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June 2008
Cooling Off "Hot Spots"
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Cooling Off "Hot Spots"
Cooling off "hot spots", Jon Plant, DVM, DACVD
Flea season is upon us and with it we will be frequently diagnosing pyotraumatic dermatitis ("hot spots"). We all know that flea bites are the most common underlying cause of pyotraumatic dermatitis in most geographic regions, but don't forget that other pruritic skin diseases, like atopic dermatitis, food allergy, pediculosis, and sarcoptic mange may result in these acute, exudative lesions as well. Otitis externa and infrequent grooming are also responsible for hot spots in many instances. Recommend a bacterial culture of deeper lesions when you recognize folliculitis or furunculosis because antibiotic-resistant organisms are more prevalent in deep pyoderma.
The treatment of pyotraumatic dermatitis should address the underlying cause, interrupt the itch-scratch cycle, and control bacterial infection. The lesions should be clipped (preferably witha #40 blade), as necessary, and the exudates cleaned from the surface. MalAcetic Wet Wipes work well for this purpose. Bathe the pet with MALACETIC Shampoo followed by leave-in MalAcetic Conditioner. MalAcetic products contain acetic and boric acids, providing both antibacterial and antifungal activity, while effectively cleaning the skin and hair coat.
The size, location and severity of the lesion will influence your choice of therapy. For instance, a superficial 2-cm diameter pyotraumatic lesion may only require cleaning with MalAcetic Wet Wipes followed by MalAcetic Conditioner spray 3-4 times daily, while a larger, more severe lesion would require more aggressive treatment. This might include injectable dexamethasone followed by oral prednisone, antibiotics, topical MalAcetic treatment, and a protective collar. Lesions on the face often require more aggressive treatment than those of equal size on the trunk.
Many of these lesions can be avoided with preventative ectoparasite control and management of allergic skin diseases, which starts with regular bathing to remove allergens, restore epidermal barrier function, and soothe the skin.
OSLO, NORWAY and KARLSBAD, SWEDEN
YT presented the 7 Steps to Treating Ears and Topical Therapy to receptive
vets who traveled from around their respective countries.
American products are excellent values with the devalued US dollar. In fact,
if compared to shopping, the USA is on sale at outlet prices while Europe (Sweden
and, especially, Norway) are the big department stores with the "Needless Markup."
There were no shopping deals. Not for the famous glass where even Kosta Boda
and Orrefors could be bought for less in the USA. Not for fish oil where EicosaDerm
sells for less in the US then similar fish oil in Norway. Bottled water and
diet coke sold for $2.50 each at the big grocery stores. Locally make vodka
cost at least twice what they could be bought for in the US (due to steep taxes).
Recently, Oslo was given the dubious distinction of being the world's most expensive
city in front of Moscow, London and Tokyo. Still, Oslo and Stockholm, which
is about 25% less expensive, were worth every penny to this business tourist.
Both the Norwegians and Swedes celebrate irony. The Nobel "Peace" prize is named
after the man who discovered dynamite. And the famous Swedish "Vassa" Museum
displays a boat that took over 3 years to build then sunk 30 minutes after it
was launched only to take 300 years to raise.
BABETTE BADDAKY is the dermatologist for the region, with offices around Norway.
Norway IS the country (and Oslo, the city) that has a close relationship to
nature. An Oslo suburb has the famous ski jump where the next world ski jump
championships will be held. Our second night there, we were taken to a beautiful
restaurant at the end of the "metro" line high on a mountain overlooking the
fjords and the city. It was a not so easy close to 1 mile walk on an unpaved,
wooded mountain path DOWN to the scenic restaurant, all the while worried about
the climb back. While on the way back, I did find that 911 is not the correct
number to dial for emergencies. It also occurred to me that this is "no country
for old men" although they do have fiscal surplus to take care of their seniors
and healthcare.
DermaPet is now also in Iceland. Plus, it appears we've had a good start with
the Finnish and look forward to a seminar in Helsinki.
KERSTI BERGVALL (who attends most derm meetings in the US and the WCVD) and
LISA HERNBLAD joined us for dinner in the old town of Stockholm.
As far as eating and drinking goes, YT boldly tried almost everything. And that
was easy with the tasty, though breath trashing, herring coming with almost
every meal in Sweden. And the Vendic roe is a most delicious appetizer. In both
Norway and Sweden, my favorite dish, the shellfish platters, were reminiscent
of Barcelona. And sushi fans will enjoy the freshness of the fish, particularly
the deep water salmon and caviar.
AAVD/ACVD Meeting, Denver
In the Roundtable on Otitis Topicals, many members of the panel commented that
MALACETIC OTIC was the product looked upon most favorably as the treatment of
choice for Malassezia otitis. They cited the boric acid as the key ingredient.
Comments regarding the use of miconazole mentioned it to be not as effective
and to have potential ototoxic side effects. For resistant or persistent yeast,
some people were adding ketoconazole to acidifying ear cleansers such as our
MalAcetic otic by dissolving up to 1200 mg in a 4 ounce bottle.
PAPICH was quoted as saying that the fluoroquinolones added to a product containing
Burrow's solution are inactivated and ineffective.
The other tris-edta + keto product in the US was cited by a few to have resulted
in numerous topical irritant reactions. These irritant reactions , probably
due to alcohol, have not been reported to occur with DermaPet's TrizULTRA (+.15%
ketonconazole); TrizEDTA is patent protected, alcohol free and produced with
USP-approved ingredients.
Virtually everyone was using a tris-edta product for gram negative otitis cases
. TrizEDTA gemishes (adding 12 ml of Baytril(R) 100 to a 4 ounce bottle of TrizEDTA
is the most common formula) were considered a more client friendly method of
application than the traditional recommendation, which is to place the TrizEDTA
in first , then wait 15-30 minutes to apply the antibiotic.
WOUND HEALING: PETER WALSH, a surgeon from UC/Davis, described using TrizEDTA
to help wound healing and for burns. I would think our TrizPLUS would possibly
offer a better choice due to the synergism shown between chlorhexidine and tris-edta.
To be sure, alcohol-containing products should be strictly avoided for this
application.
LIME SULFUR: LimePlus Dip was shown to be 98% pure versus the "reformulated"
LymDip at 77% in poster by DIESEL, VERBRUGGE and MORIELLO. All products tested
had equal efficacy making LIMEPLUS Dip the most economic alternative.
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| Steven Melman VMD DermaPet Animal Dermatology and Behavior Clinics Potomac, MD 20854 |
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Potomac, Maryland
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301-983-8387 800-755-4738 Fax 301-365-0191
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