Small Animal Dermatology, 3rd edition

CHAPTER 21 DERMATOPHYTOSIS 325

Rare cataract formation in dogs

May lighten coat color

Use with food for best absorption.

 Itraconazole:
Vasculitis and necroulcerative skin lesions reported in 7.5% of dogs treated for

blastomycosis with itraconazole at doses of 5 mg/kg q12h. Lesions were not

noted in patients receiving 5 mg/kg q24h

Hepatotoxicity has been reported in both dogs (10–15% of treated cases) and

cats (unknown %); monitor liver enzymes

Vasculitis has been reported in both the dog and cat

Use with food for best absorption.

 Lime sulfur solution, topical:
Ingestion of lime sulfur may lead to oral mucosa irritation; an Elizabethan collar

should be placed on animals (especially cats) while drying.

Alternative Drugs

 “Ringworm vaccine”: no longer available in the US; decreased clinical signs; may

encourage development of inapparent carrier states.

 Lufenuron: a chitin synthesis inhibitor used in flea control; proven not effective in

controlled studies.

 Effective topical products include ketoconazole, miconazole, micona-

zole/chlorhexidine, climbazole, accelerated hydrogen peroxide rinse (3.5% diluted

1:10), 1% clortrimazole, dilute sodium hypochlorite; essential oils (Thymus serpillum,

Origanum vulgare,Rosmarinus officinalis) may have some benefit; minimal studies.

COMMENTS

Treatment Goals (“CCATS,” Moriello)

 Confinement: affected animals should be confined to a specific area of the home.

 Cleaning: cleaning will help prevent false-positive fungal culture results on the ani-

mal; fungal spores do not “live” in the environment/spores only live in keratin; fungal

spores are easily removed by mechanical cleaning and washing with a detergent and

water; spores donotrepresent a respiratory risk; transmission of the disease from

a contaminated environment to a person in the absence of contact with an animal

is rare; bleach and hot water are not more effective than cold water in the laundry

• the most important factor is to avoid overfilling the machine; accelerated hydro-
  gen peroxide products are as effective as household bleach for hard surfaces in the
  home; carpets should be vacuumed, disinfected, and repeatedly washed with a carpet
  shampooer.

 Assessment: monitoring for a clinical response to therapy; examination for the pres-

ence or absence of lesions, Wood’s lamp, and fungal culture results (coupled with the

numbers of colony forming units per plate); routine serum chemistry and complete

blood count to monitor therapy.