothing

Medications Administered by Mouth or by Injection (Systemic Therapy)

  • Steroids to decrease inflammation and itchiness of the skin
  • Cyclosporine to decrease the immune response
  • For pets affected with airborne allergies for more than a few months out of the year, “allergy shots” (known as “allergen specific immunotherapy”) are appropriate, frequently beneficial, and may lead to a cure (in some cases)
  • Antihistamines (such as hydroxyzine, diphenhydramine, and chlorpheniramine) to prevent inflammation and itching
  • Fatty acids are available in powders, liquids, and capsules; they help block pathways that lead to inflammation, but may require 6–8 weeks of use until maximum effect is observed; fatty acids work better as preventive medications, rather than stopping the inflammation once it has become a problem; they also help reduce dry or flaky skin, which can cause itching
  • Medications to relieve anxiety or depression (known as “psychogenic drugs”) can be helpful in controlling itchiness; include such drugs as amitriptyline, fluoxetine, and diazepam
  • In rare cases, alternative medications to decrease the immune response (known as “immunosuppressive drugs,” such as azathioprine) may be utilized; however, they should be reserved for instances when all other treatments have failed

Follow-Up Care

Patient Monitoring

  • Patient monitoring is imperative; pets should be examined periodically to evaluate response to treatment
  • Pets receiving long-term (chronic) medications should be evaluated every 3–12 months for potential side effects as well as occurrence of new contributing factors

Preventions and Avoidance

  • Prevent infestation with parasites (such as fleas and mites)
  • Avoid foods identified as causing food allergy for your pet

Possible Complications

  • Owner frustration is common
  • Complications (such as increased thirst [known as “polydipsia”] and increased urination [known as “polyuria”]) are common with long-term (chronic) steroid use

Expected Course and Prognosis

  • Depend on underlying cause
  • Many causes of itchiness in pets are extremely frustrating to control

Key Points

  • Many different unrelated diseases may contribute to itchiness (pruritus), and control of one disease does not mean that other causes cannot be contributing to itchiness or cannot occur later
  • Multiple causes (such as flea allergy, inhalant allergy, and bacterial skin infection [known as “pyoderma”]) commonly are present in a single patient
  • Elimination of bacterial skin infection (pyoderma) and flea-associated disease may not be enough to significantly reduce itchiness
  • Food-allergy and inhalant-allergic pets may do well during the winter season with a hypoallergenic diet, only to become itchy during the warmer months in association with inhalant allergies

Flea Bite Hypersensitivity & Flea Control

Flea Bite Hypersensitivity & Flea Control – Overview

  • “Hypersensitivity” is an increased sensitivity or reaction in the skin due to the presence of a foreign substance; in flea-bite hypersensitivity, the foreign substance is found in flea saliva; the reaction is immune based and would be considered to be an “allergic” reaction
  • “Dermatitis” is the medical term for inflammation of the skin
  • “Antigens” are substances that induce sensitivity or immune response
  • “Flea-bite hypersensitivity”—hypersensitivity or allergic reaction to antigens in flea saliva, with or without evidence of fleas and flea dirt
  • “Flea-bite dermatitis”—inflammation of the skin due to the flea bite itself; it is not an allergic or hypersensitivity reaction, but rather an irritant response to flea bites

Genetics

  • Flea-bite hypersensitivity—unknown inheritance pattern; more common in breeds with atopy (disease in which the pet is sensitized [or “allergic”] to substances found in the environment [such as pollen] that normally would not cause any health problems)

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Mean Age and Range

  • Flea-bite hypersensitivity—rare in pets less than 6 months of age; average age range, 3–6 years, but may be seen at any age

