Cutaneous paraneoplastic syndromes in dogs and cats: a review of the literature

Medullary bone in male budgerigars (Melopsittacus undulatus) with testicular neoplasms

Medullary bone is a calcium-rich, labile bone normally occurring in female birds with each egg-laying cycle. The stimulus for formation of medullary bone is, in part, the cyclic increase in serum estrogens produced by preovulatory ovarian follicles. Increased bone density due to formation of medullary bone, particularly in pneumatic bones, has been termed polyostotic hyperostosis, even if physiologic. This study investigated the formation of medullary bone in nonpneumatic (femur) and pneumatic (humerus) bones in sexually mature male budgerigars submitted for autopsy. Of the 21 sexually mature male budgerigars submitted for autopsy, 7 (33%) had medullary bone in 1 or more bones examined. All 7 male budgerigars with medullary bone had a testicular neoplasm, which was morphologically consistent with a testicular sustentacular cell tumor, seminoma, or interstitial cell tumor. Medullary bone was not present in the 14 cases with other diseases. Medullary bone formation in pneumatic and nonpneumatic bones can occur in male budgerigars with testicular neoplasms. Radiographic increases in medullary bone density, particularly in the humerus, could provide antemortem indication of testicular neoplasia in male budgerigars.

Non-thymoma-associated exfoliative dermatitis in a European shorthair cat: A case report

The current case report presents a case of non‐thymoma‐associated exfoliative dermatitis in an 8‐year‐old European Shorthair female cat. The animal displayed extensive alopecia and excessive peeling of the epidermis. There were no other apparent disorders, except for the skin lesions. Roentgenographic and sonographic examinations, complete blood count and blood serum chemistry analyses, and skin biopsy were performed. The histopathological investigation revealed hyperkeratosis of the epidermis and the infiltration of lymphocytes and macrophages at the dermal‐epidermal junction around the hair follicles and sebaceous glands. Moreover, edema of the basal layer and melanin migration from the epidermis to the dermis were observed. The patient underwent treatment with immunosuppressive doses of prednisolone, antibiotic therapy, and baths in anti‐seborrheic shampoos and displayed resolution. However, recurrence was observed after one month. Consequently, the patient received cyclosporine A, in addition to the aforementioned treatment and the lesions resolved without relapse.

Thymic epithelial tumours in 51 dogs: Histopathologic and clinicopathologic findings

Canine thymic epithelial tumours (TET) are uncommon and little is known about their behaviour. Previous attempts at histologic classification have varied, and as such reliable prognostic information is unavailable. The aim of this retrospective multi-institutional study was to evaluate cases of canine TETs, irrespective of subtype, in order to identify useful histopathologic and clinicopathologic prognostic factors. Cases were included if the tumour arose from the cranial mediastinum and a diagnosis of TET was made on the basis of histopathology. Fifty-one dogs were included. In addition to clinicopathologic data, histology samples were reviewed for the following features: mitotic count, percentage of necrosis, presence of Hassall's corpuscles, lymphocytic infiltrate, cellular pleomorphism and vascular or capsular invasion. The median survival time for all dogs was 449 days. The 1- and 2-year survival rate was 52.6% and 26.3% respectively. On multivariable analysis surgical excision of the thymic tumour was associated with significantly prolonged survival; the presence of metastasis, myasthenia gravis and moderate or marked cellular pleomorphism were associated with significantly reduced survival. Additional studies are needed to further evaluate prognostic factors to aid treatment recommendations.

Successful Treatment of a Multi-Drug-Resistant Severely Pruritic Hypersensitivity Dermatitis in a Cat

A 3-year-old neutered female domestic shorthair cat was presented with a severely pruritic dermatitis. After exclusion of flea allergy dermatitis, ectoparasite infestation, retroviral infection, neoplasia, and cutaneous adverse food reaction, a diagnosis of nonflea, nonfood hypersensitivity dermatitis (NFNFHD) was made. The resolution of complicating bacterial infection and yeast overgrowth did not improve the animal's condition. Numerous antipruritic treatment modalities used during the investigation proved unsuccessful, including anti-inflammatory and immunosuppressive prednisolone doses, oclacitinib, antihistamines, ciclosporin A, and supplementation with essential fatty acids. Allergen-specific serology test results were negative. Treatment with oral dexamethasone allowed a complete resolution of clinical signs. The cat has been successfully maintained in remission for over 12 months. To the author's knowledge, this is the first case report of a cat with multi-drug-resistant NFNFHD treated successfully with dexamethasone.

