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The Changing Face of Canine Pyoderma- New 
Strategies for Control 
Anthony Chadwick BVSc CertVD MRCVS 
The Webinar Vet
Roger Hamilton
David Lloyd 
• Antibiotic stewardship CPD should be obligatory 
• FECAVA conference Dublin 2012
Ian Mason 
“The dog is a pyoderma waiting to happen”
What we are covering this afternoon 
• Why is the dog a pyoderma waiting to happen? 
• Classification of pyoderma 
• Clinical signs 
• Diagnosis of pyoderma- ddx 
• Treatment 
• Problems with resistance
Why?
Normal defence mechanisms defective 
• Physical 
• Chemical 
• Microbial
A Pathogenic Staphylococcus 
• S pseudintermedius 
• Bacteria produces a variety of substances including 
enterotoxins, toxic shock protein, protein A and haemolysins 
• Increase adhesion to keratinocytes 
• Act as superantigens and upregulate the immunological 
responses 
• Some strains produce slime which encapsulate the bacteria 
and inhibit phagocytosis whilst increasing its ability to adhere
Classification of pyoderma 
• Surface 
• Superficial 
• Deep
Surface pyodermas 
• Pyotraumatic dermatitis 
• Intertrigo(skin fold pyoderma) 
• Impetigo
Superficial pyodermas 
• Superficial bacterial folliculitis 
• Mucocutaneous pyoderma
Deep pyodermas 
• Deep folliculitis/furunculosis 
• Deep pyotraumatic furunculosis 
• Nasal folliculitis/furunculosis 
• Pedal furunculosis 
• GSD pyoderma 
• Acral lick dermatitis 
• Abscesses and granulomas
Clinical signs
Clinical signs
Diagnosis 
• Cytology 
• Culture and sensitivity 
• Biopsy
What is your most likely diagnosis? 
• Acute Pyoderma 
• Demodicosis 
• Chronic pyoderma 
• Mycosis fungoides 
• Pemphigus foliaceous
Differential Diagnosis 
Pyoderma is always a secondary disease
Differentials 
• Allergy 
• Ectoparasite 
• Endocrine
How long would you treat a pyoderma case? 
• 7 days 
• 7-14 days 
• 15-21 days 
• 22-30 days 
• Longer than 1 month
Treatment 
• Systemic 
• Topical
Systemic Treatments 
• Antibiotics 
• Staphage lysate 
• Autogenous vaccines
Topical Treatments 
• Shampoos 
• Creams 
• Ointments
Antibiotics 
• Potentiated sulphonamides 15-30mg/kg bid 
• Clindamycin 11mg/kg sid 
• Potentiated amoxicillin 12.5mg/kg bid 
• Cephalexin 15-30mg/kg bid 
• Cefovecin 8mg/kg ev 14 days 
• Enrofloxacin 5mg/kg sid 
• Marbofloxacin 2mg/kg sid
Cephacare pack shots
Cefovecin 
• Can increase compliance 
• But sub-optimal levels of antibiotic after the 2 weeks 
• Is a 3rd generation cephalosporin
Staphage lysate 
• Stimulates both humoral and cellular immunity 
• 1 study showed 77% of dogs had significant 
benefits
Autogenous vaccines 
• Prepared individually for each dog from a culture 
• Given with antibiotics and then weaned off 
antibiotics 
• Speak to RVC 
• Particularly useful in cases of recurrent idiopathic 
pyoderma
Shampoos 
• Ethyl Lactate 
• Chlorhexidine 
• Benzoyl peroxide
Creams 
• Fusidic acid 
• Mupirocin
Problems with Resistance Ollie 3yo
Ollie 3yo Bulldog 
• Pyoderma caused by MRSP 
• Sensitive to doxycycline 
• Treated with chlorhexidine shampoo
Lab reports
MRSA and MRSP 
How often have you seen a resistant case this year 
• 0 
• 1-2 
• 3-5 
• 6-10 
• More than 10
Methicillin resistance 
• First reported in 1960s 
• Due to a mecA gene encoding an altered PBP 
• S aureus human pathogen 
• S pseudintermedius companion animal pathogen 
• More of a problem in USA and Europe but coming
How can we prevent 
• Better hygiene in the practice. 
• Use less antibiotics where possible. 
• Higher doses and for longer times. 
• Use appropriate antibiotic for pyoderma. 
• Teach compliance. 
• Don’t use corticosteroids at the same time
Do you use something milky for your cat speys? 
