by: Erin Corb, DVM, Dermatology Intern
Lucy, a 9-month-old FS Golden Retriever, was presented with a 1-month history of progressively worsening pustules and crusts in multiple locations as well as muzzle edema, mandibular lymphadenopathy, lethargy, hyporexia, fever, and right hind limb lameness. A prednisone taper and oral antibiotics were prescribed by pcDVM. Other signs improved but skin lesions remained. Examination revealed alopecia with crusting, scabs, erythema, ulceration, and excoriations on the bridge of the nose, muzzle, chin, and periocular skin. Erythematous papules and pustules were present on the ventrum and vulva, and papules and crusts were present on the concave pinnae. She was extremely pruritic. Skin scrape was negative. Skin and ear cytology revealed bacteria (cocci) and yeast. Skin culture was submitted. Diagnosis was suspected juvenile cellulitis with secondary bacterial and Malassezia overgrowth along with otitis externa AU. Ketoconazole, MaxiOtic AU, NeoPolyDex OU, and chlorhexidine 4% shampoo were started. Prednisone was continued and slowly tapered as clinical signs improved. Skin culture revealed a multi-drug resistant bacterial infection (MRSP) so topical therapy was performed SID to EOD with 4% chlorhexidine medicated baths. At recheck 1 month later, Lucy was doing great with improved energy, secondary infections cleared, and lesions significantly improved with some scarring present.
Top photos are from original presentation and bottom photos are from 1 month recheck.
Ventral abdomen (photo on left is from original presentation and photo on right is from 1 month recheck).