Diascopy and histopathological evaluation of nonblanching erythematous dermatoses in dogs

BACKGROUND

Diascopy is a point-of-care diagnostic test used to differentiate skin erythema due to vascular dilation from haemorrhage. In the veterinary literature, only a handful of diseases have been described to be associated with a negative (nonblanching) diascopy result, and histological investigation of haemorrhage has been inconsistent.

OBJECTIVES

Retrospective study to undertake a histopathological investigation of canine, nonblanching erythematous dermatoses for the presence or absence of haemorrhage and vascular changes.

MATERIALS AND METHODS

Skin biopsies from dogs presented with moderate-to-severe nonblanching erythema were evaluated histologically. Additionally, clinical data about each patient were analysed.

RESULTS

Twenty cases were identified with nonblanching erythema. Diagnoses included vasculopathy (n = 6), canine eosinophilic dermatitis (n = 3), cutaneous epitheliotropic T-cell lymphoma (n = 2), and one case each of sterile granuloma and pyogranuloma syndrome, German shepherd dog pyoderma, multiple mast cell tumours, haemangiosarcoma, exfoliative cutaneous lupus erythematosus, canine leishmaniosis with sebaceous adenitis, sebaceous adenitis with concurrent dermatophytosis, calcinosis cutis and canine atopic dermatitis with insect-bite reaction. One or more vascular changes were present in all 20 cases and included perivascular oedema, endothelial swelling and neutrophilic infiltration of vessel walls. Haemorrhage was identified in 17 of 20 cases (85%). Three cases without dermal haemorrhage were calcinosis cutis, sebaceous adenitis with dermatophytosis and canine atopic dermatitis with insect-bite reaction.

CONCLUSIONS AND CLINICAL RELEVANCE

Negative diascopy was associated with haemorrhage and vascular pathological findings in the majority of cases, yet not all. Haemorrhage was identified histologically in all diseases previously reported as nonblanching as well as in a few additional diseases.

Microbes on Clipper Blades after Use and Disinfection in Small Animal- and Equine Practice

Clipping hair on animals can produce microtraumas of the skin and the dislodgement of microorganisms to the clipper blade. This study evaluates if clipper blades in animal hospitals in Sweden are contaminated with bacteria and/or dermatophytes after disinfection. Eleven clipper blades from three veterinary referral hospitals, including one with a small animal department and an equine department, were sampled for bacteria and dermatophytes. All the hospitals had disinfection routines in accordance with the national recommendations for hygiene in veterinary medicine. The sampled clipper blades were supposed to be disinfected and they were considered to be ready for use by staff. Five sterilized clipper blades were used as controls. The results showed that 64-100% of the disinfected clipper blades, from all three hospitals, were contaminated with bacteria, whereas all the sterilized clipper blades were negative for bacterial growth (p < 0.05). One clipper blade from the equine department was contaminated with dermatophytes. The results indicate that the disinfection routines were not sufficient for removing bacteria from used clipper blades, and that sterilization would be a more reliable way to minimize the risk of contamination.

Reactions to environmental allergens in cats with feline lower airway disease

Objectives

Aeroallergens have been discussed as potential triggers for feline asthma (FA), which can be induced experimentally by allergen sensitization. To date, only few studies have investigated reactions to environmental allergens in cats with naturally occurring feline lower airway disease (FLAD). The aim of the study was to compare results of intradermal testing (IDT) and serum allergen-specific immunoglobulin E-(IgE) testing (SAT) in cats with FLAD, and to investigate possible associations with allergen exposure.

Material and methods

Eight cats with eosinophilic airway inflammation (EI), ten cats with mixed inflammation (MI), six with neutrophilic inflammation (NI), and 24 healthy cats (HC) were included. Cats diagnosed with FLAD were assigned to the different inflammatory groups based on bronchoalveolar lavage fluid (BLAF) cytology. SAT was performed in all cats; IDT was only carried out in cats with FLAD. Information about the cats' environment and potential allergen exposure was obtained using an owner questionnaire.

Results

In comparison to 83% of HC with positive reactions on SAT only 52% of cats with FLAD had positive responses (p = 0.051). Significantly more positive reactions per cat were detected on IDT than on SAT (p = 0.001). No significant difference was found for positive reactions per cat on SAT when compared between HC, NI, EI, and MI (p = 0.377). Only "slight" agreement was found for most allergens when reactions obtained in both tests in cats with FLAD were compared, except for "moderate" agreement for English plantain (k = 0.504) and Alternaria alternata (k = 0.488). Overall, no clear association between the cats' environment and allergen reactions were detected.

Conclusions and clinical importance

Interpretation of allergy test results in cats with FLAD should be done in the context of clinical signs and individual factors.

Intradermal testing and serum allergen-specific IgE-testing in cats with naturally occurring feline bronchial disease

OBJECTIVES

While feline asthma (FA) is considered to be of allergic origin, the etiology of feline chronic bronchitis (CB) to date is unknown. Aim of the study was to compare the results of intradermal testing (IDT) and serum testing for allergen-specific immunoglobulin E (SAT) in cats diagnosed with FA and CB.

MATERIAL AND METHODS

Twenty-seven client-owned cats with clinical signs, suggestive of feline inflammatory bronchial disease (FBD) were prospectively enrolled in the study. Patients were assigned to 3 groups based on results of bronchoalveolar-lavage-fluid (BALF)-cytology: FA (n=8), CB (n=10), or cats with a physiological BALF cytology (PB; n=9). A standardized IDT for 27 allergens was performed in all cats. In addition, allergen-specific IgE was measured in serum samples using an FcεRIα-ELISA. The number of positive reactions in both tests was compared between groups, and agreement between test results of both tests was evaluated.

RESULTS

Regarding the number of positive reactions, no statistically significant difference was detected between groups in IDT (p=0.65) and SAT (p=0.51). When comparing the 2 test systems, a weak correlation was found for the allergens Tyrophagus putrescentiae (k=0.256), Dermatophagoides farinae (k=0.276), and rye (k=0.273). The most commonly observed reactions were to house dust mites, storage mites, rye and nettle in IDT and to sheep sorrel, storage mites, and house dust mites in SAT.

CONCLUSION AND RELEVANCE

IDT and SAT in cats with feline inflammatory bronchial disease (FBD) cannot be used interchangeably for allergen detection. Sensitization to environmental allergens can occur in cats with and without airway inflammation. Therefore, a positive test result should always be assessed in context with clinical signs and allergen exposure.

Cross-reactive carbohydrate determinants in atopic and healthy dogs and their influence on allergy test specificity

BACKGROUND

The selection of allergens for immunotherapy in atopic dogs is often based on serum allergy testing. Cross-reactive carbohydrate determinants (CCDs) are common structures in plant and insect allergens that reportedly induce polysensitisation, reduce agreement between intradermal and serum tests and complicate allergen selection.

METHODS

Thirty-four dogs with diagnosed atopic dermatitis and 10 healthy dogs were included in the study. An intradermal test was conducted in atopic dogs, and serum samples from allergic and healthy dogs were analysed for allergen-specific immunoglobulin E (IgE) before and after inhibition of detectable anti-CCD-IgE antibodies.

RESULTS

Anti-CCD-IgE antibodies were not found in any of the healthy dogs and no polysensitisation to plant and insect allergens was detected. The agreement between intradermal and serum allergy test results in the atopic dogs with anti-CCD-IgE antibodies improved from slight to fair after blocking the anti-CCD-IgE antibodies. In addition, blocking clearly reduced polysensitisation to plant allergens but not to acarid allergens.

LIMITATIONS

Only a limited number of healthy dogs were tested in this study. A gold standard for determining the clinical relevance of IgE sensitisation does not exist.

CONCLUSION

Inhibition of anti-CCD-IgE antibodies seems to be of importance to improve serum test specificity for allergen-specific IgE in atopic dogs in relation to intradermal allergy testing.