Signs/Observed Changes in the Pet

  • Determined by the severity of the reaction and the degree of exposure to fleas (that is, seasonal or year-round)
  • Itchiness (known as “pruritus”)
  • Compulsive biting
  • Chewing (“corncob nibbling”)
  • Licking, primarily in the back half of the body, but may include the areas
  • Signs of fleas and flea dirt; finding fleas and flea dirt is beneficial, although not essential, for the diagnosis of flea-bite hypersinsitivity
  • Sensitive pets require a low exposure to fleas to have an immune response and they tend to over groom, removingt evidence of flea infestation, and making identification of parasites difficult
  • Hair loss (known as “alopecia”)
  • Small, raised skin lesions (known as “papules”)
  • Darkened skin (known as “hyperpigmentation”) in dogs
  • Thickening and hardening of the skin, usually associated with hyperpigmentation (known as “lichenification”) in dogs
  • “Hot spots” in dogs
  • Miliary dermatitis (skin inflammation characterized by numerous, small, crusty bumps) in cats)

Causes

  • Fleas
  • Immune response to flea saliva (flea-bite hypersensitivity or flea-allergy dermatitis)

Risk Factors

  • Flea-bite hypersensitivity—intermittent exposure to fleas increases likelihood of development; commonly seen in conjunction with atopy (disease in which the pet is sensitized [or “allergic”] to substances found in the environment [such as pollen] that normally would not cause any health problems)

Treatment

Health Care

  • Outpatient treatment

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.

  • Steroids—to decrease inflammation in the skin for symptomatic relief, while instituting flea control
  • Antihistamines–symptomatic relief
  • Flea control on the pet; examples include dinotefuran/pyriproxyfen (monthly spot treatment; rapid acting; two products—one for cats and one for dogs; dog product contains high dose of the insecticide, permethrin, and should NOT be used on cats); fipronil (monthly spot treatment for dogs and cats and spray treatment for dogs); imidacloprid (monthly spot treatment for cats and dogs); metaflumizone (monthly spot treatment for dogs or cats; product for dogs contains another active ingredient [amitraz] and should not be used on cats)
  • Flea control using medications given by mouth (known as “oral medications”)—nitenpyram (rapid action, but short-acting; kills over 95% of adult fleas on dogs and cats within 4–6 hours of administration, lasts for 48–72 hours); spinosad (monthly oral treatment for dogs only)
  • Other flea control for pets (such as flea sprays and other topical treatments)—usually contain pyrethrins and pyrethroids (synthetic pyrethrins) with an insect-growth regulator or synergist; generally effective for less than 48–72 hours
  • Environmental/indoor treatment—professional exterminator or home-use fogs and premises sprays; products usually contain organophosphates, pyrethrins, and/or insect-growth regulators; apply according to manufacturer’s directions; treat all areas of the house
  • Environmental/indoor treatment using inert substances—boric acid, diatomaceous earth, and silica aerogel; treat every 6–12 months; follow manufacturer’s recommendations
  • Environmental/outdoor treatment—concentrate outdoor treatment in shaded areas; sprays usually contain pyrethroids or organophosphates and an insect-growth regulator; a product containing nematodes (Steinerma carpocapsae) is chemical-free
  • Other products for use include flea powders, dips, sprays, and foams
  • NOTE: Always read all label instructions and follow the manufacturer’s directions when using any flea-control product; ensure that the product is labeled for use on the species (dog or cat) or location (indoors or outdoors) for which you intend to apply it—for example, some products that are safe for dogs are very toxic to cats and should not be used on cats

Follow-Up Care

Patient Monitoring

  • Itchiness (pruritus)—a decrease in itchiness indicates the flea infestation and/or flea-bite hypersensitivity is being controlled
  • Fleas and flea dirt—absence is not always a reliable indicator of successful treatment in very sensitive pets

Preventions and Avoidance

  • Year-round warm climates—year-round flea control is required
  • Seasonally warm climates–begin flea control in May or June, as directed by your pet’s veterinarian

Possible Complications

  • Secondary bacterial infections
  • Sudden (acute) moist dermatitis, also known as “hot spots”
  • Acral lick dermatitis (inflammation of the skin characterized by a firm, ulcerated lesion on a leg, caused by consistant licking)

Expected Course and Prognosis

  • Prognosis is good, if strict flea control is instituted

Key Points

  • Flea control is important for dogs and cats
  • No cure exists for flea-bite hypersensitivity
  • Flea-allergic pets often become more sensitive to flea bites as they age
  • Controlling exposure to fleas is currently the only means of controlling signs; “allergy shots” (known as “hyposensitization”) for flea-bite hypersensitivity are not effective

