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Colombo S, Sartori R, Schievano C, Borio S. Development and validation of an owner-assessed Visual Analog Scale for feline pruritus severity scoring (VAScat). Vet Dermatol 2022; 33:407-413. [PMID: 35920060 DOI: 10.1111/vde.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/17/2022] [Accepted: 05/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Assessment of the severity of pruritus is difficult in cats, because they manifest discomfort by increased licking, increased scratching or both. HYPOTHESIS/OBJECTIVES Our objective was to develop and validate a feline-specific pruritus scale (VAScat). METHODS The scale was designed as a double Visual Analog Scale (VAS), one VAS for licking and one for scratching, with severity and behavioural descriptors. The highest score (VAS-max) on either VAS was taken as the pruritus score for each cat. Owners of 153 cats with skin diseases and of 108 healthy cats scored their pet's pruritus using the VAScat. Ninety-six of 153 cats with skin diseases also were re-evaluated after four to eight weeks of treatment. RESULTS Pearson's correlation value between VAS-licking and VAS-scratching scores was r = 0.26 (p < 0.01), and Cronbach's alpha was 0.41. Both indexes indicated that the two scales measure different manifestations of pruritus and supported the use of a dual assessing system. Comparison with a numerical pruritus severity scale (0, absent; 1, mild; 2, moderate; 3, severe) suggested that VAS-licking and VAS-scratching scales taken alone are unsuitable for measuring absent to mild pruritus (grades 0-1), while VAS-max is (p = 0.001). VAS-licking, VAS-scratching and VAS-max all were suitable to assess higher levels of pruritus (grades 2-3, p < 0.01). The VAScat was able to measure pruritus improvement following therapy, as post-treatment scores were significantly decreased compared to pre-treatment ones (p < 0.0001). CONCLUSIONS AND CLINICAL IMPORTANCE The VAScat proved to be a useful tool to assess pruritus in cats and for monitoring the response to treatment for pruritus.
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Affiliation(s)
| | | | | | - Stefano Borio
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
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Cyclosporine Treatment in Cats with Presumed Chronic Pancreatitis-A Retrospective Study. Animals (Basel) 2021; 11:ani11102993. [PMID: 34680012 PMCID: PMC8532754 DOI: 10.3390/ani11102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine, an immunosuppressive drug, has been suggested as an alternative treatment when other drugs that suppress inflammation are ineffective or unsuitable. However, no published studies have investigated its efficacy in cats with CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine as a treatment for pancreatitis in cats with presumed CP. All cats had a history and clinical signs suggestive of CP and blood samples showed abnormally high concentrations of feline pancreas-specific lipase (Spec fPL) on at least two occasions. This is common in CP. All cats were treated with cyclosporine for at least three weeks. Nineteen cats, aged 6.9–17.5 years, were included. Daily treatment with cyclosporine resulted in an improvement of serum Spec fPL concentrations which indicates that the pancreatic inflammation likely had improved. The study has several limitations, including different treatment durations and doses, lack of biopsies to confirm CP and the treatment effect was not compared with an untreated control group. Despite the limitations, our results suggest that cyclosporine treatment decreases serum Spec fPL concentrations and may be effective in the management of feline chronic pancreatitis. Abstract Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine has been suggested as an alternative treatment when other immunosuppressive treatments are insufficient or contraindicated. However, no published studies have investigated its efficacy on feline CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine on supranormal serum feline pancreas-specific lipase (Spec fPL) concentrations in cats with presumed CP. Inclusion criteria were history and clinical signs suggestive of CP, serum Spec fPL concentrations above 5.3 μg/L (reference range 0–3.5 μg/L, equivocal range 3.6–5.3 μg/L) on at least two occasions and treatment with cyclosporine for at least three weeks. Serum Spec fPL was analyzed at Idexx Laboratories, Kornwestheim, Germany. Nineteen cats, aged 6.9–17.5 years (median 11.6), were included. No pancreatic biopsies were available. Median (range) serum Spec fPL concentration was 14.2 μg/L (6.1–43.3) at baseline and 6.7 μg/L (0.9–23.6) at follow-up. Cyclosporine treatment (5.0–7.9 mg/kg orally SID) was associated with a significant reduction in serum Spec fPL concentrations (p < 0.001) at follow-up after 23–206 days (median 35). Body weight decreased significantly between inclusion and follow-up (p = 0.013). Significant improvement of clinical signs could not be measured (p = 0.781). This study has several limitations, including unstandardized treatment length and dose, no control group and lack of pancreatic biopsies. Despite the limitations, our results suggest that cyclosporine treatment reduces supranormal serum Spec fPL concentrations in cats with presumed CP.