Serum Allergen-Specific Immunoglobulin E in Cats with Inflammatory Bronchial Disease

The etiology of feline inflammatory bronchial disease is poorly understood. This study compares the degree of allergen-specific serum IgE responses between cats with feline asthma, chronic bronchitis, mixed inflammation, and clinically healthy cats (HCs). The retrospective case-control study used serum from eighteen cats with eosinophilic inflammation (EI), ten with neutrophilic inflammation (NI), six with mixed inflammation (MI), and fourteen HCs. Affected cats were categorized into groups based on bronchoalveolar lavage cytology. The measurement of IgE for 34 different allergens including fungal organisms, weeds, grasses, trees, mites, and insects was performed using an indirect ELISA. Positive reactions to allergens were detected in the serum of 17/18 cats with EI, 8/10 with NI, 6/6 with MI, and 11/14 HCs (p = 0.364). When overall positive reactions were compared between groups, cats with MI (p = <0.01) had significantly more positive reactions against mite allergens than HCs. Blood eosinophils inversely correlated with the absolute amount of allergen-specific serum IgE expressed in ELISA absorbance units (EAs) (p = 0.014). Sensitization against dust mites seems to be more prevalent in cats with MI. However, positive IgE reactions can be observed in healthy and diseased cats, and, therefore, need to be interpreted in the light of clinical findings and environmental conditions of individual patients.

A systematic review of allergen immunotherapy, a successful therapy for canine atopic dermatitis and feline atopic skin syndrome

Canine atopic dermatitis and feline atopic skin syndrome are common presentations in small animal practice. Numerous drugs are used for symptomatic therapy. The only definitive treatment based on the cause of the disease is allergen immunotherapy. Classical allergen immunotherapy (AIT) consists of subcutaneous injections of an extract containing offending allergens, with increasing doses and allergen concentrations at short intervals during the induction phase of several weeks to months followed by a maintenance phase, where a fixed dose is typically given at longer intervals. Dose and interval are tailored to the individual patient. Newer types of AIT include rush immunotherapy, where the induction phase is abbreviated, intralymphatic immunotherapy, and oromucosal or sublingual immunotherapy. AIT aims at inducing a regulatory T-cell response and subsequently downregulating the exaggerated immune response to offending allergens leading to clinical signs. This article reviews the published knowledge about allergen immunotherapy in dogs and cats for small animal practitioners.

A randomised, double-blinded comparison between subcutaneous rush and intralympathic allergen immunotherapy induction in atopic dogs

BACKGROUND

Atopic dermatitis (AD) is one of the most common skin diseases in small animal practice. Allergen immunotherapy (AIT) is the only curative treatment for the disease, and oral, subcutaneous and intralymphatic administration of allergens are commonly employed.

OBJECTIVES

To compare the efficacy of AIT following an induction phase with intralymphatic injections (ILIT) or rush immunotherapy (RIT).

ANIMALS

Fifty privately owned dogs with AD.

MATERIALS AND METHODS

In a double-blinded study, dogs were randomly assigned to either four monthly ILIT of allergen extract or RIT with five injections administered subcutaneously at hourly intervals on the first day. They were assessed by validated scores; Canine Atopic Dermatitis Lesion Index (CADLI) and pruritus Visual Analog Scale (PVAS) at the beginning of the study and after 1, 3, 6 and 12 months. The latter were performed daily for 7 days before each revisit. Medication scores and a total clinical score were calculated and compared between each group and time point.

RESULTS

There was no significant difference in CADLI and PVAS scores, or CADLI and medication scores between groups at any of the time points. A significant improvement with both ILIT and RIT was seen in total and pruritus scores, respectively. An owner global assessment of good-to-excellent treatment efficacy was seen in 40% of the dogs; total scores improved by 27% and 35% in the RIT and ILIT group, respectively. Adverse effects were not seen.

CONCLUSIONS AND CLINICAL RELEVANCE

Induction of AIT can be conducted either as RIT or ILIT with no loss in efficacy.

Evaluation of hypochlorous acid as an ear flush in dogs with chronic otitis externa

BACKGROUND

Chronic otitis externa (OE) in dogs frequently requires anaesthetised ear flushing.

OBJECTIVES

To evaluate hypochlorous acid as an ear flushing and antimicrobial agent in dogs with chronic OE.

ANIMALS

Twenty dogs with chronic OE caused by the same organisms bilaterally.

MATERIALS AND METHODS

One ear was flushed under anaesthesia with hypochlorous acid, the other with saline solution. Subsequently, the ear flushed with hypochlorous acid was cleaned with the same solution twice daily for 2 weeks, the other ear with a commercial ear cleaner. An ear medication containing miconazole, polymyxin B and prednisolone was used once daily in both ears. Clinical scores were determined before the flush. Ear cytological results were obtained, a hearing test was conducted before and after the ear flush, and a culture was taken directly after flushing. Ears were evaluated after 2 weeks of therapy.

RESULTS

Yeast was present in the ears of 11, cocci in one and a mixed infection in eight dogs. Five ears were negative on culture after flushing with hypochlorous acid, one after the saline flush. Clinical and cytological scores decreased significantly with both solutions after 2 weeks of treatment. There was no difference between treatments in any of the scores at any time point between treatments and in the results of the hearing test before and after the flushing procedure. Adverse effects were not seen.

CONCLUSIONS AND CLINICAL RELEVANCE

Hypochlorous acid is a suitable cleaning solution for canine OE.

Epidemiological observations on pastern dermatitis in young horses and evaluation of essential fatty acid spot-on applications with or without phytosphingosine as prophylactic treatment

Background - Equine pastern dermatitis (EPD) is a common multifactorial clinical syndrome in horses. Treatment can be difficult; pathogenesis and triggering factors cannot always be determined. Objectives - To assess risk factors for developing EPD in a large group of horses kept under the same conditions and to analyse whether or not a spot-on containing essential fatty acids and antimicrobial agents is able to prevent the development of EPD or accelerate the healing process. Conclusion and clinical importance - Moisture and lack of pigmentation predisposed to EPD. Topical application of the tested spot-on once weekly did not prevent the disease. A positive effect of both spot-on products on the severity of EPD lesions was detected.

Feline allergic diseases: introduction and proposed nomenclature

BACKGROUND

Feline allergic diseases present as challenging problems for clinicians, not least because of the number of reaction patterns of the feline skin, none of which are specific for allergy. Furthermore, there is some controversy over the nomenclature that should be used in their description.

OBJECTIVES

To review the literature, assess the status of knowledge of the topic and the extent to which these diseases could be categorized as atopic in nature, and make recommendations concerning nomenclature.

METHODS

Atopic diseases in humans and cats were researched. A comparison then was made of the essential features in the two species.

RESULTS

There were sufficient similarities between human atopic diseases and the manifestations of feline diseases of presumed allergic aetiology to justify the use of "atopic" to describe some of the feline conditions affecting the skin, respiratory and gastrointestinal tract. However, none of the allergic skin diseases showed features consistent with atopic dermatitis as described in man and the dog.

CONCLUSIONS AND CLINICAL IMPORTANCE

The term "Feline Atopic Syndrome" (FAS) is proposed to encompass allergic diseases of the skin, gastrointestinal tract and respiratory tract, and "Feline atopic skin syndrome" (FASS) proposed to describe allergic skin disease associated with environmental allergies. We are not aware of any adverse food reactions in cats that are attributable to causes other than immunological reactions against the food itself. We therefore propose an aetiological definition of "Food Allergy" (FA) to describe such cases.

