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CANINE SEBACEOUS ADENITIS

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Sebaceous Adenitis

Sebaceous Adenitis (SA)
Sebaceous Adenitis3

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Sebaceous Adenitis

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What is sebaceous adenitis?
This is a perplexing condition in which the sebaceous glands in the skin become inflamed for unknown reasons, and are eventually destroyed. These glands normally produce sebum, a fatty secretion that helps prevent drying of the skin.

Clinical signs vary with the severity of the condition, and between different breeds.

How is sebaceous adenitis inherited?
It appears that the disorder is inherited as an autosomal recessive trait in the standard poodle; however the wide variation in clinical signs suggests that inheritance is not straightforward, and breeding studies continue.

What breeds are affected by sebaceous adenitis?
Sebaceous adenitis is most often seen in the standard poodle, vizsla, Akita, and samoyed.  The condition has been diagnosed in many other breeds as well (see resource 1 below).

For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.

What does sebaceous adenitis mean to your dog & you?
Sebaceous adenitis is usually first noticed in young adult dogs (1 to 5 years of age). The condition can appear differently in different breeds, and there is also marked variability depending on the clinical severity.

One form of the disorder is seen in long-coated breeds - the Akita, samoyed, and (most-studied) the standard poodle. Typically affected standard poodles have dry scaly skin with patches of hair loss along the top of the head, back of the neck, and back. Silvery scales tightly adhere to tufts of remaining hair. Very mildly ("sub-clinically") affected standard poodles have a normal hair-coat, but abnormalities typical of the condition are seen on microscopic examination of skin biopsies. More severely affected dogs will have areas of thickened skin ("hyperkeratosis"), extensive hair loss and often a musty or rancid odour. Secondary skin infections often occur as well.

The second form of sebaceous adenitis occurs in short-coated breeds such as the vizsla. There is a moth-eaten appearance to the haircoat with mild scaling, affecting primarily the trunk, head, and ears.

Sebaceous adenitis is primarily a cosmetic disorder - that is it affects the appearance of the dog rather than his/her general health. The condition tends to be most severe in the Akita, resulting in chronic secondary bacterial infections, weight loss, and fever.

How is sebaceous adenitis diagnosed?
Your veterinarian may suspect this disorder based on your dog's clinical signs. To differentiate this condition from other skin disorders, many of which are also associated with increased scaling, a skin biopsy is necessary. This is a simple procedure done with local anesthetic, in which your veterinarian removes a small sample of your dog's skin for examination by a veterinary pathologist. The biopsy will show changes in the skin consistent with this condition.

How is sebaceous adenitis treated?
This disorder requires long term management, which can be frustrating for both owners and veterinarians because the response to treatment is highly variable. There may be periods of spontaneous improvement or worsening of the condition, independent of treatment.

Your veterinarian will likely try a combination of approaches, to determine with you what will be most effective for your dog. Most important is the regular use of anti-seborrheic shampoos to remove scales and dead hair, together with fatty acid dietary supplements. This may be all that is required in mildly affected dogs. Additional treatments include spraying the dog with a mixture of propylene glycol and water to help restore lubricants to the skin and the use of oral essential fatty acids.

For the veterinarian: Retinoid therapy and cyclosporine have been used with variable results in refractory cases. Contact the Genodermatosis Research Foundation (GRF) for the most current recommendations on therapy.

Breeding advice
Although the genetics have not been determined, the condition does appear to be inherited in those breeds studied. It is thus preferable to avoid breeding affected dogs of any breed, their siblings, and their parents.

The Institute for Genetic Disease Control in Animals (GDC) operates an open registry for sebaceous adenitis in the standard poodle. All dogs that have been used or are intended to be used for breeding purposes, or any dog with a diagnosis of sebaceous adenitis, should be registered through an annual skin biopsy. Bear in mind that subclinically affected poodles (meaning that they have no clinical signs, even though a skin biopsy shows that they have a mild form of the disorder) may produce clinically affected puppies.

