Hästens hudproblem : en retrospektiv fallstudie

Sammanfattning: SUMMARYThis work consists of a review of the medical records of 142 horses that visited the Equine dermatology clinic, at the University Animal Hospital, UDS, at Ultuna, Uppsala, Sweden, between January 2007 and June 2010. The study answers certain main questions like clinical signs responsible for the visit, the most common diagnoses, their diagnostic procedures, treatment modalities and finally, the outcome of treatment.Among 50 diagnoses, four were predominant followed by additional 46 diagnoses, each presenting by few or, in many cases, only one horse. The most common dermatological problem diagnosed was Equine Sarcoid representing 18,3 % of the cases (26/142), which probably reflects the initiation of a Sarcoid treatment-trial in 2007, that resulted in an accumulation of sarcoid horses in the clinic .The second most common diagnosis was Atopy 12 % (17/142) followed by Allergy with skin affection 9,2 % (13/142) and Acute superficial pyodermia 4,9 % (7/142). If the horses were divided into diagnostic groups, the majority (34,5 %) belonged to HA5 group, (Immunological skin diseases), followed by group HA4, (Infectious and inflammatory conditions of the skin) (22,5 %) and HA6, (Neoplasia) (21,8 %). Traumatic skin injuries represented only 2,1 % of the cases, compared to 80 % of horses in the Agria insurance statistics for veterinary care.The most common clinical sign and reasons for veterinary consultation was pruritus (35,9 %), suspected sarcoids (17,6 %), alopecia (12,7 %), nodules (12 %), seborrea, scaling and crusts (9,2 %) and excoriations (5,6 %), respectively, followed by a scattered number of more uncommon symtoms.The diagnostic methods most frequently applied were cytology and biopsy, used in 41,5 % and 36,6 % of the cases, respectively. For immunological diagnosis, HESKA serology test was used mainly prior to 2008, and thereafter, starting in 2009, IDT (intradermal test) was increasingly used,.The by far most common two breeds were the Swedish warm blood (28,8 %) and the Icelandic Horse (16,9 %). The diagnose group HA5, immunological skin diseases, was dominated by the Icelandic horse (32,6 %), while the diagnostic group HA4 Infectious and inflammatory diseases, was dominated by the Swedish warm blood (54,5 %). Stallions and geldings constituted 60 % and mares 40 % of the horses, respectively.Local treatment with Immunomodulating substances represents 50,7 % of treatments, followed by systemic corticosteroids (14,1 %), allergen specific Immunotherapy (ASIT) (12 %), antihistamine (11,3 %) and systemic and local antibiotics in 4,9 and 2,8 % of the cases, respectively. Result of treatment based on 126 of the 142 patients, where such information was available, showed that in 66,4 % of cases there has been complete or partial improvement, and in the remaining 33, 6 % of cases there had either been relapse or no improvement of condition. Euthanasia due to skin disease was registered in 7,1 % of cases, which can be compared to 13, 6 % of horses euthanised because of skin disease according to life insurance claim statistics of Agria (1997-2007). These figures do not include traumatic skin injuries.