Clinical effects of 2 commercially available diets on canine atopic dermatitis

OBJECTIVE

Canine atopic dermatitis (CAD) is a common skin disease in dogs. Prior studies were able to determine beneficial effects of essential fatty acids (EFA) on the clinical signs of CAD. The aim of this study was set to evaluate the effects of a newly designed, EFA-enriched diet on the clinical signs of CAD compared to another EFA-enriched diet.

MATERIALS AND METHODS

In this prospective, randomized, double-blinded study, 31 privately owned dogs with atopic dermatitis received either the control diet (diet A, Hill's Prescription Diet™ d/d™ Salmon & Rice, n = 17) or the test diet (diet B, Veterinary HPM™ Dermatology Support D1, Virbac, n = 14) for 12 weeks. At the beginning of the study as well as after 4, 8 and 12 weeks, skin lesions and pruritus were evaluated via validated scores and the administered medication was documented. At the same time, the dogs' coat quality was evaluated via a distinct scoring system. In both groups, a total of 7 dogs each completed the entire study.

RESULTS

After 12 weeks, there was a mild improvement in lesion scores, pruritus and coat quality with both diets.

CLINICAL RELEVANCE

In this study, both diets improved the patients' skin lesions pruritus and coat quality.

Topical treatment of multiple erosive, ulcerative skin lesions in an Indian rhinoceros (Rhinoceros unicornis)

A 30-year-old, intact female Indian rhinoceros (Rhinocerus unicornis) was presented with ongoing erosive, ulcerative skin lesions over a 4-year-period. The lesions appeared to be non-pruritic and non-seasonal. A systemic antibiotic therapy had been unsuccessful. The dermatological examination showed 8 diffusely demarcated areas of erosion, focal ulceration, mild crusting, and moderate erythema ranging from 8 to 20 cm in diameter, bilaterally on the lateral edges of the torso armor plates. The patient had no other clinical abnormalities. Coccoid and rod-shaped bacteria were identified on cytology and a bacterial culture revealed Escherichia coli spp., Staphylococcus dysgalacticae, Stenotrophomonas maltophilia, Corynebacterium spp. and Micrococus spp. A topical product line containing essential fatty acids and plant extracts was administered daily, using a spot-on, spray and balm. Within 3 weeks a substantial alleviation of clinical signs was observed. Multiple impression smears of the lesions and a bacterial culture were negative by day 21. The patient achieved complete remission within 4 months of treatment and maintained remission for the 2-year observation period with continued use of the medication. Topically administered therapeutics containing essential fatty acids and plant extracts may offer a viable treatment option for recurrent cases of bacterial infectious skin lesions in Indian rhinocerotidae.

Evaluation of a clinical scoring system for canine demodicosis

BACKGROUND

Canine demodicosis is a common disease in small animal practice. Although a number of studies evaluating treatment efficacy for canine demodicosis have used clinical scoring systems, none have been validated.

OBJECTIVES

This study evaluated the validity, reliability, reproducibility and sensitivity to change of a clinical scoring system for canine demodicosis.

METHODS AND MATERIALS

Fifty-eight dogs with generalised demodicosis were evaluated using a clinical scoring system that assessed erythema, comedones/ papules/pustules, follicular casts/scales/crusts and alopecia, rated from none to mild, moderate and severe in 36 body locations. Two evaluators scored lesions at monthly consecutive visits during treatment. Mites were counted to a maximum of 50 in four deep skin scrapings. With >50 mites, the approximate mite number was calculated with the help of a grid drawn onto the slide before placing the scraped material onto it.

RESULTS

A Pearson correlation coefficient showed a high interobserver reliability (r = 0.97) between two different clinicians evaluating the same dog. The Wilcoxon signed rank test showed good sensitivity to change with a reduction of clinical scores with each of the first six evaluations (P < 0.0001). A linear mixed model also showed a clear reduction in mite counts (P < 0.001) and clinical scores (P < 0.0001) from the first evaluation with time.

CONCLUSION AND CLINICAL RELEVANCE

The clinical scoring system for canine demodicosis evaluated in this study showed a good sensitivity to change and interobserver reliability, and can be used in studies evaluating canine demodicosis.

Cutaneous microRNA expression in healthy Labrador and Golden retrievers and retrievers with allergic and inflammatory skin diseases

BACKGROUND

MicroRNAs (miRNA) are short, single-stranded RNA molecules that regulate gene expression in a post-transcriptional manner. Their expression is proposed to be tissue-specific and alterations in miRNA expression have been detected in many diseases.

OBJECTIVE

To compare miRNA expression in the skin of healthy Labrador and golden retrievers, and those with allergic and nonallergic dermatitis.

METHODS AND MATERIALS

Formalin-fixed and paraffin-embedded (FFPE) skin specimens from seven healthy Labrador and golden retrievers, and seven dogs with allergic skin disease were collected. A further mixed nonallergic inflammation group consisted of samples from five dogs with fungal infection, demodicosis and mast cell tumours. Total RNA was extracted and miRNA primer assays for 18 target miRNAs (miR-142, miR-363, miR-18b, miR-451, miR-146a, miR-124, miR-409, miR-193b, miR-223, miR-215, miR-155, miR-423a, miR-143, miR-1839, miR-21, miR-34b, miR-146b and miR-202) were performed, with RNU6-2 and SNORD95 as miRNAs for normalisation. The selection of miRNAs for investigation was based on reported data and a pilot study evaluating miRNA extraction from FFPE tissue specimens.

RESULTS

In the two dogs with mast cell tumours, miRNA expression was undetermined for most miRNAs, so both were excluded from analysis. Although there were differences in the miRNA expression between healthy and inflamed skin, allergic and nonallergic inflammation showed similar expression patterns.

CONCLUSION AND CLINICAL RELEVANCE

Although the number of included dogs was small, based on this study, none of the evaluated miRNAs allowed differentiation of allergic dermatitis from other inflammatory skin diseases in retriever dogs.

A case series of canine cutaneous inverted papilloma with one case showing evidence of recurrence

BACKGROUND

This article describes a case of multiple, recurrent, cutaneous inverted papillomas (CIPs) in a German shepherd dog, combined with a retrospective follow-up assessment of eight cases.

METHODS

A 3-year-old, black, female German shepherd dog presented with four rapidly growing, alopecic, domed, hyperpigmented, shiny nodules, compatible with CIP. The dog was managed for pruritus, associated with atopic dermatitis, with long-term prednisolone therapy and this therapy was continued after the surgical excision. Twelve months after the initial presentation the dog was represented for two new CIP lesions, coinciding with an increased dosage of prednisolone during an allergic flare-up period.

RESULTS

Histopathological evaluation was conducted on both the original and subsequent lesions from the case with recurrence. Eight cases of CIP, based on histopathological findings, were identified retrospectively from the authors' diagnostic pathology service over the previous two years. All nine cases had lesions that exhibited varying degrees of inverted epithelial hyperplasia, multiple, endophytic, papillary epidermal projections, a cup-shaped base with central hyperkeratosis and active viral pathological findings (koilocytes). The submitting veterinarians were contacted and follow-up regarding recurrence and concurrent medications was obtained.

CONCLUSIONS AND CLINICAL IMPORTANCE

CIP is uncommonly reported, typically as a single lesion with no previous reports of recurrence, although one group of dogs with severe combined immunodeficiency developed invasive malignancies. In seven of eight retrospective cases no recurrence of CIP was recorded. The authors speculate that the recurrence in the German shepherd dog may have been associated with chronic (although low-dose) glucocorticoid administration.

Reproducibility of serum testing for environmental allergen-specific IgE in dogs in Europe

BACKGROUND

Serum testing for allergen-specific immunoglobulin (Ig)E is commonly employed to identify allergens used for allergen-specific immunotherapy in dogs, yet the reliability of results has been a matter of debate.

OBJECTIVE

The aim of this study was to evaluate the reproducibility of serum tests for environmental allergen-specific IgE in three European laboratories.