A previously undescribed cutaneous paraneoplastic syndrome in a cat with thymoma

BACKGROUND

Exfoliative dermatitis is a well-recognized cutaneous paraneoplastic syndrome (PNS) associated with thymoma in cats, of which the clinical and histopathological presentation has been well-characterized.

OBJECTIVES

To describe a novel clinical skin manifestation associated with thymoma in a cat.

ANIMAL

A 14-year-old neutered female domestic short hair cat.

METHODS AND MATERIALS

Physical, abdominal ultrasonographic, thoracic radiographic, ultrasonographic and computed tomographic examinations, histopathological assessment of the skin and mediastinal mass.

RESULTS

The cat was presented with noninflammatory alopecia, with a dorsal multifocal distribution. Examination of the alopecic areas using a dermascope indicated an apparent lack of follicular ostia. Histopathological assessment of alopecic areas confirmed follicular and epidermal atrophy, trichilemmal keratinization and mild orthokeratotic hyperkeratosis. Diagnostic imaging revealed a mediastinal mass, which was surgically removed. Histopathological and immunohistopathological examination of the mass was consistent with a thymoma, associated with multiloculated cyst formation and multifocal cholesterol granulomas. Following surgery, hair re-growth was noted in the previously alopecic areas. The cat was euthanized 3.5 months later because of recurrent chylothorax suspected to be a postoperative complication. The alopecic lesions had improved markedly.

CONCLUSIONS AND CLINICAL IMPORTANCE

Thymoma-associated PNS might not always manifest as an exfoliative dermatitis and should be considered in the differential diagnosis of multifocal noninflammatory alopecia.

Unilateral renal cystadenocarcinoma and nodular dermatofibrosis in a mixed-breed dog carrying a FLCN gene mutation

BACKGROUND

Renal cystadenocarcinoma and nodular dermatofibrosis (RCND) is a rare inherited cancer syndrome observed predominantly in the German shepherd dog breed, known to be associated with dominant autosomal transmission of mutation H255R of the encoding folliculin gene (FLCN). The syndrome usually features bilateral, multifocal kidney tumours and skin nodules, consisting of dense collagen fibres, with previous reports showing a poor prognosis. Although historically nodular dermatofibrosis (ND) has been considered a paraneoplastic syndrome associated with renal cystadenocarcinoma; this hypothesis has been questioned.

OBJECTIVES

To report a case of unilateral renal adenocarcinoma in a dog with RCND syndrome, with 40-month follow-up.

ANIMAL

A neutered 5-year-old female, mixed-breed dog.

METHODS AND MATERIALS

Nodular dermatofibrosis was confirmed with histopathological evaluation. Contrast-enhanced ultrasound (CEUS) supported a presumptive diagnosis of unilateral renal neoplasia and the kidney was removed.

RESULTS

Nodular dermatofibrosis with unilateral RC was confirmed by histopathological evaluation and DNA sequencing; this was positive for the heterozygous form for the H255R mutation in the FLCN gene. Follow-up at 40 months after nephrectomy showed progressive increase in the size and number of nodular lesions.

CONCLUSION AND CLINICAL IMPORTANCE

This case supports the hypothesis that nodular dermatofibrosis is not a paraneoplastic syndrome associated with cystadenocarcinoma. It may be instead an independent dermatological feature of the same genetic disease, linked to the mutation of FLCN given that the cutaneous nodules in this dog increased in size and number after removal of the adenocarcinoma.

Skin as a marker of general feline health: Cutaneous manifestations of systemic disease

Practical relevance: Although most skin lesions occur due to diseases primarily affecting the skin, some reflect important systemic diseases. Such lesions may relate directly to the systemic disease, or may occur due to secondary skin diseases that develop because of immunosuppression. Early recognition of skin changes as a marker of systemic disease will maximise patient outcomes. Clinical challenges: In older or clearly debilitated cats presenting with skin disease, the potential for underlying systemic disease is often readily apparent. Similarly, cats presenting with severe ulcerative or multifocal nodular skin lesions, or with concurrent signs of systemic illness, will more instinctively prompt systemic evaluation. More challenging is the cat presenting with alopecic, scaling, erythemic and/or mildly crusted skin disease, with or without pruritus; hypersensitivities and infectious dermatoses are the most common considerations, but occasionally systemic disease underlies the skin changes. Knowing when screening laboratory testing, body imaging or other systemic diagnostics are indicated is not always straightforward. Evidence base: This article reviews cutaneous presentations of systemic diseases reported in the veterinary literature, and discusses important differential diagnoses. The author draws on clinical experience, published data on disease prevalence and case evaluations, and expert opinions on approach to common systemic problems to provide guidance on when investigation for underlying systemic disease is most appropriate.