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Santoro D, Archer L, Fagman L. Intradermal immunotherapy with actinomycetales preparations as treatment for feline atopic syndrome: a randomized, placebo-controlled, double-blinded study. Vet Dermatol 2021; 32:638-e170. [PMID: 33890342 DOI: 10.1111/vde.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/13/2020] [Accepted: 12/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Feline atopic syndrome (FAS) is a common disease. Single intradermal injections of heat-killed actinomycetales have shown beneficial effects in canine allergies. HYPOTHESIS/OBJECTIVE To evaluate the clinical effects of heat-killed actinomycetales [Gordonia bronchialis (GB) and Rodococcus coprophilus (RC)], alone or in combination, in FAS. METHODS AND MATERIALS Privately owned cats with a diagnosis of FAS were assigned randomly in three treatment groups (GB, RC and GB/RC combination) or placebo. Five intradermal injections were performed over a one year period. At each visit [Day (D)0, D20, D40, D60, D90, D180 and D365], clinical signs, global owner assessment score, use of rescue medications, clinical adverse effects, skin hydration and cutaneous pH were assessed. RESULTS Seventeen cats were enrolled. When compared to the placebo group and improvement in treatment GB was sustained from D90. When compared with D0 significant improvement in the GB group was seen from D60. Over one year, a complete remission of the clinical signs was seen in 30-67% of cats in the treatment groups. A reduction in the pruritus score was seen for RC after 365 days of treatment (P = 0.04). Differences in the other variables were not seen. CONCLUSIONS AND CLINICAL IMPORTANCE The use of multiple intradermal injections of heat-killed GB shows promise as effective and well-tolerated treatment for FAS. Because of the low cost and the lack of adverse effects, GB could be a beneficial treatment option for FAS. A larger study is needed to confirm these data and to evaluate the immunological changes occurring in the treated cats.
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Affiliation(s)
- Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Linda Archer
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Lana Fagman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
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Mueller RS, Nuttall T, Prost C, Schulz B, Bizikova P. Treatment of the feline atopic syndrome - a systematic review. Vet Dermatol 2021; 32:43-e8. [PMID: 33470011 DOI: 10.1111/vde.12933] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Feline allergic skin disease and asthma occur regularly in small animal practice. OBJECTIVES To provide evidence-based recommendations for small animal practitioners on the treatment of feline atopic syndrome (FAS). METHODS AND MATERIALS The authors reviewed the literature available before February 2020, prepared a detailed evidence-based literature review and made recommendations based on the evaluated evidence. RESULTS Sixty-six papers and abstracts were identified describing treatment interventions for FAS and evaluated to establish treatment recommendations. For many treatment options, the papers were retrospective, open studies or case reports. CONCLUSION AND CLINICAL RELEVANCE In this review, there was good evidence for the efficacy of systemic glucocorticoids and ciclosporin, and limited evidence for the efficacy of topical glucocorticoids, oclacitinib and allergen-specific immunotherapy in feline atopic skin syndrome. Evidence pointed to low-to-moderate efficacy for antihistamines, fatty acids and palmitoyl ethanolamide. In feline asthma, there was good evidence for the efficacy of oral and inhaled glucocorticoids, and limited evidence of moderate efficacy for allergen-specific immunotherapy. Evidence supported low-to-moderate efficacy of mesenchymal stem cells, inhaled lidocaine and oclacitinib as treatments for feline asthma. For almost all therapeutic options (with the exception of glucocorticoids and ciclosporin), more randomised controlled trials are needed.
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Affiliation(s)
- Ralf S Mueller
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Tim Nuttall
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | | | - Bianka Schulz
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Petra Bizikova
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Maina E, Fontaine J. Use of maropitant for the control of pruritus in non-flea, non-food-induced feline hypersensitivity dermatitis: an open-label, uncontrolled pilot study. J Feline Med Surg 2019; 21:967-972. [PMID: 30427273 PMCID: PMC11132245 DOI: 10.1177/1098612x18811372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES Non-flea, non-food-induced hypersensitivity dermatitis (NFNFIHD) is a common inflammatory and pruritic skin disease in cats. When avoidance and conventional systemic immunosuppressive treatments fail to control the clinical signs, there are limited treatment options. The aim of this study was to evaluate the efficacy and tolerability of maropitant in feline NFNFIHD. METHODS In an open-label, uncontrolled study, cats with proven non-seasonal NFNFIHD were treated with maropitant 2 mg/kg PO q24h for 4 weeks. Clinical lesions were evaluated with the Scoring Feline Allergic Dermatitis (SCORFAD) system and pruritus was evaluated with a 10 cm visual analogue scale (VAS) before and at the end of the study. Owners assessed global efficacy and tolerability with a 4-point scale at the end of the study. Adverse events and body weight changes were recorded. RESULTS Twelve cats were treated with a mean initial maropitant dose of 2.22 mg/kg PO q24h. The treatment decreased both SCORFAD and pruritus VAS (pVAS) scores in all cats except one, in which only pruritus was reduced. The efficacy and the tolerability of the treatment were judged as excellent or good by 83.3% of owners. Treatment did not cause any side effects other than, in a few cases, short-time, self-limiting sialorrhoea. CONCLUSIONS AND RELEVANCE Maropitant seems to be an effective, well-tolerated therapeutic option to control pruritus in cats. Caution is needed in interpreting the results as the pVAS score system has not yet been validated in cats and the trial was uncontrolled. A further, controlled study is required to confirm our findings.