ANIMALS/METHODS

Serum was obtained from 33 client-owned dogs diagnosed with atopic dermatitis, divided into three aliquots and sent to the laboratories under different names. Two aliquots were sent simultaneously to one of the laboratories on the first day; the third sample was then sent to the same laboratory on the subsequent day. The laboratory for each patient was chosen according to a predetermined randomization list. The agreement between different samples from the same dog for each of the laboratories was calculated with a Cohen's Kappa test. Spearman's rank coefficients (r_sp ) as well as the coefficients of variation (CV) additionally were calculated.

RESULTS

The intra- and interassay agreements for laboratories A, B and C were 0.79 and 0.75, 0.92 and 0.90, and 0.90 and 0.85, respectively. The CVs were 18.92% and 22.95%, 14.43% and 18.79%, and 15.38% and 18.75% (respectively) and the r_sp 0.73 and 0.68, 0.95 and 0.92, and 0.82 and 0.74 (respectively).

CONCLUSION AND CLINICAL RELEVANCE

The differences in reproducibility between laboratories complicate test interpretation and underline the importance of interpreting results of serum testing for allergen-specific IgE in the context of the patient's clinical history.

Hair follicle dystrophy in a litter of domestic cats resembling lanceolate hair mutant mice

BACKGROUND

A new congenital hair-shaft abnormality resembling the lanceolate hair phenotype of rodents is described in a litter of four domestic short hair (DSH) cats. Data relating to hair shaft and follicle disorders remain scarce in veterinary medicine.

OBJECTIVES

To describe and compare structural abnormalities in these cats with other hair dystrophies in cats and other mammals.

ANIMALS

A DSH cat litter with progressive noninflammatory alopecia.

METHODS AND MATERIALS

Histopathological evaluation, scanning and transmission electron microscopy, and X-ray based element analysis defined the hair and skin changes in cats born with alopecia. Findings were compared to archival data from normal cats and lanceolate hair (Dsg4lahJ ) and Keratin 75 (Krt75tm1Der ) mutant mice.

RESULTS

Light and scanning electron microscopy of the hairs revealed lance- or spear-head shaped defects of the hair tip. Histological findings were swollen hair shafts, initially above the hair bulb matrix and later found in the distal parts of the telogen hair follicles, similar to those observed in Dsg4lahJ Krt75tm1Der mutant mice. Transmission electron microscopy of the hair shaft and hair follicles showed a loss in the normal structure of the guard hairs in the alopecic cats. There was a statistically significant decrease in sulfur content just below the defects in the hair shafts (trichothiodystrophy).

CONCLUSION AND CLINICAL IMPORTANCE

A rare form of congenital alopecia resulting in follicular dystrophy is described in cats which is similar to hair follicle and hair-shaft changes reported in several mutant mouse strains with single gene mutations in adhesion molecules or keratin genes.

A proposed medication score for long-term trials of treatment of canine atopic dermatitis sensu lato

BACKGROUND

The use of concurrent medications is necessary in trials of treatment of canine atopic dermatitis. Our aim was to use the best available evidence to construct and then to validate a medication score (MS) formula that will estimate the impact of concurrent medications on trial outcomes.

METHODS

Trials of 15 interventions were scrutinized to find those that were consistent in terms of specific medication, administration route and dosage regimen. A MS was constructed in five steps, starting from assigning a score of 1 for each day on oral prednisone, prednisolone or methylprednisolone at 0.5-1.0 mg/kg. The MS score was validated using the clinical records of 35 dogs with atopic dermatitis that had been treated for a period of 12 ± 2 weeks with six of these medications and compared with a previously published non-validated MS.

RESULTS

A MS could be assigned to eight treatments, six of which had been administered to the 35 dogs. A positive correlation was seen with the previously published MS and a negative correlation with changes in lesional and pruritus scores.

CONCLUSION

This MS may be a useful tool in new studies evaluating the efficacy of treatments in canine atopic dermatitis.

Treatment of the feline atopic syndrome - a systematic review

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.

Immunopathogenesis of the feline atopic syndrome

BACKGROUND

Feline diseases of possible allergic origin with similar clinical phenotypes can have a varied underlying pathogenesis. Clinical phenotype, precise aetiology and underlying immunopathogenesis all need to be considered if advances in this neglected area of dermatology are to be made.

OBJECTIVES

To document the status of research into the immunopathogenesis of the diseases that fall within the spectrum of the feline atopic syndrome (FAS ), to summarize the conclusions, identify the limitations and recommend future research directions.

METHODS AND MATERIALS

A search of the literature was undertaken. The strengths and validity of the data and the contributions to our current understanding of the immunopathogenesis were analysed. Skin diseases of presumed allergic aetiology and asthma were assessed separately, as was the role of antibodies, cells and cytokines in each.

RESULTS

The research varied in its quality and its impact often was limited by a failure to employ strict criteria in case selection. This reflected the difficulties of skin reaction patterns associated with a number of inciting causes. Research into feline asthma was handicapped by the difficulties of investigating clinical material, and much of the useful information was derived from experimental models.

CONCLUSIONS AND CLINICAL IMPORTANCE

The evidence reviewed was supportive of a role for immunoglobulin (Ig)E in the pathogenesis of both feline atopic skin syndrome (FASS) and asthma, albeit not strongly so. The inflammation noted in both FASS and asthma is accompanied by eosinophils and lymphocytes, and these findings, together with the cytokine expression, are suggestive in some (not all) cats of T-helper type 2 immune dysregulation.

Clinical signs and diagnosis of feline atopic syndrome: detailed guidelines for a correct diagnosis

BACKGROUND

Feline atopic syndrome (FAS) describes a spectrum of hypersensitivity disorders characterised by highly diverse clinical presentations including skin, gastrointestinal and respiratory systems. Among these disorders is feline atopic skin syndrome (FASS), in which hypersensitivity is typically associated with environmental allergens, although food allergy may coexist. Involvement of other organ systems (e.g. asthma) also may occur. Because of its highly heterogeneous clinical presentation, diagnosis of FASS can be challenging.

OBJECTIVES

A subgroup of the International Committee on Allergic Diseases of Animals was tasked to summarise the most current information on the clinical presentations of FASS and to develop diagnostic guidelines.

METHODS AND MATERIALS

Online citation databases and abstracts from international meetings were searched for publications related to feline allergic conditions. These were combined with expert opinion where necessary.

RESULTS

A total of 107 publications relevant to this review were identified. Compilation of these data enabled development of a detailed description of the clinical features of FASS and development of guidelines focusing on systematic elimination of other skin conditions with similar clinical characteristics. As allergen tests are frequently used by dermatologists to support a clinical diagnosis of FASS, a brief review of these methodologies was also performed.

CONCLUSIONS AND CLINICAL IMPORTANCE

In a similar way to atopic dermatitis in dogs, FASS is a clinical diagnosis based on the presence of compatible clinical signs and exclusion of other diseases with similar clinical features. Elimination or exclusion of fleas/flea allergy, other parasites, infections and food allergy is mandatory before reaching a diagnosis of FASS.

Venom immunotherapy for Hymenoptera allergy in a dog

A 1.5-year-old male castrated dog was presented in anaphylactic shock after suffering an apparent bee sting. Immunotherapy with bee venom was initiated based upon history, skin testing and serological testing for allergen-specific immunoglobulin (Ig)E. The dog was maintained on venom immunotherapy for five years and showed no signs of adverse effects from therapy or from repeated bee stings.

Food antigen-specific IgE in dogs with suspected food hypersensitivity

OBJECTIVE

Knowledge of cross-reactions in food-sensitive dogs will influence the choice of elimination diets and the long-term management of those patients. The objective of this study was to evaluate food allergen-specific IgE tests of suspected allergic dogs for concurrent positive reactions as possible evidence for cross reactions between allergens.