Hepatocutaneous syndrome in Shih Tzus: 31 cases (1996-2014)

OBJECTIVE

To characterize findings in Shih Tzus with progressive superficial necrolytic dermatitis and degenerative vacuolar hepatopathy consistent with hepatocutaneous syndrome.

DESIGN

Retrospective case series.

ANIMALS

31 Shih Tzus.

PROCEDURES

Medical records were reviewed to obtain information on signalment, history, treatment, outcome, and results of clinicopathologic testing, abdominal ultrasonography, and histologic examination of skin and liver specimens. A pedigree analysis was performed.

RESULTS

There were 16 males and 15 females. Median age at the time of diagnosis was 8 years (range, 5 to 14 years). Common clinical signs included lethargy, inappetence, weight loss, and lameness. Twenty-five dogs had cutaneous lesions consistent with hepatocutaneous syndrome; the remaining 6 initially only had hepatic abnormalities, but 3 of the 6 subsequently developed cutaneous lesions. Common clinicopathologic abnormalities included microcytosis (15/24 [63%] dogs) and high serum alkaline phosphatase activity (24/24 [100%] dogs). Hepatic ultrasonographic findings included a hyperechoic or heteroechoic appearance to the parenchyma with innumerable hypoechoic nodules. Histologic hepatic lesions consisted of degenerative vacuolar (glycogen and lipid) hepatopathy associated with minimally fibrotic to nonfibrotic, noninflammatory, proliferative nodules. Pedigree analysis confirmed a common ancestry in 12 of 18 dogs. Median survival time was 3 months (range, 1 to 36 months).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that HCS may have a heritable component in Shih Tzus, although the condition may also be identified in Shih Tzus without affected relatives. Clinical, clinicopathologic, ultrasonographic, and histologic abnormalities in affected Shih Tzus were similar to those previously reported for dogs of other breeds with HCS.

Investigation of risk factors for mortality in aged guide dogs: A retrospective cohort study

The overall median lifespan of domestic dogs has been estimated to 9-12 years, but little is known about risk factors for mortality in aged and a priori healthy dogs. The objective of this retrospective cohort study was to determine which characteristics are associated with mortality in aged and a priori healthy guide dogs, in a retrospective cohort study of 116 guide dogs followed from a systematic geriatric examination at the age of 8-10 years old. A geriatric grid collected the clinical data and usual biological parameters were measured at the time of examination. Univariate (Kaplan-Meier estimates) and multivariable (Cox proportional hazard model) survival analyses were used to assess the associations with time to all-cause death. The majority of dogs were Golden Retrievers (n=48) and Labrador Retrievers (n=27). Median age at geriatric examination was 8.9 years. A total of 76 dogs died during follow-up, leading to a median survival time from geriatric examination of 4.4 years. After adjustment for demographic and biological variables, an increased alanine amionotransferase level (adjusted Hazard Ratio (adjusted HR), 6.2; 95% confidence interval [95%CI], 2.0-19.0; P<0.01), presenting skin nodules (adjusted HR, 1.9; 95% CI, 1.0-3.4; P=0.04), and not being a Labrador Retriever (adjusted HR, 3.3; 95%CI, 1.4-10; P<0.01) were independently associated with a shorter time to death. This study documents independent associations of alanine aminotransferase level, skin nodules and breed with mortality in aged guide dogs. These results may be useful for preventive medical care when conducting a geriatric examination in working dogs.

Feline paraneoplastic alopecia associated with metastasising intestinal carcinoma

CASE SUMMARY

A 10-year-old male neutered British Shorthair cat was presented with a 6 month history of lethargy, weight loss and alopecia. Clinical examination revealed widespread alopecia of the ventral abdomen and hindlimbs. The skin in these areas was smooth and shiny and hairs could be easily epilated. Spontaneous pruritus was observed. Cytological examination of superficial impression smears showed a severe Malassezia species dermatitis and pyoderma. Ectoparasites could not be detected and no sign of dermatophytosis was visible in trichograms and Wood's lamp analysis. Abdominal ultrasound found a focally thickened wall of the large intestine and multiple nodules in the liver. Fine-needle aspirates from lymph nodes, liver and altered colonic wall were consistent with an undifferentiated malignant neoplasia. The cat was euthanased at the owners' request, owing to potential neoplasia with metastatic spread. At necropsy a metastasising carcinoma of the colonic wall was found, as well as a paraneoplastic alopecia.

