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Sebaceous Adenitis Survey Results
by Jenny Drastura
With the support of the Genodermatosis Research Foundation (GRF), I recently conducted a survey to determine what types of treatments dog owners have found to be successful in controlling Sebaceous Adenitis, a skin condition caused by an inflammation of the sebaceous (oil) glands in the skin. The survey was made available through a recent GRF newsletter; on the Internet via a web site and through at least two national breed club sites; through several independent dog-related web sites; and through at least three national breed club publications. (The survey was sent by mail to 17 national breed clubs.) Many thanks in particular to the Poodle Club of America, the Akita Club of America and the Old English Sheepdog Club of America. Responses came from the United States, Canada, Brazil, Australia, Finland and Japan. These survey results and the original survey are posted at this web site: www.webpages.marshall.edu/~drastura/sasurvey.html.
Please note that this was not a scientific survey, and the responses, in most cases, are based primarily on the observations of laymen. However, these are the people who have been responsible for the care of the SA dogs, so they are in a beneficial position to report these details.
IMPORTANT BREAKTHROUGH! As of November 1998, the Institute for Genetic Disease Control has an Open Database for Sebaceous Adenitis. This means that the database is open to all breeds, and is. For more information about this registry, phone the GDC at 530/756-6773 or write P.O. 222, Davis, CA 95617. The information is confidential.
There were 81 responses to the survey, representing 95 dogs. The dogs included in the reports were 53 Standard Poodles, 22 Akitas, 4 Lhasa Apsos, 4 Old English Sheepdogs, 2 Golden Retrievers and one each of the following breeds: Chesapeake Bay Retriever, Beagle, Border Collie, Welsh Pembroke Corgi, Visla, Samoyed, Great Pyrenees, American Eskimo, a German Sheperd Dog/Akita mix and a German Shepherd Dog/Collie mix. There were 36 males and 53 females (6 were not specified). The mean (average) age at diagnosis was 3.81, and the median age, that is, the midpoint of the ages, was 3.
Respondents were asked what signs they first noticed in their dogs that led them to seek veterinary help. Sixty-three dogs showed some hair loss. There did not seem to be a pattern in the extent or area of loss, either in general or by breed. Please note that many of these signs were noted in the early stages of diagnosis, some even years before a diagnosis was made, and therefore, could conceivably be signs of another medical problem.
Some reported hair loss only when brushing their dog; some said only the undercoat was shedding. Some dogs lost hair only on the head, on the ears or around the eyes, at least at first. Some dogs lost hair only in patches somewhere on the body, such as on back of tail, inner thighs, legs, sides, or on the back. It appears that some dogs lost coat in a fairly even distribution over the body. Several Poodle owners noted that initially, only the topknot hair fell out.
Other unique hair-related signs were reported in several Poodles. In one, the coat texture changed from soft black and curly to thin, coarse, brown/red and straight, while another dog’s coat went from tight curls to loose curls. One Poodle's coat grew back in like a soft, fine puppy coat. Two related Poodles showed discoloration of hair while another showed rust-colored hair. An Akita owner reported that the head fur started having a peculiar, wavy pattern.
The second most common sign reported was some type of skin irregularity. (These signs were reported in addition to hair loss in many of the dogs.) Fifty-three dogs had some variation of dry, flaky skin or sores. Because these skin variations so exemplify SA, the descriptions provided will be listed below in categories. (Most of these signs were reported in more than one dog.)
Twenty of the respondents reporting staph or other infections said the infection was treated either by cephalexin (6), tetracycline (1); Panalog or other topical creams (3); steroids (3); or unspecified antibiotics (10).
The next question was regarding any related dogs with SA, either owned by the respondent or not. Six Standard Poodle owners reported specific dogs closely related to their SA dog, and one knew of four others in the pedigree. One person owns six Poodles affected with SA, and knows of 18 others related. Three of the Lhasa Apsos in the survey were cousins, and the sire of one of the Lhasas has a skin problem that has been diagnosed as a fungal infection, but has never been biopsied. Two Akitas and one Old English have relatives with SA. Relatives range from littermates to grand-parents. It should be noted that many of the respondents have pets or rescue dogs and would not necessarily be familiar with family medical histories.
