THERAPEUTIC MANAGEMENT OF CONCURRENT MALASSEZIASIS AND HYPOTHYROIDISM IN A DOG

Asmita Narang1, Niddhi Arora2 and V.S. Rajora3
1M.V.Sc. Student, 2Associate Professor and 3Professor; Department of Veterinary Medicine; College of Veterinary and
Animal Sciences; G.B. Pant University of Agriculture and Technology, Pantnagar-263145, U.S. Nagar (Uttarakhand).
[Received: 01.5.2017; Accepted: 21.11.2017]

A three years old female Labrador was presented to the Department of Veterinary Medicine, Pantnagar with a
history of alopecia, heat seeking behaviour, pruritis and obesity. Gram staining revealed numerous yeast like
polymorphous spores. Serum T3 value and T4 value was 0.32 ng/mL and 1.1 μg/dL respectively. Based on findings,
the condition was diagnosed as hypothyroidism with Malassezial dermatitis. The dog was treated with ketoconazole @ 10 mg/kg BW once orally and bathed with a shampoo containing 2% miconazole nitrate and 2% chlorhexidine
gluconate. For hypothyroidism the dog was given Levo-thyroxine sodium tablet @ 20 μg/kg b.wt. SID orally for about 2 months. The dog showed improvement as there was regression of clinical symptoms.
Key words: Dog, Hypothyroidism, Levo-Thyroxine, Malasseziasis.

Malassezial dermatitis in animals occurs with allergies, endocrinopathies (hypothyroidism, Cushing’s disease),
immunosuppressive and other skin disorders. Hypothyroidism is a common canine endocrinopathy. Thyroid hormone is needed for initiation of anagen hair follicles, regulation of cornification process and sebaceous gland secretion (Jackson and Marsella, 2012). Most of the dermatological abnormalities in dogs with hypothyroid are
curable. Oral levothyroxine is the drug of choice for hypothyroidism (Feldman and Nelson, 1996), whereas a combination of topical as well as systemic antifungal therapies are effective in Malasseziasis. The therapeutic management of concurrent Malasseziasis out of hypothyroidism was successfully managed with the help of Levothyroxine sodium, ketoconazole and topical antifungal in the present case.
A 3 years old female Labrador was presented to the Department of Veterinary Medicine, College of Veterinary and Animal Sciences, Pantnagar with a history of alopecia, heat seeking behaviour, pruritis, seborrhea and obesity. Lesions were confined to the ventral side of the body mainly neck, inguinal and peri-anal areas. The dog was
previously treated with antibiotics, corticosteroids, antihistaminics and mineral supplement with slight improvement. On clinical examination the conjunctival mucus membranes were normal, respiratory rate 32/min, heart rate 82/min, and rectal temperature was 102.40F.
Physical examination of the skin revealed erythema, greasy scales, crusts and strong rancid odour. Skin scrapping was found negative for mites. Moreover potassium hydroxide preparation from skin lesions showed no fungal elements and skin scrapings were also found negative for fungal culture. However, Gram staining revealed
numerous Gram-positive, yeast like polymorphous spores. Serum biochemistry revealed normal glucose levels (90 mg/dl) whereas the serum T3 value was 0.32 ng/ml and T4 values was 1.1 μg/dl which was found to be considerably below normal. Based on clinical signs, lesions on skin and the biochemical values the dog was diagnosed to
be having hypothyroidism with concurrent Malassezial dermatitis.
The dog was treated with ketoconazole @ 10 mg/kg BW once orally and bathed with a shampoo containing 2%
miconazole nitrate and 2% chlorhexidine gluconate twice a week for three weeks. To manage hypothyroidism, the dog was given Levo-thyroxine sodium tablet @ 22 μg/kg b.wt. SID orally for about 2 months with significant success. The owner was advised to continue L-thyroxine to the dog for the rest of life.
In the present report, the dog having concurrent malasseziasis and hypothyroidism  was successfully cured with oral Levo thyroxine sodium and a combination of topical and systemic antifungal therapy. This dog with T4 concentration below normal indicated hypothyoidism, responsed to treatment with levothyroxine; confirmed the
diagnosis. Concomittant with Kumar and Srikala (2013) report of hypothroidism in 49 dogs of various breed, age and sex with successfull management of the affected dogs y Levothyroxine and other specific drugs without recurrence.
Malasseziasis that occurs due to the proliferation of yeasts possibly promoted by excessive sebum production or disruption of the epidermal barrier resulting in hypersensitivity diseases (atopy, adverse cutaneous food reactions, flea bite hypersensitivity and contact allergy), cornification disorders, ectoparasite infection, bacterial pyoderma and endocrine diseases as hyperadrenocorticism, hypothyroidism and diabetes mellitus; as also reported by
Outerbridge (2006). It has been doccumented that thyroid hormones influence serum and cutaneous fatty acid concentrations by Campbell and Davis (1990) and influence sebaceous gland function. Seborrheic changes
are common in hypothyroid dogs, that predispose secondary malassezia infections, which intensifies the seborrheic signs as also reported by Miller et al. (2012).

Conclusions
Most of the dermatological abnormalities associated with hypothyroid dogs are correctable with treatment.
Measurement of serum total T4 remains useful test for diagnosing hypothyroidism. Such mixed infections can be treated with the use of proper medication and follow up at regular intervals.

References
Campbell, K.L., and Davis, C.A. (1990). Effects of thyroid hormones on serum and cutaneous fatty acid concentrations in dogs. American J. Vet. Res., 51(5): 752.

Feldman, E.C. and Nelson, R.W. (1996). Canine and Feline Endocrinology and Reproduction, 2nd edn., W.B. Saunders, Philadelphia, U.S.A. Pp. 68-117.

Jackson, H. and Marsella, R. (2012). BSAVA Manual of Canine and Feline Dermatolog -y. 3rd edn., BSAVA, Gloucester, U.K. Pp. 94-95.

Kumar, K.S., and Srikala, D. (2013). Hypothyroidism associated skin and coat abnormalities in dogs – a study of 49
patients. Intas Polivet, 14(2): 427.

Miller Jr, W.H., Griffin, C.E. and Campbell, K.L. (2012). Muller & Kirk’s Small Animal Dermatology. 7th edn., W.B.
Saunders, Philadelphia, U.S.A. Pp. 502.

Outerbridge, C.A. (2006). Mycologic disorders of the skin. Clin. Tech. Small Anim. Pract., 21: 128-134.

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