Bacterial Skin Infections

Bacterial Skin Infections (Pyoderma) – An Overview

  • “Pyoderma” is the medical term for bacterial infection of the skin
  • Skin lesions are characterized by the presence of pus
  • “Superficial pyoderma”—involves the top surface of the skin (known as the “epidermis”) and the hair follicles
  • “Deep pyoderma”—involves the lower layers of the skin (known as the “dermis”) and possibly the tissues under the skin (known as the “subcutis”)

Breed Predilections

  • Dogs—sporting breeds, hounds, working breeds, and mixed-breed dogs (greater than 12 kg [26 lbs] of body weight)

Mean Age and Range

  • Dogs—common in young and old dogs; range, 1 month–15 years; many cases in puppies less than 1 year of age

Risk Factors

  • Contact of animals that have not been vaccinated or have not responded to vaccinations with animals that are infected with canine distemper virus (dogs or wild carnivores)

Signs/Observed Changes in the Pet

  • Cough
  • Fever
  • Labored breathing
  • Exercise intolerance
  • Lack of appetite (known as “anorexia”) and weight loss
  • Sluggishness (lethargy)
  • Nasal discharge
  • Difficult or rapid breathing
  • Abnormal breath sounds on listening to the lungs with a stethoscope (known as “auscultation”)—increased intensity or breath sounds over the bronchi; short, rough snapping sounds (known as “crackles”); and squeaking or whistling sounds (known as “wheezes”)
  • Dehydration

Causes

Dogs

  • Most common primary disease-causing organisms of the respiratory tract— Bordetella bronchiseptica and Mycoplasma.
  • Most common gram-positive bacteria—Staphylococcus, Streptococcus, and Enterococcus; gram staining is a technique in which slides with potential bacteria on them are stained in a sequential manner; gram-positive bacteria stain dark purple while gram-negative bacteria stain pink; gram staining allows differentiation of bacteria into groups (that is, gram-positive or gram-negative).
  • Most common gram-negative bacteria— Escherichia coli, Klebsiella, Pseudomonas, Pasteurella
  • Anaerobic bacteria (bacteria that can live and grow in the absence of oxygen)—found in lung abscesses and various types of pneumonia (particularly with aspiration or foreign bodies); approximately 20% of pets with bacterial pneumonia have anaerobic bacterial infections.

Cats

  • Bacteria—Bordetella bronchiseptica, Pasteurella, and Moraxella most frequently reported; Mycoplasma considered a primary disease-causing microorganism (known as a “pathogen”) in the lower respiratory tract.
  • Carrier state—may exist; periods of shedding Bordetella bronchiseptica after stress; infected female cats (queens) may not shed the organism during pregnancy (prepartum) but begin shedding it after delivering the kittens (postpartum), serving as a source of infection for kittens.