MATERIAL AND METHODS

Results of serum IgE tests from 760 suspected allergic dogs submitted to 2 laboratories were evaluated statistically. After the tested allergens were grouped by their phylogenetic relationship, odds ratios as well as a sensitivity analysis of the odds ratios were performed to evaluate if concurrent positive IgE results to 2 allergens occurred more often than expected.

RESULTS

Within related allergen pairs 27% (laboratory 1) and 72% (laboratory 2) of the pairs could be considered as associated. For the unrelated allergen pairs only 6.8% and 10.6% of the analyzed pairs were considered associated respectively. Strong correlations were shown in the group of ruminant allergens, especially beef and lamb, and grain allergens. High rates of concurrent reactions were also detected in the poultry group, especially between chicken and duck, as well as between pork and ruminant allergens, and soy and grain allergens.

CONCLUSION

As our results showed not only correlations within related but also between non-related allergens, the possible relevance of carbohydrate moieties as well as panallergens for canine hypersensitivities warrants further study. Further investigations are necessary to distinguish co-sensitization from cross-reactions and determine the clinical relevance of food-specific IgE reactivity.

CLINICAL RELEVANCE

Due to possible cross reactivity related allergens, especially beef and lamb as well as grain allergens, should not be used for an elimination diet to avoid false results.

Recurrent polyp formation with Candida tropicalis infection and otitis in a dog

To describe a case of a recurrent Candida tropicalis otitis externa, media and interna in a dog with an ear polyp. A 9-year-old Irish Setter was presented with 2 episodes of otitis sinistra, left-sided vestibular syndrome and Horner syndrome 7 months apart. At the first episode a benign ear polyp was extracted and Candida tropicalis cultured from the left middle ear. The neurological signs disappeared within 7 days, the Candida infection was more difficult to treat. Seven months later, a polyp was found in the ear again and cytology was consistent with Candida tropicalis. A unilateral left total ear canal ablation with lateral bulla osteotomy was performed and a middle ear culture confirmed Candida tropicalis. Treatment led to resolution of clinical signs. Candida tropicalis, an emerging pathogen, should be considered in cases of recurrent yeast otitis and may be difficult to treat.

Serum concentrations of IL-31 in dogs with nonpruritic mast cell tumours or lymphoma

BACKGROUND

The aim of this study was to compare serum interleukin (IL)-31 concentrations in dogs with lymphoma and mast cell tumours (MCT) without pruritus to those of healthy dogs.

HYPOTHESIS/OBJECTIVES

To determine if IL-31 plays a role in tumour pathogenesis and if IL-31 could be a biological marker for disease progression.

ANIMALS

Forty-eight healthy dogs and 36 dogs with neoplasia [multicentric lymphoma (14), MCT (15) and cutaneous lymphoma (7)] were included in the study.

METHODS AND MATERIALS

Dogs with neoplasia were assigned to three different groups. Group 1 consisted of patients with multicentric lymphoma, which were diagnosed by cytological, histopathological and clonality investigations. Thoracic radiographs, ultrasound examination of the abdominal cavity, and fine-needle aspirates from liver and spleen were used to determine the lymphoma stage Patients with cutaneous lymphoma, diagnosed by cytological and histopathological findings, were included in Group 2. Patients with MCT, diagnosed by cytological and histopathological findings, were included in Group 3. Serum was frozen at -80ºC before measuring the concentration of IL-31 via a Simoa ultra-sensitive, fully automated two-step immunoassay.

RESULTS

Serum concentrations of IL-31, regardless of the disease and its staging, were within the normal range in all patients; there was no difference between any of the different tumour groups and healthy dogs.

CONCLUSIONS AND CLINICAL IMPORTANCE

IL-31 is not likely to be involved in the pathogenesis of canine MCT or lymphoma without pruritus.

Diagnosis and treatment of demodicosis in dogs and cats: Clinical consensus guidelines of the World Association for Veterinary Dermatology

BACKGROUND

Demodicosis is a common disease in small animal veterinary practice worldwide with a variety of diagnostic and therapeutic options.

OBJECTIVES

To provide consensus recommendations on the diagnosis, prevention and treatment of demodicosis in dogs and cats.

METHODS AND MATERIALS

The authors served as a Guideline Panel (GP) and reviewed the literature available before December 2018. The GP prepared a detailed literature review and made recommendations on selected topics. A draft of the document was presented at the North American Veterinary Dermatology Forum in Maui, HI, USA (May 2018) and at the European Veterinary Dermatology Congress in Dubrovnik, Croatia (September 2018) and was made available via the World Wide Web to the member organizations of the World Association for Veterinary Dermatology for a period of three months. Comments were solicited and responses were incorporated into the final document.

CONCLUSIONS

In young dogs with generalized demodicosis, genetic and immunological factors seem to play a role in the pathogenesis and affected dogs should not be bred. In old dogs and cats, underlying immunosuppressive conditions contributing to demodicosis should be explored. Deep skin scrapings are the diagnostic gold standard for demodicosis, but trichograms and tape squeeze preparations may also be useful under certain circumstances. Amitraz, macrocyclic lactones and more recently isoxazolines have all demonstrated good efficacy in the treatment of canine demodicosis. Therapeutic selection should be guided by local drug legislation, drug availability and individual case parameters. Evidence for successful treatment of feline demodicosis is strongest for lime sulfur dips and amitraz baths.

[Effects of a homeopathic medication on clinical signs of canine atopic dermatitis]

OBJECTIVE

A commercially available medication containing homeopathic ingredients showed first signs of success in atopic dermatitis in dogs. The aim of this case series was to evaluate the effect of the preparation in a larger number of dogs with atopic dermatitis.

MATERIAL AND METHODS

Ten atopic dogs received the oral homoeopathic combination preparation daily for 3 weeks according to the manufacturer's specifications. The diagnosis of atopic dermatitis was made previously by medical history, clinical examination and exclusion of differential diagnoses. Skin infections with bacteria and yeasts were excluded by clinical examination and cytological evaluation of impression smears. In food-allergic dogs, an elimination diet was fed at least 2 months prior and during the entire study period. Patients with suspected or confirmed flea allergy received flea control for at least 1 month prior to and during the study. The clinical signs were evaluated before and after therapy using a validated Pruritus Visual Analogue Acale (PVAS) and the Canine Atopic Dermatitis Lesion Index (CADLI). The coat quality was assessed by the owners. Possible adverse effects were recorded at the recheck.

RESULTS

There were no significant changes in the lesion score (Wilcoxon test, p = 1.0), pruritus score (paired t test, p = 0.34) and coat quality (paired t test, p = 0.34) over the duration of treatment. Only one patient showed a slight improvement in itching and coat quality. No side effects were observed.

CONCLUSION AND CLINICAL RELEVANCE

In this case series, the tested homoeopathic preparation did not show a positive effect on the clinical signs of canine atopic dermatitis.

Formulations for Allergen Immunotherapy in Human and Veterinary Patients: New Candidates on the Horizon

Allergen immunotherapy is currently the only causal treatment for allergic diseases in human beings and animals. It aims to re-direct the immune system into a tolerogenic or desensitized state. Requirements include clinical efficacy, safety, and schedules optimizing patient or owner compliance. To achieve these goals, specific allergens can be formulated with adjuvants that prolong tissue deposition and support uptake by antigen presenting cells, and/or provide a beneficial immunomodulatory action. Here, we depict adjuvant formulations being investigated for human and veterinary allergen immunotherapy.

Critically appraised topic on adverse food reactions of companion animals (9): time to flare of cutaneous signs after a dietary challenge in dogs and cats with food allergies

BACKGROUND

At this time, elimination diets followed by oral food challenges (OFCs) represent the "gold standard" for diagnosing skin-manifesting food allergies (FA) in dogs and cats. Regrettably, there is no clear consensus on how long one should wait for clinical signs to flare after an OFC before diagnosing or ruling-out a FA in a dog or a cat.

