Another Skin Issue

[drjchill]

My G1P1 female llama, approximately 8 years of age has been bothered by a chronic skin issue that has become quite severe. She has been evaluated by OSU School of Veterinary Medicine and even had a dermatology consultation. The pustular eruption is depected in a photograph below. She recently completed a 7 day course of SQ Baytril per the suggestion of Dr. Lakritz at OSU. Any help would be greatly appreciated. The lesions are GETTING worse and I am quite concerned. OSU completed a UA, and bloodwork - all of which was reported as normal. Skin biopsy was non-diagnostic.

drjchill@yahoo.com

[Marty McGee Bennett]

wow! I have never seen anything like this... could it possibly be an allergic reaction of some sort? New food, new hay?

[drjchill]

OSU has never seen it before either. Some "sweet feed" was mixed with the normal Mazuri Crumbles "three months ago" and a few pieces can be seen. None of my other girls have this issue. I have tried a myriad of topical sprays without success.

[drjchill]

Of course hay changes every season - I purchase my hay from a local farmer.

[drjchill]

I have had a number of emails from Dr. Lakritz. After viewing the photo, he suggested Ivermectin + Fipronil (FRONTLINE). He feels this might be a mite issue and my llama's "hyper-response" to the infestation. I am willing to try anything. He would also like a repeat skin culture in a week or so. I will keep you all informed. I am truly at a loss.



Jeff C. Hill, MD, MPH
Chillicothe, OH

[Marty McGee Bennett]

please do this is really perplexing... I have never seen anything quite like it. Skin is such a hard thing to sort out... are there any stressors in her life that weren't there previously?

[docdennis]

Looks like a mite hypersensitivity to me. Fipronil plus Ivomec injections should help some. Antibiotics also helpful because there is likely secondary bacterial infection.
There is a tea tree lotion available from Emerald Valley Equine that I like to help soothe and heal the skin. Apply that daily, except on the days you apply the Frontline.
Dennis Thibeault, DVM

[Alicia Anderson]

I have seen a lot of this in alpacas - I could nearly say it was quite common - possibly from different climates eg. wet & hot & humid??
Most of the treatment has been with Ivomectin and Frontline (Fiponil) with great success. I'd certainly give it a go so your girl can get some relief.

[drjchill]

Thank you all. I am waiting for the Frontline - it's delivery was delayed due to the storm.

I did communicate with Dr. David Anderson. He suggested additional MVI (multivitamin) and fatty acids.

I am trying to convince myself that it is getting better. I gave Escalade Ivermectin last Thursday; Frontline pending. I will keep you informed. It's interesting that none of my other girls have any skin issues at all!!

Jeff Hill, MD, MPH
Chillicothe OH
drjchill@yahoo.com

[Nancy Woodward]

Dr. Norm Evans and Mike Safley have recipes for 'munge' medicine that we have used with some success. Because some of our problems seemed to arise from wet grass in spring, we have used products designed to deal with fungus, with success. Researching the issue, I found a recommendation for fortified vitamin B injections--can't hurt.

One breeder recommended zinc oxide ointment, and that does at least seem to offer itch relief. Zinc deficiency is sometimes thought to be at cause.

Skin problems are hard to assess or cure, since itchies from one cause--whether it's deficiencies, allergies, bites, allergies from bites! fungus, who knows? can lead to bacterial infections from scratching. So we throw the kitchen at them, and then never really know what worked.

Please stay in touch with us on this. Marty's question about stress is certainly right on the money--and since stress can cause B deficiencies, that may be why B sometimes helps?

[Nancy Woodward]

A question: If Ivomec plus is supposed to dispose of mites and biting insects, why Frontline? What is the safety factor with Frontline? What is the advantage? Do you use it with Ivomec plus or instead?

[Marty McGee Bennett]

good question Nancy... I too would love it if one of our vets would explain the difference between the action of Ivomec and Frontline on these pesky bugs... when you might reach for one or the other or both!

[drjchill]

No stress with my girls except the cold temps in southern Ohio. My Frontline arrived today and I was hit with over spray - not a good smell. My "Soothex" also arrived and I can't wait to try it.

The numbner of pustules have decreased - I am sure due to the Ivermectin not the antibiotics based on the time span.

Hopefully, a cure is at hand.

THANK YOU ALL SO MUCH!! YOUR GREAT!!:)

[Marty McGee Bennett]

please make sure to keep us up to speed on what the various things do or don't do! Glad we are all of help.

[docdennis]

Cold stress can be enough to precipitate a stress-related problem. Alpacas like cool temperate weather. Not designed for single digit weather, although my alpaca socks are!
The mites do burrow into the skin so systemic Ivomec injections "should" reach and kill them but don't always, especially for the mites that are closer to the surface or found within the big crusts and scabs. The Frontline will kill the mites on the surface, maybe not so much the deeper ones. Use the two combined to attack mites at all levels. As most on the Guild seem to know, this can be a difficult cure to achieve so we attack in multiple ways to increase the odds of a cure.
Exact biochemical mechanism of action of the drug against the mites will either take research on my part or the advice of a parasitologist. Don't think this is what you were asking.

[carolstanley]

I have just discovered that one of my alpacas has this very condition. He is white, and with all the snow we have had this year, I just never noticed until last week that, from his ankle area down on all four legs, he has lost the fleece. He has some very thickened skin, but no pustules and no bleeding. However, it doesn't seem to be bothering him all that much in terms of itching and scratching, and none of the other animals are affected. In our area, we get some extreme winter weather (-30C or lower, especially at night) but I have never seen this until now. I have some Ivomec to give him, but don't want to spray anything or apply any salves because they will freeze on his legs. I was reading the posts about Frontline, which is a canine/feline product. As that works off label for alpacas, would I also be able to use one of the products that are applied between the shoulder blades? This would solve the freezing product problem I would have with the other solutions mentioned. Thanks so much for any help you can give me. These posts are all very timely!

[Skorff]

What's the dosage of Frontline if you use it?
A question: If Ivomec plus is supposed to dispose of mites and biting insects, why Frontline? What is the safety factor with Frontline? What is the advantage? Do you use it with Ivomec plus or instead?

Sue

[Nancy Woodward]

A we have so often discussed, skin issues arise from more than one possible cause--and worse, one problem can lead to others, due to scratching causing bacterial infection. Wet hair over time can cause fungal problems. When that is the cause, products designed for treatment of rain rot on horses will be effective. My best white stud seems particularly susceptible to fungal problems, and we have therefore reluctantly decided to shave his legs. Pantaloons are cute, but they do hold moisture. In our climate, kindness dictates keeping those legs clean and dry.

[Renee T]

Our female recently had this same issue. We are treating with ivermec once a week times 4 wks. Not sure why it started none of the others have it. She is clearing up, there was no secondary infection involved so we did not use antibiotics.
Renee Tarr
Tarrhillllamas@windstream.net

[drjchill]

Well...after one month of weekly ivermectin + Frontline the pustular eruption resolved. Howerver, 9 days after her last doses the eruption reoccurred. Dr. Lakritz at OSU suggest to stop the ivermectin and to continue weely Frontline. He also suggested to remove all bedding (uneaten hay) and to spray the area with a premise spray - not specified. The mite in quesiton does not spend a lot of time on the animal but can "contaminate the barn." Well, the saga continues; however, the rash is not as severe as it was. As soon as springe get here she will get a bath and other topical treatments. I will let everyone know how it's going. :eek:

[jeannine]

Glad to hear that it responded to treatment. Has the "mite in question" been identified and named? Hope the Frontline resolves the new eruption also.