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The curious case of Eva…
16 September 2015
Eva is lovely 6 year old Labrador but her owners became concerned when she started to develop small hairless lumps on her nose.
She had never had anything like it before, and there was no clear explanation as to what was causing them. Although Eva was initially not too bothered by them, her owners took her along to her local vets, who prescribed some antibiotics and anti-inflammatory medication.
However, Eva’s skin lumps continued to get worse, increasing in size quite considerably, and oozing. Within days, the whole affected area was a large bleeding sore, and similar lesions were appearing on her ears too. Eva was clearly very uncomfortable and was rubbing and scratching around her face, which was very distressing both for Eva and her owners.
Eva’s vets took biopsies (samples) of the skin, but she continued to deteriorate whilst awaiting the results. When she developed vomiting and became very lethargic, she was referred to Willows as an emergency.
Figure 1 – Eva’s skin lesions when she first presented to Willows
Internal Medicine Specialist, Stephanie Lalor, initially assessed Eva and placed her on a drip for supportive care. By the following morning, she was much brighter and her vomiting had stopped. Stephanie arranged for Eva to be examined by Willows Dermatology Specialist, Jon Hardy, who took swabs of Eva’s skin and examined affected hairs under a microscope. This showed that Eva’s thickened and sore skin was full of inflammatory cells called eosinophils. These cells are normally found when animals have parasite infections or allergic reactions.
Figure 2 – Inflammation from Eva’s nose showing an eosinophil cell in the middle
Jon suspected a rare disease called ‘eosinophilic furunculosis of the face’. Not much is known about this disease, but it is thought to occur in dogs following insect bites or stings to the face. In affected dogs, noses and ears are the most common sites and the disease can be so severe that painful bleeding sores develop. In most cases, this disease unfortunately causes scarring at the affected areas after treatment.
As Eva’s skin was so bad, powerful anti-inflammatory drugs were started to try and reduce the inflammation and Eva returned home to continue her treatment. A day or two later, the biopsy results came back and supported the diagnosis made whilst Eva was in the hospital.
When Eva returned to see Jon a week later, she was progressing really well. The skin on her nose had stopped bleeding, but as there were still some scabs present, it was agreed that the treatment should continue for longer. Eva returned again a week later and we are delighted to report that her skin disease was under control and she was in remission. Some scarring was present, but Eva was pain free, with no lumps or no bleeding. She is now having her medication reduced, and it is hoped that she will have no further problems in the future.
Figure 3 – Eva after 2 weeks on medication
It is rare for dogs to develop such severe reactions to insect bites/stings, but veterinary attention should be sought if skin disease is noticed around the face, especially if it seems to be deteriorating quickly.