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Affiliation(s)
- Elisa Maina
- Laboratory of Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
- Medi-vet SA, Lausanne, Switzerland
| | - Jacques Fontaine
- University of Liège Veterinary Faculty, Small Animal Internal Medicine Service – Dermatology, Liège, Belgium
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Lopes NL, Campos DR, Machado MA, Alves MSR, de Souza MSG, da Veiga CCP, Merlo A, Scott FB, Fernandes JI. A blinded, randomized, placebo-controlled trial of the safety of oclacitinib in cats. BMC Vet Res 2019; 15:137. [PMID: 31068210 PMCID: PMC6506962 DOI: 10.1186/s12917-019-1893-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background Oclacitinib is a Janus kinase (JAK) 1 enzyme inhibitor and blocks JAK1-dependent cytokines and is used to control pruritus. Studies available in cats are very limited and as there is a potential role for oclacitinib in the control of pruritus in this specie, the aim of this study was to evaluate the safety and clinical effects of oral oclacitinib maleate in healthy cats. Results Thirty mixed-breed cats weighing from 2.1 to 5.3 kg each were randomly allocated to three treatment groups of 10 animals each. Cats in two groups received oclacitinib at 1 mg/kg or 2 mg/kg q 12 h orally for 28 days. Cats in the third group were given placebo tablets (cornstarch) q 12 h orally for 28 days. Oclacitinib maleate was well tolerated during the study and few adverse events were observed in treated cats. Clinical signs of toxicity were not observed in any animals treated at 1 mg/kg. Gastrointestinal clinical signs observed in the 2 mg/kg group included vomiting in two of the 10 cats and soft stools in two cats. One cat treated with placebo also exhibited soft stools. No significant differences were observed between the groups for hematologic analyses performed during the study. There was a slight increase in neutrophils and monocytes and a decrease in eosinophil mean counts in treated cats. Mean renal and liver enzymes remained normal throughout the entire study. A small, but significant increase in fructosamine levels was observed for both treated groups compared with placebo; however, values remained within the normal reference range. There were no significant difference between treated groups and the placebo group for urine specific gravity, pH, or urine protein to creatinine ratio mean values. Conclusions Oclacitinib maleate was well tolerated by cats at 1 mg/kg and 2 mg/kg and appeared to be safe for this species when administered orally twice daily for 28 days. More studies would be needed to demonstrate if oclacitinib maleate may be a suitable alternative to treat pruritic cats.
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Affiliation(s)
- Natália Lôres Lopes
- Veterinary Medicine, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropédica, Brazil.
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Amengual Batle P, Rusbridge C, Nuttall T, Heath S, Marioni-Henry K. Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective study of seven cases and proposal for an integrated multidisciplinary diagnostic approach. J Feline Med Surg 2019; 21:178-185. [PMID: 29595359 PMCID: PMC10814607 DOI: 10.1177/1098612x18764246] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
CASE SERIES SUMMARY This was a retrospective study on the clinical features and response to treatment in seven cats with feline hyperaesthesia syndrome (FHS) and tail mutilation. FHS is a poorly understood disorder characterised by skin rippling over the dorsal lumbar area, episodes of jumping and running, excessive vocalisation, and tail chasing and self-trauma. The majority of the cats were young, with a median age of 1 year at the onset of clinical signs, male (n = 6) and with access to the outdoors (n = 5). Multiple daily episodes of tail chasing and self-trauma were reported in five cats, with tail mutilation in four cats. Vocalisation during the episodes (n = 5) and rippling of lumbar skin (n = 5) were also reported. Haematology, serum biochemistry, Toxoplasma gondii and feline immunodeficiency virus/feline leukaemia virus serology, MRI scans of brain, spinal cord and cauda equina, cerebrospinal fluid analysis and electrodiagnostic tests did not reveal any clinically significant abnormalities. A definitive final diagnosis was not reached in any of the cats, but hypersensitivity dermatitis was suspected in two cases. A variety of medications was used alone or in combination, including gabapentin (n = 6), meloxicam (n = 4), antibiotics (n = 4), phenobarbital (n = 2), prednisolone (n = 2) and topiramate (n = 2); ciclosporin, clomipramine, fluoxetine, amitriptyline and tramadol were used in one cat each. Clinical improvement was achieved in six cases; in five cats complete remission of clinical signs was achieved with gabapentin alone (n = 2), a combination of gabapentin/ciclosporin/amitriptyline (n = 1), gabapentin/prednisolone/phenobarbital (n = 1) or gabapentin/topiramate/meloxicam (n = 1). RELEVANCE AND NOVEL INFORMATION This is the first retrospective study on a series of cats with FHS. The diagnostic work-up did not reveal any significant abnormalities of the central or peripheral nervous system; dermatological and behavioural problems could not be ruled out. We propose an integrated multidisciplinary diagnostic pathway to be used for the management of clinical cases and for future prospective studies.
