In vitro efficacy of a topical antimicrobial mousse and shampoo at proximal and distal hair locations against Staphylococcus pseudintermedius and Staphylococcus schleiferi

BACKGROUND

Topical therapy is essential in assisting with the resolution of pyoderma.

OBJECTIVES

(i) Evaluate the in vitro efficacy and residual activity of two different hair segments treated with shampoo and mousse against meticillin-sensitive and meticillin-resistant staphylococci; (ii) compare proximal and distal hair portions treated with the products and (iii) describe a new disc diffusion method for assessing residual efficacy.

ANIMALS

Eleven privately owned, medium-haired dogs.

MATERIALS AND METHODS

In this randomised, blinded and negatively controlled study, dogs were treated once with a 3% chlorhexidine digluconate-0.5% ophytrium shampoo on the lateral thorax, and the corresponding mousse on the opposite side. Hairs were plucked before treatment, two hours post-treatment, and day (D)2, D4, D7, D10 and D14. Hairs were weighed (0.01 g) and cut (1.0 cm) from the proximal portion, moistened with saline and placed on a sterile diffusion disc to absorb the solution. Proximal and distal hair bundles and diffusion discs were placed onto agar inoculated with an isolate of meticillin-sensitive or meticillin-resistant Staphylococcus pseudintermedius or Staphylococcus schleiferi. Inhibition zones were measured following incubation.

RESULTS

Distal hairs had larger (p < 0.001) inhibition zones compared to proximal hairs. Mousse had significant differences (p < 0.05) between time points and locations for both the hair bundles and discs, while shampoo only had a significant difference (p < 0.001) between time points for the hairs.

CONCLUSIONS AND CLINICAL RELEVANCE

Mousse was effective, and shampoo was only minimally effective in inhibiting bacterial growth in vitro, with the greatest effect occurring at the two hours time point. The distal hair shafts had greater inhibition.

The use of oclacitinib compared to azathioprine in the management of canine pemphigus foliaceus: A retrospective analysis

BACKGROUND

Oclacitinib (Apoquel; Zoetis) has been reported to be beneficial for treating immune-mediated disorders.

HYPOTHESIS/OBJECTIVES

This retrospective study evaluates in which group of dogs [oclacitinib (OC) or azathioprine (AZ)] remission of pemphigus foliaceus (PF) was more effectively achieved with matched induction dosing of glucocorticoids; it further evaluates which group had a higher glucocorticoid-sparing effect.

ANIMALS

Review of 30 medical records of dogs diagnosed with PF presented to a private practice dermatological service.

MATERIALS AND METHODS

Retrospective analysis of dogs diagnosed with PF and treated with OC or AZ in combination with glucocorticoids.

RESULTS

There was no significant difference in the ability to induce remission between AZ and OC groups. In the AZ group, 13 of 15 dogs went into some type of remission (partial or complete), compared with 11 of 15 in the OC group. There was no significant difference between the two groups for the glucocorticoid-sparing effect. The AZ group had an average reduction of 77.9% from the induction glucocorticoid dose, and OC group had an average reduction of 64.4%. One of 15 patients in the AZ group and three of 15 patients in the OC group had a 100% reduction of the glucocorticoid dose.

CONCLUSIONS AND CLINICAL RELEVANCE

These results indicate that OC can be considered as a treatment option for canine PF.

Comparison of three canine nose guards for reduction of ultraviolet (UVA and UVB) solar radiation

BACKGROUND

Protection from solar ultraviolet (UV) radiation is paramount for some dermatological conditions, yet there are no studies assessing UV nose guards for dogs.

OBJECTIVES

Compare the ability of three nasal guards to block solar UV radiation (UVR) from the canine nose, using two commercial products and one created by the authors.

ANIMALS

Four fabric model dogs were used in this prospective controlled trial.