RELEVANCE AND NOVEL INFORMATION

Feline paraneoplastic alopecia has been reported in association with pancreatic carcinoma, bile duct carcinoma and hepatocellular carcinoma, as well as with neuroendocrine pancreatic carcinoma and hepatosplenic plasma cell tumour. This is the first reported case of feline paraneoplastic alopecia associated with a colon carcinoma.

Lymphocytic mural folliculitis and pancreatic carcinoma in a cat

A 9-year-old castrated domestic shorthair cat was presented with a 6 week history of progressive non-pruritic alopecia, polyphagia and weight loss. A diagnosis of lymphocytic mural folliculitis was made and the cat was treated with a combination of prednisolone and ciclosporin; this produced an improvement in the alopecia but no resolution. Sixteen months after the initial assessment and diagnosis, the cat was re-evaluated for intermittent vomiting and weight loss with normal appetite. On examination the dermatopathy was still evident and a mass involving the duodenum and pancreas was present, which was diagnosed as a pancreatic carcinoma. From this case it would appear that lymphocytic mural folliculitis might be an early dermatological manifestation of pancreatic neoplasia.

Perioperative Mortality and Long-Term Survival in 80 Dogs and 32 Cats Undergoing Excision of Thymic Epithelial Tumors

OBJECTIVE

To examine perioperative mortality, long-term survival, causes of death, and prognostic factors for dogs and cats undergoing surgical excision of thymic epithelial tumors (TETs).

STUDY DESIGN

Multi-institutional case series.

ANIMALS

Eighty dogs and 32 cats.

METHODS

Follow-up information was obtained for dogs and cats that underwent surgical excision of a TET between 2001 and 2012.

RESULTS

Perioperative mortality was 20% in dogs and 22% in cats. No independent risk factors for perioperative mortality were identified. The estimated median survival time for all dogs was 1.69 years (95% CI 0.56-4.32) and the 1- and 4-year survival rates were 55% (95% CI 44-67) and 44% (95% CI 32-56). The estimated median survival time for all cats was 3.71 years (95% CI 0.56-unestimatable) and the 1- and 4-year survival rates were 70% (95% CI 53-87) and 47% (95% CI 0-100). Of animals that survived to discharge, 42% of dogs and 20% of cats eventually died of TET-related causes. The presence of paraneoplastic syndromes (hazard ratio [HR] 5.78, 95% CI 1.64-20.45, P = .007) or incomplete histologic margins (HR 6.09, 95% CI 1.50-24.72, P = .01) were independently associated with decreased survival in dogs. No significant predictors of survival were identified in cats. Conclusions regarding the effect of chemotherapy or radiation therapy could not be made.

CONCLUSIONS

While there is substantial risk of perioperative death in dogs and cats undergoing surgery for TETs, many animals that survive to discharge have prolonged survival. Survival is significantly decreased in dogs with paraneoplastic syndromes or incomplete histologic margins.

Systemic Infection Due to Candida parapsilosis in a Domestic Ferret (Mustela putorius furo)

An 18-month-old castrated male ferret (Mustela putorius furo) was presented to the veterinary hospital for acute collapse but died despite initiation of emergency treatment. The body was submitted for a complete postmortem examination. The pathologist determined the ferret was suffering from severe necrotizing encephalitis, necrogranulomatous mediastinal lymphadenitis, and ulcerative dermatitis attributable to systemic Candida parapsilosis. This is the first report of systemic Candida parapsilosis in a ferret.

Superficial necrolytic dermatitis in a dog with an insulin-producing pancreatic islet cell carcinoma

A 10-year-old dog presented with convulsive crisis and symmetrical hyperkeratotic cutaneous lesions affecting the abdomen, inguinal area, eyelids, muzzles, both pinnae, and all the paw pads. Hypoglycemia and hyperinsulinemia were the main biochemical findings. A mass 2 cm in diameter was detected within the left pancreatic lobe by ultrasonography. It was surgically removed and histologically and immunohistochemically diagnosed as an insulin-producing pancreatic islet cell carcinoma. The animal was eventually euthanized due to lack of clinical improvement. At necropsy, metastatic nodules were observed in the pancreatic lymph nodes and liver. Histopathological findings of cutaneous lesions were highly suggestive of superficial necrolytic dermatitis and were interpreted as a paraneoplastic syndrome derived from the islet cell carcinoma. To the authors' knowledge, this is the first report of superficial necrolytic dermatitis associated with an insulin-producing pancreatic neuroendocrine carcinoma in dogs.