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Affiliation(s)
- Pablo Amengual Batle
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Clare Rusbridge
- Fitzpatrick Referrals, Godalming, UK
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Tim Nuttall
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Katia Marioni-Henry
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK
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Colombo S, Sartori R. Ciclosporin and the cat: Current understanding and review of clinical use. J Feline Med Surg 2018; 20:244-255. [PMID: 29478396 PMCID: PMC10816290 DOI: 10.1177/1098612x17748718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Ciclosporin (CsA) is a systemic immuno-modulatory drug widely used to treat immune-mediated diseases in humans and veterinary species. CsA was registered for use in cats in the USA and Europe in 2011, and is indicated for the treatment of chronic allergic dermatitis at a recommended daily dose of 7 mg/kg PO. AUDIENCE This review will be of interest to all veterinarians working with cats, given the wide range of potential applications of CsA and its safety profile. Although the drug is currently only licensed to treat chronic allergic dermatitis in cats, a small number of reports describe its use in non-dermatological conditions. Evidence base: This article reviews the mechanism of action, pharmacokinetics, drug interactions, adverse effects and clinical use of CsA, both for the licensed indication and for off-label use in the feline patient. Information presented has been summarised from the existing literature on CsA, with specific interest in studies carried out in cats. For its licensed indication, chronic allergic dermatitis, evidence provided includes randomised, placebo or prednisolone-controlled studies (EBM grade I) and prospective or retrospective open trials.
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Affiliation(s)
- Silvia Colombo
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| | - Roberta Sartori
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
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Koch SN, Torres SMF, Diaz S, Gilbert S, Rendahl A. Subcutaneous administration of ciclosporin in 11 allergic cats - a pilot open-label uncontrolled clinical trial. Vet Dermatol 2017; 29:107-e43. [DOI: 10.1111/vde.12505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra N. Koch
- Department of Veterinary Clinical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
| | - Sheila M. F. Torres
- Department of Veterinary Clinical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
| | - Sandra Diaz
- Department of Veterinary Clinical Sciences; The Ohio State University; 601 Vernon Tharp Street Columbus OH 43210 USA
| | - Sophie Gilbert
- Centre Vétérinaire Laval; 4530 Highway 440 Laval Quebec Canada H7T 2P7
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
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Marsella R, De Benedetto A. Atopic Dermatitis in Animals and People: An Update and Comparative Review. Vet Sci 2017; 4:vetsci4030037. [PMID: 29056696 PMCID: PMC5644664 DOI: 10.3390/vetsci4030037] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/20/2017] [Accepted: 07/22/2017] [Indexed: 12/13/2022] Open
Abstract
Atopic dermatitis is an extremely common, pruritic, and frustrating disease to treat in both people and animals. Atopic dermatitis is multifactorial and results from complex interactions between genetic and environmental factors. Much progress has been done in recent years in terms of understanding the complex pathogenesis of this clinical syndrome and the identification of new treatments. As we learn more about it, we appreciate the striking similarities that exist in the clinical manifestations of this disease across species. Both in animals and people, atopic disease is becoming increasingly common and important similarities exist in terms of immunologic aberrations and the propensity for allergic sensitization. The purpose of this review is to highlight the most recent views on atopic dermatitis in both domestic species and in people emphasizing the similarities and the differences. A comparative approach can be beneficial in understanding the natural course of this disease and the variable response to existing therapies.
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Affiliation(s)
- Rosanna Marsella
- Department of Dermatology, College of Medicine, University of Florida, 4037 NW 86 Terrace, Gainesville, FL 32606, USA.
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32610, USA.
| | - Anna De Benedetto
- Department of Dermatology, College of Medicine, University of Florida, 4037 NW 86 Terrace, Gainesville, FL 32606, USA.
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Gruen ME, Dorman DC, Lascelles BDX. Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. Vet Rec 2017; 180:473. [PMID: 28270539 DOI: 10.1136/vr.104168] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 12/20/2022]
Abstract
A literature review identified six placebo-controlled studies of analgesics in client-owned cats with degenerative joint disease-associated pain. Five studies with 96 cats had available data. Caregiver responses on a clinical metrology instrument, Client-Specific Outcome Measure (CSOM), were compared to measured activity. Cats were categorised as 'successes' or 'failures' based on change in CSOM score and activity counts from baseline. Effect sizes based on CSOM score were calculated; factors that were associated with success/failure were analysed using logistic regression. Effect sizes ranged from 0.97 to 1.93. The caregiver placebo effect was high, with 54-74 per cent of placebo-treated cats classified as CSOM successes compared with 10-63 per cent of cats classified as successes based on objectively measured activity. 36 per cent of CSOM successes were also activity successes, while 19 per cent of CSOM failures were activity successes. No significant effects of cat age, weight, baseline activity, radiographic score, orthopaedic pain score or study type on CSOM success in the placebo groups were found. The caregiver placebo effect across these clinical trials was remarkably high, making demonstration of efficacy for an analgesic above a placebo difficult. Further work is needed to determine whether a potential placebo-by-proxy effect could benefit cats in clinical settings.