MATERIALS AND METHODS

Each model had a UV dosimeter applied to the dorsal nose and anterior nasal planum. Three models had nose protectors applied: (1) a mesh hood (OutFox Field Guard, OutFox For Dogs); (2) a fabric nose shield (Nose Protector, Dog Nose Protectors); or (3) a basket muzzle with ultraviolet protection factor (UPF) 50+ fabric developed by the authors. The control had no protective device applied. All the models were placed in direct sunlight and measurements taken over nine 2 h time periods. Total cumulative UVR was analysed for each location and type of guard or control.

RESULTS

All guards provided statistically significant UV protection compared to control at all time points (p < 0.001). The basket muzzle with UPF 50+ guard was consistent in protecting the dorsal and anterior nose, blocking 94.2% and 94.3% UVR, respectively. The fabric nose protector blocked 99.2% UVR from the dorsal and 82.9% anterior. The mesh hood blocked 72.5% of UVR dorsal and 71.4% anterior.

CONCLUSIONS AND CLINICAL RELEVANCE

Two guards were superior in blocking UVR; however, the choice of UV guard in a clinical setting depends on an individual's disease location and tolerance of the device.

An explorative study comparing skin surface lipids in the West Highland white terrier dog with and without atopic dermatitis

Background

The skin barrier is important in the pathogenesis of atopic dermatitis and stratum corneum lipids have a critical role. Skin surface lipids have been largely overlooked but also contribute to barrier function. An untargeted approach was used to compare the skin surface lipids from atopic and non-atopic West Highland White terrier dogs (WHWT).

Objectives

The primary hypothesis was that a difference in the lipidome would exist. The secondary hypothesis was that affected and unaffected skin lipids would differ.

Animals and methods

This prospective, cross-sectional, case-controlled study included thirty-nine privately owned WHWTs. Dogs were assigned to one of four disease status groups based on strict criteria. Samples for lipid analysis were collected from the skin surface of unaffected and affected sites. Lipid analysis was by untargeted liquid chromatography/mass spectrometry and utilised lipid identification software packages. Principle component analysis (PCA) and partial least-squares discriminant analysis (sPLS-DA) statistical methods analysed the association between the relative lipid abundance and disease status and affected and unaffected skin.

Results

Samples for lipid analysis found 421 lipid soluble features of which ten lipids were positively identified. Statistical analysis could not distinguish between non-atopic and atopic dogs but did reveal a statistically significant difference in the lipid profiles from affected and non-affected skin irrespective of disease status.

Conclusions

A large array of unidentified lipids from the skin surface were found with a difference between affected and unaffected skin unrelated to disease status. Investigation into the lipidome of the skin surface is an emerging area of research with clinical and therapeutic applications.

Evaluation of the use of paired modified Wright's and periodic acid Schiff stains to identify microbial aggregates on cytological smears of dogs with microbial otitis externa and suspected biofilm

BACKGROUND

Micro-organisms associated with canine otitis externa (OE) may cause biofilm-associated infections (BAI). A key component of biofilm is microbial aggregate and extracellular polymeric substance (EPS). Periodic acid Schiff (PAS) can stain polysaccharide EPS in human otitis media with effusion, but this has not been tested in canine OE. There is no cytological definition for microbial aggregate, and definitive methods for identifying BAI in a clinical setting in canine OE have not been defined.

OBJECTIVES

To establish whether PAS stain can identify polysaccharide matrix on cytological smears; and to determine the reproducibility of identification of microbial aggregates within a discrete area of stained matrix, using paired modified Wright's and PAS-stained smears.

ANIMALS

Forty privately-owned dogs presenting to a dermatological referral practice.

METHODS AND MATERIALS

In this prospective, cross-sectional study, three investigators independently and blindly classified 40 paired modified Wright's-PAS slide sets into groups: aggregate-associated infection (AAI) and non-AAI (n = 27); and control (n = 13). Agreement between investigators for presence of AAI was measured using Fleiss' kappa statistic (FK). Agreement between investigators and dermatologists for presence of AAI upon cytological evaluation, and suspected BAI based on clinical examination, was measured using Cohen's kappa statistic.