Risk Factors

  • Preexisting viral infection.
  • Regurgitation (return of food or other contents from the esophagus or stomach back up through the mouth), dysphagia (difficulty swallowing), or vomiting (forceful ejection of stomach contents up through the esophagus and mouth).
  • Functional or structural (anatomic) defects—paralysis of the voice box or larynx (known as “laryngeal paralysis”); enlarged esophagus (known as “megaesophagus”); cleft palate; inherited disorder in which the normal secretion clearance mechanism of the lungs is defective (known as “primary ciliary dyskinesia”).
  • Reduced level of consciousness—stupor, coma, or anesthesia.
  • Foreign body in the bronchi (part of the airway).
  • Long-term (chronic) dilation of bronchi or bronchioles, as a consequence of inflammation or blockage of the airway (known as “bronchiectasis”).
  • Drugs to decrease the immune response (known as “immunosuppressive drugs”)—such as chemotherapeutic drugs and steroids.
  • Severe metabolic disorders—excess levels of urea and other nitrogenous waste products in the blood (known as “uremia” or “azotemia”); sugar diabetes (diabetes mellitus); excessive production of steroids by the adrenal glands (known as “hyperadrenocorticism” or “Cushing’s syndrome”).
  • Presence of pus-forming bacteria and their poisons in the blood or tissues (known as “sepsis”).
  • Age—very young more susceptible to fatal infections.
  • Vaccination status.
  • Environment—housing, sanitation, ventilation.
  • Abnormal function of cells that normally remove bacteria and foreign materials from the body (known as “phagocyte dysfunction”)—feline leukemia virus (FeLV) infection and diabetes mellitus.
  • Complement (a protein substance in the blood that contributes to the destruction and removal of bacteria from the body) deficiency—rare.
  • Selective immunoglobulin A (IgA) deficiency; immunoglobulin A is an immune protein, found in the intestines; it functions as a protective barrier to prevent limit antigens (substance to which the immune system is responding and producing antibodies) and disease-causing microorganisms from entering the body through the intestines—rare.
  • Combined T-cell and B-cell dysfunction—rare; a lymphocyte is a type of white blood cell, formed in lymphatic tissue throughout the body; lymphocytes are further divided into T lymphocytes (which are involved in cell-mediated immunity), so-called “T-cells” and B lymphocytes (which produce antibodies as part of the immune process), so-called “B-cells”—rare.

Treatment

Health Care

  • Inpatient—recommended with signs involving multiple body systems (such as lack of appetite [anorexia], high fever, weight loss, and sluggishness [lethargy]).
  • Maintain normal hydration—important to aid the normal secretion clearance mechanism of the lungs; use a balanced electrolyte solution.
  • Administration of medication in a fine spray (known as “nebulization”) with saline aerosol—results in more rapid resolution, if used with physiotherapy and antibiotics.
  • Physiotherapy—efforts to dislodge secretions in the lungs and to induce coughing (known as “coupage”); windpipe manipulation to stimulate mild cough; and postural drainage; may enhance clearance of secretions; always do immediately after nebulization; avoid allowing the pet to lie in one position for a prolonged time.
  • Oxygen therapy—for pets with low levels of oxygen in their blood (known as “hypoxemia”) and signs of severe breathing difficulties (known as “respiratory distress”).

Activity

  • Restrict during treatment (inpatient or outpatient), except as part of physiotherapy after administration of medication in a fine spray (nebulization).

Diet

  • Ensure normal intake of food, with foods high in protein and calorie or energy density.
  • Feeding directly into the intestinal tract (known as “enteral feeding”) or through the veins (known as “parenteral nutrition”)—indicated in severely ill pets.
  • Use caution in feeding pets with an enlarged esophagus (megaesophagus); lack of normal function of the voice box or larynx (known as “laryngeal dysfunction”) or surgery on the voice box or larynx; disease of the throat or pharynx (known as “pharyngeal disease”), and pets that are unable to get up (they are recumbent).

Surgery

  • Surgical removal of a lung lobe (known as “lung lobectomy”)—may be indicated with lung abscesses or foreign body in the bronchus with secondary pneumonia; may be indicated if the pet is unresponsive to conventional treatment and disease is limited to one or two lobes of the lung(s).

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

Antibiotics

  • Antibiotics are best selected based on results of bacterial culture and susceptibility testing from transtracheal wash (a technique in which samples from the lower airways are obtained for bacterial culture and/or for evaluation through a microscope) or other diagnostic techniques.
  • Reasonable initial antibiotic choices pending culture results include amoxicillin–clavulanic acid, cephalexin, enrofloxacin, or trimethoprim-sulfonamide.
  • Gram-positive cocci—ampicillin, ampicillin-sulbactam; amoxicillin; amoxicillin–clavulanic acid; azithromycin; chloramphenicol, erythromycin; gentamicin; trimethoprim-sulfonamide; first-generation cephalosporins.
  • Gram-negative rods—enrofloxacin; chloramphenicol; gentamicin; trimethoprim-sulfonamide; amikacin; marbofloxacin; carboxypenicillins.
  • Bordetella—doxycycline; chloramphenicol; enrofloxacin; azithromycin.
  • Mycoplasma—doxycycline, enrofloxacin, marbofloxacin, chloramphenicol.
  • Anaerobes (bacteria that can live and grow in the absence of oxygen)—amoxicillin–clavulanic acid; chloramphenicol; metronidazole; clindamycin; ticarcillin-clavulanic acid.
  • Administration of gentamicin in a fine spray (known as “gentamicin nebulization”) for Bordetella—typically used in conjunction with antibiotics given by mouth or injection.
  • Continue treatment for at least 10 days beyond clinical resolution and/or 1–2 weeks following resolution of x-ray (radiograph) evidence of pneumonia.