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Affiliation(s)
- M E Gruen
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA
| | - D C Dorman
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - B D X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA
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Roberts ES, Speranza C, Friberg C, Griffin C, Steffan J, Roycroft L, King S. Confirmatory field study for the evaluation of ciclosporin at a target dose of 7.0 mg/kg (3.2 mg/lb) in the control of feline hypersensitivity dermatitis. J Feline Med Surg 2016; 18:889-897. [DOI: 10.1177/1098612x16636660] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives This study was designed to confirm the efficacy and tolerability of a daily dose of 7.0 mg/kg (3.2 mg/lb) ciclosporin (CsA) in the treatment of feline hypersensitivity dermatitis (HD), as this includes some of the most frequently suspected skin diseases in cats and recent publications have reported the successful use of CsA in the treatment of feline HD. Methods In total, 217 cats with feline HD were treated daily for 42 days with a target dose of 7 mg/kg CsA (n = 144) or a placebo control (n = 73) administered either in the food or directly in the mouth following feeding. Clinical and dermatological evaluations were conducted on days 0, 21 and 42, or study exit. Safety was evaluated through physical examinations, clinical pathology and the monitoring of adverse events (AEs). Results Administration of CsA at 7.0 mg/kg produced a significant improvement in the total lesion score ( P <0.0001). The average reduction from visit 1 to visit 3 was 65.1% in the CsA group (9.2% for the placebo). In addition, owners assessed 78.3% of the cases in the CsA group as a success. Statistically significant recoveries were also seen in extent of lesions, investigator assessment of overall improvement, and mean improvement in both the investigators’ and owners’ assessment of pruritus. Mild gastrointestinal disorders were the most common AEs but did not require cessation of therapy. Conclusions and relevance Results confirm that 7.0 mg/kg CsA dosed daily in food or orally for up to 6 weeks is effective and well tolerated by cats with feline HD.
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Roberts ES, Tapp T, Trimmer A, Roycroft L, King S. Clinical efficacy and safety following dose tapering of ciclosporin in cats with hypersensitivity dermatitis. J Feline Med Surg 2016; 18:898-905. [DOI: 10.1177/1098612x15602523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives This study was designed to evaluate the efficacy and safety of reducing ciclosporin (CsA) dosing frequency from daily to every other day (EOD) or twice a week (TW) according to clinical response in cats with hypersensitivity dermatitis (HD) and treated with CsA. Methods One hundred and ninety-one cats with HD were given 7 mg/kg CsA daily for at least 4 weeks. Depending on clinical response, the dosing frequency was tapered from daily to EOD over the next 4 weeks and further to TW for an additional 4 weeks. Safety was evaluated through physical examinations, clinical pathology and the monitoring of adverse events (AEs). Results The majority of cats were able to have their dose of CsA tapered to either EOD (15.5%) or TW (62.9%) according to the clinical response. Observed AEs were most frequently mild and self-limiting vomiting and diarrhea. A higher percentage of AEs occurred with daily administration (73%) compared with other dosing regimens (27%). Conclusions and relevance Following 4 weeks of daily dosing at 7 mg/kg, CsA may be tapered to EOD or TW while maintaining the desired therapeutic response in cats with HD. Additionally, CsA appears to be well tolerated with fewer AEs at EOD or TW dosing. Establishing the lowest effective dosing frequency of CsA improves the drug’s safety profile.
