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Skin and ear disease can represent a variety of different disorders. The good news is that the problem is often literally on the surface. This allows for direct observation of lesions and for diagnostic tests to be performed in a quick and typically painless way. Veterinary dermatologists and the staff at Animal Dermatology Clinic are trained in evaluating these tests on site, in our laboratory to provide results in minutes instead of days. This allows more rapid and accurate decisions on the right course of treatment instead of waiting for test results that may be sent to outside laboratories.
Tests performed during a typical examination may include: impression smear cytology, superficial or deep skin scrapes, trichography, fungal cultures and in house blood tests. Depending on the individual pet’s presentation of symptoms, a skin biopsy and dermatopathology reading may be recommended and scheduled.
Diagnostic cytology, also called impression smear cytology, is a common diagnostic test that is used to determine the presence of bacteria, yeast or other infections, inflammation and neoplastic (cancer) cells, and alert the dermatologist to other potential disease processes. Samples for diagnostic cytology are often collected by cotton swab, direct smearing of a glass microscope slide, use of clear tape to collect samples, or in some cases fine needle aspirate to obtain samples from a mass or lesion beneath the skin.
By performing this test in-house, veterinary dermatologists can obtain valuable information about a patient or condition while the pet is in the office. This allows for more accurate diagnosis, better decision making on therapies and better patient outcome in managing problem skin diseases.
The Value of Cytology
Cytology, impression smear cytology or diagnostic cytology is a non-invasive method that can provide tremendous value, especially in the diagnosis and reassessment of skin and ear diseases. Cytology is the process of obtaining samples from a patient in order to examine those samples under a microscope to provide more information and evidence of a particular problem. In skin and ear disease, this is especially useful in diagnosing infections but may also be helpful for initial assessment of some immune mediated diseases and certain types of cancer.
Ear cytology is a test performed most often by using a cotton swab to gather material and debris from the ear canal. This material is then spread onto a microscopic slide, stained in a laboratory and examined under a microscope. This test often provides significant information about the type and degree of infection present in an ear.
Cytology, impression smear cytology or diagnostic cytology is the process of obtaining samples from a patient in order to examine those samples under a microscope to provide more information and evidence of a particular problem. Samples may be obtained with a cotton swab, by rubbing a microscope slide on an area being sampled or by using other instruments such as blades or forceps to obtain samples. Samples are then stained and examined under a microscope.
Cytology, impression smear cytology or diagnostic cytology samples, may be examined right away by some veterinarians, especially in a veterinary specialist’s office such as a dermatologist, making results available during the appointment time. For others, samples may be submitted to an outside laboratory. If so, results may take 1-3 days.
Cytology, impression smear cytology or diagnostic cytology, involves the collection of material from a particular patient. This material is then examined microscopically. It's value or accuracy depends on the disease or problem being evaluated, the sample that can be obtained and the experience of the observer. For example, cytology can be very accurate in diagnosing a bacterial or yeast infections, but is not the diagnostic tool of choice for diagnosing skin cancer.
Cytology, impression smear cytology or diagnostic cytology, is performed by obtaining samples from a patient and examining those samples under a microscope to provide more information and evidence of a particular problem. Samples maybe obtained using a cotton swab, by rubbing a microscope slide along areas of interest or using other instruments to collect material. It is typically a non-invasive procedure. Once collected, material is examined under a microscope to look for evidence of infections, type of inflammation, immune mediated disease or neoplasia. Cytology is often performed by specialists such as clinical pathologists at outside labs or in-house by veterinary dermatology specialists.
No, cytology is less invasive than biopsy. Cytology or impression smear cytology involves the collection of material from a particular patient that is often from the surface of skin or other lesions. Biopsy is instead the process of obtaining a small piece of tissue from an area of disease in order to submit that tissue for processing and examination by a histopathologist. Cytology is often done in-house by veterinary dermatologists with results delivered during an exam while others may send these samples to an outside lab.
Skin scrapes are another useful tool often performed by veterinary dermatologists. Unlike cytology, skin scrapes are performed by using a dulled scalpel blade to scrape along the surface of the skin to collect material for examination under the microscope. Material is placed onto a microscope slide with a small amount of mineral oil and is examined closely for evidence of parasites. Skin scrapes are used primarily to look for mites including Demodex or the mites that cause Scabies.
Demodex mites commonly live within hair follicles of the skin and may cause inflammation, hair loss scaling and secondary infections. Since these mites live below the surface of the skin, a “deep” skin scrape is needed to identify them. Deep skin scrapes are often performed in relatively small areas (approx. 1 cm diameter) and typically leave a small superficial abrasion, indicating that the scrape has been done deep enough to find the mites.
