Development and validation of a questionnaire to assess owner and canine quality-of-life and treatment satisfaction in canine allergic dermatitis

BACKGROUND

Animal and owner quality-of-life (QoL) is pivotal in treatment decisions. Accurate measurement of owner-reported QoL and treatment satisfaction (TS) supports disease burden and treatment benefit evaluation.

OBJECTIVES

Develop and evaluate an owner-completed canine dermatitis QoL and TS questionnaire (CDQoL-TSQ) in allergic dogs.

MATERIALS AND METHODS

The CDQoL-TSQ was drafted following review of existing measures and expert input. Content validity was assessed through interviews with owners of allergic dogs. Psychometric properties of the QoL domains (Canine QoL, Owner QoL) were evaluated. Score interpretation was derived.

RESULTS

Twenty dog owners were interviewed. Item wording was amended following the first 10 interviews. Data from 211 owners were used in the psychometric evaluation. The Canine QoL domain demonstrated strong internal consistency (α = 0.89), test-retest reliability (ICC2,1  = 0.844), moderate convergent validity (r = 0.41) and moderate-high known-groups validity (effect size 0.37-0.64). The Owner QoL domain demonstrated strong internal consistency (α = 0.73), high convergent validity (r = 0.63) and moderate-high known-groups validity (0.43-0.63). Test-retest reliability approached moderate strength (ICC2,1  = 0.490). Group-level interpretation analysis showed minimal important difference of 7.0-13.6 points for dogs and 13.0-13.6 for owners. For individual dogs a change of 6.3 or 12.5 points for dogs, and 12.5 or 18.8 for owners indicates a response.

CONCLUSIONS AND CLINICAL RELEVANCE

The CDQOL-TSQ is a two-part assessment to evaluate QoL and TS in canine allergic dermatitis. The QoL questionnaire demonstrated validity and reliability, and interpretation of scores was derived, making it suitable for use in research and practice. The TS module is suitable for clinical setting use to improve owner-veterinarian communication.

Efficacy of an ethanol/guar/triclosan/glycerine gel on bacteria and yeast loads in canine pododermatitis: a pilot study

OBJECTIVES

To assess efficacy of a gel compound containing guar, glycerine, triclosan and ethanol (Pawcare®, JOKER Technologies, Kerzers, Switzerland) in decreasing bacterial and yeast loads on the paws of dogs with erythematous, greasy and/or malodorous pododermatitis.

METHODS

In 20 dogs, each with at least two affected paws, semiquantitative Malassezia species counts were performed on 10 oil-immersion fields (range: 0 to 30) from acetate tapes pressed on the palmar/plantar surface of one paw. Half of the area was sampled before and the other half immediately after the application of Pawcare(®) . With a similar procedure, swab samples were collected from the other paw for bacterial culture, identification and evaluation of colony-forming units before and immediately after treatment. Statistical evaluation of pre- and posttreatment counts was performed with the Wilcoxon signed-rank test.

RESULTS

Nine dogs were positive for Malassezia species Mean acetate tape preparation counts decreased significantly from 8·78 (±8·03) to 5·668 (±6·65) (P=0·0039) after treatment. Twenty-five bacterial isolates of 11 different species were cultured in 19 dogs. Posttreatment cultures were sterile in 8 dogs that had an initial zero or low number (1 to 2 log counts) of colony-forming units. In cases with a higher pre-treatment number of colony forming units (2 to 6 log counts), there was a significant decrease - by a mean of 1·16 log counts (pre 3·12 ±1·69, post 1·96 ±1·57) (P=0·0002).

CLINICAL SIGNIFICANCE

The findings of the present study support the use of PawCare® gel to decrease bacterial and yeast loads in dogs affected by chronic diseases involving the inter-digital spaces.

Suggested guidelines for using systemic antimicrobials in bacterial skin infections (1): diagnosis based on clinical presentation, cytology and culture

Systemic antimicrobials are critically important in veterinary healthcare, and resistance is a major concern. Antimicrobial stewardship will be important in maintaining clinical efficacy by reducing the development and spread of antimicrobial resistance. Bacterial skin infections are one of the most common reasons for using systemic antimicrobials in dogs and cats. Appropriate management of these infections is, therefore, crucial in any policy for responsible antimicrobial use. The goals of therapy are to confirm that an infection is present, identify the causative bacteria, select the most appropriate antimicrobial, ensure that the infection is treated correctly, and to identify and manage any underlying conditions. This is the first of two articles that will provide evidence-led guidelines to help practitioners address these issues. This article covers diagnosis, including descriptions of the different clinical presentations of surface, superficial and deep bacterial skin infections, how to perform and interpret cytology, and how to best use bacterial culture and sensitivity testing. Part 2 will discuss therapy, including choice of drug and treatment regimens.

Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part 2-- antimicrobial choice, treatment regimens and compliance

Systemic antimicrobials are critically important in veterinary healthcare, and resistance is a major concern. Antimicrobial stewardship will be important in maintaining clinical efficacy by reducing the development and spread of antimicrobial resistance. Bacterial skin infections are one of the most common reasons for using systemic antimicrobials in dogs and cats. Appropriate management of these infections is, therefore, crucial in any policy for responsible antimicrobial use. The goals of therapy are to confirm that an infection is present, identify the causative bacteria, select the most appropriate antimicrobial, ensure that the infection is treated correctly, and to identify and manage any underlying conditions. This is the second of two articles that provide evidence-led guidelines to help practitioners address these issues. Part 1 discussed the use of clinical signs, cytology and culture in diagnosis. This article will cover the rationale for topical and systemic antimicrobial therapy, including choice of first-, second- and third-line drugs, the dose, duration of therapy, compliance and identification of underlying predisposing conditions. In addition, there is guidance on cases of therapeutic failure and environmental hygiene. These guidelines will help veterinarians avoid the development and propagation of antimicrobial-resistant bacterial strains.

Efficacy and tolerability of once-daily cephalexin in canine superficial pyoderma: an open controlled study

OBJECTIVES

The aims of this study were to evaluate the efficacy and tolerability of oral cephalexin given at 30 mg/kg once daily in dogs with superficial pyoderma and to compare them with those of oral cephalexin given at 15 mg/kg twice daily.

METHODS

Twenty dogs with superficial pyoderma were treated with cephalexin at 30 to 60 mg/kg orally once daily (group A) and compared with 20 dogs treated at a dose of 15 to 30 mg/kg orally twice daily (group B). Dogs were treated until 14 days after clinical remission. Type and distribution of lesions, pruritus and general health status were assessed every 14 days using a numerical scale until 14 days after treatment discontinuation. Total scores for each evaluation day were compared between the two groups as well as time to obtain resolution and percentage of relapses.

RESULTS

Resolution of superficial pyoderma was obtained in all dogs in 14 to 42 days (median 28 days for both groups), with no difference between groups. Six dogs experienced vomiting or diarrhoea but did not require discontinuation of the treatment. Only one dog (in group A) relapsed nine days after treatment discontinuation.

CLINICAL SIGNIFICANCE

Once-daily cephalexin is as effective as twice-daily cephalexin in the treatment of canine superficial pyoderma.

Conjugated linoleic acid and black currant seed oil in the treatment of canine atopic dermatitis: A preliminary report

Although conjugated linoleic acid (CLA) shows inhibitory effects on histamine release, eicosanoid production and pruritus in laboratory rodents, its use in canine atopic dermatitis (AD) has not been reported. The aims of this study were to assess the efficacy of CLA, black currant seed oil (BSO) or a combination of both, compared to placebo, in dogs with AD and to evaluate any changes in fatty acid metabolism with these treatments. Twenty-four dogs with AD were randomly allocated to four groups, and were treated orally each day for two months with either 1 mL/10 kg CLA (80% purity), 1 mL/10 kg pure BSO, 1 mL/10 kg CLA+1 mL/10 kg BSO, or 1 mL/10 kg sugar syrup (placebo). Serum was obtained on days 0, 30 and 60 for analysis of CLA metabolites, linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA). At the same time point, the owners were asked to assess pruritus and the veterinarians evaluated any skin lesions present. Although the best clinical results occurred with BSO treatment alone, improvement of clinical signs and pruritus was not significant with any of the treatments. Serum levels of GLA and DGLA significantly increased in BSO-treated dogs, but not in the CLA+BSO group. CLA at the dosage used in this study was not efficacious in treating canine AD, whereas BSO may help some dogs with AD, although further studies are necessary before this can be recommended as a treatment.

Prospective open pilot study on the use of ciclosporin for feline allergic skin disease

OBJECTIVES

To evaluate the efficacy of ciclosporin in cats with allergic skin disease.

METHODS

Ten cats with signs of allergic skin disease were administered ciclosporin daily at a dose of 3.6 to 8.3 mg/kg for one month. None of these cats had previously responded to a hypoallergenic diet trial, and all animals had previously been treated with endectoparasiticidal drugs, with no improvement two weeks before entering the trial. On days 0 and 30, owners assessed pruritus with a visual analogue scale, and veterinarians evaluated cutaneous lesions.