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Affiliation(s)
| | - Tiffany Tapp
- Veterinary Healing Arts, East Greenwich, RI, USA
| | - Ann Trimmer
- Animal Allergy and Dermatology Specialists, Las Vegas, NV, USA
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Ortalda C, Noli C, Colombo S, Borio S. Oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis: results of a small prospective pilot study of client-owned cats. Vet Dermatol 2015; 26:235-e52. [DOI: 10.1111/vde.12218] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Christian Ortalda
- Servizi Dermatologici Veterinari; Strada Revigliasco 11 Moncalieri 10024 Italy
| | - Chiara Noli
- Servizi Dermatologici Veterinari; Strada Bedale della Ressia 2 Peveragno 12016 Italy
| | - Silvia Colombo
- Servizi Dermatologici Veterinari; via Felice Musazzi 24 Legnano 20025 Italy
| | - Stefano Borio
- Servizi Dermatologici Veterinari; via Italia 12 San Mauro Torinese 10099 Italy
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15
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Jensen-Jarolim E, Einhorn L, Herrmann I, Thalhammer JG, Panakova L. Pollen Allergies in Humans and their Dogs, Cats and Horses: Differences and Similarities. Clin Transl Allergy 2015; 5:15. [PMID: 25852853 PMCID: PMC4387677 DOI: 10.1186/s13601-015-0059-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/16/2015] [Indexed: 11/17/2022] Open
Abstract
Both humans and their most important domestic animals harbor IgE and a similar IgE receptor repertoire and expression pattern. The same cell types are also involved in the triggering or regulation of allergies, such as mast cells, eosinophils or T-regulatory cells. Translational clinical studies in domestic animals could therefore help cure animal allergies and at the same time gather knowledge relevant to human patients. Dogs, cats and horses may spontaneously and to different extents develop immediate type symptoms to pollen allergens. The skin, nasal and bronchial reactions, as well as chronic skin lesions due to pollen are in principle comparable to human patients. Pollen of various species most often causes allergic rhinitis in human patients, whereas in dogs it elicits predominantly eczematous lesions (canine atopic dermatitis), in horses recurrent airway obstruction or hives as well as pruritic dermatitis, and in cats bronchial asthma and so-called cutaneous reactive patterns (eosinophilic granuloma complex, head and neck pruritus, symmetric self-induced alopecia). In human allergy-specific IgE detection, skin tests or other allergen provocation tests should be completed. In contrast, in animals IgE and dermal tests are regarded as equally important and may even replace each other. However, for practical and economic reasons intradermal tests are most commonly performed in a specialized practice. As in humans, in dogs, cats and horses allergen immunotherapy leads to significant improvement of the clinical symptoms. The collected evidence suggests that canines, felines and equines, with their spontaneous allergies, are attractive model patients for translational studies.
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Affiliation(s)
- Erika Jensen-Jarolim
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, c/o Institute of Pathophysiology and Allergy Research, Währinger G. 18-20, Vienna, 1090 Austria
| | - Lukas Einhorn
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, c/o Institute of Pathophysiology and Allergy Research, Währinger G. 18-20, Vienna, 1090 Austria
| | - Ina Herrmann
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Johann G Thalhammer
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Lucia Panakova
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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16
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Lappin MR, VanLare KA, Seewald W, Roycroft LM, Scorza AV, King S, Roberts ES. Effect of oral administration of cyclosporine on Toxoplasma gondii infection status of cats. Am J Vet Res 2015; 76:351-7. [PMID: 25815576 DOI: 10.2460/ajvr.76.4.351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate whether anti-inflammatory doses of cyclosporine activate Toxoplasma gondii in chronically infected cats or potentiate infection in cats exposed for the first time. ANIMALS 30 T gondii-negative cats. PROCEDURES Cats were assigned to 1 of 3 groups (10 cats/group). Group 1 (control) cats were administered a placebo for 126 days; group 2 cats were administered a placebo for 84 days, followed by cyclosporine at 7.5 mg/kg/d, PO, for 42 days; and group 3 cats were administered cyclosporine at 7.5 mg/kg/d, PO, for 126 days. Cats were orally inoculated with T gondii on day 42. Results for fecal flotations, PCR assays, and histologic examinations and IgM and IgG titers were analyzed. Cyclosporine concentrations were measured on selected days. RESULTS All cats were infected by T gondii and developed signs of self-limiting gastrointestinal tract infection. Group 3 had the highest incidence and severity of CNS and pulmonary histopathologic findings typical of toxoplasmosis. One cat in group 3 died of systemic toxoplasmosis; that cat had a cyclosporine concentration of 1,690 ng/mL. Group 2 cats infected with T gondii before cyclosporine administration did not have repeated oocyst shedding. Group 3 cats shed fewer oocysts for a shorter time than did control cats of group 1. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of cyclosporine in accordance with the protocol for this study did not potentiate the enteroepithelial phase of T gondii infection. Cats with high cyclosporine blood concentrations at the time of primary T gondii infection may be at risk of developing systemic toxoplasmosis.
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Affiliation(s)
- Michael R Lappin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523
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17
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Abstract
Practical relevance: The field of veterinary medicine is constantly evolving. New medications are being introduced into clinical practice, and novel uses for established medications are frequently being discovered as new information comes to light. Clinical challenges: Therapeutic options for our feline patients can be restricted based on inadequate clinical evidence, adverse effects and patient compliance concerns. Additionally, with the reduced availability of commonly used medications in some regions, clinicians are forced to utilize alternatives with which they may have limited experience. Audience: This review article is directed towards primary care veterinarians working with feline patients. The selection of medications discussed is based on many of the clinical challenges commonly encountered in practice. Evidence base: The evidence for use of some of these medications is limited due to their novelty. Known mechanisms of action, pharmacokinetic and pharmacodynamics data, adverse effects and clinical uses are reviewed where possible, with clinical recommendations made based on the evidence of data available.
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Affiliation(s)
- William Whitehouse
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| | - Katrina Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
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18
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Nafe LA, Leach SB. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. J Feline Med Surg 2014; 17:1073-6. [PMID: 25527351 DOI: 10.1177/1098612x14563342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy.