Antibiotics

  • Recommended by some veterinarians; no objective evidence that they increase movement of mucus or mobilization of secretions.

Bronchodilators

  • Recommended by some veterinarians; used to decrease spasm of the bronchi; bronchodilators are medications that enlarge the bronchi and bronchioles in the lungs.

Follow-Up Care

Patient Monitoring

  • Monitor breathing rate and effort.
  • Complete blood count (CBC) should be performed periodically; CBC should return to normal as the pet responds to treatment.
  • Arterial blood gases, to monitor levels of oxygen and carbon dioxide in the blood—most sensitive monitor of progress.
  • Monitor pulse oximetry; : “pulse oximetry” is a means of measuring oxygen levels in blood.
  • Listen to the pet’s lungs (auscultate) frequently.
  • Chest x-rays (radiographs)—improve more slowly than the clinical signs.

Preventions and Avoidance

  • Vaccination—against upper respiratory viruses; against Bordetella bronchiseptica, if dog is boarded or exposed to large number of other dogs.
  • Catteries—environmental strategies to lower the number of cats or the close proximity in which they are housed (known as “population density”) and improve hygiene help control outbreaks of bordetellosis (infection caused by Bordetella).

Possible Complications

  • Presence of pus-forming bacteria and their poisons in the blood or tissues (sepsis).

Expected Course and Prognosis

  • Prognosis—good with aggressive anti-bacterial and supportive therapy; more guarded in young pets, pets with decreased ability to develop a normal immune response (immunodeficiency), and pets that are debilitated or have severe underlying disease.
  • Prolonged infection—potential for long-term (chronic) inflammation of the bronchi (bronchitis) or chronic dilation of bronchi or bronchioles, as a consequence of inflammation or blockage of the airway (bronchiectasis) in any pet.
  • High death rates are associated with severely low levels of oxygen in the blood (hypoxemia) and presence of pus-forming bacteria and their poisons in the blood or tissues (sepsis).

Key Points

  • Inflammation in the lung as a response to disease-causing bacteria, characterized by accumulation of inflammatory cells and fluid in the lung, conducting airways (bronchi and bronchioles), and alveoli (the terminal portion of the airways, in which oxygen and carbon dioxide are exchanged).
  • More common in dogs than in cats.
  • Antibiotics are best selected based on results of bacterial culture and susceptibility testing.
  • High death rates are associated with severely low levels of oxygen in the blood (hypoxemia) and presence of pus-forming bacteria and their poisons in the blood or tissues (sepsis).

Pet Dermatology

Common Skin Conditions Seen In Dogs & Cats

Here, we have listed some of the most common skin conditions and provided you with the typical symptoms, and possible treatment. In some instances (when possible), we’ve included information about treatment that can be done with readily available at-home remedies. However, we would like to remind you that most skin conditions can be difficult to treat and will require veterinary assistance.

  • Mange
  • Bacterial Skin Infections (Pyoderma)
  • Inflamed Skin & Allergies
  • Eosinophilic Granuloma In Dogs & Cats
  • Loss of Pigment in Dogs & Cats
  • Flea Bite Hypersensitivity & Flea Control
  • Tick & Tick Control
  • Hair Loss In Cats (Feline Alopecia)
  • Hair Loss In Dogs (Canine Alopecia)
  • Hair Loss Without Inflammation of The Skin In Dogs
  • Nail & Nailbed Disorders
  • Itchiness in Dogs & Cats
  • Inflammation of the Outer & Middle Ear (Otitis Externa)
  • Pemphigus
  • Bumps On Skin (Papulonodular Dermatoses)
  • Skin Disorders Caused by Reactions to Food
  • Pododermatitis (Inflammation of Skin of the Paws)
  • Blisters & Pustules (Vesiculopustular Dermatoses)
  • Sterile Nodular Granulomatous Skin Diseases
  • Ulcers of the Skin
  • Skin Disorders of the Nose in Dogs (Canine Nasal Dermatoses)

We will work closely with you to diagnose, treat and monitor any skin, ear, nail or foot problem your pet may have. We are here to help your pet with problems such as diseases of the skin, dog or cat ear infections or immune-mediated problems.

