1	Rosebud Intro 18 months old lab mix dermatitis started 6 months ago (in Feb) scratches everywhere and ALL the time therapy Depomedrol injection helped for 1 week
2	“Rosebud” exam $75
3	“Rosebud” 2
4	“Rosebud” 3
5	Problem List Differentials
6	A Pattern Approach 10 common patterns Folliculitis Pododermatitis Otitis Yeast Dermatitis Pruritus Nonpruritic Alopecia Autoimmune Skin Disease Keratinization Defects Lumps, Bumps, and Draining Tracts Weirdopathies
7	2 ?s 2^o Infections Pyoderma Allergies Demodex Atopy Dermatophyte Food Yeast Dermatitis Scabies Otitis Pododermatitis Endocrine Hypothyroid Cushing’s
8	Skin Scrapes $15
9	Cytology $15
10	DTM Fungal Culture $40
11	Wood’s Lamp $? Woods Lamp negative
12	Otoscopy $?
13	Otic Cytology R $15
14	Otic Cytology L
15	CBC $23 CBC WNL
16	Serum Chemistries $43 Serum Chemistries elevated Alk Phos (244) T. protein (8.1) + Albumin (3.0)
17	Urinalysis $18 Urinalysis (free catch) normal
18	IDAT $150 Allergy Skin Test positive to house dust mite
19	IDAT 2
20	Food Trial $120 ($80) Food Trial IVD duck and potato 10 week trial no treats, chew bones, chewable meds
21	Bacterial Culture $43 Skin Culture swab Staphylococcus sp. Resistant to ampicillin, penicillin
22	Otic Culture $43 Otic Culture swab Staphylococcus sp. Resistant to ampicillin, penicillin, cephalosporin
23	Thyroid Testing $47 Total T4 Normal TSH Normal
24	Adrenal Testing $105 ACTH stim Normal LDDST Normal
25	Biopsy $75 Biopsy chronic superficial perivascular dermatitis
26	Diagnosis
27	Diagnosis Pyoderma, Malassezia Dermatitis Otitis Scabies/food allergy/atopy Started at 1 year of age Seasonal ?? – February Steroids – not responsive Ear margins - BAAAD
28	Treatment Treatment Cephalexin, Clavamox, TMS 3 weeks, high dose Otomax bid Malaseb shampoo + Oatmeal/pramoxine conditioner Diphenhydramine (1mg/lb tid) Revolution q 2wks for 3 treatments Food Trial
29	Response 6 weeks later Lesions 95% better Pruritus 98% improved Otitis resolved Owner is pleased as pie
30	Summary Secondary infections Pyoderma Otitis Yeast dermatitis Scabies Food Allergy
31	“Rosebud”
32	Doc Itchy's DDX 2^o Infections Pyoderma Allergies Demodex Atopy Dermatophyte Food Yeast Dermatitis Scabies Otitis Pododermatitis Endocrine Hypothyroid Cushing’s