Respondents were asked if any diagnosis other than SA was initially made, and how the incorrect diagnosis may have affected treatment. [Note: In some cases, these diagnoses were valid for other problems, but the signs persisted and the final diagnosis of SA was not made until later. Or, like staph infections, the diagnosis was related to SA.]
The most common initial diagnosis was hypothyroidism (12 dogs). Also diagnosed were: allergies (10); staph or other "skin" or bacterial infections (8); hormonal (3); pyoderma (2); yeast or fungal infections (2); mange (1); Cutaneous Malassezia (1); dandruff (1); "pimple-like" irritation (1). Eight dogs did not get a definitive diagnosis at first but their vets tried various medicated shampoos that were ineffective. One vet suspected "a disease of dogs with pendulous ears." One exasperated respondent reported that there were "too many to even name." One person whose dog was being treated for SA said there was a major flare-up of the SA when two dosages of thyroid hormone were missed.
The average amount of time between noticing the signs and receiving a proper diagnosis was 9 months. The median time (midpoint of the distribution) was 6 months, and the mode (most frequently reported time) was also 6 months. Forty-two respondents said the diagnosis was made by their local vet, usually with the biopsy sent to a dermatologist or veterinary school. Twenty-three said the diagnosis was made by a dermatology specialist; five said it was made at a veterinary school; one person, a medical doctor, made the diagnosis herself; and three respondents have not had an official diagnosis as of this time.
Interestingly, these misdiagnoses were as common in Standard Poodles and Akitas as in breeds less known to have SA.
Were these misdiagnoses harmful? In some cases, as stated above, the initial diagnoses were valid, if not the correct diagnosis for the SA. For example, the hypothyroid dogs that tested low were clearly in need of supplement, so that diagnosis was beneficial to the dog in other ways. Those given antibiotics for a diagnosis of infection felt the medication helped clear up those infections. Dogs diagnosed with allergies benefited in some ways by injections. A dog given steroids for ear swelling and itching improved, but then the more significant symptoms began to appear. Twelve respondents said the misdiagnosis was either of no significance or not at all helpful.
One respondent felt that the initial diagnosis for staph infection only and the subsequent weekly baths further dried out the skin. Two others also felt that the misdiagnoses were harmful in that the treatment for SA was delayed as a result. The owner of the dog misdiagnosed with Cutaneous Malassezia fears that the drugs used to treat that disease may have been harmful to the dog’s immune system and may have contributed the appearance of the SA symptoms.
In a few cases the signs of SA seem to have appeared immediately following another medical problem. An Old English Sheepdog that experienced an allergic reaction to a vitamin supplement began to exhibit major lesions and reddened skin within days; when the supplement was withdrawn, the lesions remained for several weeks, gradually replaced by the typical features of SA (lesions, skin flaking, drastic coat loss, odor, etc.) In another case, a Standard Poodle’s hair did not regrow after treatment for a cyst; then, other SA signs followed. An Akita and a Standard Poodle experienced problems with cysts before the SA signs began to appear at those sites.
Treatments for SA
If any conclusion can be drawn from this survey, it is that oil baths are the single-most successful treatment reported that gave the dogs the best the chance of improvement in coat, skin and well-being.
Sixty-four dogs were given some type of oil bath or daily to weekly oil sprays. Most of the oils used were some type of mineral oil based product such as baby oil, Alpha-Keri oil or Avon Skin-So-Soft. One person uses cod liver oil. Three use a commercial oil treatment (Nexus Botanical, Humilac and Pure Pet). While everyone did not specify whether these oils are mixed with water, quite a few do so, and a 50/50 mixture is what is recommended by most practitioners. The oils are left on the dog anywhere from 10 minutes to six hours, the most common being either one hour or two hours. The frequency of baths ranges from weekly to once a month; most respondents begin with weekly baths and vary the frequency later after several months as symptoms improve or recur.
