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Clinical management of juvenile impetigo in a pup.

Introduction

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

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.

Discussion

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.

References

Baker, B.B. (1987). Bacterial dermatoses in dogs. Mod Vet. Pract. 68: 472-76.

Baker, K.P. and Thomsett, L.R. (1990). Canine and Feline Dermatology. Blackwell Scientific Publication, Bostons. pp 102-103.

Codner, E.C. (1988). Classifying and diagnosing cases of canine pyoderma. Vet. Med. 83: 984-94.

Gross, T.L., Ihrke, P.J. and Walder, E.J (2005). Skin Diseases of the Dog and Cat. Clinical and Histologic Diagnosis, 2nd ed. Blackwell Science, Ames. p. 4-6.

Gross, T.L., Ihrke, P.J. and Walder, E.J. (2005). Skin Diseases of the Dog and Cat. Clinical and Histologic Diagnosis, 2nd ed. Blackwell Science, Ames. p. 4-6.

Kunkle, G.A. (1985). A problem-oriented approach to pediatric dermatology. Comp Cont Edu. 7: 377-82.

Medleau, L. and Hnilica, K.A. (2001). A Color Atlas and Therapeutic Guide. W. B. Saunders Co., Philadelphia. pp-15.

Nesbitt, G.H. and Ackerman, L.J. (1998). Canine and Feline Dermatology. Diagnosis and Treatment. Veterinary Learning Systems, Trenton. p. 205-06.

Reme, C.A., Schroeder H. and Briggs, M. (2005). Efficacy of a 3% Chlorhexidine Shampoo for the Resolution of Canine Juvenile Impetigo. 20th ESVD-ECVD Congress Chalkidiki--Greece.

Scott, D.W. and Miller, W.H. (2008). Juvenile Impetigo in Dogs: A Retrospective Study of 65 Cases (1976-2005) JVCS. 1 : 1-10.

Scott, D.W., Miller, W.H. and Griffin, C.E. (2001). Muller and Kirk's Small Animal Dermatology, 6th ed. W. B. Saunders Co., Philadelphia, p. 274-296.

White, S.D. and Ihrke, P.J. (1987). Dermatology. In: Nesbitt, G. H., ed. Churchill Livingstone, New York; p. 95-121.

(a)--Brand of Intas Animal Health, Ahmedabad

Mukesh Srivastava [1], Subhash Kachhawaha [2] and J.P. Kachhawa [2]

Department of Veterinary Clinical Medicine

College of Veterinary and Animal Science

Rajasthan University of Veterinary and Animal Sciences

Bikaner--33400l (Rajasthan)

[1.] Post Graduate Scholar and Corresponding author

E mail: drmukeshvetmed@rediffmail.com

[2] Post Graduate Scholar
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Title Annotation:Short Communication
Author:Srivastava, Mukesh; Kachhawaha, Subhash; Kachhawa, J.P.
Publication:Intas Polivet
Article Type:Report
Geographic Code:9INDI
Date:Jul 1, 2013
Words:889
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