The GDC (http://www.vetmed.ucdavis.edu/gdc/gdc.html)  provides registration forms, instructions for veterinarians regarding biopsies, and a list of participating pathologists. Registration requires evaluation of two 6-mm skin biopsies by a participating dermatopathologist, who will send the results to the submitting veterinarian and GDC for their computer files.

In sub-clinically affected dogs (those with a normal haircoat), histologic lesions consistent with sebaceous adenitis may not be evident in a particular biopsy sample. Thus a pathologist's report of "normal" does not guarantee that the dog is unaffected, but rather that the skin biopsies examined showed no evidence of the disorder. By having the poodle biopsied and registered annually however, the owner has done all that s/he can to ensure the animal is suitable for breeding, and has contributed information to the registry to decrease the incidence of this disease in the standard poodle.

FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.
Resources
Campbell, K.L. 1997. Diagnosis and management of keratinization disorders in dogs.  ACVIM - Proceedings of the 15th Annual Vet. Medical Forum. pp 220-222.
Dunstan, R.W., Hargis, A.M. 1995.  The diagnosis of sebaceous adenitis in standard poodle dogs. In J.D. Bonagura and R.W. Kirk (eds.) Kirk's Current Veterinary Therapy XII Small Animal Practice. p 619-622.   W.B. Saunders Co., Toronto. Genodermatosis Research Foundation (GRF), 1635 Grange Hall Road, Dayton, OH, 45432

Copyright © 1998 Canine Inherited Disorders Database. All rights reserved. Revised: October 30, 2001.
This database is funded jointly by the Sir James Dunn Animal Welfare Centre at the Atlantic Veterinary College, University of Prince Edward Island, and the Canadian Veterinary Medical Association.
Reprinted with kind permission of
Alice Crook, DVM Coordinator, Sir James Dunn Animal Welfare Centre
Atlantic Veterinary College University of Prince Edward Island


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Sebaceous Adenitis (S.A.)

By Judy King

Sebaceous Adenitis is a hereditary autoimmune skin disease whose mode of Inheritance is believed to be simple autosomal recessive, requiring a single Defective gene from both sire and dam. SA is not sex linked. A genetic disease of this type cannot be cured, but can be treated and most definitely can be bred away from.

SA has been diagnosed in many breeds including Airedale, Akita, Chow Chow, Collie, Dalmatian, Dachshund, German Shepherd, Golden Retriever, Irish Setter, Lhasa Apso, Maltese, Miniature Pinscher, Old English Sheepdog, Pomeranian, Poodle, Samoyed, Springer Spaniel, St. Bernard, Vizsla, and Weimaraner, as well  as in mixed breeds. Sebaceous Adenitis is most frequently seen in younger dogs but does effect dogs of senior age as well. A parent of a SA dog may or may not show clinical symptoms, being what is known as subclinically affected, meaning that some inflammation may exist but has not progressed to destruction of the glands and the subsequent loss of hair. They may have been described as having some skin allergies, but they are carriers none the less.

 In SA the sebaceous glands that adjoin the hair follicles become inflamed and gradually are destroyed. Symptoms of SA can resemble allergies and can often go improperly diagnosed for some time. The most common symptoms are excessive dandruff (scaling) and hair loss, which can be from moderate to severe. The hair loss is usually patchy, giving a moth-eaten look. Itchiness is not indicative of SA, but can accompany secondary skin infections, which can flare up and are often accompanied by a musty odor. The treatment includes antibiotics when secondary skin infections are present.

Accurate diagnosis requires punch biopsy. A local anesthetic is injected into the site to be biopsied (usually near the withers or affected area). When the area is numb, a tiny 6mm Baker's biopsy punch is used to remove a tiny plug of skin. Usually only one to two sutures are needed to close the biopsy site. The sample will then be gently placed (without squeezing) in formalin and sent for evaluation by a dermatopathologist.

