{"version":"1.0.0","segments":[{"startTime":0.0,"endTime":3.68,"body":"Well, welcome to another episode of the Dermvet podcast."},{"startTime":3.68,"endTime":8.56,"body":"I wanted to go over a disease of something that I don't see a ton of, but I recently saw"},{"startTime":8.56,"endTime":15.16,"body":"a case of and I thought it could be a really good refresher on a certain alopeicic disease"},{"startTime":15.16,"endTime":20.4,"body":"that can get mistaken for things like allergies, which makes sense in some of the aspects"},{"startTime":20.4,"endTime":22.16,"body":"of this process."},{"startTime":22.16,"endTime":26.12,"body":"But there are some clinical signs that can give you a good indication you are dealing"},{"startTime":26.12,"endTime":28.92,"body":"with this disease process itself."},{"startTime":28.92,"endTime":33.6,"body":"And then that disease is going to be color delusion alopecia."},{"startTime":33.6,"endTime":39.04,"body":"So color delusion alopecia can be a bit tricky because ultimately some of these dogs are"},{"startTime":39.04,"endTime":43.92,"body":"pretty paritic and itchy because of the secondary infection."},{"startTime":43.92,"endTime":49.12,"body":"So what is color delusion alopecia and how I expect to see that in a case that I am"},{"startTime":49.12,"endTime":51.04,"body":"evaluating in the clinic?"},{"startTime":51.04,"endTime":56.28,"body":"So color delusion alopecia is exactly as it sounds, a disease that we tend to see and color"},{"startTime":56.28,"endTime":57.92,"body":"delute pets."},{"startTime":57.92,"endTime":66.88,"body":"So if you think of some of our blue diluents of a case for a coat, some of our silver, anything"},{"startTime":66.88,"endTime":72.8,"body":"that's more dilute, even some of these like lighter colored, like the light orange colors,"},{"startTime":72.8,"endTime":78.78,"body":"anything where their particular hair coat color is a more dilute variant."},{"startTime":78.78,"endTime":84.12,"body":"It doesn't mean they have color delusion alopecia, but they could be at risk of it."},{"startTime":84.12,"endTime":89.92,"body":"It's kind of a tail-tell sign when you see a dog primarily, or we see this disease, a dog"},{"startTime":89.92,"endTime":95.36,"body":"with this color of a coat in certain clinical signs that you should be thinking color delusion"},{"startTime":95.36,"endTime":97.08,"body":"alopecia."},{"startTime":97.08,"endTime":99.0,"body":"What are those clinical signs?"},{"startTime":99.0,"endTime":105.28,"body":"The main thing we will see in dogs that have color delusion alopecia is they will have"},{"startTime":105.28,"endTime":112.44,"body":"kind of a really patchy alopecia or hepotrachotic coat mostly on the dorsum."},{"startTime":112.44,"endTime":119.4,"body":"They tend to be dogs that are younger, so puppies to maybe young adulthood, they'll start"},{"startTime":119.4,"endTime":124.04,"body":"just getting a thinner coat on the dorsum itself."},{"startTime":124.04,"endTime":128.28,"body":"They can get it in other areas too, but the dorsal area is the most common area we see."},{"startTime":128.28,"endTime":133.52,"body":"So a blue silver, fawn colored pet that's having hair loss along the dorsum and they're"},{"startTime":133.52,"endTime":134.52,"body":"younger."},{"startTime":134.52,"endTime":139.6,"body":"If you describe that to me, I would say color delusion alopecia until proven otherwise,"},{"startTime":139.6,"endTime":141.8,"body":"but what's tricky about these pets?"},{"startTime":141.8,"endTime":147.12,"body":"What can be tricky is that they're itchy, so because we see this history of them becoming"},{"startTime":147.12,"endTime":153.56,"body":"paritic, which the disease itself is not really itchy, but because they are so predisposed"},{"startTime":153.56,"endTime":157.92,"body":"to pyaderma, they become paritic from that."},{"startTime":157.92,"endTime":163.2,"body":"So we'll see young dogs coming in for itchiness, of course, the dorsal area of the trunk is"},{"startTime":163.2,"endTime":166.44,"body":"something we can see affected with allergies."