Generalized Demodicosis
July 2014

A 9 month old, male intact Boxer presented for alopecic lesions of 2-3 weeks duration. The owners reported mild pruritis and a history of fleas. Flea preventative (Frontline) was initiated and mostly resolved the pruritis per the owner.

On physical examination, he had multifocal alopecic, scaly lesions on his trunk and was thin. A skin scraping was performed and 3+ Demodexmites were observed. He was diagnosed with juvenile onset generalized demodicosis. A heartworm test was also submitted and found to be negative.

Classically, with generalized demodicosis the entire dog is affected with patchy alopecic lesions, skin infections and scaly skin. The secondary bacterial infections make this an itchy and often smelly skin disease. The approach to generalized demodicosis typically depends on the age at which the dog develops the disease.

Oral Ivermectin was dispensed along with DermaZoo’s GlycoBenz Shampoo and 3 weeks of the antibiotic, Simplicef®. The dose of Ivermectin was increased every 3 days until a dose of 600 mcg/kg orally once daily was reached. The gradual dose increase was was intended to make sure the dog could tolerate the Ivermectin. The owner was instructed to give a bath with GlycoBenz Shampoo twice weekly.

Re-check of the patient 4 weeks later revealed fewer alopecic lesions and 2+ Demodex mites on skin scraping. The owner was instructed to continue the oral Ivermectin. Re-check 2 weeks later revealed 1+ mites and very few lesions. The owner was again instructed to continue the oral Ivermectin. Re-checks at 2 weeks and then 4 weeks revealed no mites on skin scraping. The owner was instructed to continue the oral
Ivermectin for 2 additional weeks after the second consecutive negative skin scraping was performed.

In addition to treating the Demodex, it was recommended that flea preventative (Frontline) was continued on a monthly basis and the environment (owner’s home) be treated for fleas with a thorough cleaning. Additionally, the dog’s caloric intake was increased for weight gain. Finally, the dog was neutered at 1 year of age.


Professional Dental Cleaning: Use of TrisDent Dental Rinse

Dental disease is the most common clinical condition occurring in both adult dogs and cats. The key to management of this common problem is prevention through routine dental care at home. However, a professional dental cleaning is often needed in order to address periodontal disease prior to sending our patients home with preventative care instructions.

According to Dr. Coffman, DVM, FAVD, DAVDC, as outlined in his lecture, Basic Periodontal Therapy, presented at the Western States Veterinary Conference, February 2014, “The 5 Steps toProfessional Periodontal Therapy” include:

1. Supra-gingival ultrasonic cleaning and hand scaling

2. Sub-gingival cleaning

3. Irrigation and a 0.1-0.12% chlorhexidene rinse prior to cleaning to prevent bacteria spraying during the dental. The 0.1-0.12% chlorhexidene rinse may be used as a final rinse after the dental cleaning as well.

4. A complete oral exam with radiographs and a dental chart

5. Equipment maintenance

The TrisDent Oral Rinse can be the chlorhexidine rinse mentioned above for use during and after a professional dental cleaning. T/Edta/C Rinse contains a unique combined dental formulation of 0.12% Chlorhexidine Gluconate, Tromethamine (Tris) and Edetate Disodium Dihydrate (Edta), which help to provide antibacterial action, plaque and calculus prevention.

Tris-Edta may inhibit plaque by helping to block its mineralization to calculus through chelating minerals and also offers antibacterial activity. Chlorhexidine is an antiseptic and is a very effective chemical anti-plaque agent.

After the professional dental cleaning, excellent oral health can be maintained at home with a consistent oral hygiene regimen.  This regimen should focus on preventing bacteria and plaque build-up, which in turn mineralizes to calculus on the teeth and leads to periodontal disease. Daily at home dental care should help to prevent the need for a professional dental cleaning.

This home oral health care regimen can be facilitated by the use of products from the TrisDent Dental Line (formerly T/Edta/C): TrisDent Water Additive, TrisDent Oral Rinse, TrisDent Gel and TrisDent Wipes. All of the products in the T/Edta/C Dental Product Line contain 0.12% Chlorhexidine Gluconate, Tromethamine (Tris) and Edetate Disodium Dihydrate (Edta).

The TrisDent Gel is ideal for brushing. The TrisDent Water Additive, TrisDent Rinse and TrisDent Wipes are all easy alternatives for those who are unable to brush their pet’s teeth. The TrisDent Rinse may also be used during and after a professional dental cleaning as mentioned above.


Hypertonic Nasal Saline Drops for an Upper Respiratory Infection
Feb. 5, 2014

A 10 year-old FS DSH presented for chronic sneezing and nasal discharge. The owner reported that she had been placed on antibiotics several times in the past with some improvement but no resolution of clinical signs.

On physical examination, she had bilateral mucopurulent nasal discharge, moderate dental disease and referred upper respiratory noise on auscultation of her lungs.

Diagnostics offered to the owner included blood work, nasal radiographs, rhinoscopy +/- biopsy and culture if indicated. A dental was also recommended. The owner elected to start with blood work, and a dental with nasal radiographs. The blood work revealed a leukocytosis. The remainder of the blood work was within normal limits, including a negative FIV/FeLV.  The nasal radiographs were performed under general anesthesia at the same time as the dental. The radiographs revealed a mild increased density of both nasal passages.