One other product used successfully by a professional groomer who deals with multiple SA dogs is a special All Systems product mixture (one part Pure Lanolin Plus Skin & Hair Emollients, one part Super-Rich Protein Lotion Conditioner and two parts any cream rinse, all mixed with 8 ounces of water). This mixture is used in place of the oil, and is washed out with a detergent shampoo and cream rinse. The benefit is that the formula is much easier to wash out of the coat. This writer tried the formula after several months of using oil, and we were able to maintain the progress we made after using the oil. To be safe, we used oil very fourth time.
The oil is most often washed out with a dishwashing liquid such as Dawn or Palmolive (24 used these). Most people follow this with a more gentle shampoo, an oatmeal-based shampoo being the most used (5). Other shampoo choices include Wonderful, Suave Daily Clarifying, J&J Almond, Dr. Bizonner’s pure castile soap, Absolutely Natural, Coat Guard and Epi-Smooth. Five respondents used medicated shampoos after the oil, such as SebaLyt, Sulfoxydex or Sebolux.
Cream rinses such as Jhirmack E.F.A., Nexus Humectress, Mr. Crystal’s Oil of Orchard and Groomer’s Edge are used by some respondents after the final shampoo. At least five use a mixture of propylene glycol and water as a rinse or in a spray bottle between baths; two respondents use tea tree oil mixture.
Unfortunately, rating one oil, one shampoo, or even one frequency of bathing over another is virtually impossible. Results range drastically, but it is safe to say that all dogs showed at least some improvement after receiving as few as one or two oil baths. Respondents reported that scales, flakes and odor greatly disappeared after even one bath. One dog, for example, went from completely bald to a full coat; another was able to maintain its coat. A long-haired dog (Lhasa Apso) went from completely bald on the body and tail to a coat that touched the ground, but with no undercoat and sparse tail hair. An Old English Sheepdog also was able to grow back a fair amount of coat, but also had no undercoat. After four years of oil baths, one dog has only lost a few patches of hair that have grown back, albeit thin. One person found that as long as the baths are given weekly, the coat looks fine. But once this routine is broken, the coat drops. Another person found she can go 3 weeks without giving the dog a bath, but any more results in clumps of hair falling out. Several people mention that summertime brings on coat loss regardless of the frequency of bathing, a phenomenon that could may or may not be related to the SA. It appears that the only conclusion that can be drawn here is that while oil is definitely a successful factor in improvement, the amount used and the frequency of the baths just may depend on the individual dog. From the descriptions given, there did not appear to be a great variation in the actual methods used to give the baths.
At least seven respondents were not told by their veterinarian to use the oil baths for treatment. Three of the respondents found out about the oil baths as a result of this survey and have seen marked improvement as a result. One Poodle owner feels that in addition to a great improvement in the skin texture and a modest regrowth of hair, the dog’s disposition has also improved. A Samoyed owner who has seen marked improvement in skin and coat also feels that her dog is much happier and feels much better since the oil treatments have been started. Several others who had not been told about the oil plan to try the method and update us at a later time.
Some of the respondents not using oil baths are not without progress. One person sprays her dog with tea tree oil twice a week, uses Redken products every other month and oatmeal-based products as needed in between. This person’s dog is being shown in obedience. Propylene glycol helped another dog regain coat on both sides of the spine. One Lhasa owner whose dog clearly had signs of SA, but who did not have an official diagnosis, used Desenex shampoo and dabbed the lesions with Listerine. That dog is now in coat, according to the owner. However, at least four dogs being bathed only in medicated or other shampoos are still experiencing moderate to severe skin and coat problems.