RESULTS

All the cats had pruritus and erythema, five had alopecia, two had an eosinophilic plaque, one had miliary dermatitis and two had both alopecia and an eosinophilic plaque. Good or excellent improvement was observed in 40 per cent of cats for pruritus, 57 per cent of cats for alopecia and 60 per cent of cats for erythema. A significant decrease in mean scores was observed for pruritus only, while for erythema and alopecia, it was close to being significant (P < 0.052).

CLINICAL SIGNIFICANCE

Ciclosporin may be helpful in symptomatically treating signs of feline allergic skin disease. However, it is important to remember that ciclosporin is not licensed for use in cats.

Remission of the clinical signs of atopic dermatitis in dogs after cessation of treatment with cyclosporin A or methyiprednisolone

Seventy-eight dogs with atopic dermatitis were treated for four months with either cyclosporin A or methylprednisolone. During the two months after the treatment ceased, 87 per cent of the dogs treated with methylprednisolone relapsed after a mean period of 27.9 days, whereas only 62 per cent of the dogs treated with cyclosporin A relapsed after a mean period of 40.7 days (P < .0.001). The clinical condition of the dogs was evaluated either when they relapsed, or two months after the treatment ceased if they had not relapsed. Both the skin lesions and pruritus increased significantly more markedly in the dogs treated with methylprednisolone than in those treated with cyclosporin A. At the end of the study the skin lesions were markedly less severe than before the therapy; in the dogs in both groups that did not relapse, the lesion score was improved by 77 per cent two months after the treatment had stopped, and in the dogs that did relapse the lesion scores had improved by 45 per cent and 35 per cent in the dogs treated with cyclosporin A and methylprednisolone, respectively. Pruritus remained well controlled in the dogs that did not relapse, but increased to baseline levels or close to baseline in the dogs that relapsed.

Acrochordonous plaques in two Bulldogs and a Pug dog

Acrochordons or fibroepithelial polyps are exophytic to pedunculated tumour-like lesions of the skin reported to occur in humans and animals. We report here a new and unusual presentation of numerous, closely associated acrochordons forming a plaque, preferentially located at the dorsal neck of two Bulldogs and a Pug dog. Histopathologically these plaques were characterized by oedematous to fibrous cores enclosed by normal to moderately hyperplastic epidermis. We propose the name acrochordonous plaque to reflect the clinical lesion and the histopathological appearance of numerous, closely spaced acrochordons. Although the aetiology of these lesions remains unclear, there may be a breed predisposition for Bulldog-like breeds.

Quantitative analysis of tryptase- and chymase-containing mast cells in eosinophilic conditions of cats

The presence and density of tryptase-positive/chymase-positive mast cells (MCs) (MC(TC)), chymase-positive/tryptase-negative MCs (MCC), and tryptase-positive/chymase-negative MCs (MC(T)) in lesional skin from cats with eosinophilic conditions were investigated. Skin biopsy specimens from eight cats with eosinophilic plaque (three cats), eosinophilic granuloma (two cats), and eosinophilic dermatitis (three cats) were studied. Toluidine blue staining and a double-enzyme-immunohistochemical staining technique were performed to determine MC density and MC subtypes, respectively. MC density varied from 170.3 to 503 cells/mm2 (mean value of 314.9 cells/mm2). In the superficial dermis, 5.9% of the MC belonged to the MC(T), 12.8% to the MC(C), and 81.2% to the MC(TC) subtype. In the deep dermis, 12.8% belonged to the MC(T), 12.8% to the MC(C), and 73.8% to the MC(TC) subtype. It is the first time that MC(C) have been identified. The double-labeling procedure proved to be a reliable tool for identifying simultaneously the presence of MC subtypes in feline skin.

The mast cell in wound healing

This review describes the role of the mast cell in the pathobiology of skin healing. After illustrating its main morphofunctional characteristics, with special reference to the dog and cat, we consider the involvement of the mast cell in the various phases of skin repair. With the aid of a wide array of newly formed or preformed mediators released by degranulation, the activated mast cell controls the key events of the healing phases: triggering and modulation of the inflammatory stage, proliferation of connective cellular elements and final remodelling of the newly formed connective tissue matrix. The importance of the mast cell in regulating healing processes is also demonstrated by the fact that a surplus or deficit of degranulated biological mediators causes impaired repair, with the formation of exuberant granulation tissue (e.g. keloids and hypertrophic scars), delayed closure (dehiscence) and chronicity of the inflammatory stage.