RESULTS

The matrix was confirmed to stain PAS-positive. Interinvestigator agreement for AAI was very good using PAS (0.82 FK) and fair using modified-Wright's (MW) (0.33 FK). Reproducible cytological features associated with AAI were the presence of: three or more distinct aggregates (0.76 FK); discrete areas of PAS-positive matrix (0.70 FK); and the presence of high-density material (0.70 FK) using PAS stain.

CONCLUSION

PAS can stain the extracellular matrix on otic smears, and a novel protocol for reproducible identification of cytological features such as microbial aggregates has been established.

Development of multiple cutaneous and follicular neoplasms associated with canine papillomavirus type 3 in a dog

A 12-year-old spayed English pointer dog developed multiple skin lesions including pigmented viral plaques, basal cell carcinomas, squamous cell carcinomas and trichoblastomas. Canine papillomavirus type 3 was detected in multiple lesions suggesting common aetiology.

Culture-independent and dependent evaluation of the equine paranasal sinus microbiota in health and disease

BACKGROUND

Horses with bacterial sinusitis frequently undergo empirical treatment with antimicrobials, however, in some cases bacterial culture of the affected sinus is used to direct therapy. Data regarding which organisms are part of the commensal microbiota of the equine sinus are lacking making it difficult to interpret culture results and guide empiric antimicrobial selection.

OBJECTIVES

Our objectives were to describe the bacterial and fungal microbiota of the paranasal sinuses in clinically normal horses using culture-dependent and independent approaches and to compare the bacterial culture and susceptibility patterns of normal horses with those from horses affected with primary and secondary sinusitis.

STUDY DESIGN

Experimental study and descriptive retrospective review of case records.

METHODS

Sinus washes were collected from 23 healthy horses. Washes were submitted for routine culture and susceptibility testing and DNA was isolated for next generation sequencing of bacterial and fungal marker genes. For clinical cases of sinusitis, medical records from 2010 to 2017 were reviewed and horses diagnosed with primary and/or secondary sinusitis were included.

RESULTS

The paranasal sinus cavity hosts multiple bacterial and fungal organisms. The bacterial microbiota of healthy horses consists largely of uncultivable, aerobic bacteria. While few anaerobes were isolated from normal horses, the majority of clinical cases resulted in growth of anaerobic organisms with no difference in the proportion of aerobic and anaerobic bacteria isolated from clinical cases.

MAIN LIMITATIONS

Small sample size in both populations of horses and heterogeneity of the population prevent a more in-depth analysis.

CONCLUSIONS

The microbiota of the paranasal sinuses of horses consists primarily of aerobic bacteria and fungal organisms, the majority of which are uncultivable via common clinical methods. Anaerobic bacteria are found in the majority of horses with clinical sinusitis. These findings suggest anaerobic bacteria are associated with sinusitis and their presence should be considered when treating horses with sinusitis.

Changes in the stress markers cortisol and glucose before and during intradermal testing in cats after single administration of pre-appointment gabapentin

OBJECTIVES

Intradermal allergy testing can be difficult to interpret in cats. Studies have shown that intradermal testing leads to elevations in blood cortisol, which may be an explanation for weak wheal reactions in cats. The primary objective of this study was to determine whether utilizing pre-appointment gabapentin will alter stress before and during intradermal testing, as determined by cortisol/glucose concentrations.

METHODS

This was a randomized, single-blinded, crossover clinical trial of 16  privately owned healthy cats. Cats were scheduled two veterinary visits and randomly assigned to receive either gabapentin (25.0-30.5 mg/kg) or no treatment prior to the first visit and the opposite treatment prior to the second visit. Blood samples were obtained to measure cortisol/glucose concentrations at three time points: directly after physical examination; directly after sedation; and 10 mins after the second blood sample. A limited intradermal test was performed after the second blood sample. The primary author also recorded which visit they believed gabapentin was administered with low/high confidence. A non-blinded owner assessment survey documenting stress levels in their cats was also obtained.

