Presentasi Studi Kasus

Canine Scabiosis
Selasa, 24 Januari 2023
19.00 – 21.00 WIB

Drh Gagas Adyatama

General Practicioner at Pet Derm Clinic, BSD

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Sinyalmen
Nama : Molly
Jenis, ras : Dog, Mini Poodle
Jenis Kelamin :
Warna : Black
Umur : 10 bulan

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Anamnesis (11 Januari 2023)
• Baru di-rescue dari breeder
• Sedang di-foster, sudah 2 minggu
• Tempramen/sikap: sangat aktif, namun
sangat gatal, nangis kalau ditinggal
• Makan: biasa diberi RC recov, app menurun
2 hari ini
• Minum: ok
• Pup: ok (tidak ada keluhan)
• Pipis: ok (tidak ada keluhan)
• Vaksinasi: sempat sekali saat di breeder,
tidak ada buku
Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023
• Rambut sempat dibotakin semua
• Kontrol parasit: belum
• Mandi: belum
• Populasi di rumah: 5, tidak ada yang
menunjukkan gejala yang sama
• Outdoor
• Sudah dilakukan pemeriksaan dokter, Dx tidak
ada informasi, Pengobatan sudah diberikan:
sulfa-tri, vitamin (?): 7d. Belum ada respon
perbaikkan kondisi
Pemeriksaan Fisik
• Berat: 1.9 kg
• Suhu: 39 oC
• Tempramen/sikap di klinik: cukup aktif, ragu-
ragu, sangat gatal
• BCS: 4/9
• Hidrasi: good
• Membran mukosa: pink rose licin

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

• Alopecia multi focal diffuse(periocular, ventral leher-inguinal, elbow depan, lateral thorax-abdomen, )
• Erythema + excoriation
• Crusty (kuning, merah) scally multifokal

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis Banding
• Scabiosis
• Flea infest
• Demodicosis
• Superficial pyoderma (sekunder)
• Fungal infection (sekunder)
• Allergy (FAD, FA, CAD), Cross-
sensitisasion with house dust mites

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Pemeriksaan Lanjutan:
• Pinnae-Pedal Reflex: positif
• Lumbal scratch: negatif
• Trichogram: anagen-catagen masih
dominan, folicullar cast, hs broken, no artsp,
no ekto
• Superficial skin scraping (elbow): scab

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis
• Scabiosis
• Superficial pyoderma (sekunder)

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Treatment
Nama Sediaan Indikasi Pemberian
NexGard Spectra (Afoxolaner, Milbemycin • Antitungau Per 4 minggu
Oxime)
Prednison 5 mg/tab • Antipruritus S2dd 0.5 tab 7d
Rilexine (Cephalexine 75 mg/tab) • Antibiotik S2dd 1 tab 7d
4Life Transfer Factor (TF min) • Suplemen imun S2dd 1 cap 14d
Megaderm (fatty acids) • Suplemen kulit dan S1dd 4 mL 14d
rambut
• Antiinflamasi

Techno De (HOCl) • Antiseptik S2dd all body

Techno De Shampoo • Antiseptik 1x seminggu

Proplan Puppy • Makanan reguler

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Follow up
21 Januari 2023 (10d)
• Pruritus masih ada, namun
sangat berkurang
• Lesio membaik, kulit melembut.
Scale masih ada: elbow

• PPR masih positif

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Canine Scabiosis/Sarcoptic mange/Kudisan
Parasitologi
• Sarcoptes scabiei var. canis
• Obligate parasites
• can survive and occasionally establish in non-canine hosts
• Mites can survive of a canine host for up to 21 days
• lives in the stratum corneum (horn layer) of the skin and feeds on cell fluid
• Completion of the mite life-cycle, egg to adult, has been estimated at 15 to 21 days

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Canine Scabiosis/Sarcoptic mange/Kudisan
Epidemiologi
 Non-seasonal
 Highly contagious
 Zoonotic
 Globally
 WHO: Human neglected tropical diseases

