Skin conditions are some of the most frequent reasons dogs and cats are turned in to shelters and rescue groups. But with an organization's limited resources, they may not be equipped to diagnose, treat, and prevent most dermatological problems.
Dermatitis can mean the difference between relinquishment and a forever home within the shelter and rescue setting. There are more options to treat skin conditions in order to give dogs (and their owners) relief, and to lead a normal life.
This article outlines causes of canine dermatitis, a shelter case study and the successful treatment of a dog presenting with dermatitis in an animal shelter.
Dermatitis Associated with Itch in Dogs 1
There are three main causes of dermatitis:
- Parasites - such as fleas, ticks, and lice are visible to the naked eye, but it also encompasses parasitic mites that can only be seen under a microscope (Demodex, Sarcoptes, Cheyletiella, and Otodectes).
- Infections - such as yeast, and ringworm (Dermatophytosis), and bacterial (Staphylococcal). Bacterial and yeast infections are caused by overgrowth of normal body flora and are not contagious; they often occur together but cannot be differentiated by “looks alone”. Bacterial infections can be misdiagnosed as ringworm or Demodex.
- Allergies – examples include flea allergy, atopic dermatitis (environmental allergies that can occur seasonally or year-round), adverse food reactions (food allergy)
Canine Itch Scale (formally known as Pruritus Visual Analogue Scale) 2
The Canine Itch Scale can be used upon intake of new dogs into your shelter or rescue whether coming from a private home, another animal welfare organization, or an unknown history where you need to determine the level of canine itch severity. Itching can include scratching, biting, licking, chewing, nibbling, and rubbing.
The scale, which is used in clinical practice also serves other purposes: to determine whether a dermatologic treatment is working; for clear communication between general practitioners and specialists; and for use in studies evaluating antipruritic treatments.
Canine Dermatitis Case Study – Walter
Walter is a 6-to-8-year-old, underweight hound mix surrendered to Joseph’s Legacy Rescue in Middletown, Ohio. He was covered in fleas and had a history of allergic disease with his previous owner that was not treated, which caused him to chew his skin. Walter’s case stresses the importance of providing itchy dogs relief from pruritus.
Walter’s treatment was out of the Monroe Family Pet Hospital.
- Thickened, red, scaly skin on back down to tail area and on legs; no hair on tail
- Scabs present on back and on back legs
- Odor emanating from skin
- Missing hair all the way down his back and legs
- Possible demodex
Initial Treatment (Pre-Diagnosis):
None; previous owner did not treat before relinquishing to rescue
- Alopecia on back, base of tail head, back of legs, red skin, irritated and thickened; scratched himself raw on the middle of his back; underweight, nails were very long
- Allergic Dermatitis with possible flea allergy
- Suspected bacterial infection
Walter was administered flea and tick prevention and Convenia® (cefovecin sodium) and Cytopoint®, both long-acting injectables. He was less red, scabby, and itchy 12 hours later. His reduction in itch after the first injection of Cytopoint showed 90% improvement, according to the attending veterinary technician and his new adopter.
- Marked improvement in Walter’s overall skin redness, scabs, and odor
- Constant itching and chewing on his skin decreased and major improvement was observed
- Second injection of Cytopoint was administered based upon the effectiveness of initial Cytopoint treatment. Apoquel® (oclacitinib tablet) was also administered for approximately one week, and is used as needed. 3,4
- Convenia with bastrotrasin oinment.
- Additional flea and tick prevention administered.
- Terbinatine adminstered after cytology showed yeast infection and staphylococci.
Walter is now given Apoquel® once daily to provide long-term management of his allergic itch and his quality of life has drastically improved. Initial administration of Convenia and Cytopoint helped busy shelter staff focus on pets, and not on treatments.
Walter was adopted by Melissa Rafalowski, Administrative Assistant for Monroe Family Pet Hospital.
“ Walter is now in training to be a therapy dog at our local children’s hospital - just loves everyone, ” said Melissa.
