Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

A 10-year-old Maltese neutered female was presented for lip dermatitis and mild generalised pruritus. On examination, there were multiple lesions affecting the peri-oral and peri-nasal mucocutaneous junctions as well as distal limbs. Serum chemistry and a bile acids test were indicative of hepatocellular injury and hepatic dysfunction. Plasma amino acids were markedly depleted. Ultrasonography of the liver revealed a honeycombed appearance. A CT scan was performed to rule out a porto-vascular abnormality, hepatic or pancreatic neoplasia. Abnormalities in hepatic architecture are described in this confirmed case of hepatocutaneous syndrome (HCS) for the first time on CT. This is the first reported case of HCS in Hong Kong. The dog was treated with a high-quality protein diet and amino acids transfusions. Eleven months after presentation the dog was still alive with good control of clinical signs.http://vetrecordcasereports.bmj.comhj2020Companion Animal Clinical Studie

Rare Generalized Form of Fungal Dermatitis in a Horse: Case Report

A rare case of Geotrichum spp. dermatitis in a horse is presented. After unrelated, previous surgery and antibiotic treatment, a saddle horse showed well-circumscribed areas of non-pruritic alopecia. Suspecting allergic skin disease, the horse was treated with corticosteroids. The skin lesion spread, and a second veterinarian was consulted. At clinical examination, the horse was lethargic, pyretic and hair was shedding/easily epilated over the head, neck, shoulders, and legs and the hind legs were swollen. Blood analysis revealed mild leucocytosis and hyperglobulinemia. Hair, skin scraping, and skin biopsy ruled out parasites and bacteria; cytology identified yeast-like structures with hyphae or pseudohyphae. Geotrichum candidum was isolated on culture. Treatment consisted of stable disinfection, topical application of an antifungal solution, vitamins C and E supplementation and allowing the horse to graze in sunlight for at least 6 h/day. At 3-weeks follow-up, the horse had gained weight, alopecia was decreased, and all other clinical parameters were normal. Antifungal treatment was continued twice a week for three months. This study suggests Geotrichum candidum may cause skin lesions in horses after long-term use of corticosteroids or antibiotics. To avoid unnecessary and prolonged suffering in cases of dermatitis, veterinarians should be promptly consulted, appropriate diagnostic procedures conducted, so that a definitive diagnosis can be reached, and an appropriate treatment regimen implemented