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Deep Pyoderma - Coggle Diagram
Deep Pyoderma
clinical signs
papules
hemorrhagic bullae
erosin/ulceration
draining tracts
+/- pruritus
less often than superficial pyoderma
may lick
licking = pain
lymphadenopathy and systemic signs
nodules
interdigital
treatment
must ID and treat undelrying conditions
systemic abx
:forbidden:
penicillin
ampicillin
amoxicillin
tetracycline
streptomycin
treat for 2w past resolution of signs
consider 1st tier
1st gen cephalosporin
cephalexin
ceadroxil
amox + clauvanic acid
clindamycin
must be sus to erythromycin on c&s
if strain is resistant to all 1st tier/drug rxn risk....
2nd tier treatments
3rd gencephalosporin
cefovecin
cefpodoxime
fluroquinolones
avoid
doxycycline
chloramphenicol
dangerous to humans, last resort
aminoglycosides
rifampin
great against staph spp
hepatotoxicity risk
needs monitoring
if this fails...
probably won't get to use 3rd tier w/o case review
linezolid
teicoplanin
vancomycin
must culture
must do C&S
topicals
abx shampoos, sprays, mousse w. biocidals
not very effective but helps with crusting
+/- topical mupirocin
localized lesions
:warning: only for MRSP
+/- gentamycin + steroid ointment
Otomax
mometamax
localized lesions
clip long hair
RECHECK
1st recheck 3-4w
ddx
demodicosis w/ furunculosis
deep/sq fungal infection
atypical bacterial infection
if localized lesion
foreign body
general
associated with
rupture of hair folicle
furunculosis
draining tracts
localized
chin, lips
acne
young
short-coated
nose
nasal deep pyoderms
deep acute moist dermatitis (hot-spot)
interdigital dermatitis
more common in short-coated breeds
can affected 1+ feet
abnormal body weight bearing
on feet predisposes
bleeding nodules
generalized
generalized deep pyoderma
German Shepherds overrepresented
eroded to ulcerated skin
draining blood
diagnosis
cytology
degenrate neutrophils
cocci
may be challenging to find
skin scrapings
bacterial culture
abx selection