},{"startTime":166.44,"endTime":171.76,"body":"A lot of times when they go on medications to treat the allergic symptoms, whether it's"},{"startTime":171.76,"endTime":177.12,"body":"apaquil or steroids are often going on anti-infectives if there's a secondary infection because of"},{"startTime":177.12,"endTime":182.52,"body":"the crusting, the hair loss they are experiencing, they'll go on infection control so their itch"},{"startTime":182.52,"endTime":183.52,"body":"will get better."},{"startTime":183.52,"endTime":188.6,"body":"So it really feels like their itch will get better, their young dog makes sense."},{"startTime":188.6,"endTime":193.76,"body":"So we see these delupereats come in and again, usually see it distributed along the back"},{"startTime":193.76,"endTime":195.08,"body":"portion of the body."},{"startTime":195.08,"endTime":199.2,"body":"And I will make sure to share some pictures on my social media just so you guys can clinically"},{"startTime":199.2,"endTime":200.6,"body":"see those."},{"startTime":200.6,"endTime":205.08,"body":"So we'll see kind of that area on the dorsum that is thin, haired."},{"startTime":205.08,"endTime":210.28,"body":"They tend to be kind of scaling crusty again because one, they're infected, but even if"},{"startTime":210.28,"endTime":215.6,"body":"they're non-infected, their skin doesn't tend to look perfect because ultimately they still"},{"startTime":215.6,"endTime":220.52,"body":"have skin barrier defects, just like we'd expect in a dog who has allergies, they have skin"},{"startTime":220.52,"endTime":221.72,"body":"barrier defects."},{"startTime":221.72,"endTime":224.6,"body":"But what is this disease process itself?"},{"startTime":224.6,"endTime":229.76,"body":"Why don't we see every blue or silver dog come in having color delusional apisha?"},{"startTime":229.76,"endTime":237.28,"body":"We certainly see blue dobes, silver labs, silver pitties that come in without having the"},{"startTime":237.28,"endTime":239.48,"body":"actual alopecia symptoms themselves."},{"startTime":239.48,"endTime":245.4,"body":"Well, what can happen with some of these dilute colors is we obviously expect that their"},{"startTime":245.4,"endTime":250.96,"body":"pigment, their melanin within the hair itself is going to be distributed differently to"},{"startTime":250.96,"endTime":252.96,"body":"give that blue color."},{"startTime":252.96,"endTime":257.76,"body":"But what can happen is we can get clumping in something called macromalanusomes."},{"startTime":257.76,"endTime":262.2,"body":"So essentially they have a genetic defect that causes them to distribute the pigment in"},{"startTime":262.2,"endTime":264.6,"body":"their hairs when they have this disease process."},{"startTime":264.6,"endTime":270.12,"body":"They'll get that unusual hair color, but not just that getting that blue or fawn color,"},{"startTime":270.12,"endTime":276.84,"body":"that melanin will clump and will cause a lot of different changes to the hair, the hair"},{"startTime":276.84,"endTime":277.84,"body":"itself."},{"startTime":277.84,"endTime":282.56,"body":"You actually do a tricograeum, which would be plucking the hairs."},{"startTime":282.56,"endTime":286.72,"body":"Sometimes you can see just abnormal clumping within that hair follicle versus, or sorry,"},{"startTime":286.72,"endTime":291.48,"body":"that hair cortex, the hair shaft itself versus what you'd see in a normal dog would be"},{"startTime":291.48,"endTime":292.8,"body":"very organized."},{"startTime":292.8,"endTime":296.16,"body":"It's going to be a lot of disorganization."},{"startTime":296.16,"endTime":301.04,"body":"And then that clumping, those macromalanusomes can start damaging the cortex."},{"startTime":301.04,"endTime":305.32,"body":"And these dogs themselves when they have that alopecia region, especially on their"},{"startTime":305.32,"endTime":312.08,"body":"dorsum, it's really due to the damage of the hair they break, they're really weak."