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Canine Scabiosis/Sarcoptic mange/Kudisan

Patogenesis:
1. Direct/indirect contact
2. burrowing activity and mechanical damage
3. irritant action of their secretions and excretions
4. allergic reactions to some of their extracellular products
5. Secondary infection
6. App loss, malnutrition
7. Death

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis
Signalment:
 all ages
 all breeds
 all sex
 overcrowded areas may be at increased risk

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis
Gejala Klinis:
 Pruritus (intense)
 Distribution on bridge of nose, face, pinnae, paws, and tail
 Appetite slightly decrease
 Mild fever
 anorexia, depression, emaciation, dehydration, secondary bacterial infection

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis
Lesio:
 Distribution on bridge of nose, face, pinnae, paws, and tail
 Scale
 Scabs/scale (hyperkeratosis)
 Alopecia
 inflammation of the ears, head, and feet, lichenification
 peeling skin
 Excoriation
 secondary infection

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

 Figure 1: Initial physical examination.
Extensive alopecia and poor body
condition (a); close view of the head:
alopecia, erythema, crusts, and scaling
localised mainly on the convex aspect
of the pinna and muzzle (b). Self-
inflicted lesions associated with
alopecia, papules, and thick crusts on
the shoulder and elbow (c). Alopecia,
erythema, and thick scaling/crusting on
the distal part of a hind leg (d). Least-
affected dogs only showed alopecia on
the pinnae and face (e).

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Diagnosis
Microskopis:
 Superficial skin scraping
 Morris and Dunstan observed that >50% of skin scrapping can be negative in dogs
 Due to the low sensitivity of the skin scraping technique, a few mites or eggs may have been missed at
the one-month examination

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Tindakan dan Teraapi
Scabicidal
 ensure that eggs hatching subsequent to treatment do not produce viable larvae
 all in-contact hosts (including non-canine hosts) must be efectively treated
 Oral/spot-on: isoxazoline such as afoxolaner, fluralaner, and sarolaner. Lotilaner
 at least two treatments with monthly re-dosed isoxazolines are required to potentially achieve
parasitological cure

 Fluralaner: All mites were eliminated within 4 weeks following a single treatment; all negative 14
days after receiving orally administered furalaner
 oral sarolaner, the parasitological cure rate was 88.7% at 30 days following the frst treatment and
100% at 30 days following the second treatment
 Sarolaner effective within 14 days of dose against nymphs, larvae, and adults, with over 99% efficacy
by week 2 and 100% reduction by week 4
 afoxolaner. parasitological cure was achieved after 56 days (2 treatment to obtain 99% ). slower speed
 Imidacloprid + moxidectin

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023
Tindakan dan Teraapi
Antipruritus
 Oclaticinib at 0.5 mg/kg PO s2dd for 14 days followed by s1dd for another 14 days. a significative
decrease in pruritus within 24 hours

Antibiotik
 Prn, Broad-spectrum (secondary infection)

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Antipruritic yang direkomendasikan:
• Oclaticinib efective within 24h, short course
• Oral gc, short (max 5d)
• Terbinadine (mild-moderate)
• Lokivetmab (initial)

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Tindakan dan Teraapi
Antiseptik/Mandi
 2-3x sehari (spray/wipes)
 Pyrethrin shampoo

Fluid therapy
 Prn

Skin nutrition
 Prn: fatty acid (antiinflam, barrier)

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023

Evaluasi Pengobatan
• elimination of mites may take longer than 1 month. most likely due to re-infestation from fomites
• It is possible that dead mites remaining in the skin continue to induce local irritation or
hypersensitivity
• absence of mites on multiple scrapings at the end of the 84-day study, combined with resolution of
skin lesions and pruritus supports the conclusion that parasitological cures were achieved
• If skin lesions fail to improve after 3–4 weeks of therapy, skin culture and/or biopsy may be indicated

Studi Kasus: Canine Scabiosis. Drh Gagas Adyatama. Januari 2023