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84 How I treat: equine bacterial folliculitis ACVSC Proceedings Dermatology Chapter Science Week 2005 Sonya Bettenay The diagnosis of bacterial folliculitis in the horse will be made typically based on the clinical lesions, frequently with supportive cytology and bacterial culture. Less frequently a biopsy will be performed. Clinical presentation: Varies depending on the underlying predisposing cause. It occurs frequently secondary to trauma and maceration, less commonly to an underlying disease and is most commonly seen in spring and summer. Bacterial folliculitis is also a frequent complicating factor of Dermatophytosis. Lesions are often painful which can have interesting consequences when the affected area is in the saddle and/or tack area. Indeed the pain (or rather the horses response to it!) is often the driving reason for the consultation and need for therapy. The most common initial lesions include papules, pustules, crusted papules and larger crusts. These may not be observed until there are actual fissures and/or ulcers with larger crusts. However they may be detected early in animals which are groomed daily. Urticaria with small follicular papules is a common early presentation of some horses, which can be confused as an uncomplicated allergy. These early cases will frequently respond to symptomatic steroid therapy, only to relapse again once the anti-inflammatory component of the treatment has stopped. They may also show a slightly more prolonged clinical response to a topical combined antibiotic-steroid agent…. But have a higher relapse rate as these topicals do not always reach the deeper affected areas of the follicle. Medication Choices: Bacterial folliculitis in the horse is most frequently caused by coagulase-positive staphylococci. This is a “deep” pyoderma, which will typically not self resolve and so antibacterial therapy is an essential part of any treatment regime. Clipping and cleaning, topical antibacterial agents and systemic antibiotics are frequently all utilised and even then the lesions may take quit some time (weeks to months) to resolve. Superficial pyodermas can, at least initially, be treated empirically. If appropriate therapy does not resolve the condition, a culture and sensitivity is
indicated. Each sample for culture and sensitivity should be accompanied by cytologic examination and culture results interpreted in light of the cytology, as growth of different microorganisms does not indicate necessarily that they are present in significant numbers in vivo. A bacterial culture and sensitivity is almost always indicated when treating horses with a deep pyoderma, however whether the owners will elect to pursue this without an initial empirical trial therapy is another question. Therefore we frequently make a “best guess” when using systemic antibiotics. Whilst Streptococcus equi or Corynebacterium pseudotuberculosis are the most common organisms found in abscesses, Streptococci and coagulase-positive staphylococci and are most commonly seen with folliculitis. Local geographic use of antimicrobials does lead to a geographic variation in resistance (and sensitivity) rates, so that extrapolating a report from Colorado to Queensland or even Sydney to Brisbane is not necessarily useful and may even be counterproductive. Similarly a horse stabled in (for example) a busy racing stable, with multiple animals and a frequently changing population which is intensively husbandried in Melbourne, may have quite a different bacterial population than one in the Dandenongs which is not stabled, lives alone, retired in a paddock with a few sheep. They may both have a coagulase-positive staphylococcus, but the resistance patterns may have more to do with husbandry and immediate environment, than with significant geography. The intensity of investigation and treatment will, as always in veterinary medicine, be to a large part determined by the owner finances, expectations and abilities to undertake recommended treatment regimes. 1. Shampoo therapy. Shampoo therapy can provide effective medical and cosmetic management of dermatoses. However, shampooing the whole body of a horse is a major undertaking and thus shampoo therapy is most commonly used for localized skin disease. Fungal and bacterial infections, allergies as well as mane and tail seborrheas are the most common indication for shampoo therapy in equine practice. There are few adverse effects associated with shampoo therapy, although they are recognized. However, shampoo therapy is a symptomatic treatment, and rarely "cures"a dermatosis. Chlorhexidine (frequency q 1-14 days) is useful in horses as it is not inactivated by organic matter and tends to be not irritating or drying. Benzoyl peroxide (frequency q 7-14 days) is a far more potent antibacterial agent. Degreasing (and thus drying), keratolytic. In horses with dry or normal skin, a moisturizer must be used after the shampoo! It may be irritating, particularly in concentrations over 3%. Iodofors (frequency q 7-14 days) are typically used by every horse owner as the first step prior to calling the vet, they are antifungal, antibacterial, viricidal and sporicidal. They may also be helpful in decreasing environmental contamination with fungi. ACVSC Proceedings Dermatology Chapter Science Week 2005 85
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Australian College of Veterinary Sc
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Australian College of Veterinary Sc
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3.00 Afternoon tea 3.30 How I treat
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Dr Jennifer A. Charles BVSc MVS Dip
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Scientists in Feline Medicine in 19
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IgE-bearing cells have been demonst
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years, median age 6.5 years, with a
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dusts, grain smuts, moulds, danders
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References: Evans AG, Paradis MR, &
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Comparatively simple, cheap and eff
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TABLE 1: CURRENT ALLERGENS SELECTED
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AmericanCockroach Cockroach mix
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Patient Preparation Drug Withdrawal
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Each injection site is visually exa
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References 1. Scott DW, Miller WH:
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Intradermal Testing (IDT) in Horses
Page 33 and 34: TABLE 2 Additional allergens used i
Page 35 and 36: Allergen Positive reactions Mosquit
Page 37 and 38: much higher and corresponded to the
Page 39 and 40: and this and other uncontrolled tri
Page 41 and 42: Introduction Diagnostic Approach to
Page 43 and 44: Wheals vary in size and shape and q
Page 45 and 46: References Evans AG, Paradis MR & O
Page 47 and 48: Introduction: Equine Chronic Urtica
Page 49 and 50: Acute treatment - Epinephrine 1:100
Page 51 and 52: anecdotal success with use of human
Page 53 and 54: an 80:20 mixture of evening primros
Page 55 and 56: Clinical approach to the horse with
Page 57 and 58: identify plants in a pasture that m
Page 59 and 60: Equine sarcoidosis Sonya Bettenay T
Page 61 and 62: described as a possible feature of
Page 63 and 64: others 2001), isotretinoin(Waldinge
Page 65 and 66: 12. LeGall, F., Loeuillet, L., Dela
Page 67 and 68: Introduction The equine sarcoid: an
Page 69 and 70: Clinical Presentation Small fibrous
Page 71 and 72: Assessment should be made on the fo
Page 73 and 74: (ix)Bone becomes devitalized if inc
Page 75 and 76: and mitomycin C have been used. All
Page 77 and 78: Owen LN & Barnett KC (1983) - Treat
Page 79 and 80: any anatomic location but commonly
Page 81 and 82: epidermis may be histologically nor
Page 83: References D.C. Knottenbelt, S. Edw
Page 87 and 88: Proper dosage and proper duration a
Page 89 and 90: 2. Affect on the horse and 3. Affec
Page 91 and 92: Affected horses usually scratch and
Page 93 and 94: • Cattle ear tags impregnated wit
Page 95 and 96: How I treat: equine pemphigus folia
Page 97 and 98: Treatment of pemphigus foliaceus in
Page 99 and 100: SCOTT, D.W., WALON, D.K., SLATER, M
Page 101 and 102: Diagnosis History of access of hors
Page 103 and 104: These vaccines are not manufactured
Page 105 and 106: References Alfaro AA & Mendoza L (1
Page 107 and 108: y a variety of fungal metabolites.
Page 109 and 110: Authors recommendations: 1. Both Im
Page 111 and 112: chorioptic mange by the author (Lit
Page 113 and 114: Clinical Disease The clinical resul
Page 115 and 116: treatment options have been used. P
Page 117 and 118: Notes ACVSC Proceedings Dermatology
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