},{"startTime":312.08,"endTime":318.28,"body":"And it's really hard because of that clumping within that hair itself, the fur itself, to"},{"startTime":318.28,"endTime":320.72,"body":"really prevent that from happening."},{"startTime":320.72,"endTime":322.36,"body":"So we get excessive pigment clumping."},{"startTime":322.36,"endTime":324.04,"body":"You get breakage of the hair shops."},{"startTime":324.04,"endTime":327.84,"body":"And then that in turn creates abnormal and stunted hair growth."},{"startTime":327.84,"endTime":331.96,"body":"We also end up with a lot of secondary infections additionally."},{"startTime":331.96,"endTime":337.12,"body":"So if you see a dog who comes in, they have a very dilute coat plus that dorsal aspect,"},{"startTime":337.12,"endTime":340.84,"body":"they're young, that dorsal aspect looks really alopeasheck."},{"startTime":340.84,"endTime":345.44,"body":"They're getting scaling, crusting, sometimes they get combatone, things like that."},{"startTime":345.44,"endTime":350.16,"body":"Then I would want you to be considering something like other dilution alopecia."},{"startTime":350.16,"endTime":354.48,"body":"What's tricky is we can see dogs who have multiple diseases."},{"startTime":354.48,"endTime":359.8,"body":"So I just named some breeds that we also see a lot for, you know, adipi."},{"startTime":359.8,"endTime":364.68,"body":"So we see a lot of pitties for adipi, we see dobes for adipi, labs for adipi, and there's"},{"startTime":364.68,"endTime":368.76,"body":"other different breeds that can get this disease too."},{"startTime":368.76,"endTime":375.44,"body":"But I have had plenty of dogs who have color dilution alopecia, but they also have atopic"},{"startTime":375.44,"endTime":382.44,"body":"dermatitis or food allergy or a mix of those so that also can be really complicated because"},{"startTime":382.44,"endTime":388.6,"body":"if they are additionally besides having that hair loss on the back of their, their trunk,"},{"startTime":388.6,"endTime":391.64,"body":"they're also licking their paws and chewing their paws and getting ear infections, you're"},{"startTime":391.64,"endTime":393.56,"body":"probably dealing with multiple issues."},{"startTime":393.56,"endTime":398.64,"body":"You can get other areas of the body affected, but I don't usually suspect to see that they're"},{"startTime":398.64,"endTime":402.8,"body":"going to lick their paws to their paws, you know, break out on their ventral abdomen where"},{"startTime":402.8,"endTime":406.92,"body":"they don't have much hair anywhere, really break out with things like ear infections."},{"startTime":406.92,"endTime":410.2,"body":"We predominantly see it kind of on that trunkal area."},{"startTime":410.2,"endTime":414.08,"body":"So if you have multiple diseases, then we just need to make sure we're addressing both"},{"startTime":414.08,"endTime":415.92,"body":"these separately."},{"startTime":415.92,"endTime":419.08,"body":"What are some of the complications that we can see with this disease process?"},{"startTime":419.08,"endTime":422.52,"body":"Well, one of the complications is obviously infection as we talked about."},{"startTime":422.52,"endTime":427.72,"body":"I've seen occasionally malnsezia dermatitis with this disease, but I would say predominantly"},{"startTime":427.72,"endTime":432.32,"body":"I see a secondary pyiderma that is frustrating because it can kind of keep happening and"},{"startTime":432.32,"endTime":434.08,"body":"be recurrent."},{"startTime":434.08,"endTime":440.92,"body":"The other complication of this disease, excuse me, is that they do not tend to fully resolve."},{"startTime":440.92,"endTime":446.64,"body":"So it is by nature more a cosmetic disease, except for the secondary infections."},{"startTime":446.64,"endTime":452.68,"body":"That's obviously really bothersome for the pet and the owner, but that secondary, sorry,"},{"startTime":452.68,"endTime":457.52,"body":"the appearance of them kind of having that alopecia on their back."