In Akita's, systemic illness (weight loss and fever) appears more common and is suspect as being indicative of a secondary underlying disease/condition. However, this is not to say all SA-affected Akita's have accompanying ill health. Many owners have claimed relative ease of maintenance of their SA-affected Akita, provided they stay on top of the situation by careful monitoring the condition of the skin and the overall appearance of their Akita's health.

Currently there is no cure for SA but with good care, the affected dog can be comfortable, healthy, happy, and capable of giving and receiving love just as before developing SA. Dogs with SA can live happy lives free of pain and suffering. Treatment is relatively inexpensive, the most difficult aspect of SA usually being a cosmetic one. Some recommend oil baths, rubbing well into the skin a non-perfumed oil (baby oil, bath oil i.e., Alpha Keri, and Redken products have proven beneficial) to ensure saturation and allowing it to soak into the skin for about an hour. The oil loosens the scales and lubricates skin compromised by the absence of sebaceous oil glands.

Palmolive dish-washing detergent is good for removing the oil, and often requires several shampoos. Finish with a mild dog shampoo and creme rinse. Repeat this procedure bi-weekly or monthly as needed. Some dogs grow new hair after treatment; others do not. The hair loss and regrowth is cyclical. Many Akita owners have disclaimed this treatment, not having seen significant improvement, preferring instead to gently brush affected areas a few times a week with a very soft bristle brush, thus removing the scales that harbor bacteria, which can lead to secondary, skin infections. How can we rid our breed of this disease? We now understand with certainty the mode of inheritance. We can strive to breed away from this disease by using the objective diagnostic protocol on breeding stock.

 We can register affected dogs with the GDC (Institute for Genetic Disease Control in Animals), P.O. Box 222, Davis, CA 95617; Phone: 916-756-6773. We can participate freely with the Open Registry for SA and share our knowledge of the mode of inheritance with other breeders and owners. Last, but not least, (and the point of this page) you can contribute to SA research by purchasing the '98 Challenge Pin. Funds from the sale of the '98 pin are dedicated toward SA research.  To receive updates about SA research, subscribe to Progress in SA Research,  published by GRF (Genodermatosis Research Foundation). Write to 1635 Grange Hall Road, Dayton, OH, 45432 USA  or phone 513-426-7060 for subscription information. Please note: The author gives permission for and encourages distribution of this article for education purposes.  

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Sebaceous Adenitis

By: Dr. Rosanna Marsalla
http://www.petplace.com

Section: Overview
sebpetplace1 Open Image Viewer.  Sebaceous adenitis is an uncommon skin disease of dogs that is genetically inherited and runs in families. Poodles, Akitas, Samoyeds and Vizlas are at increased risk for this condition, but it has been reported in other breeds and in mixed breed dogs.

The exact cause is not known, but it may be caused by an attack of the immune system against the sebaceous glands responsible for the production of sebum (oil) on the skin. As a consequence, the skin becomes dry and scaly and loses the hair (alopecia). Some dogs may develop skin infection as a consequence of the abnormal skin oil and may become itchy because of the skin infection. Skin infections manifest with odor, papules (red bumps) and excessive shedding.

The disease starts on top of the head and spreads to the rest of the body. It starts when dogs are one to three years of age and tends to get progressively worse with time.

Screening can be done in dogs belonging to breeds at increased risk for this disease to identify individuals carrying the disease. Biopsies taken from clinically normal skin may already reveal changes suggestive of the condition. Dogs carrying the disease should be excluded from breeding programs due to the genetic nature of this condition.

Diagnosis
Other skin diseases may look similar to sebaceous adenitis and must be ruled out by appropriate testing.

Demodicosis is a much more common condition that could also cause hair loss and scaling. For this reason, skin scrapings are done to rule out this type of mange.

Many dogs with sebaceous adenitis have a concurrent skin infection. Cytology – tape impressions of the skin stained to reveal bacteria and yeast – should be done to determine the type and severity of the skin infection.

The final diagnosis of sebaceous adenitis is made by histopathology, so skin biopsies are normally taken. Since the changes seen with this condition may not be present in all the areas, it is important that several biopsies are taken. Stitches are places in the biopsy sites to ensure fast and proper healing.

