CASOS CLÍNICOS CLÍNICA DE PEQUENOS ANIMAIS

Caso clínico 1.

Canino SRD macho 2 meses de idade, adotado de canil, apresenta quadro tegumentar representado por: alopecia, eritema, escamas cutâneas e crostas melicéricas aderidas em face. Ainda apresenta ao longo dos membros e dorso, nódulos violáceos com eliminação de material pio-sanguinolento.

Foi realizado EPRC: positivo para Demodex canis

Diagnóstico: demodiciose com piodermite profunda secundária

RESOLUÇÃO:

Caso 2. 

Fel, Persa, 3 anos de idade com alopecia disseminada, pelame facilmente avulsionável e escamas cutâneas por toda extensão corpórea. Realizado cultivo fúngico: crescimento de Microsporum canis. Diagnóstico: dermatofitose disseminada

RESOLUÇÃO

Caso 3. Fel, SRD, 20 dias de idade. Áreas alopécicas circulares com deposição de escamas cutâneas. Realizado cultivo fúngico: crescimento de Microsporum canis. Diagnóstico: dermatofitose

Caso 4. Fel, SRD, 4 anos, com presença de lesões ulceradas em face e densa deposição de crostas hemáticas. Realizada citologia: presença de leveduras. Diagnóstico: esporotricose

Caso 5. Can, SRD, 4 meses, prurido intenso e lesões cutâneas hiperqueratóticas em bordas de pavilhões auriculares. EPRC: positivo para Sarcoptes scabiei var canis. Diagnóstico: escabiose (sarna sarcóptica).

Caso 6. Can, Shihtzu, 3 anos, com quadro tegumentar representado por pústulas, crostas melicéricas com halo eritematoso, por toda a extensão corpórea. Diagnóstico: piodermite superficial

RESOLUÇÃO

Amikacin 15–30 mg/kg i.v., i.m. or s.c. once daily Useful for treatment of multidrug-resistant organisms. Potentially nephrotoxic and ototoxic. Avoid in animals with renal insufficiency* Amoxicillin–clavulanate 12.5–25.0 mg/kg p.o. twice daily Cefalexin, cefadroxil 15–30 mg/kg p.o. twice daily Cefovecin 8 mg/kg single s.c. injection Pharmacokinetic data are available to support the use in dogs with duration of 14 days. Repeat injection after 14 days in most cases if infection is not resolved and to meet the criterion for treatment to 7 days beyond resolution Cefpodoxime proxetil 5–10 mg/kg o.o. once daily Chloramphenicol 40–50 mg/kg p.o. three times a day Reserved for multidrug-resistant infections with few other options. Myelosuppression can occur, particularly with long-term therapy. Vomiting is frequently encountered. Avoid contact by humans because of rare idiosyncratic aplastic anaemia. Wearing of gloves by owners handling the drug is essential Ciprofloxacin 25 mg/kg p.o. once daily Sometimes used because of lower cost than enrofloxacin. Lower and more variable oral bioavailability than enrofloxacin, marbofloxacin and orbifloxacin76. Difficult to justify over approved fluoroquinolones. Dosing recommendations are empirical Clindamycin 5.5–10 mg/kg p.o. twice daily If there is erythromycin resistance with clindamycin susceptibility, the D-test should be performed (or molecular methods for detection of erm genes) to determine likelihood of clindamycin resistance Doxycycline 5 mg/kg p.o. twice daily or 10 mg/kg once daily Enrofloxacin 5–20 mg/kg p.o. once daily Lincomycin 15–25 mg/kg p.o. twice daily Gentamicin 9–14 mg/kg i.v., i.m. or s.c. once daily Potentially nephrotoxic. Avoid in animals with renal insufficiency* Marbofloxacin 2.75–5.5 mg/kg p.o. once daily Minocycline 10 mg/kg p.o. twice daily Pharmacokinetics and dose in dogs have not been evaluated; recommended to be prescribed as per doxycycline Orbifloxacin 7.5 mg/kg p.o. once daily Ormetoprim–sulfadimethoxine 55 mg/kg on first day, then 27.5 mg/kg p.o. once daily Concerns regarding idiosyncratic and immune-mediated adverse effects in some patients, especially with prolonged therapy. If prolonged (>7 day) therapy is anticipated, baseline Schirmer’s tear testing is recommended, with periodic re-evaluation and owner monitoring for ocular discharge. Avoid in dogs that may be sensitive to potential adverse effects, such as keratoconjunctivitis sicca, hepatopathy, hypersensitivity and skin eruptions Pradofloxacin 3.0 mg/kg p.o. once daily Rifampicin 5–10 mg/kg p.o. twice daily May cause red/orange urine, tears and saliva. Hepatotoxic. Associated with rapid development of resistance. Trimethoprim–sulfadiazine or sulfamethoxazole 15–30 mg/kg p.o. twice daily See comments for ormetoprim–sulfadimethoxine above

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