Our specialist Dermatologists offer a comprehensive, friendly, referral service for canine and feline skin and ear disorders. We are also happy to advise and examine other species with dermatological problems. We treat every client and case as an individual and want to work closely with referring veterinary surgeons. We work alongside our fellow Specialists in anaesthesia, imaging, internal medicine, pathology and surgery to offer a first class referral and a holistic, multidisciplinary approach.
We provide intradermal testing and individualised immunotherapy formulations for our patients; we have a particular interest in ear disease and manage many cases, including the use of CT imaging and ear irrigation procedures.
Laboratory services on site allow quick turnaround of results and the ability to speak directly to the laboratories about difficult cases.
We hope you find the questions below useful.
Delta's Story: Delta is a 4 year old female neutered crossbreed, who presented to us with a long history of itchy skin disease that started shortly after she was acquired from a rescue centre. The worst affected areas were her feet, chest, face and ears.
As can be seen in these pictures the skin is lichenified, alopecic and hyperpigmented. Initially a large amount of skin infection was present. This was treatment with antibiotics and antifungal shampoo. A dietary trial was also performed to exclude the possibility of a cutaneous adverse food reaction.
Once ectoparasites, infection and diet had been excluded as causes for her skin disease we were able to make a diagnosis by exclusion of atopic dermatitis.
Allergy testing was performed which supported the clinical diagnosis and a course of immunotherapy was ordered for Delta.
Although Delta did improve with antibiotics she was still unacceptably itchy and so, as it would take many months for the benefits of the immunotherapy to be seen, treatment was started with ciclosporin.
Ciclosporin is a drug that helps suppress the immune response to allergy.
Lupoid Dermatosis: This middle aged German Shepherd dog was presented with a chronic relapsing dermatosis that primarily involved the nasal folds and dorsal aspect of the nose and muzzle. There was some response to oral antibiotics suggesting that mucocutaneous pyoderma was a component; there was a good response to topical tacrolimus which is a drug similar to ciclosporin and has also been used in anal furunculosis (a disease process that is particularly common in this breed). Images show before and after treatment.
Idiopathic Symmetric Lupoid Onchodystrophy (ILSO): A male neutered three year old Rhodesian Ridgeback dog was presented with a history of all of the nails progressively becoming loose or splitting, including the dew claws, with some nails lost altogether. On physical examination the dermatological findings were limited to the digits with the hind feet having several claws missing and the front feet having a number of dystrophic claws including some with obvious deviations in the dorsal claw material with a transverse line just distal to the claw bed. The dew claws had similar lesions.
The diagnosis is most likely a dystrophic nail condition and histopathological findings may help to confirm the diagnosis of ILSO. The dew claws are the easiest digit to amputate and the whole nail and third distal phalanx should be submitted for histology. In the absence of any history or signs of systemic disease it is difficult to recommend extensive investigation in terms of looking for an underlying disease or trigger factors. So, the test results for blood samples for haematology, serum biochemistry, thyroid function and ANA testing are likely to be normal. Some cases also have fungal cultures performed (usually negative and one would also expect some involvement of the adjacent haired skin which is not the case with ILSO) and bacterial culture of any exudate. In most cases any bacterial isolates are likely to be secondary and treatment may provide little to some benefit.
This condition is poorly understood and yet very distinct. It is usually seen in larger breed dogs, including German Shepherds, border collies and greyhound-crosses, but may also be seen in smaller breeds including some terrier breeds. It is extremely painful when the nails start to lift off and while pain relief may be helpful it is preferable to sedate/ anaesthetise the dog and remove all of the lose nails, bandage and give a short course of antibacterial therapy combined with NSAIDs for pain relief.
Longer term, many cases will have recurrent bouts of nail loss and warrant some kind of intervention. Treatment options may include high doses of oral essential fatty acids (EFAs). This may help to avoid further rounds of claw loss rather than repair of the damaged nail bed. Deformed or dystrophic nails are likely to be a persistent feature of this condition. The most important thing is to reduce the incidence of repeated nail loss because this is a painful process. It may take several months to appreciate that such therapy has helped to prevent the loss of claws given that such losses may only occur every few months. Other treatment options may include pentoxifylline (Trental) or tetracycline and niacinamide and in severe cases possibly glucocorticoids or azathioprine. The nails should be kept short to avoid them being caught and ripped, i.e. trimmed and filed/rubbed down to avoid loose edges.
My pet's been referred for an intradermal test, what does this involve?
An intradermal test should only be performed when a diagnosis of atopic dermatitis has already been made and to enable avoidance of the allergen or to identify allergens to formulate a course of allergen specific immunotherapy for the patient.
The test kit is prepared in advance.
Our kit comprises 50 everyday allergens including house dust mites, grass, tree and weed pollens, with positive and negative control.
Your pet will be sedated, to keep them nice and calm and ensure they don't feel any discomfort.
An area is clipped on the side of their trunk, to allow the dermatologists to visualise your pet's skin. The test site is marked with a felt tip pen, to show where the injections will be placed.
A tiny amount of each allergen is then injected into your pet's skin. The test is then read after 15 minutes.
Any positive results appear as wheals (see picture). This means that their immune system has had a strong reaction to one of the allergens injected into that part of their skin. The dermatologists will read this result and it will assist them to determine which allergens may be important for your pet. They will discuss the implications of these results with you.
Don't worry your pet's skin will return to normal within a few days, and the hair will regrow quickly.