Dermatology-Immune Related Skin Disorders

Your pet’s immune system plays a large role in many of the dermatology problems in both dogs and cats that we see at Tri-County Animal Hospital. Just like humans who can inherit allergies in the “gene lottery”, our canine & feline counterparts can have this unfortunate trait passed down to them. Pet’s often show allergic reactions to certain grasses, plants, and even certain types of food. While humans generally show allergies through sneezing, dogs and cats usually show through their skin.

In dogs, susceptibility to demodectic mange is another example of an immune related skin problem. This is a skin issue caused my microscopic mites, and can be relatively common in puppies. Diagnosis is determined through a simple skin scraping. Our veterinarians will look under the microscope to see if these mites are the cause of your dog’s skin condition, and recommend the appropriate treatment.

Environmental Related Skin Disorders (Sometimes Physical / Self Inflicted)

Environmental skin disorders are another common problem that we see at our animal hospital. The majority of these conditions are caused by excessive licking or chewing of the skin. In order to solve this challenge, our veterinarian not only treats the visible skin problem, but also determines the underlying problem that is causing your dog or cat to chew on themselves.

Lick granulomas are an example of this type of skin condition. Oftentimes, dogs will lick themselves so excessively that an open wound is left behind. While there could be numerous reasons for this type of self-destructive behavior, it is usually the result of a psychological issue (boredom, stress, anxiety). Our Staff will work to pinpoint the cause and help eliminate the harmful behavior.

Infectious Skin Disorders

Infectious skin diseases occur in both cats and dogs, and can be both contagious or non-contagious. The contagious infections fall under a broad range of viral, parasitic, fungal and bacterial diseases. Ringworm is one common example of this type of skin disorder. This fungal skin infection is contagious to dogs, cats and even humans. Diagnosis is determined through a culture, during which time, Dr. Silberman will advise treatment for your pet accordingly.

Another example of an infectious skin disorder is a staph infection. Staph infection is caused by bacteria belonging to genus Staphylococcus, and usually presents on the skin as scales or severe redness. In these cases, Dr. Silberman will examine your pet and often take cotton swab culture samples and perform cytologic evaluation under the microscope.

Secondary Conditions Caused By Internal Diseases

Sometimes, skin conditions are simply the manifestation of larger, underlying illnesses in your dog or cat. Many hormonal abnormalities have the ability to affect the quality of your pet’s skin and coat. In dogs, thyroid disease and Cushing’s Disease (hyperadrenocorticism), causing skin issues are probably the most common. Among cats, hyperthyroidism and diabetes may cause a dull coat, very matted fur, and in some cases, lose patches of hair from over-grooming. Dr. Silberman will determine which treatment is best for your pet, and discuss all available options with you.

Nail & Nailbed Disorders

Nail & Nailbed Disorders – An Overview

  • Nail and nailbed disorders are a group of abnormalities or diseases that affect the nail or claw and/or the tissues surrounding the nail or claw (that is, the nailbed)
  • “Onycho-” or “onych-” refers to the nail or claw
  • Inflammation of soft tissue around the nail or claw (known as “paronychia”)
  • Fungal infection of the nail or claw (known as “onychomycosis”)
  • Brittle nails or claws that tend to split or break (known as “onychorrhexis”)
  • Sloughing of the nail or claw (known as “onychomadesis”)
  • Deformity of the nail or claw caused by abnormal growth (known as “nail dystrophy” or “onychodystrophy”) that is often the result of a nail or nailbed disorder
  • Softening of the nails (known as “onychomalacia”)