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Affiliation(s)
- Laura A Nafe
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
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19
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Lappin MR, Roycroft LM. Effect of ciclosporin and methylprednisolone acetate on cats previously infected with feline herpesvirus 1. J Feline Med Surg 2014; 17:353-8. [PMID: 25204453 DOI: 10.1177/1098612x14548865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Feline herpesvirus 1 (FHV-1) is a common ocular and respiratory pathogen of cats that can be associated with recurrent clinical signs of disease. Ciclosporin (cyclosporine) is commonly administered per os (PO) for the treatment of a number of inflammatory diseases in cats. A number of client-owned cats administered ciclosporin (cyclosporine) A (CsA) PO to block renal transplant rejection have developed clinical signs of upper respiratory tract disease that may have been from activated FHV-1. In this study, cats experimentally inoculated with FHV-1 several months previously were administered methylprednisolone acetate intramuscularly, CsA PO or a placebo PO. While clinical signs of activated FHV-1 occurred in some cats, disease was mild and self-limited in most cats. There was no vomiting, diarrhea, inappetence, weight loss, polydipsia, polyuria or polyphagia recognized.
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Affiliation(s)
- Michael R Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, USA
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20
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Moriello KA. The secret sits. Vet Dermatol 2014; 25:332-3. [PMID: 25124178 DOI: 10.1111/vde.12153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karen A Moriello
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive West, Madison, WI, 53706, USA.
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21
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Roberts ES, VanLare KA, Roycroft LM, King S. Effect of high-dose ciclosporin on the immune response to primary and booster vaccination in immunocompetent cats. J Feline Med Surg 2014; 17:101-9. [DOI: 10.1177/1098612x14533550] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ciclosporin (Atopica oral solution for cats 100 mg/ml; Novartis Animal Health) was recently approved for use in cats with feline hypersensitivity dermatitis. The immunosuppressant effect of ciclosporin on the ability of cats to mount an immune response following vaccination was determined. Thirty-two healthy, immunocompetent adult cats (16 cats/group) were treated with either ciclosporin for 56 days at a dose of 24 mg/kg once daily or sham dosed. Prior to treatment, cats had an adequate antibody response to primary vaccination against feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), feline panleukopenia virus (FPV), feline leukemia virus (FeLV) and rabies. Booster vaccination or novel vaccination with feline immunodeficiency virus (FIV) was administered 28 days after initiation of treatment with ciclosporin. There were no differences between the ciclosporin-treated and control cats for FCV and FPV antibody titers following booster vaccination. There were delays/reductions in antibody response to FHV-1, FeLV and rabies in treated cats; however, adequate protection was achieved in response to all booster vaccinations. Following primary vaccination with FIV, control cats showed a response, but treated cats showed no antibody production. Adverse events commonly associated with ciclosporin treatment, including diarrhea/loose stool, vomiting, salivation and regurgitation, were reported. In adult cats treated with 24 mg/kg/day of ciclosporin (more than three times the therapeutic dose), vaccine titer levels were adequate for protection following booster vaccination. In contrast, treated cats failed to mount a humoral response to a novel (FIV) vaccination, suggesting that memory B-cell immune responses remain intact during repeated high-dose ciclosporin administration in cats, but that primary immune responses are impaired.
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22
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Favrot C. Feline non-flea induced hypersensitivity dermatitis: clinical features, diagnosis and treatment. J Feline Med Surg 2014; 15:778-84. [PMID: 23966004 DOI: 10.1177/1098612x13500427] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Hypersensitivity dermatitis (HD) is often suspected in cats and is mostly caused by insect bites, food or environmental allergens. Cats with non-flea induced HD are reported to present frequently with one or more of the following cutaneous reaction patterns: miliary dermatitis, eosinophilic dermatitis, self-induced symmetrical alopecia or head and neck excoriations/pruritus. CLINICAL CHALLENGES None of the above patterns are, however, pathognomonic for non-flea induced HD and the diagnosis of this condition is based on exclusion of diseases presenting similarly and an adequate response to treatment. Therapeutic approaches to affected cats include use of immunomodulatory drugs (ciclosporin, glucocorticoids, antihistamines), hypoallergenic diets and allergen-specific immunotherapy. EVIDENCE BASE This review provides an update on the clinical signs, diagnosis and treatment of feline non-flea induced HD. It draws on the findings of a recent large-scale study that described the clinical signs of numerous cats with non-flea HD and has proposed criteria to facilitate the diagnosis of the condition.