Oral Zithromax® (Azithromycin), Chlorpheniramine and Cerenia® (Maropitant citrate) tablets were dispensed for a total of 3 weeks. The doses were as follows:  Chlorpheniramine 2 mg PO BID; Cerenia for 5 days initially then twice weekly; Zithromax 20 mg PO once daily. Cerenia works to reduce nasal discharge and itchiness from infection, and also works well with antihistamines as they potentiate each other.

Hypertonic saline and neopolydex ophthalmic drops were also dispensed to be applied to the nasal passages twice daily for 3 weeks. DermaFlush Premixed Saline Packets were used to make the hypertonic saline nasal drops by simply adding 2 of the premixed saline packets to 1 Liter of water. The hypertonic saline was then placed in a dropper bottle and instructions were to instill several drops to both nasal passages twice daily prior to application of the neopolydex ophthalmic drops. Hypertonic saline works to help reduce edema and flush out debris.

DermaFlush Saline Packets are an economic and convenient form of saline when added to water. The saline is soothing, preservative and iodine free, and may be made into an isotonic or hypertonic saline.

The patient returned for a re-check after 3 weeks and her sneezing and nasal discharge had resolved. She was sent home on an L-lysine supplement and was told to call or return for a re-check if the discharge and/or sneezing recur.


The Earigator: Wound Flushing
September 2013

The Earigator may be used in other ways besides flushing ears. If presented with a bite wound that needs to be flushed under pressure, the Earigator may be used along with DermaFlush(™) Premixed Saline Packets. DermaFlush is a saline crystal packet that when added to water creates a saline solution which can be used anywhere a saline flush may be beneficial, including ears, sinuses, wounds and external surgery. DermFlush will be available in October 2013.

Prior to using the  Earigator to flush a wound, clean and flush the unit and the tubing with a mild bleach solution and water. Then cut the tip off the catheter tipped end of a 10 – 12 Fr red rubber feeding tube to fit the trumpet valve nipple. Fill the Earigator flush bottle with a saline solution made with DermaFlush(™). The catheter can be used, with the fluid under pressure, to snake under the skin and into loose skin or muscle tissue and wash abscesses and fistulated areas. The saline acts as an osmotic agent helping to reduce edema and the pressure provided by the Earigator can help remove debris, such as purulent discharge that may be present in an infected wound.


GlycoZoo Case Study
January 2014

A 5 year-old female spayed cocker spaniel presented for a routine annual veterinary examination. On physical examination, she had grade 2/4 dental disease, a greasy, malodorous coat with generalized scaling and was slightly overweight. The owner reported that that patient was not pruritic but did notice that she smelled badly.

Skin cytology and skin scraping were performed and found to be negative. Blood work (including a thyroid level) and a urinalysis were submitted to the laboratory, and returned normal besides a slightly elevated Alkaline Phosphatase (ALKP), which was attributed to the dental disease. A DTM was also performed and negative results were obtained a few weeks later.

The patient was diagnosed with a mild form of seborrhea oleosa (greasy seborrhea) and was sent home with GlycoZoo Shampoo and Spray Conditioner to be used 2-3 times a week for 3 weeks, until re-check. The owner was instructed to lather, massage, and then allow skin contact time of at least 10 minutes before rinsing the GlycoZoo Shampoo. The GlycoZoo Spray Conditioner is leave-in, dry-on and may be used after bathing (as was done in this case) or alone.

Seborrhea is an inherited disorder of keratinization. Seborrhea (excessive scaling) is associated with abnormal (accelerated) epidermal turnover which gives rise to excessive scaling. Seborrhea oleosa (greasy seborrhea) is typified by greasy skin and haircoat, a malodor, and brown-yellow scales and sebum that clump to the hair and skin.

Keratolytic agents, such as Glycolic Acid, may be used to treat seborrhea complex. Keratolytic agents loosen adhesion between cells in the epithelium and facilitate cell shedding (removal of excess scale).

The patient returned for a dental 3 weeks later and the coat was significantly improved with decreased scaling, and no odor or greasiness appreciated. The Glycolic Acid worked to exfoliate the excess dead skin cells as a result of the seborrhea, and the drying effects of the Boric Acid helped to degrease the skin and coat. Both ingredients helped to remove the odor.

A routine dental under general anesthesia was performed with no extractions and the patient was sent home with T/Edta/C Dental Wipes to maintain a good oral hygiene regimen at home.

The owner was also instructed to use the GlycoZoo Shampoo and Spray Conditioner weekly for maintenance to keep the skin and coat healthy.

What is Glycolic Acid?
Glycolic Acid is the current gold standard in chemical exfoliants available within the human dermatology market. It is a gentle yet effective acid from the Alpha-Hydroxy Acid (AHA) family and derived from sugar cane. It is the smallest molecule of the Alpha-Hydroxy Acid (AHA) family and this is one of reason it’s such a great chemical exfoliant. It dissolves the glue between the dead cells in the upper most layer of the epidermis, which then causes those excess dulling, clogging and unhealthy dead cells to fall off; which is the definition of exfoliation: the removal of dead cells. This information was obtained from, Dr. Neal Schultz, M.D..

GlycoZoo Dermatology Products utilize 2% glycolic and boric acids with ceramides, and are available in shampoo, spray, wipes and otic. GlycoZoo has now introduced the “gold standard of chemical exfoliants” to the veterinary market.

GlycoZoo products may be used for maintenance, deodorizing and also to aid in the topical treatment of seborrhea complex and other conditions where Glycolic Acid and/or Boric Acid may be beneficial. Ceramides aid in restoring moisture to dry and damaged skin.