Expression of GM-CSF receptors in male germ cells and their role in signaling for increased glucose and vitamin C transport

We studied the expression and function of the granulocyte-macrophage colony stimulating factor (GM-CSF) receptor in male germ cells. RT-PCR showed expression of mRNAs encoding the alpha- and beta-subunits of the GM-CSF receptor in human testis, and the presence of the alpha- and beta-proteins was confirmed by immunoblotting with anti-alpha and anti-beta-antibodies. Immunolocalization studies showed the level of expression of GM-CSF alpha- and beta-subunits in the germ line in the testis and in ejaculated spermatozoa. Receptor binding studies using radiolabeled GM-CSF revealed that bull spermatozoa have about 105 high-affinity sites with a K(d) of 222 pM and approximately 1100 low-affinity sites with a K(d) of 10 nM. GM-CSF signaled, in a time- and dose-dependent manner, for an increased uptake of glucose and vitamin C.

Clinical and histological evaluation of an analogue of palmitoylethanolamide, PLR 120 (comicronized Palmidrol INN) in cats with eosinophilic granuloma and eosinophilic plaque: a pilot study

Fifteen cats with eosinophilic granuloma or eosinophilic plaque were given PLR 120 at the dosage of 10 mg kg-1 twice daily for one month. PLR-120 down-modulates mast cell degranulation via a receptor-mediated mechanism. No other drugs were permitted and cats were kept free of parasites throughout the study. A clinical evaluation and skin biopsies were performed before and after the treatment. Clinical improvement was assessed at 15 and 30 days. Mast cell numbers were counted and their granular content was assessed by densitometric analysis on toluidine blue-stained sections before and after the treatment. Ten of 15 (67%) cats showed clinical improvement of signs and lesions. There was no significant difference between mast cell numbers in skin biopsies taken before and after the trial, whereas the number of granules was significantly increased (P < 0.009). This pilot study suggests that PLR-120 might be a useful drug for the treatment of eosinophilic granuloma and eosinophilic plaque.

The significance of reactions to purified fractions of Dermatophagoides pteronyssinus and Dermatophagoides farinae in canine atopic dermatitis

The significance of reactions to crude extracts and purified fractions of the house dust mites Dermatophagoides pteronyssinus (Der p I and Der p II) and Dermatophagoides farinae (Der f I and Der f II) was evaluated in dogs with clinical manifestations of atopic dermatitis (AD). In 13 healthy control dogs and eight dogs with AD, immediate skin test reactivity was determined to serial dilutions of Der p I, Der p II, Der f I and Der f II. In addition, allergen-specific IgGd antibodies were determined by means of an enzyme-linked immunosorbent assay (ELISA) and Western blots. The results suggest that, in contrast to what occurs in humans and despite immediate skin test reactivity in some dogs, Der p I, Der p II, Der f I and Der f II are unlikely to be major allergens in dogs with AD. However, only serum of atopic dogs consistently binds a 90 kDa polypeptide of D. farinae, as shown by Western blot analysis.

Demodicosis in ferrets (Mustela putorius furo)

This report describes the clinical signs, diagnosis, and therapy of demodicosis in ferrets. Two ferrets (Mustela putorius furo) were presented with a history of local alopecia and pruritus after repeated treatment with a glucocorticoid-containing ointment for recurrent ear mite infections. Skin scrapings and biopsies revealed adult mites and larvae of Demodex spp., which were measured according to current classification techniques. Treatment with amitraz was effective and did not cause noticeable side effects. To the authors' knowledge this is the first report of demodicosis in ferrets.

A retrospective evaluation of adverse reactions to trimethoprim-sulphonamide combinations in dogs and cats

Adverse reactions to various trimethoprim-sulphonamide (T-S) combinations were studied retrospectively in dogs and cats referred to the Utrecht University Department of Clinical Sciences of Companion Animals during the period 1985-1994. Dermatological and systemic reactions were observed in 19 dogs and 2 cats. Specific histological reaction patterns were seen in 3 dogs with toxic epidermal necrolysis, in 1 dog and 1 cat with erythema multiforme, and in 1 dog with pemphigus foliaceus. Diagnostic criteria used in humans proved to be reliable in dogs and cats as well. Adverse reactions were observed within 7-14 days after administration and were most often due to sulphadiazine (76%) and sulphatroxazole (14%). The incidence of adverse reactions to T-S was 0.25%.