Home Care
There is no definite cure for this condition. However, several topical and systemic treatments can be tried to decrease the clinical signs.

You may need to bathe your dog several times a week using medicated shampoos to soothe the skin and remove the excessive scaling. You will also have to use medicated shampoos (Oxydex) to help speed the recovery from skin infections.

Systemic medications are given to eliminate skin infections and normalize the sebum production. The most popular medications used for this condition are retinoids. They are quite expensive and have the potential for serious adverse effects. They are teratogenic, which means they have the potential to cause fetal malformation in pregnant animals, thus they should not be used in breeding animals. As they accumulate in the fat for a long time, the teratogenic effect persists for several months after the discontinuation of the therapy. This type of medication should be tried for at least two months before assessment of the efficacy is made. The most commonly used retinoid is Accutane (isotretinoin).

For dogs that do not respond to retinoids, other medications may be tried. Cyclosporines have been effective in a few refractory cases. This medication is immunosuppressive, which means it suppresses the reaction of the immune system, and therefore has the potential to increase the risk for bacterial infections. Your dog should be closely monitored for adverse effects including vomiting, diarrhea, liver and kidney disease.

 Information In-depth
 Sebaceous adenitis is an inflammatory disease of the sebaceous (oil) glands leading to the destruction of the glands. Vizlas, Akitas, poodles and Samoyeds are predisposed and the exact pathogenesis has not been established. It seems to be a genetically inherited defect and young dogs are usually affected.

In Poodles, it is believed to be an autosomal recessive mode of inheritance due to the fact that 25 percent of affected dogs may be sub-clinical. Several theories have been formulated to explain this condition:

According to one theory the disease is auto-immune in nature and the sebaceous glands are targeted by the immune system and destroyed.

Another theory is that the destruction of the sebaceous glands is secondary to a disease of keratinization, which leads to obstruction of the duct and ultimately disappearance of the glands.
It is also hypothesized that both the adenitis and the keratinization defects are secondary to an imbalance in lipid metabolism.

Related Symptoms or Ailments

Bacterial folliculitis (superficial pyoderma)

Demodex

Dermatophytosis (ringworm)

Disease of keratinization

Mycosis fungoides

Endocrinopathies (diseases of the endocrine system)

Pemphigus foliaceous

Follicular dysplasia

Deep skin scrapings should be done in any dog with these clinical signs to rule out demodicosis.

Veterinary Care In-depth
 sebpetplace2 Open Image Viewer          Diagnosis In-depth
The early lesions include alopecia (hair loss) with excess scaling and brittle hairs. The top of the head, the dorsal planum of the nose, dorsal neck and dorsal midline are commonly affected areas.

Sebaceous adenitits has a cyclic pattern in some dogs with periods of improvement and worsening. Symptoms are slightly different according to the type of hair coat:
In short coated breeds (Vizlas), circular areas of alopecia with fine, white, non-adhering scaling are commonly the first manifestation of the disease. Infections are not common in these dogs and itchiness is usually not present.

In poodles, the scales are tightly adherent and follicular casts – accumulations of keratinous debris around the hair shaft seen protruding from the follicle – are visible.

In Akitas, seborrhea oleosa is usually the first sign. Greasy, yellow follicular casts are common.These animals tend to get systemically ill. Concurrent epilepsy has been reported in some dogs. Secondary bacterial infection is common, causing itchiness.

In Samoyeds the most severe sign is alopecia on the trunk with follicular casts.

Diagnosis of sebaceous adenitis is made by histopathology, and several biopsies may be needed to make a final diagnosis. Biopsies should be taken from affected and non-affected skin. Subtle early lesions are most useful to document active inflammation.

Secondary bacterial infection and Malassezia dermatitis are commonly present at the time of initial evaluation. Cytology is important to determine the type and severity of the infection. Infections should be cleared before skin biopsies are taken to minimize secondary non-specific changes.

