Bacterial Dermatits
Diagnostics
Required
Skin Dx Rule outs
- Skin Impression and Cytology (Tape prep) - In House
- Skin Scraping and Microscopic Evaluation
Skin Fungal rule outs (choose 1)
- DTM Fungal Culture - In House
- IDEXX Ringworm (Dermatophyte) RealPCR™ Panel
Recommended
Supplements
- EICOSA 3FF Snip Caps (Small)
Recommended Rx Diets:
- Clinic - Royal Canin Hydrolyzed Protein HP 7.7lb (Canine)
Treatment
Required
Antibiotics (choose 1)
- (cefovecin sodium) - Convenia Injection 80mg/ml - Under 20lb
- Cefpodoxime Proxetil 100mg Tablets
- Cephalexin Capsules 250mg
- Cephalexin Chewable Tablets 150mg
- Amoxicillin & Clavulanate potassium 125mg tablets
Immune Therapy (choose 1)
- Cytopoint Injection 0-20lb
- Apoquel 3.6mg Tablet
Recommended
Medicated Shampoo (choose 1)
- Trizchlor 4 Shampoo 8oz
- Chlorhexidine Shampoo 8 oz
- KetoChlor Shampoo (1% Ketoconazole 2% Chlorhex) 16oz
- Ketochlor Shampoo 8oz
- Miconahex Triz Shampoo 8oz
- Chlorhex
4% ShampooConditioner or Mousse (choose 1)
- Miconahex Triz Mousse 7.1oz
- DOUXO S3 PYO Mousse 5.1oz 150mL
Wipes (choose 1)
- Douxo S3 PYO Antiseptic and Antifungal Wipes, 30 Count
- Mal-a-ket Wipes (Pledgets)
- KetoHex Wipes 50 count
Comfort
Required
Recommended
Anti-inflammatory (choose 1)
- Dexamethasone SP 4mg/ml Injection
- Prednisone 5mg• Tablets Prednisolone 5mg
- Tablet Dexamethasone 2mg/ml
- Injection Triamcinolone 10mg/ml
- Gentacalm Spray 60ml
Prevention
Recommended
Supplements
- EICOSA 3FF Snip Caps (Small)
Recommended Rx Diets:
- Clinic - Royal Canin Hydrolyzed Protein HP 7.7lb (Canine)
Facts
- Even though skin is colonized by staph bacteria, the immune system and skin barrier keep bacteria from penetrating the skin and causing an infection.
- Diseases like atopic dermatitis and allergies cause the skin to be inflamed and itchy, which breaks down the skin barrier and allows the bacteria to penetrate the skin and cause an infection.
- Antibiotics clear the infection, but if the underlying inflammation is not controlled, it is only a matter of time before the staph bacteria cause an infection again.
- Healthy dogs do not get skin infections. The underlying cause of an infection should always be looked for.
- Diagnostic tests may include bloodwork to look for organ or endocrine dysfunction (particularly in older pets).
- If the underlying cause is atopic dermatitis, this needs to be addressed. This may be for a few weeks, through the allergy season, or constantly year-round, depending on what the dog is allergic to.
Guide: Diagnosis & Treatment
- A sample should be taken from the affected area of the skin to confirm bacterial presence and to rule out other causes of skin disease, such as skin scrapings for mites and tape preps for yeast.
- It is always a good idea to culture skin infections. BUT if a dog is cultured prior to starting antibiotics, the culture may or may not identify the resistant bacteria, and re-culturing may be needed when the pet is on antibiotics to single out the resistant strains.
- If bacteria are present while a dog is on antibiotics, they need to be cultured, and an antibiotic chosen based on the culture results.
- Antibiotics duration - 3-4 weeks for a superficial infection (1 week beyond resolution) or at least 6 weeks for a deep infection (2 weeks beyond complete resolution).
Combine oral antibiotics with topicals:
- Topical antibiotics may be used in concentrations above what bacteria can develop resistance to.
- Alcohol containing products may sting raw skin, in these cases ointments are better.
- Gentamicin containing ointments or sprays or mupirocin ointment are recommended as most include steroid to relieve skin inflammation.
- Steroids can cause skin atrophy with long term use and so should not be a sole therapy for recurrent infections.
Supportive care:
- Chlorhexidine-containing shampoos can be used several times a week if helpful.
- Frequent bathing is very helpful and very necessary in greasy and odiferous pets.
- Pets with dry skin will be worsened with frequent bathing, and may benefit from chlorhexidine sprays or mousse instead of bathing.
What to Avoid
- Antibiotic “pulse therapy” to prevent recurrence of resistant infections is not recommended.
- Avoid using alcohol-containing products may sting raw skin, in these cases ointments are better.
- Avoid frequent bathing in pets with dry skin as this may worsen symptoms. Instead, recommend chlorhexidine sprays or mousse.
- Most owners mistake flakey skin as a sign of dry skin but, in fact, most pets with allergies are oily and flakey.
Resources
- Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA)
- Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part 2— antimicrobial choice, treatment regimens and compliance
- The Association Between the Use of Oclacitinib and Antibacterial Therapy in Dogs With Allergic Dermatitis: A Retrospective Case-Control Study
- Evidence-Based Treatment of Canine Atopic Dermatitis: 2010 Practice Guidelines - The WSAVA Hills Excellence in Veterinary Healthcare Award
Ask the Board!