Pododermatitis and Buttholes

Question 1

How do cats with Plasma cell pododermatitis typically present?

Answer 1

• Multiple pads affected, usually metacarpal/metatarsal pads
• Soft, swollen, mushy pads (“pillow foot”)
• Lameness
• Blueish tinge with white striae on pads
• Occasional oral lesions (plasma cell stomatitis)
• Occasional renal disease

Question 2

How can plasma cell pododermatitis be diagnosed aside from history and clinicals signs?

Answer 2

• Cytology showing plasma cells, mott cells, and macrophages
• FIV/FeLV testing (up to 65% of cats are FIV +)
• Chemistry showing hypergammaglobinemia and/or renal disease
• biopsy/histo

Question 3

A FIV+ cat is presenting with lameness. Upon physical exam you note both metatarsal pads are soft and mushy, with ulcerative lesions and bleeding. What is your most likely diagnosis and how would you treat?

Answer 3

• Plasma cell pododermatitis
• Treat with Doxycycline for up to 8 weeks

Question 4

What is the treatment plan for a cat with plasma cell pododermatitis?

Answer 4

Treat with Doxycycline for up to 8 weeks

Question 5

Idiopathic footpad hyperkeratosis has an autosomal recessive mode of inheritance in which dog breed?

Answer 5

Irish terriers

Question 6

How do dogs with idiopathic footpad hyperkeratosis typically present?

Answer 6

• Multiple pads including carpal pads affected
• Severe keratinous proliferation
• Fissuring and splitting
• Cutaneous horns
• No other systemic signs, present BAR and asymp other than maybe lameness

Question 7

What is the treatment plan for a dog with idiopathic footpad hyperkeratosis?

Answer 7

• Regular trimming of excessive keratin
• Soften pads with proplyene glycol

Question 8

What is the top differential for a patient presenting with pododermatitis affecting multiple digits?

Answer 8

metastatic carcinoma (Ex: mets from lung ACA)

Question 9

How do dogs with Epitheliotropic lymphoma typically present?

Answer 9

• Depigmentation of paw pads
• Scaling, erythema and plaques
• Very poor prognosis

Question 10

How can Symmetric lupoid onychodystrophy in dogs be diagnosed aside from history and clinical signs?

Answer 10

Biopsy of P3

(NB: P3 is weight bearing so if dew claw is also affected, take biopsy of dewclaw)

Question 11

What is the treatment plan for Symmetric lupoid onychodystrophy in dogs?

Answer 11

• Glucocorticoids
• Omega 3-6 EFA’s long term to maintain nail strength
• Vitamin E

(Don’t use Abxs!!!)

Question 12

How do dogs with Symmetric lupoid onychodystrophy typically present?

Answer 12

• Multiple claws affected on multiple feet
• Sloughing, deformed, “broken” claws

Question 13

What causes greasy brown exudate affecting multiple claw folds?

Answer 13

malassezia onychitis

Question 14

How do dogs with interdigital follicular cysts typically present?

Answer 14

• Cysts on the ventral aspect of the front feet
• Recurrent interdigital lesions that fail to completely resolve with long term Abx’s
• Commonly reoccurs!!
• Young onset

Question 15

Which of the following causes depigmentation of the paw pads in dogs?

A. Epitheliotropic lymphoma
B. Idiopathic footpad hyperkeratosis
C. Eosinophilic granulomas
D. Symmetric lupoid onychodystrophy

Answer 15

A. Epitheliotropic lymphoma

Question 16

Which of the following causes sloughing and deformed claws on multiple feet?

A. Epitheliotropic lymphoma
B. Idiopathic footpad hyperkeratosis
C. Eosinophilic granulomas
D. Symmetric lupoid onychodystrophy

Answer 16

D. Symmetric lupoid onychodystrophy

Question 17

Which of the following causes of pododermatitis is most commonly seen in Irish terriers?

A. Epitheliotropic lymphoma
B. Idiopathic footpad hyperkeratosis
C. Eosinophilic granulomas
D. Symmetric lupoid onychodystrophy

Answer 17

B. Idiopathic footpad hyperkeratosis

Question 18

Which of the following causes of pododermatitis typically requires amputation of P3 to make a definitive diagnosis?

A. Plasma cell pododermatitis
B. Idiopathic footpad hyperkeratosis
C. Eosinophilic granulomas
D. Symmetric lupoid onychodystrophy

Answer 18

D. Symmetric lupoid onychodystrophy

Question 19

Which of the following causes of pododermatitis shows a partial response with antibiotics but tends to recur?

A. Plasma cell pododermatitis
B. Idiopathic footpad hyperkeratosis
C. Follicular cysts
D. Symmetric lupoid onychodystrophy

Answer 19

C. Follicular cysts

Question 20

What is the treatment plan for a patient presenting with an interdigital follicular cyst?

Answer 20

• Partial response to Abx’s, usually a long course
• CO2 ablation of cysts
• Podoplasty

Question 21

A dog is presenting with erosive and crusting lesions on the nasal planum and footpads following a 2 week travel with the owner to Italy. What is your top differential given the history?

Answer 21

Leishmaniosis

Question 22

How can Leishmania be diagnosed in a patient with nasal planum and footpad lesions?

Answer 22

• Cytology showing amastigotes in macrophages

Question 23

How do patients with Leishmaniosis typically present?

Answer 23

• Erosions, crusting, and ulceration seen on the nasal planum and footpads
• Hyperkeratosis to foot pads
• History of travel to endemic area

Question 24

What dogs are more at risk for an anal sac impaction?

Answer 24

• Small breed OBESE dogs

Question 25

What can be incorporated in the long term management of anal sac impactions in small breed obese dogs that are predisposed?

Answer 25

- **Increase fiber in the diet** - Repeated flushing

Question 26

Which dog breed is most susceptible to perianal fistulas?

Answer 26

- **GSD!!!**

Question 27

What is the treatment protocol for a patient presenting with a perianal fistula?

Answer 27

- **Cyclosporine**

Question 28

What is the treatment protocol for a patient with an anal sac adenocarcinoma?

Answer 28

**Surgical excision AND castration** of intact male dogs