Clinical management of juvenile impetigo in a pup.
Impetigo is a benign, non-contagious, non-zoonotic superficial bacterial infection of skin that does not involve hair follicles (Scott et al., 2001) and contributes to 0.5% of all the canine dermatology cases (Scott and Miller, 2008). It is recognized in two forms i.e. juvenile and bullous form, former affects young dogs before puberty (Codner, 1988), while bullous form is common in adult to older dogs that have concurrent metabolic and/or immunologic disorders. Juvenile impetigo has also been called milk rash or juvenile pustular dermatitis or puppy pyoderma (White et al., 1987) and characterized by non-follicular sub-corneal pustules located on the glabrous areas particularly axillae, groin and ventral abdomen (Medleau and Hnilica, 2001). Recent literature indicates Staphylococcus intermedius as primary pathogen (Gross et al., 2005) but Staphylococcus aureus and Streptococci spp. has also been reported (Kunkle, 1988). In majority of dogs spontaneous resolution occurs (Baker, 1987), but topical and/or systemic antibacterial therapy proven to hasten the recovery (Nesbitt and Ackerman, 1998).
History and Clinical findings
Two month old male, German Shepherd pup was presented with symptoms of development of pustules and erosions on abdomen. History revealed recent deworming with Pyrantel palmoate, one shot of seven in one vaccine within the week and roaming of pup at wet and watery places. Clinical examination showed several intact pustules and erosions on abdomen with very little collarettes and crust (Fig. 1), the rashes were neither pruritic nor painful. Colour of pustules was whitish to yellow with yellowish to brownish crusts, due to rupture of pustules at some places of abdomen. Vital parameters, general behaviour and routine hematology were unremarkable. Based on history and finding of clinical examination, early and mild juvenile impetigo was diagnosed.
Pus of intact pustule was collected for cytological examination, which showed degenerated and non-degenerated neutrophils, while culture and antibiotic sensitivity tests showed presence of Staphylococcusintermedius in the lesion with best sensitivity for amoxicillin clavullonic acid.
Treatment was initiated with cleaning of abdomen and topical application of Kiskin (a) lotion (Ofloxacin, Clobetasol propionate, Miconazole nitrate and Zinc sulphate) twice daily and oral antibiotic syp. of Amoxicillin Clavulanic acid @ 12.5 mg/kg bwt along with tab. A to Z (b) (Multivitamins with Minerals), 1/2 tab daily. Number of pustules gradually started decreasing from third day of therapy onwards and new pustules were not developed during therapy. After one week of therapy, oral antibiotic was stopped, but topical treatment was continued for next two weeks. Uneventful recovery was recorded with this treatment regimen.
Canine juvenile impetigo usually Decurs secondary to various debilitating conditions like canine distemper and other infectious diseases, ectoparasites, endoparasites, poor nutrition, poor hygiene and immunologic abnormalities (Kunkle, 1988), but affected puppies may be healthy (Gross et al., 2005) as seen in this case. Canine juvenile impetigo is visually distinctive and a good history and physical examination are sufficient for diagnosis (Gross et al., 2005). Location and type of skin lesions in present case was similar to Scott and Miller (2008), who reported that in 98% of dog with impetigo lesions were confined to abdomen without any systemic illness. Although it is previously reported that, spontaneous resolution occurs (Baker, 1987), but to hasten the recovery, topical and systemic antibacterial therapy was given in this case. Reme et al. (2008) reported that 3% chlorhexidine shampoo twice weekly as an effective sole therapy for juvenile impetigo in 80% of the puppies, but due to very less age of pup it was not advocated in this case.
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(a)--Brand of Intas Animal Health, Ahmedabad
Mukesh Srivastava , Subhash Kachhawaha  and J.P. Kachhawa 
Department of Veterinary Clinical Medicine
College of Veterinary and Animal Science
Rajasthan University of Veterinary and Animal Sciences
[1.] Post Graduate Scholar and Corresponding author
E mail: email@example.com
 Post Graduate Scholar
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|Title Annotation:||Short Communication|
|Author:||Srivastava, Mukesh; Kachhawaha, Subhash; Kachhawa, J.P.|
|Date:||Jul 1, 2013|
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