Superficial skin scrapes involve a broader sweeping scrape done over a larger surface area. This type of scrape is designed to collect surface crust and skin cells and often leave little external evidence that it was performed. Superficial scrapes are used to look for Sarcoptes and other surface mites that may cause inflammation and in many cases intense itching and scratching. Unlike Demodex mites, parasites found on superficial skin scrapes may be elusive with only a few present in a given area making them difficult to find.
Skin scrapes can be a game changer since finding mites can dramatically alter the course of treatment and often leads to much more rapid resolution of skin disease and discomfort.
A skin scrape is a simple and incredibly valuable in-house test performed by veterinary dermatologists primarily to look for microscopic parasites. These include especially the causes of “mange”, suchas Demodex and Sarcoptes mites. Results are available during the visit and may results in an immediate diagnosis and the right treatment plan.
A skin scrape is a common test performed by veterinary dermatologists. It is performed by using a scalpel blade or other scraping utensil to scrape along the surface of the skin in order to collect material for examination under a microscope. Superficial skin scrapes are often done when a veterinarian is looking for Sarcoptes or Scabies mites or other surface parasites. A deep skin scrape is done in a much smaller area (often ~1 cm) and produces a small abrasion when completed. This type of scrape is performed to look for Demodex mites, which live deeper in hair follicles.
Trichography is the microscopic examination of hairs. Normal hairs of animals have well documented appearance and structure. By plucking hairs from an animal with skin or haircoat disease, a veterinary dermatologist can evaluate the hairs and look for evidence of infection, trauma or malformation. This can also identify parasites like Demodex that live within the hair follicle.
A trichogram or trichography is the microscopic examination of hairs. A trichogram is performed by plucking hairs, often placing those in a small amount of mineral oil and then examining them under a microscope. By examining hairs from an animal with skin or hair coat disease, a veterinary dermatologist can evaluate the hairs and look for evidence of infection, trauma or malformation of hairs. Occasionally, this will also identify parasites like Demodex that live within the hair follicle.
Dermatophytosis (ringworm) is a fungal infection of the hair, superficial skin, and occasionally nails. It’s not caused by a worm and often lesions are not in rings. Dermatophytosis is instead caused by infection with one of three species of fungal organism: Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes.
Common sources of infection include infected pets, rodents, contaminated environments, and occasionally the soil. While less common than many other skin diseases, dermatophytosis is a contagious and zoonotic disease that can in some cases be transmitted to humans. This makes it an important disease to assess and diagnose when the index of suspicion is high. Methods for diagnosing dermatophytosis include fungal culture, PCR testing and on occasion skin biopsy. In some cases, fungal spores may be identified on impression smear cytology raising the suspicion of dermatophytosis. Woods lamp examination may also increase suspicion of dermatophytosis.
If a veterinary dermatologist feels it is appropriate to test for dermatophytosis, most often he or she will collect hair and skin samples from the area(s) involved for one of these tests. Identification of the specific fungal organism responsible for skin lesions via fungal culture is the most reliable of these methods. Fungal cultures often take 14 to 21 days to complete to allow identifiable fungal organism growth.
When treating a pet for dermatophytosis it is imperative to treat the animal beyond clinical cure, when no further lesions can be seen. To confirm that the infection has been completely resolved a fungal culture is typically repeated to confirm successful therapy.
Dermatophyte, or dermatophyotisis (ringworm), is a fungal infection of the hair, superficial skin, and occasionally nails. It is not caused by a worm and often lesions are not in rings. Dermatophytosis is instead caused by infection with one of three species of fungal organisms: Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes.
A diagnosis of dermatophytosis is made by finding and identifying the fungal organism responsible for the disease. Diagnostic methods include fungal culture, PCR testing and on occasion skin biopsy. In some cases, fungal spores may be identified on impression smear cytology raising the suspicion for dermatophytosis. Woods lamp examination may also increase suspicion of dermatophytosis.
To perform a fungal culture, a veterinary dermatologist may obtain hair and skin samples that are then incubated on fungal culture media. These cultures are then monitored for growth and any growth is examined microscopically for diagnosis. Fungal cultures may become positive as quickly as 3-5 days in some but in other cases may need 14 to 21 days for final results.
Dermatophyte Test Media (DTM) is a common culture plate used to grow the fungal organisms that cause dermatophytosis (ringworm): Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes.
