Nina is a 7y FS Pomeranian who presented for a 3-year history of alopecia sparing the head and paws.
Curtis Plowgian, DVM, DACVD
Animal Dermatology Clinic, Indianapolis, IN
SUBJECTIVE HISTORY:
The first problem that owner noticed was very poor hair regrowth after trimming with clippers at the groomers. Owner had noticed one episode of chewing at one leg, but generalized pruritus was not noted at home. There were no other pets at home, and no people in the house were affected. No people in the house are on any forms of hormone therapy (topical or oral) that Nina could have been exposed to. The primary veterinarian noticed hair loss and suspected allergies or a thyroid condition, but thyroid function was never tested. The veterinarian gave an 8-month course of Apoquel, but the owner didn’t notice any improvement with this. Cytopoint was discussed but declined by the owner. Revolution is given monthly for flea and heartworm prevention. Nina is bathed once a month, and the owner has tried to increase bathing, but this doesn’t seem to change the skin or coat quality at all. Nina is fed Hills for small breeds, and there are no digestive abnormalities — no gas or borborygmus noted.
EXAM FINDINGS
BARH, BCS 5/9. Generalized patchy, moth-eaten alopecia sparing the head and paws. Bilateral medial patellar luxation (more pronounced on the right), erythema on the right stifle and tarsal varus of the right rear limb.
DIAGNOSTICS ADVISED
Cytology (trunk, flanks): Keratinocytes with TNTC melanin granules but no organisms
UT Adrenal Panel (results 2 weeks):
|
Test |
Result (baseline) |
Normal Range |
Result (Post-ACTH) |
Normal Range |
|
Cortisol (µg/dL) |
6.5 |
<1.0-5.9 |
10.8 |
6.5-17.5 |
|
Androstenedione (ng/mL) |
2.15 |
0.05-0.57 |
5.30 |
0.27-3.97 |
|
Estradiol (pg/mL) |
59.7 |
30.8-69.9 |
46.9 |
27.9-69.2 |
|
Progesterone (ng/mL) |
0.73 |
<0.2-0.49 |
1.86 |
<0.2-1.5 |
|
17OH Progesterone (ng/mL) |
1.38 |
0.08-0.77 |
7.23 |
0.4-1.62 |
|
Testosterone (ng/mL) |
<15.0 |
<15-32 |
<15 |
<15-45 |
ASSESSMENT
Sex Hormone Alopecia and Hair Cycle Arrest (Alopecia X)
IF YOU ARE VET : To read the full text, please register at the upper right of the website. ThanksREFERENCES
- Miller WH, Griffin CE, Campbell KL. Muller and Kirk’s Small Animal Dermatology. 7th Philadelphia, PA: Saunders, 2013; 537-540.
- Cerundolo R et al. Treatment of canine Alopecia X with trilostane. Vet Dermatol, 2004; 15:5, 285-293.
- Diamond J et al. A small scale study to evaluate the efficacy of microneedling in the presence or absence of platelet-rich plasma in the treatment of post-clipping alopecia in dogs. Vet Dermatol, 31:3, 214-e45.