Respondents were asked about the use of supplements. The supplements being used are: fatty acids (11); Vitamin E (10); Derm Caps (9); oil of primrose (7); flax seed oil (6); Vitamin A (6); Missing Link (6); Vitamin C (5); fish oil (4); cod liver oil (3); brewer’s yeast (3); garlic (3); Ester-C (3); kelp (2); selenium (2); and one each Linatone, zinc, Solid Gold sea meal, shark cartilage, pureed spinach, Vitamin K, Lipiderm, vegetable oil, peanut butter, Vita-Coat, sunflower oil, Canine Complete, astragulus, flax meal, Vitamin D, C-Biotics, seaweed mineral food, Allerderm caps and Prozyme. When asked if these supplements have been useful, most respondents are unsure since there are other factors involved and other treatments being used at the same time. Twenty-one felt that any supplements they have used have not been helpful. However, these positive comments were made:
Food effectiveness was the next question. Thirteen respondents specifically said they felt the food they use has had no effect one way or the other. There were nine foods listed by respondents who were unsure of how effective the choices were. These foods are: Nutro or other lamb and rice foods (4); Nutro Natural Choice (4); Kal Kan Pedigree (3); Iams Eukaneuba (2); and one listing each for Bil Jac, Sold Gold, Purina, Kibble and Bits plus table scraps, and a natural diet of raw meat and vegetables plus cooked grains.
There were positive comments about the following foods: Iams Eukaneuba (2 positive comments); Solid Gold Hundenflocken mixed with California Natural and cooked food; Nutromax (2 positive comments); canned Nature’s Recipe; Lick Your Chops fed with cooked chicken and cottage cheese; Wysong (2 positive comments); Wendy Volhard’s Natural Diet; Eagle; and an all-natural diet.
Nine respondents have sought help from a holistic or homeopathic practitioner. One saw improvement after seeing a veterinary chiropractor who treats all skin conditions as a parasitic problem. A formula called Unda #3 was prescribed, and the owner saw improvement after one month. This owner does not use the oil treatments. Another dog was prescribed Lipoform, Tang-Kuie 18 and Thymus PMG and has shown no improvement, but that person was not told about oil baths and has not yet tried them. Another person felt that the dog’s overall health has improved as a result of homeopathic care, but the SA has not improved. No oil treatments were prescribed for this dog either. Five other dogs were not helped by homeopathic remedies, including one who received acupuncture, and one dog’s SA was worse after acupuncture treatments. Several people plan to try homeopathic methods and said they will update their dogs’ progress later.
Ten respondents have tried retinoids. One felt that Accutane helped, although it took several months. Another dog was made ill by the Accutane, and another person felt it did not work at all. A dog treated with Retin-A did not improve. Another person who tried Tegisin saw improvement in hair growth on the dog’s back, but within a month, the dog was affected on its head. Tegisin worked somewhat, however, for another dog, and the owner plans to try other retinoids as suggested by the vet. A Standard Poodle owner felt the dog improved with the use of Rogaine. Three others said they used these products and saw no improvement.
Twenty-two respondents have noticed a cyclical hair growth/hair loss (when asked if the dog ever managed to grow a full coat, and then lose it). Twelve noted that their dogs have maintained either the original coat or the regrowth. Both figures include respondents with multiple SA dogs, and the use (or non-use) of oil or any other product for treatment was not a factor in these tallies.
Twenty-two dog owners are attempting to keep their dogs in coat, or at least not opting for close clipping, while 37 have opted for either shaving down the dog, keeping a short clip or shaving or clipping affected areas only.
None of the dogs, in the opinion of the owners, have improved enough to pursue or continue a career in conformation; however, six of the dogs are being shown in obedience. Three of the dogs had finished (championships) before the SA appeared; at least two dogs had their careers end due to the condition. (This figure is probably substantially greater since the question was not specifically asked.) It is not clear, however, if many of the respondents made an attempt to get the dog back into coat specifically to show, so this does not rule out the possibility of this being successful.