RESULTS

We searched two databases on October 23, 2019 to look for specific information on the time for a flare of clinical signs to occur during OFCs after elimination diets in dogs and cats with skin-manifesting FAs. Altogether, we reviewed the study results of nine papers that included 234 dogs and four articles containing data from 83 cats. As multiple OFCs could be done in the same patient and not all animals included were subjected to an OFC, we were able to compile 315 and 72 times to flare (TTF) after an OFC in dogs and cats, respectively. When regrouping all cases together, about 9% of dogs and 27% of cats exhibited a flare of clinical signs in the first day after an OFC; 21% of dogs and 29% of cats had such relapse by the end of the second day. The time needed for 50 and 90% of dogs to exhibit a deterioration of clinical signs (TTF50 and TTF90) was 5 and 14, respectively; in cats, these times were 4 and 7 days, respectively. By 14 days after an OFC, nearly all food-allergic patients from both species had had a relapse of clinical signs. These results are limited by the likely under-reporting of flares that occur on the first day immediately following an OFC, the time in which IgE-mediated acute allergic reactions typically develop.

CONCLUSION

Veterinary clinicians performing an OFC need to wait for 14 and 7 days for more than 90% of dogs and cats with a skin-manifesting FA to have a flare of clinical signs, respectively.

Critically Appraised Topic on Adverse Food Reactions of Companion Animals (8): Storage Mites in Commercial Pet foods

Background

Dogs with year-round atopic dermatitis are often sensitized to Dermatophagoides house dust mites (HDM). Storage mites (SM) are known to grow on cereal-rich foods. Tyrophagus SM can exacerbate clinical signs of allergy in laboratory dogs sensitized to HDM. Consequently, atopic dogs with high-levels of HDM-specific IgE are likely to have a flare of signs after eating a food contaminated with SM; the development of such flares would lead to a false positive diagnosis of food allergy. Herein, we reviewed the published evidence about the growth of SM on commercial dry pet foods.

Results

We searched two databases on January 25, 2019 for articles providing original information on the growth of SM on commercial dog foods. We found ten articles, five reporting results of laboratory experiments and five from field studies. Storage mites, especially Tyrophagus putrescentiae, can multiply on protein- and fat-rich dog foods. The population growth is higher when the initial mite density is high and when kibbles are crushed. When storage conditions lead to the overgrowth of molds on the kibbles, the mite proliferation is higher. Storage mites do not bore holes in food packages but invade bags via defective seals. In the field, SM contamination usually is undetectable in newly-opened commercial dog foods, and, if present, their number is low. When newly-purchased bags are stored in temperate conditions indoors, little overgrowth—if any—of SM occurs. However, when kept in environmental conditions with higher temperature and humidity, Tyrophagus mites will enter and proliferate in sealed food packages.

Conclusions

Commercial dry pet foods should be kept indoors and sealed to decrease the risk of contamination with SM. When performing dietary restriction (elimination) and provocation trials for the diagnosis of food allergies in dogs, it seems preferable to choose newly-purchased bags—of both original and testing diets—to reduce the probability of their contamination with SM, especially Tyrophagus putrescentiae. In case of doubt about the presence of SM in any of these foods, one should perform food challenges with single home-cooked ingredients. Storage mite contamination might lead to an erroneous diagnosis of food allergy in HDM-sensitized dogs.

Successful treatment of a mucous membrane pemphigoid in a young dog

Mucous membrane pemphigoid was diagnosed in a 2.5-year-old male intact foxhound-beagle cross which was presented with an acute onset of non-pruritic, multifocal, slowly progressive erosive-ulcerative dermatitis predominantly affecting the nasal planum, eyelids and muzzle with multiple vesicles on the inner pinnae, oral mucosa and tongue. The diagnosis was based on clinical signs and histological examination of skin biopsies. The patient did not respond to immunosuppressive prednisolone therapy, but went into complete remission with oral doxycycline and niacinamide and stayed in remission on long-term exclusive niacinamide treatment.

[Successful treatment of a mucous membrane pemphigoid in a young dog]

Mucous membrane pemphigoid was diagnosed in a 2.5-year-old male intact foxhound-beagle cross which was presented with an acute onset of non-pruritic, multifocal, slowly progressive erosive-ulcerative dermatitis predominantly affecting the nasal planum, eyelids and muzzle with multiple vesicles on the inner pinnae, oral mucosa and tongue. The diagnosis was based on clinical signs and histological examination of skin biopsies. The patient did not respond to immunosuppressive prednisolone therapy, but went into complete remission with oral doxycycline and niacinamide and stayed in remission on long-term exclusive niacinamide treatment.

Dermatophytosis in dogs and cats - an update

Dermatophytosis is a cutaneous infection, caused by several types of keratophilic fungi (dermatophytes). It represents a serious and common contagious skin disease in dogs and cats. The significance of this disease for pet owners is based on the zoonotic potential. The prevalence varies with climate and local dermatophyte infestation. The most common infection in dogs and cats are caused by the genera Microsporum (M.), Nannizzia (N.) or Trichophyton (T.). The aim of this article is to summarise novel taxonomy, diagnosis, and treatment recommendations as well as the recently revised recommendations of the World Association of Veterinary Dermatology.

Is there a correlation between canine adult-onset demodicosis and other diseases?

Demodicosis is frequently seen in small animal practice. In older dogs, it is often associated with immunosuppression and immunosuppressive diseases. The aim of this study was to evaluate a larger number of dogs with adult-onset demodicosis (AOD) at the veterinary teaching hospitals of the University of Sydney/Australia and the University of Munich/Germany. Breed predispositions were compared with the two control populations. Of more than 20 000 dogs and 15 000 in each respective hospital population, 54 dogs in Munich and 68 dogs in Sydney were diagnosed with AOD at a mean age of 8 years. Breed predispositions were seen for West Highland White Terriers in Munich (p<0.0001) and Maltese Terriers and Shih Tzus in Sydney (p<0.01). Concurrent diseases were confirmed in approximately 40% of the dogs both in Munich and Sydney. A significant association was only found between AOD and hyperglucocorticoidism, hypothyroidism and (in Munich) leishmaniosis. Neoplastic diseases were not significantly more common in dogs with demodicosis than in the total population at both locations (p>0.05). Consequently, dogs with AOD should be evaluated for concurrent hyperglucocorticoidism and hypothyroidism, and, in areas of the world where this is prevalent, also for leishmaniosis.

Canine symmetrical lupoid onychomadesis in bearded collies

BACKGROUND

Symmetrical lupoid onychomadesis (SLO) is a disease not infrequently seen in bearded collie dogs in Germany.

OBJECTIVES

The aim of this study was to compare historical and clinical data, as well as the mineral content of the hair and claws of bearded collies with SLO with that of normal control dogs.

ANIMALS

Twenty-eight affected bearded collie dogs and 39 control dogs.

METHODS AND MATERIALS

Owners completed an extensive questionnaire regarding upbringing, environmental conditions and diets. Claw specimens were obtained by claw trimming or gathering lost claws; hairs were obtained by plucking samples from several areas of the body; samples were converted to ash and evaluated in an atomic absorption spectrophotometer.

RESULTS

Clinical signs in affected dogs eventually involved all claws on all paws. In twelve dogs recurrence of onychomadesis was observed. There was no relevant association between gender, housing, diet and health management, physical stress and the development of SLO with exception of the age at which more intense exercise began. The most commonly used treatment combination was fatty acids, pentoxifylline and tetracycline; improvement occurred in 17 animals. Calcium, sodium and phosphorus concentrations were higher in the claws of affected dogs, whereas zinc concentrations were lower. The mineral content of hair samples of the affected dogs was not significantly different than controls.