RESULTS

Mean cortisol concentrations were calculated to be 0.30 μg/dl lower in the gabapentin group but this reduction was not significant. Mean glucose concentrations were calculated to be 18 mg/dl higher in the gabapentin group. Gabapentin had no negative effect on intradermal histamine readings. The author was able to correctly identify when 14/16 cats received gabapentin. Non-blinded owners (n = 14/16) believed their cats were less stressed when gabapentin was administered.

CONCLUSIONS AND RELEVANCE

Gabapentin did not significantly decrease cortisol/glucose concentrations. A sedative effect, rather than suppression of the pituitary-adrenocortical axis, may have led to the lower stress assessment. It is unlikely that pre-appointment gabapentin will alter intradermal testing in a majority of cats. This study supports recent clinical trials demonstrating that administration of gabapentin can lower veterinarian/owner assessment of stress in cats.

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.

A cross-sectional study of show English bulldogs in the United States: evaluating paw lesions, cytological findings, pruritic behaviours and gastrointestinal signs

BACKGROUND

English bulldogs (EBDs) are considered to commonly show signs of pododermatitis and gastrointestinal (GI) disease.

HYPOTHESIS/OBJECTIVES

To describe a population of presumed healthy EBDs: (i) evaluate dogs according to published criteria for health, (ii) describe paw lesions, if present, (iii) report pruritic behaviours and GI signs and compare to normal values, (iv) report pedal cytological findings, and (v) determine correlation between lesions, cytological results and pruritic behaviours.

ANIMALS

Thirty four EBDs participating in a dog show.

METHODS AND MATERIALS

Dogs were examined, and pedal cytological samples were collected. Pruritic behaviours, GI signs and medical history were assessed. Owners completed questionnaires regarding history and assessed pruritus.

RESULTS

No dog met criteria for being healthy. All dogs had an abnormal dermatological examination, 22 of 34 had a history of recent drug administration and 16 of 34 had a history of dermatological disease. Every dog had at least one erythematous paw. Compared to values for a healthy dog population, facial rubbing was the only increased pruritic behaviour, and GI signs differed in belching, flatulence and regurgitation. Mean cytological evaluation values were within normal ranges except for inflammation. Lesions did not correlate with cytological findings or pruritic behaviours, with the exception of white coloured exudation with inflammation and cocci.

CONCLUSIONS AND CLINICAL IMPORTANCE

This study supports that show EBDs have frequent pedal lesions and history of dermatological disease, with over half receiving medication, as well as increased frequency of belching, flatulence and facial rubbing. Pedal cytological findings were not predictive of lesions, with the exception of white coloured exudation.

Trichographic features of hair from normal black Dobermann pinscher dogs

BACKGROUND

Dobermann dogs are predisposed to colour dilution alopecia and follicular dysplasia. Limited information is available regarding the trichographic features of normal canine hair shafts, including those from Dobermanns, with no studies of inter-observer agreement for canine trichographic features.

OBJECTIVES

To characterize the trichographic features of normal black Dobermann hair shafts evaluating the following variables; gross appearance, primary versus secondary hairs, colour change, tip structure, curling, twisting, bending, cuticle changes (breaks, compression, loss or abnormal overlapping), fractures and variations in hair diameter.

ANIMALS

Twenty client-owned, normal, black Dobermanns of different ages and genders.

METHODS AND MATERIALS

A systemized trichographic evaluation of hair samples from five body locations, which were evaluated independently by two observers, and inter-observer agreement evaluation. Kappa statistics, positive and negative agreement were determined.

RESULTS

Agreement between investigators ranged from 87% to 99% for each examined variable. Kappa statistics showed excellent (0.81-1.00) to substantial agreement (0.61-0.80) for all variables with the exception of moderate agreement (0.41-0.60) for cuticle compressions and variations in hair diameter. A novel finding of a "round hair tip" was made, which was more commonly found on the dorsal head. Colour change to the proximal hair shaft was more common on the thighs and flanks.