Genetics

  • Certain breeds appear to be more susceptible to nail and nailbed disorders than other breeds, suggesting a possible genetic basis

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Breed Predilections

  • Brittle nails that tend to split or break (onychorrhexis)—dachshund
  • Symmetrical deformity of the nails or claws caused by abnormal growth (nail dystrophy or onychodystrophy) that is related to the autoimmune disease, lupus, or a lupus-like disease (condition known as “symmetrical lupoid onychodystrophy”)—German shepherd dog, rottweiler, possibly giant schnauzer and Doberman pinscher
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy) of unknown cause (condition known as “idiopathic onychodystrophy” [“idiopathic” means unknown])—Siberian husky, dachshund, Rhodesian ridgeback, rottweiler, cocker spaniel
  • Sloughing of the nail or claw of unknown cause (condition known as “idiopathic onychomadesis”)—German shepherd dog, whippet, English springer spaniel

Mean Age and Range

  • Symmetrical deformity of the nails or claws caused by abnormal growth (nail dystrophy or onychodystrophy) that is related to the autoimmune disease, lupus, or a lupus-like disease (symmetrical lupoid onychodystrophy)—3–8 years of age

Signs/Observed Changes in the Pet

  • Licking at the feet and/or nails
  • Lameness
  • Pain
  • Swelling, redness of the skin and tissues (known as “erythema”), and discharge from the nail or the area where the skin and nail or claw come together at the top of the toe (known as the “ungual fold” or “nail fold” or “claw fold”)
  • Deformity or sloughing of one or more nails or claws
  • Discoloration of the nail
  • Bleeding from the nail
  • Loss of one or more nails
  • Being “tender-footed”

Causes

  • Inflammation of soft tissue around the nail or claw (paronychia)
  • Infection or infectious disease—bacteria, fungus (known as “dermatophytosis”), yeast (Candida, Malassezia), demodectic mange mites (condition known as “demodicosis”), leishmaniasis
  • Immune-mediated disease—types include the following: pemphigus, bullous pemphigoid, systemic lupus erythematosus, drug eruption, symmetrical lupoid onychodystrophy
  • Tumor or cancer—types include the following: squamous cell carcinoma, melanoma, eccrine carcinoma, osteosarcoma, subungual keratoacanthoma, inverted squamous papilloma
  • Abnormal communication between an artery and a vein (known as an “arteriovenous fistula”)
  • Fungal infection of the nail or claw (onychomycosis)
  • Dogs—Trichophyton mentagrophytes (usually generalized fungal infection of the skin, involving the nails)
  • Cats—Microsporum canis
  • Brittle nails or claws that tend to split or break (onychorrhexis)
  • Unknown cause (so-called “idiopathic disease”)—especially in dachshunds; involves multiple nails
  • Trauma
  • Infection—fungal infection (dermatophytosis), leishmaniasis
  • Sloughing of the nail or claw (onychomadesis)
  • Infection
  • Immune-mediated disease—types include the following: pemphigus, bullous pemphigoid, systemic lupus erythematosus, drug eruption, symmetrical lupoid onychodystrophy
  • Decreased or inadequate blood flow (known as “vascular insufficiency”)—inflammation of the blood vessels (known as “vasculitis”); clumping together or agglutination of red-blood cells when the temperature of the cells drops below normal body temperature (known as “cold agglutinin disease”), such as exposure of the legs to cold weather
  • Tumor or cancer—types include the following: squamous cell carcinoma, melanoma, eccrine carcinoma, osteosarcoma, subungual keratoacanthoma, inverted squamous papilloma
  • Unknown cause (so-called “idiopathic disease”)
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy)
  • Condition caused by excessive levels of growth hormone, leading to enlargement of bone and soft-tissues in the body (known as “acromegaly”)
  • Increased levels of thyroid hormone in the cat (known as “feline hyperthyroidism”)
  • Zinc-responsive skin disorder (known as “zinc-responsive dermatosis”)
  • Congenital (present at birth) malformations of the nail or claw