},{"startTime":457.52,"endTime":462.68,"body":"That is something that ultimately is probably never going to be totally normal."},{"startTime":462.68,"endTime":466.96,"body":"So the owners also have to accept that, which is really difficult when we have some of these"},{"startTime":466.96,"endTime":471.48,"body":"diseases with hair loss that we cannot fully reverse."},{"startTime":471.48,"endTime":475.84,"body":"So think about some of the frustrating diseases, like the follicular dysplasia, even some"},{"startTime":475.84,"endTime":481.04,"body":"of the hormonal diseases like the dreaded alopecia X or whatever you want to call it."},{"startTime":481.04,"endTime":485.92,"body":"There are certain diseases we deal with where even if they're quote unquote cosmetic, which"},{"startTime":485.92,"endTime":490.36,"body":"I always have a bit of a hard time when we call things cosmetic if they can lead to other"},{"startTime":490.36,"endTime":495.24,"body":"issues like secondary, secondary infections or if it can lead to things like skin barrier"},{"startTime":495.24,"endTime":500.8,"body":"abnormalities, but cosmetic disease in itself, meaning that, you know, besides kind of restoring"},{"startTime":500.8,"endTime":506.52,"body":"the skin and preventing infections, they're just going to have not as much hair there can"},{"startTime":506.52,"endTime":510.76,"body":"still be really emotional and frustrating for the owner because they didn't expect to"},{"startTime":510.76,"endTime":513.44,"body":"get a dog that the rest of that dog's life."},{"startTime":513.44,"endTime":517.44,"body":"And remember a lot of these doctors are quite young when they're diagnosed that when they"},{"startTime":517.44,"endTime":520.96,"body":"walk it down the street, people are going to wonder why it doesn't have much hair or"},{"startTime":520.96,"endTime":524.04,"body":"with scaling crusty, do they have mean?"},{"startTime":524.04,"endTime":525.84,"body":"Is that owner taking care of the pet?"},{"startTime":525.84,"endTime":530.08,"body":"So that's something that we really have to consider that this is still something that really"},{"startTime":530.08,"endTime":531.08,"body":"affects the owners."},{"startTime":531.08,"endTime":535.52,"body":"It can affect their, you know, the what they expected with their pet, their quality of life"},{"startTime":535.52,"endTime":539.32,"body":"as far as being able to able to visually show their pet."},{"startTime":539.32,"endTime":543.68,"body":"So something that we definitely want to think about because we can restore that skin barrier,"},{"startTime":543.68,"endTime":550.36,"body":"we can do our best to try to prevent things like infections or current issues, but we're"},{"startTime":550.36,"endTime":554.16,"body":"probably never going to fully normalize that hair coat."},{"startTime":554.16,"endTime":557.04,"body":"What are some of the treatment options we can consider?"},{"startTime":557.04,"endTime":558.64,"body":"There is no cure for this disease."},{"startTime":558.64,"endTime":564.36,"body":"There's not many cures for things in dermatology unless you have like, skabies or dermatitis."},{"startTime":564.36,"endTime":569.68,"body":"But the, the really the main treatment is trying our best to try different tools to minimize"},{"startTime":569.68,"endTime":571.68,"body":"those pet dermas."},{"startTime":571.68,"endTime":575.6,"body":"So we want to utilize things that are going to help with secondary infections."},{"startTime":575.6,"endTime":579.48,"body":"You know, certainly these are some of those dogs that have to end up on more chronic"},{"startTime":579.48,"endTime":584.88,"body":"things like car accident based products if they are really susceptible to breaking out with"},{"startTime":584.88,"endTime":587.36,"body":"infection because there's not really a systemic therapy."},{"startTime":587.36,"endTime":588.88,"body":"You can try things like melatonin."