Tässä sitten se patologin lausunto sellaisena, kuin se meille tuli. . . oivallinen tapa verestää englannin-taitoa ja vähän vaihtelua niihin näytelmä-arvosteluihin .

Description

Number of biopsies examined - 3. The epithelium is hyperkeratotic and acanthotic with rete elongation. There is very marked exocytosis of lymphocytes but minimal keratinocyte damage. Similar pathology is present in follicular infundibula. The papillary dermis has a dense, band-like infiltrate of almost entirely lymphocytes with a few neutrophils. Similar infiltrate is present around follicles. No Demodex, bacteria, fungi or yeasts seen.

Morphological diagnosis

Hyperkeratosis. Band-like superficial dermatitis.

Aetiological diagnosis

The pathology is consistent with mucocutaneous (lip fold and nasal) pyoderma, confirming your clinical diagnosis.

Comments

One in four cases of similar disease on the nose respond completely to antimicrobials. More than half also need anti-inflammatories (topical cyclosporine, betnovate, tacrolimus 0,1% or Optimmune eyedrops an sunscreen) for prolonged remission - but three weeks antibiotic is recommended before adding anti-inflammatories. Cases that respond to antibiotics alone are not distinguishable clinically or histologically from those that also need anti-inflammatories. Tacrolimus stings.

The history is interesting. This dog has far more lymphocytes and much more exocytosis than most dogs so I would expect it to require anti-inflammatories. The lack of response to steroids is surprising - but perhaps there was too much infection at that stage. You may get a response with anti-inflammatories now.

Karenssi-aika on 28vrk anti-inflammatori-hoidon jälkeen ja kun tuota antibioottia annettiin taas lisää, niin eipä tarvitse paljon pohtia, osallistuako mihinkään tai sitten ei . Näillä näkymin siis menee ainakin tuonne syyskuun lopulle ennenkuin voidaan taas palata ihmisten (tai koirien) ilmoille. Vielä meidän täytyy ainakin kerran käydä eläinlääkärin vastaanotolla ennen terveeksi julistamista. 

Onneksi tuo koira ei koe itseään millään tapaa sairaaksi. Nyt kun on tikeistä päästy, niin arkielämä voi olla ihan normaalia .