Now that we're back from Maui, I thought I'd share some highlights for DermaPet. Besides the moonlite cocktails, the Luau, Jimmy Noxon walking between rooms keeping everybody smiling and everything going and the early morning swims, there was an excellent meeting. Of note: my pick for most progressive derm dept is Texas A&M.
In the typical saving the best for last tradition, Sandy Merchant closed the meetings with her Otitis Externa talk. For resistant Pseudomonas, at THREE different points including her concluding Key Points, she expressed enthusiasm for TrizEDTA even saying that she heard from Carol Foil that the DermaPet version was "essentially the same" as what she is using from the pharmacy at LSU. She stated that the most prevalent cause of OE was Malassezia and had heard that our acetic/boric acid containing Ear/Skin Cleanser was quite effective. For both Pseudomonas and Malassezia, she is also a fan of corticosteroids.
At the roundtable's, there were two Otitis Externa tables to which I attended one and snorkeled through the other. Andrea Cannon led one where Doug DeBoer expounded on the virtues of TrizEDTA in maintaining chronic Pseudomonas cases. The Mechanism of Action of TrizEDTA is to chelate minerals (Mg and CA) from the cell wall of bacteria this making them more susceptible to antibiotics like Baytril and aminoglycosides. Fernando Vasquez of Bayer explained a dose of 10 mg/kg/QD would be adequate for Batyril which can be assisted in this goal of penetrating the cell wall by TrizEDTA. The issue of acidifying agents inactivating most antibiotics thus potentially creating resistant strains of bacteria came up. The subject of ototoxocity received mixed comments with my interpretation being "if you know it's supposed to be ototoxic then use something else if close to as effective". Two examples: chlorhexidine was again discussed as penetrating even intact tympanum; aminoglycosides should be saved for only the most resistant cases, if there is a ruptured tympanum.
The Malassezia dermatitis Roundtable had a spirited discussion that left participants with no definitive way to diagnose or treat. My interpretation of the final consensus was that a dog that is pruritic and frequently, but not always oily, containing "some" Malassezia on cytology using various techniques AND it responded to various therapies THEN it had Malassezia. One monitor thought that he had successfully treated using singular treatment with antibiotics, corticosteroids and topical therapy. Most agreed it was a secondary disorder although primary cases are seen in hound dogs (like my Basset), West Highland Whites and Dachshunds. Nizoral tabs, benzoyl peroxide and ketoconazole shampoo were discussed. My recommended treatment of MalAcetic Shampoo and/or MalAcetic Conditioner as often as possible, short term corticosteroids and pyoderma treatment (cephalexin) should work for most cases.
As with most meetings, I came back with a new patentable product idea.
Benzoyl Peroxide Plus gallons are now available. Keep in mind that we have 2.5% benzoyl peroxide, 1% sulfur and 1% salicylic acid. The "other product" has less benzoyl and no salicylic acid. Keep in mind that sulfur and salicylic acid are synergistic.
TrizEDTA Tidbits: It is autoclavable. For pododermatitis wrap a TrizEDTA saturated (perhaps with Baytril or Gentocin added) piece of gauze or cotton around the affected area and place a microwaved (heated) wet towel around that. Of course, use systemic antibiotics and watch out for underlying problems, especially Demodex.
In Maui, I had the special privilege of hosting a wine tasting (wine provided by the Rosenblum winery) for the World Congress meetings next year. Many thanks to Pete Ihrke for arranging this in AAVD executive secretary Judy Shramm's suite. Attended by Candace Sousa, Thelma Lee Gross, Doug DeBoer, Didier Carlotti, Hans Koch, Susan Reinke, Helen Power, Rod Rosychuck, Steve White, Emily Walder, Jacques Dubreuil, spouses and others. DermaPet and Rosenblum hope to co-sponsor the wine at the World Congress of Dermatology next Labor Day in San Francisco across the bridge from Oakland where Dr. Rosenblum - also a veterinarian - has a practice and winery.
If you have any questions please contact me.
Steve
| Steven Melman VMD
DermaPet |
dermapet@aol.com
http://www.dermapet.com |
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Potomac, Maryland 20854
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