SEBACEOUS ADENITIS MEANS INFLAMMATION OF THE SEBACEOUS GLANDS
WHAT DOES AN AFFECTED DOG LOOK LIKE?
This depends a great deal on whether the hair is short or more plush/fluffy. The condition is generally not itchy unless there is an accompanying Staphylococcal infection.
For short-haired dogs, a fine white dandruff begins on the head and ears which ultimately progresses to the whole body. Scaling areas have a tendency to be round or S-shaped. For long haired or plush-coated breeds, the scale is most obvious as a clump of dandruff sticking to a group of hairs. The coat is dull and brittle and tends to develop a reddish tint. In time, bald spots develop. Again, usually the head is where problems start.
For these breeds, a fine white dandruff begins on the head and ears which ultimately progresses to the whole body. Scaling areas have a tendency to be round or S-shaped.
Fluffy or Plush-coated dogs
In these breeds, the scale is most obvious as a clump of dandruff sticking to a group of hairs. The coat is dull and brittle and tends to develop a reddish tint. In time, bald spots develop. Again, usually the head is the area where problems start.
BIOPSY IS REQUIRED FOR DIAGNOSIS.
Response to therapy largely depends on whether there are still living sebaceous glands present in the biopsy sample or not. If there are no glands left and they have all been destroyed, it will be much harder to get a response though it is possible for glands to regenerate with treatment. The inflammation that destroyed (or is destroying) the sebaceous glands must be stopped. Further, new hair growth depends on a coat of sebum (skin oil) so if the patient's skin is not making adequate skin oil, the oil must be replaced.
Oil replacement treatments are performed frequently at first and taper down to less frequent applications after the first month. Every dermatologist seems to have their own preferred regimen so here are some typical recommendations:
Mineral oil, mineral bath oil (such as Alpha Keri®) or propylene glycol mixed with water, sprayed onto the coat or affected area of the coat, rubbed in, and shampooed out with a degreasing shampoo after a one hour soak. This is performed typically once a week for the first month then as needed. Many specialists add an oral cyclosporine product to the topical treatment and report greater success. Phytosphyingosine-containing products (such as those in the Douxo® line) enhance the barrier function of the skin and are being used instead of the oil soaks. Omega 6 fatty acid topicals (such as Dermoscent-6® by Allerderm) are also becoming more popular as an easy way to replenish skin oil as they are easily applied as a top spot.
Oral omega 3 fatty acids are almost always included in the treatment regimen of this disease. Vitamin A has been advocated for sebaceous adenitis but seems to be fading out of popularity with the advent of other oral treatments (see below).
Cyclosporine seems to be at the heart of treatment for the more severely affected dogs; further, on cyclosporine, dogs with only 2% of their sebaceous glands left have been able to increase this number to 40%. Cyclosporine is an immunomodulator which is able to suppress the inflammation that is destroying the sebaceous glands. Many patients are able to discontinue this medication after a couple of months but there is no way to determine from the beginning which patients will need on-going low dose therapy and which ones will be able to stop treatment.
Synthetic retinoids have held a great deal of promise in the treatment of sebaceous adenines but they are tightly regulated by the government and are not readily available for veterinary patients.
Immunomodulation with doxycycline is an emerging therapy but still in the investigational stage. Doxycycline is first and foremost an antibiotic but has numerous immunomodulating properties as well and is used widely in the treatment of immune mediated disease.
Page posted: 4/17/2008