Dermatophyte infection (dermatophytosis, ringworm) is a fungal infection of the skin, hair follicles and occasionally nails. It is treated with antifungal medications such as itraconazole or terbinafine often combined with frequent topical cleaning and bathing with antibacterial/antifungal shampoos. The exact treatments used for a case may vary depending on the degree and severity of the infection, areas involved and the condition of the patient. It is important to have a specific and accurate diagnosis of this infection prior to treatment and to consult a veterinarian or veterinary dermatologist on the right approach for each pet.
YES! Ringworm (dermatophytosis) can be a contagious infection and in some cases be passed from cats or dogs to their human companions. However, this is extremely variable depending on the specific type of infection, areas of infection on the pet and the individual susceptibility of the person. Because other types of infections often look like ringworm it is important to make an accurate diagnosis of dermatophytosis before pursuing treatments for the pet or the pet owner.
Skin disease in animals can sometimes be an external marker of an internal problem. Examples include disease such as Hypothyroidism, Cushing’s disease and others. For these conditions, information provided by bloodwork or urinalysis can be vital to reaching a diagnosis and directing a proper course of treatment. Animal Dermatology Clinics perform many blood tests in our in-house laboratory, providing more rapid information and diagnosis.
Blood and urine tests in animals may help us understand a variety of body systems. Laboratory tests run on blood and urine may provide information on liver and kidney function, anemia, thyroid function and many other systems. These tests provide valuable information on what is happening on the inside that can’t be readily assessed from the outside. Periodic blood and urine tests may also detect early disease processes before outward symptoms are noted.
Urine testing (urinalysis) can provide information that often helps to expand the understanding or information provided from blood tests. Urinalysis is not better or worse than blood testing, but instead helps to provide more comprehensive information when combined with blood testing.
Timing on blood test results depends on the type of test being run. Some tests may be run in-house in veterinary practices making test results available during the visit, while others may be submitted to an outside laboratory. If sent to an outside lab, results are typically available within 1-3 days, again depending on the type of test being performed.
To perform a biopsy is to surgically remove a portion of diseased skin, tissue or tumor in order to further analyze this tissue and understand the disease process more completely. For some skin diseases, this is the only accurate way to differentiate one disorder from another and can be the difference between accurate diagnosis and the wrong direction.
To perform a skin biopsy, most animals are sedated or anesthetized and often a local anesthetic is used to provide further anesthesia and pain control. Many skin biopsies are performed using a “punch” biopsy instrument - a small circular blade that may vary from 4 to 8 mm. Use of a biopsy punch allows a small sample to be obtained from areas of concern and are often sutured with a single stitch.
What happens to biopsy skin or tissue after this procedure is performed is of equal importance as the procedure itself. Animal Dermatology Clinic is fortunate to have an in-house dermatopathology service to interpret findings from the biopsy once the tissue has been processed. Dr. Wayne Rosenkrantz, DVM, DACVD, and Dr. Kelly Keating, DVM, DACVP provide dermatopathology interpretation services to both Animal Dermatology Clinic dermatologists, and other specialists and general practitioners. For veterinarians interested in learning more about this service, click here.
Dermatology is the study of clinical skin disease while dermatopathology is the microscopic study of skin disease. When your pet is examined by a veterinary dermatologist, he or she may take a biopsy (skin or tissue sample) and submit it to a dermatopathologist for analysis. The microscopic exam of skin and tissue samples at the cellular level often provides more in-depth information about the disease process occurring for a particular disorder. Different from other pathologists, a dermatopathologist is specially trained in and specializes in diseases of the skin.
Skin biopsy is the process of obtaining a piece of skin or lesions associated with the skin in order to better understand the disease process or infection that is present. While some skin diseases can be diagnosed based on appearance alone, others require a more in depth analysis of the changes that are occurring. By obtaining a sample of the skin, it can be observed in cross section in its entirety often providing a much better understanding of the problem.
Skin biopsy is performed in order provide a more accurate diagnosis and more detailed description of skin disease, infection or growths and tumors. For some diseases it may be the only way to arrive at the correct diagnosis and provide more accurate treatment options.
Skin biopsy is typically an easy outpatient procedure. Since it involves surgically removing a small sample of the skin or the lesion being evaluated, pets are usually sedated and a local anesthetic used to numb the area. Most biopsy samples are 5 to 8 mm in diameter and often have only one suture. After care is typically minimal and pets don’t typically experience any pain from the biopsy sites.
Results from biopsies may take 1-3 weeks to return. When samples are obtained, they are placed in a preservative and sent to a laboratory for processing and tissue staining. The samples are then forwarded to a dermatopathologist for review and analysis. Once findings are recorded by the dermatopathologist they are forwarded to the veterinary dermatologist for review and further treatment decisions. In some cases, special stains or advanced analysis may be needed and may require additional steps and time.
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