},{"startTime":588.88,"endTime":592.96,"body":"It's not really going to do anything in this particular disease because it is that dilute"},{"startTime":592.96,"endTime":597.72,"body":"hair itself and not so much the melatonin receptors on the hair follicle, but it's that dilute"},{"startTime":597.72,"endTime":601.32,"body":"coat and those abnormal aggregations of those pigments itself."},{"startTime":601.32,"endTime":607.04,"body":"So melatonin's safe, but probably not going to do a whole lot in most of these cases."},{"startTime":607.04,"endTime":610.88,"body":"So then you're really trying to do things to help with secondary infection."},{"startTime":610.88,"endTime":616.28,"body":"So you can do more mild things like topicals, I have salicylic acid in them, sometimes"},{"startTime":616.28,"endTime":617.28,"body":"solfers."},{"startTime":617.28,"endTime":619.68,"body":"I've seen people use benzoyl peroxide based products."},{"startTime":619.68,"endTime":625.64,"body":"The idea behind that being that it flushes out the follicle and has some antiseptic properties."},{"startTime":625.64,"endTime":631.04,"body":"I think in some cases those can work well, but benzoyl peroxide is also more drying if you've"},{"startTime":631.04,"endTime":633.52,"body":"ever used it on your own skin."},{"startTime":633.52,"endTime":636.96,"body":"So sometimes I have cases where it seems to dry out their skin more and we will switch"},{"startTime":636.96,"endTime":641.6,"body":"to something like a Duke, so as three, you know, PIO, if they are susceptible to infection"},{"startTime":641.6,"endTime":646.6,"body":"because then we're not only treating the infection with chlorhexidine, but utilizing something"},{"startTime":646.6,"endTime":650.44,"body":"that has oveatrium in it, which is to restore their skin barrier."},{"startTime":650.44,"endTime":652.4,"body":"There's other things you can use too."},{"startTime":652.4,"endTime":655.4,"body":"Dermacent has some topical products to restore the skin barrier."},{"startTime":655.4,"endTime":660.68,"body":"They also have things that help with things like the PIO line that can have more natural"},{"startTime":660.68,"endTime":665.72,"body":"herbal things in it that can help also be defensive again secondary infections."},{"startTime":665.72,"endTime":670.76,"body":"I just find a lot of times you have to kind of trial and error some things that work"},{"startTime":670.76,"endTime":672.52,"body":"for that particular pet."},{"startTime":672.52,"endTime":674.96,"body":"What is treating the infection?"},{"startTime":674.96,"endTime":676.84,"body":"What is preventing the infection?"},{"startTime":676.84,"endTime":678.76,"body":"What do we need to do long term?"},{"startTime":678.76,"endTime":681.68,"body":"And then what's also helping to restore that skin barrier?"},{"startTime":681.68,"endTime":686.44,"body":"So whether that is, you know, trying to do things like supplementations with fish oils or"},{"startTime":686.44,"endTime":691.04,"body":"certain skin barrier supplementations that are out there, some of the diets that are"},{"startTime":691.04,"endTime":693.76,"body":"out there to help restore that skin barrier."},{"startTime":693.76,"endTime":698.92,"body":"It's not going to treat the disease itself, but if we can try to nutritionally help the"},{"startTime":698.92,"endTime":702.28,"body":"skin, hopefully that will benefit us in some degree."},{"startTime":702.28,"endTime":707.64,"body":"You also want to make sure that the owner is really cautious of things like harsh grooming"},{"startTime":707.64,"endTime":709.04,"body":"or being really rough with that."},{"startTime":709.04,"endTime":713.32,"body":"So these are not dogs you want like metal combs used on the back end."},{"startTime":713.32,"endTime":717.8,"body":"I'm probably just going to ask for some irritation and a reaction to that."},{"startTime":717.8,"endTime":720.2,"body":"Really gentle grooming going to the direction of the hair."},{"startTime":720.2,"endTime":724.56,"body":"This is not a disease where you kind of want to be rubbing them multiple directions because"},{"startTime":724.56,"endTime":729.64,"body":"those hairs are fur are already susceptible to breakage."