Addressing Canine Itch 1
When dogs enter your shelter or rescue, where do you start when it comes to dermatitis and itching? Ask the “right” questions:
• Is there medical history?
• Does it include disease history?
• Does it include drug history?
• Does it include a history of itching, contagion, fleas or parasites?
Where to Start When You Don’t Have a Clue:
• Is the dog sick?
• Rule parasites including fleas, demodicosis
• Look for yeast and bacteria on ear cytology or on skin cytology
“Does the Dog Itch?”:
• What do you see if you watch the dog for 5 minutes?
• Does the dog “gag”?
• Is there excessive shedding?
Unraveling Clues from the Dermatological Examination:
• Itch trumps all other dermatological problems
• Itch almost always leads to secondary infections
• Evidence of “cure it pattern” or evidence of “life-long manageable disease”
• Dermatology TPR
• Skin scraping and/or hair plucking (trichogram)
• Ear swab cytology in mineral oil
• Ear swab cytology for staining
• Skin cytology
• Groom the hair coat
– Easier to assess the skin changes – Improves dog’s appearance
– Easier to bathe
• Bathe at least once a week
– Pre-dilute shampoo 1:4 before applying, then massage, massage, massage
Understanding the first signs of pruritus can help your shelter or rescue provide itch relief for animals in your care before cases become extreme. It can also improve an animal's chances of being adopted into a forever home
IMPORTANT SAFETY INFORMATION: People with known hypersensitivity to penicillin or cephalosporins should avoid exposure to CONVENIA. Do not use in dogs or cats with a history of allergic reactions to penicillins or cephalosporins. Side effects for both dogs and cats include vomiting, diarrhea, decreased appetite/anorexia and lethargy. See full Prescribing Information.
IMPORTANT SAFETY INFORMATION: Do not use APOQUEL in dogs less than 12 months of age or those with serious infections. APOQUEL may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. APOQUEL has not not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. APOQUEL has been used safely with many common medications including parasitcides, antibiotics and vaccines. See full Prescribing Information.
8 Important #SocialMedia Tips for Shelters and Rescues
Healing the Heart:
Shelter and Rescue Protocol for Heartworm-Positive Dogs
Marie Calabrasa, a widow in her early 70’s, saw Keni the hound’s photo on a local Pennsylvania rescue group’s website. His sweet face and floppy ears almost completely won her over, except for one thing. Rescued from an overcrowded shelter in North Carolina, Keni had been overlooked by potential adopters because he was heartworm positive.
“I’ll be honest—I was concerned because I thought he had a health issue. I’m on a fixed income and was worried about the cost of treatment,” said Marie. After careful thought, she decided to adopt him and took him for his continued treatments, paying for it out of her own pocket. “The rescue did not have the funds to treat him,” she said.
This is not an uncommon scenario that plays out with dogs that are rescued from an area of the country with a high stray animal population where heartworm disease is prevalent1. Sheldon Rubin, 2007-2010 president of the American Heartworm Society, says that “Heartworm disease has not only spread throughout the United States, but it’s also now found in areas where veterinarians used to say ‘Oh, we don’t have heartworm disease’ -- areas like Oregon, California, Arizona, and the desert, where irrigation and building are allowing mosquitoes to survive.”1
Heartworm Disease Prevention
Daily decisions must be made about the best allocation of resources for prevention and treatment of disease, spaying/neutering, and behavioral rehabilitation. Heartworm disease is among the most complex infectious diseases to detect, treat, and prevent. For that reason, it presents a special challenge to animal shelters.2
Challenges in the Shelter Setting
According to Martha Smith-Blackmore, DVM, research assistant professor at Cummings School of Veterinary Medicine at Tufts University, and author of “Managing Heartworm Disease in Shelter Animals” published by the American Heartworm Society (AHS), animal shelters face significant challenges in preventing, diagnosing, and treating many forms of infectious disease due to limited financial and organizational resources. In shelter animals, risk for heartworm infection is thought to be higher than in privately owned pets because stray and surrendered shelter animals are less likely to receive prior veterinary care.5
According to compliance data provided by Vetstreet in 2016, 64.31% of dogs do not receive any heartworm disease preventive medication.3,5 “Considering how difficult achieving compliance with veterinary recommendations is among the best clients, it is easy to understand how a surrendered animal is unlikely to have received good or consistent preventive veterinary care3”, stated Dr. Smith-Blackmore.