CONCLUSION AND CLINICAL IMPORTANCE

Symmetrical lupoid onychomadesis in bearded collies is clinically similar to what has been described in other breeds with regard to clinical signs and response to treatment. Early strenuous activity may increase the risk for disease occurrence in this breed.

Critically appraised topic on adverse food reactions of companion animals (7): signalment and cutaneous manifestations of dogs and cats with adverse food reactions

BACKGROUND

Outside of pruritus, there is no clear consensus on the nature and prevalence of cutaneous manifestations of adverse food reactions (AFRs) in dogs and cats.

RESULTS

We searched two databases on August 7, 2018, for articles reporting detailed data on the signalment and clinical signs of at least one dog or cat with a cutaneous AFR (CAFR). We identified 233 and 407 citations from which were selected 32 articles reporting original information. Twenty-two articles included data on 825 dogs with CAFRs. The reported age of onset varied from less than one to 13 years of age; a beginning of signs by 6 or 12 months of age was noted in 22 to 38% of dogs, respectively. The female-to-male ratio also varied considerably. Four breeds (German shepherd dogs, West Highland white terriers, Labrador and golden retrievers) accounted for about 40% of affected dogs. Most dogs diagnosed with a CAFR were pruritic, most often in a generalized pattern, with the ears, feet, and abdomen also being frequently affected; the perineum was uncommonly targeted, however. Canine CAFRs presented mainly as recurrent bacterial skin infections, otitis externa and atopic dermatitis. Twelve articles reported novel information on 210 cats with this syndrome. There was no apparent breed and gender predisposition for feline CAFRs, but cats appeared to develop signs later than dogs with the same syndrome. Most cats with a CAFR were pruritic, especially on the head/face and neck, with the abdomen and ears also commonly involved. Symmetric self-induced alopecia, a head-and-neck self-traumatic dermatitis, miliary dermatitis and variants of eosinophilic diseases were the most common manifestations of feline CAFRs.

CONCLUSIONS

CAFRs affect dogs and cats of any age, any breed, and both genders, with the proportion of juvenile dogs diagnosed about twice that of cats. There are no reliable breed predisposition data. Most patients are pruritic, with half the dogs having generalized pruritus and half the cats scratching their face/head or neck. Canine CAFRs most often manifest as bacterial skin infections, otitis externa or atopic dermatitis; cats with CAFRs will exhibit the expected clinical phenotypes associated with feline hypersensitivity dermatitides.

EAACI position paper: Comparing insect hypersensitivity induced by bite, sting, inhalation or ingestion in human beings and animals

Adverse reactions to insects occur in both human and veterinary patients. Systematic comparison may lead to improved recommendations for prevention and treatment in all species. In this position paper, we summarize the current knowledge on insect allergy induced via stings, bites, inhalation or ingestion, and compare reactions in companion animals to those in people. With few exceptions, the situation in human insect allergy is better documented than in animals. We focus on a review of recent literature and give overviews of the epidemiology and clinical signs. We discuss allergen sources and allergenic molecules to the extent described, and aspects of diagnosis, prophylaxis, management and therapy.

Agreement of serum allergen test results with unblocked and blocked IgE against cross-reactive carbohydrate determinants (CCD) and intradermal test results in atopic dogs

BACKGROUND

Tests for allergen-specific immunoglobulin E (IgE) are used to select allergens for immunotherapy in atopic dogs. Antibodies against cross-reactive carbohydrate determinants (anti-CCD IgE) have been identified in serum samples of atopic dogs. Their presence in humans is a known cause of clinically irrelevant polysensitization to plant allergens.

OBJECTIVES

To compare the results of an intradermal test (IDT) and a serum test for allergen-specific IgE, with and without blocking anti-CCD IgE, before testing in dogs.

ANIMALS

Thirty-one privately owned dogs with atopic dermatitis.

METHODS AND MATERIALS

Dogs were prospectively skin tested and their serum samples were analysed for anti-CCD IgE. An Fc-ε receptor-based serum test for allergen-specific IgE was performed with and without blocking anti-CCD IgE.

RESULTS

In dogs with negative anti-CCD IgE samples, the agreement between the results of the serum test and the IDT was substantial (κ = 0.71). Dogs with positive anti-CCD IgE samples (38.7%) showed no agreement between serum and skin testing (κ = -0.35), blocking anti-CCD IgE in those samples resulted in a fair agreement (κ = 0.43). Anti-CCD IgE positive sera had multiple positive results for grass and weed allergens, and blocking decreased them markedly.

CONCLUSION AND CLINICAL IMPORTANCE

Intradermal testing agreed best with serum testing in dogs with no detectable anti-CCD IgE. Sera containing anti-CCD IgE had no agreement with IDT. Test agreement was improved by blocking the anti-CCD IgE. Apparent serum test polysensitization to plant allergens was associated with anti-CCD IgE.

Determination of minimum inhibitory concentrations for silver sulfadiazine and other topical antimicrobial agents against strains of Pseudomonas aeruginosa isolated from canine otitis externa

BACKGROUND

Otitis externa is a common presenting complaint in practice. Ear infections by Pseudomonas aeruginosa are particularly problematic due to the organism's high level of resistance and ability to damage the tympanum. Treatment should be based on susceptibility testing although minimum inhibitory concentrations (MICs) are not available for all treatment options. Silver sulfadiazine has been used in cases of recurrent P. aeruginosa otitis, although a MIC for silver sulfadiazine as a single agent has not been established.

OBJECTIVES

To describe susceptibility patterns of P. aeruginosa isolated from canine otitis externa and determine the MIC for silver sulfadiazine and other topical antimicrobials.

ANIMALS

Thirty-six P. aeruginosa isolates were collected from client-owned dogs, suffering from otitis externa.

METHODS AND MATERIALS

Susceptibility patterns were established using disc diffusion susceptibility testing against 17 antimicrobial agents. For determination of the MIC, selected strains were tested against increasing concentrations of marbofloxacin, enrofloxacin, gentamicin, polymyxin B and silver sulfadiazine using broth microdilution.

RESULTS

For nine of 17 antimicrobial agents, complete resistance was seen in all isolates tested via disk diffusion susceptibility testing. Approximately 94% and 96% of isolates were susceptible to gentamicin and imipenem, respectively. These findings were consistent with broth dilution, where all strains were susceptible to gentamicin. Resistance was higher against polymyxin B and the fluoroquinolones. Silver sulfadiazine was effective in vitro with a MIC ranging from 1 to 64 μg/mL.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

As the MIC of silver sulfadiazine was lower than the concentration in a 1% preparation, such a product potentially represents a treatment option for dogs with P. aeruginosa otitis.

Retrospective analysis of pleural effusion in cats

OBJECTIVES

Pleural effusion is a common presenting cause for feline patients in small animal practice. The objectives of this study were to identify possible correlations between the aetiology of effusion and clinical and laboratory findings.

METHODS

In this retrospective study of 306 cats diagnosed with pleural effusion of established aetiology, cats were divided into six major groups: cardiac disease (CD), feline infectious peritonitis (FIP), neoplasia, pyothorax, chylothorax and miscellaneous. Clinical, laboratory and radiographic parameters were compared between groups.