• Yes 
• No
Thanks 
• David Lloyd 
• Tony Liepman at Animalcare 
• You for listening
Any Questions?

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The changing face of canine pyoderma- new strategies for control

  • 1. The Changing Face of Canine Pyoderma- New Strategies for Control Anthony Chadwick BVSc CertVD MRCVS The Webinar Vet
  • 3. David Lloyd • Antibiotic stewardship CPD should be obligatory • FECAVA conference Dublin 2012
  • 4. Ian Mason “The dog is a pyoderma waiting to happen”
  • 5. What we are covering this afternoon • Why is the dog a pyoderma waiting to happen? • Classification of pyoderma • Clinical signs • Diagnosis of pyoderma- ddx • Treatment • Problems with resistance
  • 7. Normal defence mechanisms defective • Physical • Chemical • Microbial
  • 8. A Pathogenic Staphylococcus • S pseudintermedius • Bacteria produces a variety of substances including enterotoxins, toxic shock protein, protein A and haemolysins • Increase adhesion to keratinocytes • Act as superantigens and upregulate the immunological responses • Some strains produce slime which encapsulate the bacteria and inhibit phagocytosis whilst increasing its ability to adhere
  • 9.
  • 10. Classification of pyoderma • Surface • Superficial • Deep
  • 11. Surface pyodermas • Pyotraumatic dermatitis • Intertrigo(skin fold pyoderma) • Impetigo
  • 12. Superficial pyodermas • Superficial bacterial folliculitis • Mucocutaneous pyoderma
  • 13. Deep pyodermas • Deep folliculitis/furunculosis • Deep pyotraumatic furunculosis • Nasal folliculitis/furunculosis • Pedal furunculosis • GSD pyoderma • Acral lick dermatitis • Abscesses and granulomas
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
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  • 22. Diagnosis • Cytology • Culture and sensitivity • Biopsy
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  • 26. What is your most likely diagnosis? • Acute Pyoderma • Demodicosis • Chronic pyoderma • Mycosis fungoides • Pemphigus foliaceous
  • 27.
  • 28. Differential Diagnosis Pyoderma is always a secondary disease
  • 29. Differentials • Allergy • Ectoparasite • Endocrine
  • 30. How long would you treat a pyoderma case? • 7 days • 7-14 days • 15-21 days • 22-30 days • Longer than 1 month
  • 31. Treatment • Systemic • Topical
  • 32. Systemic Treatments • Antibiotics • Staphage lysate • Autogenous vaccines
  • 33. Topical Treatments • Shampoos • Creams • Ointments
  • 34. Antibiotics • Potentiated sulphonamides 15-30mg/kg bid • Clindamycin 11mg/kg sid • Potentiated amoxicillin 12.5mg/kg bid • Cephalexin 15-30mg/kg bid • Cefovecin 8mg/kg ev 14 days • Enrofloxacin 5mg/kg sid • Marbofloxacin 2mg/kg sid
  • 36. Cefovecin • Can increase compliance • But sub-optimal levels of antibiotic after the 2 weeks • Is a 3rd generation cephalosporin
  • 37. Staphage lysate • Stimulates both humoral and cellular immunity • 1 study showed 77% of dogs had significant benefits
  • 38. Autogenous vaccines • Prepared individually for each dog from a culture • Given with antibiotics and then weaned off antibiotics • Speak to RVC • Particularly useful in cases of recurrent idiopathic pyoderma
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  • 45.
  • 46. Shampoos • Ethyl Lactate • Chlorhexidine • Benzoyl peroxide
  • 47. Creams • Fusidic acid • Mupirocin
  • 49. Ollie 3yo Bulldog • Pyoderma caused by MRSP • Sensitive to doxycycline • Treated with chlorhexidine shampoo
  • 51. MRSA and MRSP How often have you seen a resistant case this year • 0 • 1-2 • 3-5 • 6-10 • More than 10
  • 52. Methicillin resistance • First reported in 1960s • Due to a mecA gene encoding an altered PBP • S aureus human pathogen • S pseudintermedius companion animal pathogen • More of a problem in USA and Europe but coming
  • 53. How can we prevent • Better hygiene in the practice. • Use less antibiotics where possible. • Higher doses and for longer times. • Use appropriate antibiotic for pyoderma. • Teach compliance. • Don’t use corticosteroids at the same time
  • 54. Do you use something milky for your cat speys? • Yes • No
  • 55. Thanks • David Lloyd • Tony Liepman at Animalcare • You for listening