Pathological changes of the tissue vary according to the stage of the disease.

At the beginning, a nodular inflammation targeting the sebaceous glands is evident. Discrete nodules of histiocytes, neutrophils and lymphocytes are seen at the site of sebaceous glands. One disease that can appear similar to the inflammatory stage of sebaceous adenitis is the sterile pyogranuloma syndrome. However, in the latter, the inflammation is less focused on the sebaceous glands and clinically it has raised firm nodules rather than with scaling and alopecia.

As the disease progresses, the inflammation decreases until sebaceous glands are no longer evident.

When biopsy samples are submitted, pathologists should be made aware of the suspicion of sebaceous adenitis so that multiple biopsy sections are prepared and special attention is paid to the number and shape of the sebaceous glands.

Treatment In-depth
Treatments include anti-seborrheic shampoos, emollients, essential fatty acids, antibiotics for the secondary bacterial folliculitis, and retinoids.

Topical therapy:
Keratolytic shampoos are helpful in mild cases. The most commonly used include a combination of sulfur and salycilic acid. Alternately, antibacterial products like benzoyl peroxide in combination with sulfur (OxyDex) may be beneficial.

Topical propylene glycol (50 to 75 percent) diluted with water is also effective to decrease the scaling. It is used as a spray once or twice daily.

Soaks with baby oil have also been reported to help in severely affected dogs. Dogs need to be shampooed several times to remove the oil from the skin.

Systemic Therapy:

Essential fatty acids at high doses

Evening primrose oil at 500 mg twice daily orally

Eicosapentaenoic acid at 180 mg per 10lb of body weight daily orally

Retinoids in refractory cases, due to their ability of modulating epidermal growth and differentiation. Retinoids should be given for a minimum of two months. Outcome cannot be predicted on the basis of clinical signs or histologic findings and a prognosis cannot be determined on the basis of whether sebaceous glands are evident histologically.

Toxicity in animals seems to be less severe than in humans. Adverse effects include: vomiting, diarrhea, erythema, keratoconjunctivitis and stiffness.

Isotretinoin (Accutane) has been reported to be very successful in Vizlas with sebaceous adenitis. Isotretinoin has marked sebostatic activity. It decreases the proliferation of basal sebocytes and it suppresses sebum (oil) production. Other retinoids have been reported to be only moderately successful.

Cyclosporines (Sandimmune) have been used in a few cases with good success. In some dogs, good clinical response is observed in spite of absence of sebaceous glands histologically. Although cyclosporine has immunosuppressive properties (strong inhibitory effect on lymphocyte proliferation), this drug also has inhibitory effects of keratinocyte proliferation, which may be beneficial in some cases. Adverse effects include: vomiting, diarrhea, gingival hyperplasia, kidney toxicity, liver toxicity and increased incidence of bacterial infections.

Systemic antibiotics may be necessary for four to six weeks.

Follow-up
This condition is genetic and can be prevented by identifying affected animals and carriers and eliminating these animals from the breeding program.

This is a lifelong condition, thus chronic maintenance therapy (both topical and systemic) is necessary.

© Copyright 1999-2007 Intelligent Content Corp., All Rights Reserved
"This article has been provided courtesy of PetPlace.com
(http://www.petplace.com), the definitive online source for pet news, health,
and wellness information." 

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An SA Story
Report about the successful treatment of Sebaceous Adenitis through self-invented therapy
Sebaceous Adenitis
Sebaceous Adenitis Survey Results
Breeds Known to Have SA
The Use of Essential Oils in the Treatment of Sebaceous Adenitis
Skin Biopsies
A Retrospective on the use of Baby Oil Soaks in the Treatment of SA
Living with SA
Sebaceous Adenitis - Decisions, Responsibilities & Realities
Test breedings reveal inheritance mode of SA, DMS
Sebaceous Adenitis
SA




Website of interest
http://www.sebadenitis.de
(a german site - for translation go to AltaVista Babelfish at http://babel.altavista.com)

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The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.