RESULTS

CD was the most common aetiology (35.3%), followed by neoplasia (30.7%), pyothorax (8.8%), FIP (8.5%), chylothorax (4.6%) and miscellaneous diseases (3.7%). In 26 (8.5%) cats, more than one underlying disease was diagnosed as a possible aetiology for pleural effusion. Cats with FIP were significantly younger than those with CD (P <0.001) and neoplasia (P <0.001). Cats with CD were presented with a significantly lower body temperature compared with cats with FIP (P = 0.022). Cats with CD had significantly higher serum alanine aminotransferase activity compared with all other cats (FIP and pyothorax, P <0.001; neoplasia and chylothorax, P = 0.02) and serum alkaline phosphatase activity compared with the pyothorax (P <0.001) and FIP groups (P = 0.04), and significantly lower protein concentrations (FIP, pyothorax and neoplasia, P <0.001; chylothorax, P = 0.04) and nucleated cell counts in the effusion than all other groups (pyothorax and neoplasia, P <0.001; chylothorax, P = 0.02; FIP, P = 0.04). The glucose level in the effusion of cats with pyothorax was significantly lower than glucose levels in patients with CD, neoplasia and chylothorax (P <0.001). Of 249 cats with a follow-up of at least 10 days, 55.8% died or were euthanased during that time.

CONCLUSIONS AND RELEVANCE

CD and neoplasia were the most common causes for feline pleural effusion. Age, liver enzymes, as well as cell count, protein and glucose levels in the effusion can aid in the investigation of underlying aetiologies.

Effect of an insect protein-based diet on clinical signs of dogs with cutaneous adverse food reactions

OBJECTIVE

Edible insects (like mealworms, locusts and crickets) contain energy, protein, fatty acids, minerals and trace elements and have been found to be high quality food sources. They could provide a new food source for patients with adverse food reactions, as well as being of ecological and ethical interest. The aim of this study was to evaluate the effect of a new commercially available, insect protein-based diet on the clinical signs in those dogs via Canine Atopic Dermatitis Lesion Index (CADLI), Pruritus Visual Analogue Scale (PVAS) and coat quality score.

MATERIALS AND METHODS

A total of 20 dogs with atopic dermatitis due to previously diagnosed adverse food reaction were included in this study. This food was the only food fed to the patients for 2 weeks.

RESULTS

The lesion score improved in 12 out of 20 dogs in. Only two dogs out of 15, which completed the study, showed mild deterioration of their lesions (on average by 1.5 CADLI points). One dog's skin lesions were unchanged. Pruritus could be reduced in eight patients but remained unchanged in four dogs. Two further patients deteriorated minimally (on average by 1.5 pruritus score points) and one dramatically (8 pruritus score points). The coat quality was only evaluated in 14 dogs. Six of 14 dogs showed an improvement in coat quality. The improvement of the lesion scores (Wilcoxon test, p = 0.007) and coat quality (Wilcoxon test, p = 0.01) was significant, there was no significant change in pruritus scores (p = 0.53). The palatability was very good the compatibility was except for one patient very good.

CONCLUSION AND CLINICAL RELEVANCE

Based on these results, the investigated insect protein-based diet is an interesting alternative for dogs with food intolerance.

Prevalence of Clostridium perfringens netE and netF toxin genes in the feces of dogs with acute hemorrhagic diarrhea syndrome

BACKGROUND

Recently, novel pore-forming toxin genes designated netE and netF were identified in a Clostridium perfringens type A strain isolated from a dog with acute hemorrhagic diarrhea.

OBJECTIVES

Pore-forming toxins could play an important role in the disease pattern of acute hemorrhagic diarrhea syndrome (AHDS) in dogs. Thus, we aimed to determine the prevalence of C. perfringens genes encoding for netE and netF in the feces of dogs with AHDS and to evaluate any association between selected clinical variables and the presence of these toxin genes.

ANIMALS

In total, 174 dogs were included in the study.

METHODS

Fecal samples of all dogs were tested by real-time polymerase chain reaction for netE and netF genes. Time to recovery, hospitalization time, and selected laboratory variables were compared between dogs with AHDS that were positive or negative for the toxin genes.

RESULTS

A significant difference was found among the 3 groups in the prevalence of the pore-forming toxin genes netE and netF: dogs with AHDS: 26 of 54 (48.1%); dogs with canine parvovirus (CPV) infection: 0 of 54 (0%); and healthy dogs: 8 of 66 (12.1%; P < .001). In dogs with AHDS, no significant difference was detected in any variables evaluated between netE-positive and netF-positive and netE-negative and netF-negative dogs.

CONCLUSIONS AND CLINICAL IMPORTANCE

The prevalence of C. perfringens encoding for netE and netF is significantly higher in dogs with AHDS compared to control dogs. Further studies are warranted to evaluate whether these toxins are an inciting cause for AHDS in dogs.

Critically appraised topic on adverse food reactions of companion animals (6): prevalence of noncutaneous manifestations of adverse food reactions in dogs and cats

BACKGROUND

Many reports describe the cutaneous signs of adverse food reactions (AFR) in the dog and cat. However, various non-cutaneous clinical signs are less well described. Our objective was to systematically evaluate these non-cutaneous signs of AFR in small animals.

RESULTS

We searched two databases (MEDLINE and Web of Science) for pertinent references on non-cutaneous signs of adverse food reactions. Among 117 and 764 articles found in the MEDLINE and Web of Science databases, respectively, we selected 47 articles that reported data related to non-cutaneous clinical signs of AFR. Gastrointestinal signs, symmetrical lupoid onychitis, conjunctivitis, sneezing, and anaphylaxis were reported to be associated with AFR in dogs and gastrointestinal and respiratory signs, conjunctivitis, and hyperactive behaviour in cats. In Border terriers with paroxysmal gluten-sensitive dyskinesia, an underlying AFR should be considered. Of these clinical signs diarrhoea and frequent defecation were most frequently reported to be diet-responsive in dogs; in the cat, these were vomiting and diarrhoea.

CONCLUSIONS

An elimination diet should be considered early in the work-up of dogs and cats with chronic vomiting and diarrhoea. Other non-cutaneous signs occur less commonly because of AFRs.

Development of a core outcome set for therapeutic clinical trials enrolling dogs with atopic dermatitis (COSCAD'18)

BACKGROUND

For decades, the efficacy of interventions in clinical trials enrolling dogs with atopic dermatitis (AD) relied on heterogeneous evaluations of skin lesions and pruritus using unvalidated tools. Although some instruments for clinical signs were validated later, there was little impact on standardizing outcome measures resulting in difficulties in comparing treatment efficacy between trials and impeding meta-analyses.

RESULTS

Participants in the Outcome Measures subcommittee of the International Committee of Allergic Diseases of Animals (ICADA) collaborated for two years to develop a core outcome set (COS) for canine AD, the COSCAD. This project involved several steps, constantly-re-assessed during online exchanges, to define the scope of this COS, to identify the relevant stakeholders, the domains to be evaluated, the instruments available for measuring agreed-upon domains and how to express outcome measures. This COSCAD'18 was designed principally for therapeutic-but not preventive or proactive-clinical trials enrolling dogs with chronic, nonseasonal (perennial), moderate-to-severe AD. Selected domains were skin lesions, pruritus manifestations and perception of treatment efficacy. Instruments to evaluate these domains were the CADESI4 or CADLI, the 10-point pruritus visual analog scale (PVAS10) and the Owner Global Assessment of Treatment Efficacy (OGATE), respectively. The COSCAD'18 has three outcome measures: the percentages of dogs with veterinarian-assessed skin lesions or owner-rated pruritus manifestation scores in the range of normal dogs or those with mild AD; the third is a good-to-excellent global assessment by the pet owners of their perception of treatment efficacy. Importantly, this COSCAD'18 is not meant to represent the sole-or primary-outcome measures evaluated in a trial; authors are always free to add any others, which they deem will best assess the efficacy of tested interventions. Benchmarks to define a threshold for treatment success were not set, as what constitutes a clinically-relevant therapeutic efficacy is expected to vary greatly depending interventions.

CONCLUSIONS

This COSCAD'18 should help veterinarians and owners compare the benefits of treatments in future trials. This COS should also facilitate the combination of trial results in future systematic reviews, thereby producing more reliable summary estimates of treatment effects and enhancing evidence-based veterinary dermatology.