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MOTIVATION “Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure…” -Marianne Williamson An acute or chronic inflammatory disease of the external ear canal Clinical signs: Head rubbing or shaking Ear scratching Head tilt – with the affected ear tilted down Malodorous otic discharge (brown, greenishyellow) › Lichenification, hyperpigmentation, crusts, erythema and excoriations may be present › Aural hematoma › › › › NOTE THE EXCESS BROWN EXUDATE ERYTHEMA, HYPERPIGMENTATION, LICHENIFICATION AURAL HEMATOMA PREDISPOSING FACTORS: › Conformation Heavy, pendulous ears Stenotic ear canals Ear hair › Excessive moisture Frequent bathing or swimming › Hypersensitivities Food allergy, atopy DIAGNOSIS: › Otoscopic exam › Clinical signs › Cytology, ear smear Yeast, bacteria, cerumen, skin cells MALASSEZZIA OTITIS Malassezzia resemble footprints, bowling pins, or snowmen BACTERIAL OTITIS ROD-SHAPED BACTERIA AND A SKIN CELL TREATMENT › Always treat the underlying condition if present › Topical meds instilled daily Antibacterial, antifungal, or combination products often with steroids (otomax, tresaderm, baytril otic) Cleaning ears during treatment › Surgical intervention may be required Aural hematoma Chronic conditions (Total Ear Canal Ablation) The anal sacs are located between the muscle layers of the anus at the 4 and 8 o’clock positions. Each sac connects to the surface through a narrow duct. Sebaceous glands produce a foul-smelling oily, brown fluid. The sacs are naturally expressed during defecation, but can sometimes overfill. IMPACTION › When the sacs overfill, the water can be reabsorbed, and the material dries out. Sacs become a source of discomfort for the dog and are difficult to express at this time. › Impaction can lead to abscessation and rupture. Clinical signs include: scooting rear end across the floor, painful defecation, tail chasing, perianal erythema, and/or swelling DIAGNOSIS › Palpation (rectally or externally) › Clinical signs TREATMENT › › › › › Express contents Flush sac Instill antibiotic ointment Oral antibiotics, anti-inflammatories Surgery? WEARING GLOVES, GENTLY MILK THE GLANDS IN AN UPWARD MOTION TO EXPRESS. Tumors are a new growth of tissue characterized by progressive, uncontrolled proliferation of cells. Benign vs. Malignant Localized vs. Invasive Adenoma/Carcinoma vs. Sarcomas HISTIOCYTOMA: small, button-like tumors that are usually pink, hairless, and raised. They are rapidly growing Common locations include the pinnae, head, and legs HISTIOCYTOMA › Occurs almost exclusively in young dogs <4yrs old DIAGNOSIS › Appearance › biopsy TREATMENT › These tumors may spontaneously regress, but surgical excision is the treatment of choice ROUND CELL TUMOR LIPOMA: tumor of the subcutaneous adipocytes (fat cells) that are typically freely movable and well-circumscribed › Common in older, female, obese dogs DIAGNOSIS: › Biopsy › Fine needle aspirate LIPOMA › TREATMENT: Surgical excision Benign neglect lipocytes PAPILLOMAS: wart-like growths that develop as smooth, white/pink/pigmented, elevated lesions in the oral cavity (oral papillomatosis) or on the skin (cutaneous papillomas) › These growths are caused by a papillomavirus PAPILLOMAS › DIAGNOSIS: Appearance Biopsy › TREATMENT Usually spontaneous regression Autogenous vaccine BENIGN TUMORS OF THE SKIN SEBACEOUS GLAND CYSTS: Slow growing, encapuslated, round, and exude a gray, cheeselike material. Caused by degenerative changes in the glandular area surrounding the follicle. › Common in cocker spaniels DIAGNOSIS Contents of the cyst histology TREATMENT › Surgical removal of entire encapsulated cyst BENIGN TUMORS OF THE SKIN SEBACEOUS CYSTS MALIGNANT SKIN TUMORS FELINE VACCINE-INDUCED FIBROSARCOMAS: rapidly developing, highly invasive, malignant tumors that occur at the site of vaccination ~4-6 weeks later. › VACCINES MOST COMMONLY IMPLICATED ARE THOSE WITH ADJUVANTS (substance that enhances the immune response by increasing the stability of a vaccine in the body) SUCH AS FeLV AND RABIES MALIGNANT SKIN TUMORS VACCINEASSOCIATED SARCOMAS › DIAGNOSIS: Biopsy of fine needle aspirate Physical exam findings Swelling in area of recent vaccination Rapidly growing firm elongated mass MALIGNANT SKIN TUMORS VACCINE-ASSOCIATED SARCOMAS › TREATMENT Radical surgical excision which may involve limb amputation is the treatment of choice › CLIENT INFORMATION Poor prognosis if not detected early and treated aggressively Inflammatory lumps may do develop after vaccines but usually disappear within 1-2 weeks MALIGNANT SKIN TUMORS FELINE VACCINE-ASSOCIATED SARCOMAS MALIGNANT SKIN TUMORS MAST CELL TUMORS: firm nodules on the skin that may be ulcerated or edematous. Mast cells contain histamine and heparin MALIGNANT SKIN TUMORS FINE NEEDLE ASPIRATE OF MAST CELL TUMOR; NOTE THE NUMEROUS GRANULES MALIGNANT SKIN TUMORS IN CATS, MAST CELL TUMORS ARE USUALLY BENIGN AND MAY SPONTANEOUSLY REGRESS MALIGNANT SKIN TUMORS MAST CELL TUMOR › TREATMENT Chemotherapy Radiation therapy BENADRYL H2 blockers to treat gastric ulceration and irritation › PROGNOSIS Depends on biopsy “grading” results MALIGNANT SKIN TUMORS MELANOMA (Benign or Malignant) › BENIGN: small, slow growing, hairless, pigmented › MALIGNANT: large, dome-shaped sessile +/pigmentation Ex: Tumors of the oral cavity and digits Poor prognosis Metastasize readily Recurrence after surgery is common MALIGNANT SKIN TUMORS TREATMENT INVOLVES SURGICAL REMOVAL AND POSSIBLY TREATMENT WITH THE VACCINE