Vesicular, ulcerative, and necrotic dermatitis of reptiles

Vesicular, ulcerative, and necrotic dermatologic conditions are common in captive reptiles. Although these conditions have distinct differences histologically, they are commonly sequelae to each other. This article examines the anatomy and physiology of reptile skin; discusses reported causes of vesicular, ulcerative, and necrotic dermatologic conditions; and reviews various management options.

Cutaneous vasculitis in small animals

Cutaneous vasculitis is an inflammatory process targeting blood vessels. Underlying factors include drugs, infectious diseases, adverse reactions to food, malignancies, and immune-mediated diseases. Vasculitis is a reaction pattern warranting a workup to identify triggers. Presenting symptoms include purpura, pitting edema, and skin ulcerations. Constitutional signs include fever, depression, and anorexia and seem to be present in the majority of patients. Once a diagnosis is confirmed, treatment and follow-up must be tailored to the individual. High-dose immunosuppressive medications are only recommended once infectious diseases capable of producing a similar constellation of clinical signs have been ruled out.

Nodular dermatofibrosis in a dog without a renal tumour or a mutation in the folliculin gene

Canine nodular dermatofibrosis is a rare skin disease associated with renal cystadenoma or cystadenocarcinoma and uncommonly with uterine leiomyoma. It is generally seen in German shepherd dogs, but has been also reported in other breeds, and a relationship has been suggested with mutation of the gene encoding folliculin (FLCN), which is located on chromosome 5. A 10-year-old female golden retriever was presented because of numerous firm cutaneous nodules up to 4 cm in diameter over the entire body surface. Cytological and histopathological examinations confirmed generalized cutaneous nodular dermatofibrosis, but ultrasonography of both kidneys ruled out renal neoplasia. Ovariohysterectomy was performed because of prolonged oestrus periods. Microscopical examination of the excised tissues confirmed the absence of uterine neoplasia, but identified rete adenoma of the right ovary. Abdominal ultrasound performed repeatedly over a 5-year follow-up period did not identify any alteration in the renal parenchyma. Molecular studies excluded the presence of any mutation in the FLCN gene.

Alopecia: a common paraneoplastic manifestation of cholangiocarcinoma in humans and animals

The coincidence of alopecia and a tumour may indicate the paraneoplastic nature of alopecia. Paraneoplastic alopecia is not uncommon in animals, feline paraneoplastic alopecia being the best example known. We present a case of alopecia coinciding with the presentation of a cholangiocarcinoma in a woman. Following surgical resection of the tumour, alopecia resolved spontaneously and it reappeared on local recurrence, 2 years later. As far as pathogenesis is concerned, the coincidence of alopecia and cholangiocarcinoma may indicate the paraneoplastic nature of alopecia as a rare complication of this rare tumour in humans. This also implies that common interspecies mechanism(s) must exist as far as this paraneoplastic complication is concerned.

Use of intralesional oestradiol concentration to identify a functional pulmonary metastasis of canine sertoli cell tumour

A seven-year-old, 31 kg male neutered Labrador was investigated for signs of feminisation syndrome and prostatic disease four years after castration and removal of a testicular sertoli cell tumour (SCT). Investigations revealed an elevated serum oestradiol-17beta concentration, a pulmonary mass containing fluid high in oestradiol-17beta and cystic changes in the prostate gland. The pulmonary mass was surgically excised and histologically confirmed to be a SCT metastasis. To the authors' knowledge, this is the first reported case of a proven functional extranodal SCT metastasis and the first to be diagnosed by oestradiol-17beta measurement of intralesional fluid.

Síndrome do gucagonoma em cão

O eritema necrolítico migratório é rara dermatose caracterizada por lesões erodo-ulcerativas e crostosas em áreas intertriginosas, junções mucocutâneas, superfícies articulares e de apoio crônico, que tem sido descrita em seres humanos, cães, gatos e rinocerontes. Sua etiologia tem sido relacionada a neoplasias pancreáticas, mormente das células alfa produtoras de glucagon, e a graves doenças do parênquima hepático ou gastroentérico. Relata-se o caso de um cão com necrose epidérmica metabólica secundária a glucagonoma, que apresenta fortes similaridades com a síndrome do glucagonoma em humanos.

