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CiTiVET Presented by : Dr. Peter van der Merwe CiTiVET • The desire to scratch, lick, rub, chew and nibble at skin surface in response to chemical stimulus. • Itchiness causes discomfort and decreases pet’s quality of life. “An itchy pet is an unhappy pet” Usually living with a frustrated owner External parasites : • • • Fleas Mange mites Lice • Allergies: • Atopy (hayfever) • Caused by interaction of abnormal • Skin barrier genes • Immune function genes • Exposure to allergens & pathogens • Allergens incl house dust, dust & storage mites, pollens, moulds • Characterised by initial seasonal occurrence & “flare ups” • Flea bite allergy • Abnormal response to flea saliva • Often worse in atopic individuals • Food • Itchy skin sometimes with digestive upsets • Usually non seasonal -> ears, rears, paws • Contact allergies • Very rare, Skin infections Bacteria • Staphylococcus • Streptococcus • Yeast (Malessia) Flea control • Adulticides on pet e.g Frontline, Advantage, Practic • Capstar • Enviromental control pyrethroids and methoprene • Sprays -> Flego, Ultrum Duration Treatment of mange mites • Revolution • Advocate • Amitraz dips such as Amitrax, Triatix Control skin infections • Bacteria – Anti bacterial shampoos and wipes • Antibiotics • Yeast – Shampoos • Anti Fungals (eg Ketazol) • Allergic skin disease – Atopy • • • • Can’t be cured, only controlled Multimodal approach is essential First control parasite & microorganism infections High quality diet especially fish based -> hypoallergenic formulations are best • Omega 3 supplementation • Barrier treatments – Allerderm – decreases secondary infections, less effect on itchiness – Shampoo – best is Allermyl but physical action of washing is most important, bath 1-2x weekly • Topical -> new cortisone spray Cortavance • Corticosteroids • Best given as short acting tablets eg lenisilone • Many side effects including weight gain, urinary tract infections, increase risk of skin infections, decrease in bone and muscle strengths • Safe annual dose calculated as 30x dog’s body weight in milligrams of steroid i.e. 10 kg dog can take 300 mg of steroid over a year • Cyclosporin • New drug being launched today • Long term control not for use in controlling acute flare ups • Side effects – – – – Very Expensive Vomiting in approximately 30% of patients Hriutism, gingival hyperplasia, urinary tract infections Rare s/e unmasking systemic infections e.g. fungal infections and Toxoplasmosis – In humans may increase risk for lymphoma (cancer) – not proven in dogs • Antihistamines – Only work in 10% of patients – Generally safe and used with other treatments especially cortisone. – Main side effect is sedation but should be used with caution in animals with glaucoma, heart disease, urinary bladder problems • Immunotherapy – Based on blood tests of IgE levels – Problem ->approximately 30% of atopic dogs do not have raised IgE levels – Test does not indicate if raised IgE is causing symptoms, merely that IgE level is high – HOWEVER immunotherapy is the only treatment that allows us to reverse part of the pathology, works for majority of patients, reasonable cost • If all else fails – Gabbapentin -> acts on nerve endings – Maropitant (Cerenia) -> substance P – Pentoxfyline – Prayer • Diet trail essential for diagnosis, blood tests are inaccurate • Diagnosis confirmed by provocative exposure • List of common food allergens include – Beef, lamb, chicken – Soya – Maize, rice, wheat • avoid all protein treats, faeces (cat poop!!) • Commercial diet trail foods are superior to home cooked diets • Treatment -> avoid offending foods • Thanks once again to all our client who continue to support us • • • • • Genna van der Merwe Tamsen Maritz Royal Canin Afrivet Citivet staff • Itching to get answers??