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Alopecia of the flank in a female Glen of Imaal Terrier

Alopecia of the flank in a female Glen of Imaal Terrier. Author: Cathy Curtis. Editor: David Lloyd. Downloded from www.pharmacy123.blogfa.com. History. 3 year old neutered female Glen of Imal Terrier Presented with flank alopecia of 3 months duration There were no signs of pruritus

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Alopecia of the flank in a female Glen of Imaal Terrier

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  1. Alopecia of the flankin a female Glen of Imaal Terrier Author: Cathy Curtis Editor: David Lloyd Downloded from www.pharmacy123.blogfa.com

  2. History • 3 year old neutered female Glen of Imal Terrier • Presented with flank alopecia of 3 months duration • There were no signs of pruritus • The dog was in good general health Click to reveal the text on this screen Click the forward arrow to jump to the next screen History

  3. Clinical signs General clinicalexamination was unremarkable • The flanks showed • Bilateral, well-demarcated areas of alopecia • Intense hyperpigmentation of the underlying skin Signs

  4. How would youapproach this case? • What are the next steps you would take? • Make a list of your principle differential diagnoses • List any samples you would collect • List any tests you would perform to assist in making a definitive diagnosis Signs

  5. Case investigation - 1 • Principle differential diagnoses • Inflammatory causes of alopecia • Bacterial - Staphylococcal folliculitis • Fungal – Dermatophytosis • Parasitic - Demodex canis • Non- inflammatory causes of alopecia • Hormonal • Dystrophic or dysplastic • Telogen or anagen effluvium • Cicatricial Differentials

  6. Case investigation - 2 • Initial tests • Skin scrapings, hair plucks and fungal culture • Haematology and biochemistry profiles • Urinalysis Tests

  7. Results • Skin scrapings and fungal culture • No ectoparasites or dermatophytes demonstrated • Hair pluckings from the edges of the alopecic areas showed all hairs to be in telogen • Haematology and biochemistry profiles • Routine haematology and biochemistry profiles were unremarkable • Urinalysis • Unremarkable Tests

  8. What now? • Which differentials can you now eliminate? • Are there any other tests you would carry out or samples you would collect? • Should you institute therapy at this stage? Tests

  9. Additional procedures • Skin scapings and fungal culture results suggest that dermatophytosis and demodicosis are unlikely • Endocrine tests and biopsy examination are now required • No therapy is indicated at this stage Tests

  10. Additional diagnostic procedures - 1 • Blood tests to investigate possible endocrinopathy • Total T4 and endogenous TSH levels to assess thyroid function • ACTH stimulation or low dose dexamethasone suppression test for adrenocortical function • ACTH stimulation test for adrenocortical reproductive hormone function (basal reproductive hormone assays if the above is unavailable) • Xylazine or clonidine stimulation test for growth hormone status (if available) • Skin biopsy Tests

  11. Results of additional tests • Thyroid testing • Endogenous TSH – within normal range • Total T4 – within normal range Tests

  12. Results of ACTH stimulation test Tests

  13. Additional diagnostic procedures - 2 • Histopathology report (Joan Rest) • There is hyperpigmentation of the non-thickened epidermis with markedly dilated follicular ostea filled with keratin • Most follicles seen are in telogen • Sebaceous glands are not atrophic • A few melanophages are present adjacent to the bases of the follicles • No current inflammation or micro-organisms were observed Tests

  14. Additional diagnostic procedures - 3 • Morphological diagnosis • Atrophic dermatosis Tests

  15. What is yourdiagnosis? • Do the investigations permit a definitive diagnosis? • Are there any additional investigations which you think may need to be done? Tests

  16. Diagnosis • Canine idiopathic flank alopecia Tests

  17. How would you deal with this case? • What is your prognosis? • How will you advise the owner? • What treatment would you consider? Therapy

  18. Prognosis • In many dogs with idiopathic flank alopecia, hair loss is temporary and regrowth may occur spontaneously • In some cases, there is a cyclical pattern to the disease and it may be possible to predict the time of hair loss and hair regrowth • Affected dogs remain healthy so the prognosis is good Therapy

  19. Action • Client education and conservative treatment Therapy

  20. Comment • The dog was followed for the next 18 months • She regrew her hair 2 months after the referral appointment but again developed flank alopecia at the same time the following year • Predictably, the hair regrew 5 months later • No treatment has been administered and the dog remains in good general health Therapy

  21. Final diagnosis • Canine idiopathic cyclic flank alopecia Therapy

  22. Review • If you would like to review this case, please use the navigation buttons below Notes

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