},{"startTime":729.64,"endTime":734.32,"body":"And if you keep breaking those hairs, you potentially could still aggravate things to get"},{"startTime":734.32,"endTime":738.4,"body":"to the point of causing the recurrent infections, which is certainly not something we want to"},{"startTime":738.4,"endTime":741.4,"body":"do with this disease process."},{"startTime":741.4,"endTime":745.44,"body":"And then we just have to take the time to educate owners about this disease."},{"startTime":745.44,"endTime":750.0,"body":"Again, you these are ones that really clinically we can tell pretty well."},{"startTime":750.0,"endTime":753.96,"body":"By looking at them, if you are going to talk to them about diagnostics, kind of the main"},{"startTime":753.96,"endTime":756.92,"body":"things you can do is the trigogram we talked about."},{"startTime":756.92,"endTime":762.92,"body":"If you collect a trigogram, which is like plucking hairs, you can look for things like abnormal"},{"startTime":762.92,"endTime":766.92,"body":"clumpings of melanin granules, if they're kind of breaking the hairs, destroying that cortex"},{"startTime":766.92,"endTime":768.6,"body":"of the hair itself."},{"startTime":768.6,"endTime":772.0,"body":"And then in certain cases, if you're not sure, you think multiple things are going on,"},{"startTime":772.0,"endTime":777.96,"body":"it certainly wouldn't be wrong to biopsy these pets to rule out maybe other things."},{"startTime":777.96,"endTime":782.84,"body":"If I see a dog coming in with this, I have a really, you know, educational conversation with"},{"startTime":782.84,"endTime":788.52,"body":"the owner about the fact that this is a disease that we'll have to manage."},{"startTime":788.52,"endTime":790.16,"body":"We're never going to have perfect."},{"startTime":790.16,"endTime":794.44,"body":"We're just going to do our best to utilize some supplemental things, some topical things"},{"startTime":794.44,"endTime":798.56,"body":"to prevent infections, which hopefully will keep them comfortable and then restore that"},{"startTime":798.56,"endTime":799.56,"body":"skin barrier."},{"startTime":799.56,"endTime":803.08,"body":"But they kind of have to be accepting of the fact that that hair will never fully grow"},{"startTime":803.08,"endTime":804.08,"body":"in."},{"startTime":804.08,"endTime":807.4,"body":"And so these are some big things we want to think about."},{"startTime":807.4,"endTime":811.16,"body":"This is a disease that hopefully clinically as you get more comfortable, you can start"},{"startTime":811.16,"endTime":817.6,"body":"to pick up on again, young dog coming in with that dilute hair coat around the door."},{"startTime":817.6,"endTime":822.72,"body":"Some I would automatically start thinking about things and they have that that presentation"},{"startTime":822.72,"endTime":823.72,"body":"we talked about."},{"startTime":823.72,"endTime":826.88,"body":"I would automatically start thinking about those things like color delusional apesia."},{"startTime":826.88,"endTime":830.32,"body":"Of course, there can be wacky cases."},{"startTime":830.32,"endTime":834.8,"body":"So if it makes sense to run some lab work to rule out things like hypothyroidism, which could"},{"startTime":834.8,"endTime":839.68,"body":"also affect their hair, coat and lead to them to secondary infections, occasionally get younger"},{"startTime":839.68,"endTime":842.08,"body":"dogs that have that that would not be wrong."},{"startTime":842.08,"endTime":846.44,"body":"But hopefully as you game or experience and you start to pick up on some of these cues,"},{"startTime":846.44,"endTime":850.68,"body":"you can feel more confident in this diagnosis and then set up a good treatment plan, but"},{"startTime":850.68,"endTime":856.16,"body":"also set up your owner's expectations long term to manage a disease and have realistic"},{"startTime":856.16,"endTime":861.28,"body":"expectations of management of a disease like color delusion alopecia."},{"startTime":861.28,"endTime":871.28,"body":"[BLANK_AUDIO]"}]}