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Affiliation(s)
- Claude Favrot
- Dermatology Department, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
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23
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Roberts ES, Vanlare KA, Strehlau G, Peyrou M, Roycroft LM, King S. Safety, tolerability, and pharmacokinetics of 6-month daily dosing of an oral formulation of cyclosporine (ATOPICA for cats®) in cats. J Vet Pharmacol Ther 2013; 37:161-8. [PMID: 24134659 PMCID: PMC4282489 DOI: 10.1111/jvp.12081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/23/2013] [Indexed: 11/28/2022]
Abstract
Cyclosporine was proven efficacious in the treatment of feline hypersensitivity dermatitis. This target animal study was conducted to evaluate the safety, tolerability, and pharmacokinetics of ATOPICA for Cats® (cyclosporine oral solution, USP) MODIFIED following 6-month daily dosing in cats. Forty healthy cats (four cats/sex/group) received 0, 8 (1×), 16 (2×), 24 (3×), or 40 (5×) mg/kg cyclosporine once daily for 6 months (183 days). Body weight, food consumption, ophthalmoscopic, physical examinations including neurological assessments, blood pressure, electrocardiography, clinical pathology (hematology, coagulation, clinical chemistry, urinalysis), organ weights, and macroscopic and microscopic examinations were performed and assessed. In addition, blood concentrations of cyclosporine were measured at the pretreatment trough on Days 1, 2, 7, 14, 31, 91, 154, and 182, and post-treatment on Days 1, 31, and 182. Adverse effects possibly related to treatment included prolonged APTT and one report each of bone marrow hypocellularity and lymphoma; all occurred in cats treated with doses more than 16 mg/kg. There was no significant accumulation of cyclosporine beyond the first week of treatment. Results confirm that ATOPICA for Cats is safe and well tolerated in cats without unexpected accumulation beyond the first week of treatment when administered as directed.
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Affiliation(s)
- E S Roberts
- Novartis Animal Health US, Inc, Greensboro, NC, USA
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24
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Wildermuth K, Zabel S, Rosychuk RAW. The efficacy of cetirizine hydrochloride on the pruritus of cats with atopic dermatitis: a randomized, double-blind, placebo-controlled, crossover study. Vet Dermatol 2013; 24:576-81, e137-8. [DOI: 10.1111/vde.12067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Kerstin Wildermuth
- Department of Clinical Sciences; Colorado State University College of Veterinary Medicine and Biomedical Sciences; 300 West Drake Fort Collins CO 80523 USA
- Tierdermatologie Dr. Wildermuth; Borsigstraße 7a 65205 Wiesbaden Germany
| | - Sonja Zabel
- Department of Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; 501 DW Brooks Drive Athens GA 30602 USA
| | - Rod A. W. Rosychuk
- Department of Clinical Sciences; Colorado State University College of Veterinary Medicine and Biomedical Sciences; 300 West Drake Fort Collins CO 80523 USA
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25
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Steffan J, Roberts E, Cannon A, Prélaud P, Forsythe P, Fontaine J, King S, Seewald W. Dose tapering for ciclosporin in cats with nonflea-induced hypersensitivity dermatitis. Vet Dermatol 2013; 24:315-22, e70. [PMID: 23530522 PMCID: PMC7169265 DOI: 10.1111/vde.12018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little information is available on the ciclosporin dose-tapering regimen and clinical response in the treatment of feline hypersensitivity dermatitis. HYPOTHESIS/OBJECTIVES To test a dose-tapering regimen and assess efficacy and clinical safety for up to 18 weeks. ANIMALS Eighty-eight client-owned cats with feline hypersensitivity dermatitis. METHODS Cats that received either a placebo or ciclosporin at 2.5 mg/kg or 7 mg/kg daily for 6 weeks were given 7 mg/kg ciclosporin daily for 4 weeks. Depending on the clinical response, the dose was tapered from daily to every other day over the next 4 weeks and further to twice a week for an additional 4 weeks. RESULTS After all cats received 7 mg/kg for 4 weeks, the dose could be tapered to every other day for the next 4 weeks in 70% of cats remaining in the study. During the next 4 weeks, 57, 15 and 22% of cats remaining in the study could be treated at twice a week, every other day or daily, respectively. After the first 4 weeks, the mean lesion score and owner-assessed pruritus improved over baseline by 69 and 61%, respectively, and remained stable during the following 8 weeks. Approximately 65% of the cats in the study were reported to have an adverse event (AE), very often mild and resolving spontaneously. The most frequent AEs were gastrointestinal and included primarily vomiting and diarrhoea. Eighty per cent of AEs occurred when cats were on daily treatment. CONCLUSIONS AND CLINICAL IMPORTANCE Results suggest that the induction dose of 7 mg/kg ciclosporin can be tapered as soon as 4 weeks without deterioration of the clinical response. Establishment of the lowest effective dosing regimen of ciclosporin reduced the frequency of AEs.
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Affiliation(s)
- Jean Steffan
- Novartis Animal Health, Schwarzwaldallee 214, Basel, Switzerland.
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26
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Steffan J, Olivry T, Forster SL, Seewald W. Responsiveness and validity of the SCORFAD, an extent and severity scale for feline hypersensitivity dermatitis. Vet Dermatol 2012; 23:410-e77. [DOI: 10.1111/j.1365-3164.2012.01071.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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