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How I approach… Canine pododermatitis
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Dogs with sore feet may at first sight be mundane and easy to treat, but pitfalls await the unwary; Rosanna Marsella takes a personal look at what can be a remarkably complex clinical disorder and gives some useful tips for diagnosis and treatment.
Rosanna Marsella
DVM, Dip. ACVD
Dr. Marsella is a Diplomate of the American College of Veterinary Dermatology and full Professor at the University of Florida. She has served as co-editor for Veterinary Dermatology and is a member of the Task Force on Canine Atopic Dermatitis. She also co-edited the current BSAVA Dermatology Manual.
Key Points
- Canine pododermatitis can be primary or secondary in nature, and the clinician should follow a logical approach to ascertain the underlying etiology.
- Identifying the distribution and type of primary lesions are essential in making a diagnosis.
- Demodex mites should always be considered as a possible cause of pododermatitis.
- Some causes of pododermatitis affect not only the haired skin but also the nails, which can help in the differential diagnosis of the underlying disease.
Canine pododermatitis is a very common presentation in veterinary dermatology, but since it can result from many different causes it is important to have a logical and sequential diagnostic approach in order to successfully identify the primary disease responsible. With the correct diagnosis, clinical management becomes easier and more targeted. However, as with many dermatological cases, secondary infections and chronic skin changes frequently complicate the clinical picture, whatever the underlying disease, so it is always important to consider the primary, secondary and perpetuating factors for pododermatitis (Table 1).
Whilst primary causes of pododermatitis may be pruritic or non-pruritic, secondary infection is frequent and will often cause pruritus, so it is not uncommon for many dogs with pododermatitis to present with pruritus as one of the main complaints. It is therefore important to treat any infection and then re-evaluate for pruritus to effectively identify the triggering disease.
How are the lesions distributed?
Primary causes of pododermatitis are diseases that can directly target the feet, although many of them may also affect other body regions. It is therefore important to identify the distribution of lesions on clinical examination. This allows the clinician to appropriately rank the various differential diagnoses in order of likelihood.
Some diseases affect all four feet, while others only the front feet, at least initially. An example of the former is contact allergy, an example of the latter is atopic dermatitis, which typically starts on the forepaws and then progresses to all four feet. Flea allergy, on the other hand, tends to primarily affect the back feet. [...]
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