Risk Factors

  • Inflammation of soft tissue around the nail or claw (paronychia) due to infectious causes—decreased ability to develop a normal immune response (known as “immunosuppression”), which may be related to immune-system problem of the body or to the use of medications to decrease the immune response; feline leukemia virus (FeLV) infection; trauma; and diabetes mellitus (sugar diabetes)
  • Sloughing of the nail or claw due to bacterial infection (bacterial onychomadesis)—excessively short nail trimming (into the quick) postulated to increase likelihood of bacterial infection and subsequent sloughing of the nail or claw

Treatment

Health Care

  • Inflammation of soft tissue around the nail or claw (paronychia)
  • Surgical removal of the hard part of the nail (known as the “nail plate” or “shell”)
  • Antimicrobial soaks
  • Identify underlying condition and treat specifically
  • Fungal infection of the nail or claw (onychomycosis)
  • Antifungal soaks—chlorhexidine, povidone iodine, lime sulfur
  • Surgical removal of the hard part of the nail (nail plate or shell)—may improve response to medication administered by mouth or injection (known as “systemic medication”)
  • Amputation of the third bone of the toe (known as the “third phalanx”), which is continued by the nail or claw
  • Brittle nails or claws that tend to split or break (onychorrhexis
  • Repair with fingernail glue (type used to attach false nails in humans), as performed or directed by your pet’s veterinarian
  • Remove splintered pieces
  • Amputation of the third bone of the toe (third phalanx), which is continued by the nail or claw
  • Treat underlying cause
  • Sloughing of the nail or claw (onychomadesis)
  • Antimicrobial soaks
  • Treat underlying cause
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy)
  • Treat underlying cause
  • Tumor or cancer
  • Determined by biologic behavior of specific tumor
  • Surgical removal of the tumor
  • Amputation of toe
  • Amputation of leg
  • Chemotherapy
  • Radiation therapy

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive

  • Bacterial infection/inflammation of soft tissue around the nail or claw (paronychia)—antibiotics based on bacterial culture and sensitivity, administered by mouth or injection (systemic antibiotics)
  • Yeast (Candida or Malassezia) infection/inflammation of soft tissue around the nail or claw (yeast paronychia)—ketoconazole administered by mouth (systemic treatment); nystatin or miconazole applied to the affected area directly (topical treatment)
  • Fungal infection of the nail or claw (onychomycosis)—griseofulvin or ketoconazole administered by mouth (systemic treatment) for 6–12 months until negative fungal cultures; itraconazole administered by mouth for 3 weeks and then as directed by your pet’s veterinarian
  • Sloughing of the nail or claw (onychomadesis)—depends on cause; medication to decrease the immune response (known as “immunosuppressive therapy”) for immune-mediated diseases
  • Other medications include cyclosporine, tetracycline with niacinamide, pentoxifylline, vitamin E, essential fatty acid supplementations, and chemotherapeutic agents (such as azathioprine, chlorambucil)

Follow-Up Care

Patient Monitoring

  • Determined by underlying cause

Preventions and Avoidance

  • Determined by underlying cause

Possible Complications

  • Determined by underlying cause

Expected Course and Prognosis

  • Bacterial infection/inflammation of soft tissue around the nail or claw (paronychia) or fungal and yeast infection of the nail or claw (onychomycosis)—treatment may be prolonged and response may be influenced by underlying factors Fungal infection of the nail or claw (onychomycosis) and brittle nails or claws that tend to split or break (onychorrhexis)—may require amputation of the third bone of the toe (third phalanx), which is continued by the nail or claw, in order to get resolution
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy)—prognosis is good when underlying cause can be effectively treated
  • Sloughing of the nail or claw (onychomadesis)—prognosis determined by underlying cause; immune-mediated diseases and blood vessel/blood flow (vascular) problems carry a more guarded prognosis than do trauma or infectious causes
  • Tumor or cancer—removed surgically by amputation of the toe; some are highly malignant and may have already spread (known as “metastasis”) by the time of diagnosis

Key Points

  • Nail and nailbed disorders are a group of abnormalities or diseases that affect the nail or claw and/or the tissues surrounding the nail or claw (that is, the nailbed)