Unusual dermatological toxicity of hydroxyurea in two dogs with spontaneously occurring tumours

Hydroxyurea is a chemotherapeutic agent used to treat hypereosinophilic syndrome, mast cell tumours and many myeloproliferative disorders. It is usually well tolerated; however, reported side effects include myelosuppression and gastrointestinal complications as well as cutaneous toxicity, in very rare cases. We report the unusual appearance of onychomadesis involving several claws on all feet in two canine patients receiving long-term hydroxyurea treatment. The healing of nail lesions required cessation of treatment in one dog and dose reduction in the second animal, supporting a strict relationship between onychopathy and administration of hydroxyurea. The aim of this case report is to increase clinical awareness of dermatological toxicity associated with long-term administration of hydroxyurea.

Paraneoplastic alopecia associated with hepatocellular carcinoma in a cat

A 15-year-old spayed female domestic shorthair cat presented with alopecia associated with hepatocellular carcinoma. Clinical signs, which had commenced 6 months previously, included loss of appetite, loss of weight, and depression. As reported by the owner, the cat developed alopecia a week before referral. The hair loss was localized to the ventral aspect of the thorax and abdomen, medial aspect of front and hind limbs, and ventral aspect of the tail, and was associated with histological features consistent with paraneoplastic alopecia. At necropsy, multiple hepatic nodules were observed, and subsequent histopathological investigation showed cords and sheets of hepatocyte-like neoplastic cells positive for the hepatocyte marker (Hep Par 1), thereby demonstrating the hepatocellular origin of the tumour, which was diagnosed as a hepatocellular carcinoma. This is the first report of feline paraneoplastic alopecia associated with hepatocellular carcinoma confirmed by the Hep Par 1 marker.

Pemphigus Foliaceus in 91 Dogs

A retrospective study of 91 dogs with pemphigus foliaceus was performed. Clinical signs of the disease included crusts (n=79), pustules (n=36), and alopecia (n=33). Lesions were most common on the trunk (n=53), inner pinnae (n=46), face (n=37), and foot pads (n=32). Cytological evaluation revealed acantholytic keratinocytes in 37 of 48 dogs. Results of combination treatment with prednisolone and azathioprine were comparable to results with prednisolone therapy alone. More than half of the dogs achieved remission with appropriate therapy, and another 25% significantly improved.

Manifestations cutanées des maladies internes du chien

Les manifestations cutanées des maladies internes commencent à être bien connues chez le chien, même si leur étiologie et leur pathogénie ne sont pas toujours élucidées. Elles sont d'une très grande diversité clinique et en relation avec des maladies internes variées. Leur connaissance est importante car ces lésions cutanées entrent dans de nombreux diagnostics différentiels et apparaissent, pour certaines, précocement avant les symptômes de la maladie interne sous-jacente. Enfin, certaines de ces manifestations cutanées constituent des syndromes paranéoplasiques cutanés. Sont envisagées la dermatofibrose nodulaire, l'érythème nécrolytique migrant, la dermatomyosite, les calcinoses, les amyloses, les xanthomes cutanés, le syndrome d'automutilation podale et le syndrome syringomyélie.

Thymoma-associated exfoliative dermatitis in a rabbit

A 5-year-old rabbit with generalized scaling is presented. Multiple skin scrapings and acetate tape impressions were negative for mites and Malassezia. Culture for dermatophytes was also negative. Skin biopsies showed similarities with sebaceous adenitis described in rabbits (absence of sebaceous glands, perifollicular lymphocytic infiltrate at the level of the absent sebaceous glands, lymphocytic mural folliculitis, interface dermatitis). The owners refused any treatment and 2 months later the rabbit was euthanized due to anorexia. At necropsy a mass was found in the anterior mediastinum. Histopathology confirmed a diagnosis of thymoma. A possible paraneoplastic skin disease was suspected, based on similarities with thymoma-associated exfoliative dermatitis in cats.

Senior and Geriatric Care Programs for Veterinarians

Earlier detection allows earlier intervention, and thus improved treatment success. Senior profiling improves anesthetic safety by identifying hidden existing diseases and permitting the postponement of anesthesia or altering the anesthetic plan. Furthermore, pharmaceutic safety is increased through the detection of underlying diseases that may preclude the use of certain drugs or suggest new alternative treatments. Many dietary recommendations are based on disease diagnosis, making senior profiling an important dietary database. Finally, earlier disease management by means of improved anesthetic, pharmaceutic, and dietary recommendations offers our patients and clients the best medical management possible.