In 2014, The Association of Shelter Veterinarians (ASV) and the American Heartworm Society joined forces to discuss the prevention, treatment, and management of heartworm disease in animal shelters. In January 2015, the Heartworm Disease Resource Task Force was formed to formally address this issue.
Heartworm Disease Diagnosis2,4
Although funds may not be available for heartworm disease diagnostics in all shelters, an ideal goal is to perform a heartworm antigen and microfilaria test in all dogs at intake, as recommended by the American Heartworm Society in their current guidelines.
Shelters that evaluate dogs for heartworms should communicate to adopters that immediate, and annual testing is critical to detect infection and initiate treatment, if needed. Additionally, shelters should reinforce the importance of giving pets preventative medications as a safeguard, so heartworm disease does not become an issue.
Heartworm Disease Treatment2,5
The American Heartworm Society’s protocol is considered the gold standard for elimination of heartworms from dogs, based on current knowledge. This protocol for dogs entails a pre-treatment phase, which includes administration of doxycycline, and monthly heartworm preventive agents for 2 months before beginning a 3-injection treatment with an adulticide. Some shelters can implement this protocol while dogs are under their care or in foster homes, while others must leave treatment to adopting owners and their veterinarians to implement.
Use of Other Protocols4
If the shelter does not use, or recommend, the AHS’ recommended protocol for treatment, adopters need to be informed about the risks and responsibilities associated with the selected treatment method, including the following:
“Slow kill” treatment is less effective than the adulticide treatment recommended by the AHS and may not eliminate all the worms—even after 18 months or more of treatment.
During the lengthy waiting period, the worms in the dog’s body will continue to damage the heart,lungs,and pulmonary vasculature.
Strict exercise restriction is needed for the entire time that the animal harbors worms.
Risk for selection of resistant heartworm populations is increased.
Not all shelters share the same level of expertise in heartworm treatment or client education. In the shelter setting, the decision to use a treatment protocol other than the AHS protocol can be a deliberate “war zone” approach to treating heartworm disease—in human medicine, treatment options in war zones or developing countries do not always reflect the best recommendation available but are better than no option.
According to Dr. Smith-Blackmore, shelter staff should inform adopters when dogs are being treated with a protocol that is less than the gold standard, and instruct them to consider following up with their veterinarians for further treatment. This is a rational approach given the limited time and resources in the shelter setting.2,5
Association of Shelter Veterinarians (ASV) Position Statement on Heartworm Disease Management6,7
The ASV supports the application of the American Heartworm Society guidelines for the prevention, diagnosis, and management of canine and feline heartworms in animal shelters.
Regardless of geographic location, sheltering organizations are urged to maintain all dogs and cats on monthly heartworm preventive medications year-round to protect individual animal health and welfare and limit disease transmission within the community.
The ASV encourages shelters to perform screening tests on all dogs to identify infected dogs and institute therapy to reduce pathology and infective potential. Alternatives to maintenance of infected dogs within the shelter population, such as foster care and transfer to partnering agencies, should be considered when possible.
Organizations choosing to treat and/or adopt out infected dogs should ensure that:
Resources and mission allow for the humane care of exercise restricted dogs with extended lengths of stay
Shelter staff, volunteers, and potential adopters are educated on the importance of adhering to each component of the management protocol
Potential adopters are encouraged to consult with their veterinarian for further guidance.
Shelter and Rescue Heartworm Disease Resources
In 2017, The American Heartworm Society and ASV published new 'best practices' to help stop heartworm transmission via transported dogs.
A Heartworm Disease Management for Animal Shelters Webinar is also available.
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