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Symmetrical lupoid onychodystrophy/onychomadesis is a complex disease with potentially multiple different causes. The most significant contributing factors identified in the literature were genetic predisposition and diet, with mechanical trauma exacerbating clinical signs.
From the literature available, it appears that no treatment option is universally effective. However, in some cases, it may be prudent to trial a diet rich in fatty acids alongside antibiotic therapy.
Some authors report that owners perceived an improvement in the claw condition after treatment with oral essential fatty acids, or relapse after stopping treatment. Therefore, oral essential fatty acids should be considered as an adjunct or maintenance therapy alongside other suggested treatments such as tetracyclines and niacinamide, prednisolone or pentoxifylline.
A five-year-old, neutered male lurcher is presented to you with a history of onychoschisis on one claw progressing to onychorrhexis and onychomadesis, which is now affecting multiple claws on all four feet and causing the dog great discomfort and lameness. A sample taken from the claw bed for cytological examination did not reveal any microorganisms, so the owner consented to amputation of the third phalanx on one claw in order to collect a specimen for histological examination. The histopathology report described lichenoid and hydropic interface dermatitis.
The dog had initially partially responded to a course of oral prednisolone at 1.5 mg/kg once daily, but the owner reported that the dog was showing side effects such as urinating in the house. However, when the dosing was reduced to every other day, the nail condition appeared to relapse. You wonder whether oral essential fatty acids would be an effective alternative treatment.
In [dogs affected by lupoid symmetrical onychodystrophy], how does treatment with [oral essential fatty acids] compare with [other available treatment options] to improve [growth of normal nails]?
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