CONCLUSIONS AND CLINICAL IMPORTANCE

Trichographic features of 500 hairs collected from 20 normal black Dobermann dogs are described. A previously unreported finding of round hair tips was seen. We describe a systematic approach for evaluating hair shafts that can be applied in future studies for both normal and abnormal Dobermanns, and potentially other dog breeds.

Owner assessment of pruritus and gastrointestinal signs in apparently healthy dogs with no history of cutaneous or noncutaneous disease

BACKGROUND

Determining the cause of pruritus relies on establishing the pattern of abnormal pruritus. The presence of gastrointestinal (GI) disease has also been helpful in determining the cause of pruritus. No study has systematically evaluated typical GI signs and pruritic behaviours in apparently healthy dogs.

HYPOTHESIS/OBJECTIVES

To evaluate owners' perceptions of pruritus and GI signs in apparently healthy dogs, and determine if age, breed, activity, diet or supplements affected these signs.

ANIMALS

Three hundred and fourteen apparently healthy dogs ≥ 12 months old with an unremarkable physical examination and no history of pruritus, otitis, skin/hair disease, metabolic or GI disease were enrolled.

METHODS

Thirty one veterinarians enrolled dogs after establishing their pruritus visual analog scale (PVAS) score and faecal consistency score (FCS); owners completed a comprehensive online survey regarding GI signs, possible pruritic behaviours, ear cleaning and sneezing.

RESULTS

A PVAS score of ≤ 1.9 was recorded in 87.6% of dogs and the FCS was 2-3 in 94.9% of dogs. PVAS was positively correlated with paw licking/chewing, facial/muzzle rubbing, head shaking and sneezing. Scooting was positively correlated with sneezing. Over 96% of dogs had 1-3 bowel movements (BM) per day. Age was positively correlated with facial/muzzle rubbing, sneezing, coprophagia and borborygmi. The number of walks/day was positively correlated with paw licking/chewing, head shaking, sneezing, number of BM/day, coprophagia, belching, flatulence and borborygmi.

CONCLUSION AND CLINICAL IMPORTANCE

A standard method of asking relevant questions was developed and the frequency of GI signs and many behaviours that may indicate pruritus in apparently healthy dogs was established.

LD-aminopterin in the canine homologue of human atopic dermatitis: a randomized, controlled trial reveals dosing factors affecting optimal therapy

Background

Options are limited for patients with atopic dermatitis (AD) who do not respond to topical treatments. Antifolate therapy with systemic methotrexate improves the disease, but is associated with adverse effects. The investigational antifolate LD-aminopterin may offer improved safety. It is not known how antifolate dose and dosing frequency affect efficacy in AD, but a primary mechanism is thought to involve the antifolate-mediated accumulation of 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR). However, recent in vitro studies indicate that AICAR increases then decreases as a function of antifolate concentration. To address this issue and understand how dosing affects antifolate efficacy in AD, we examined the efficacy and safety of different oral doses and schedules of LD-aminopterin in the canine model of AD.

Methods and Findings

This was a multi-center, double-blind trial involving 75 subjects with canine AD randomized to receive up to 12 weeks of placebo, once-weekly (0.007, 0.014, 0.021 mg/kg) or twice-weekly (0.007 mg/kg) LD-aminopterin. The primary efficacy outcome was the Global Score (GS), a composite of validated measures of disease severity and itch. GS improved in all once-weekly cohorts, with 0.014 mg/kg being optimal and significant (43%, P<0.01). The majority of improvement was seen by 8 weeks. In contrast, GS in the twice-weekly cohort was similar to placebo and worse than all once-weekly cohorts. Adverse events were similar across all treated cohorts and placebo.

Conclusions

Once-weekly LD-aminopterin was safe and efficacious in canine AD. Twice-weekly dosing negated efficacy despite having the same daily and weekly dose as effective once-weekly regimens. Optimal dosing in this homologue of human AD correlated with the concentration-selective accumulation of AICAR in vitro, consistent with AICAR mediating LD-aminopterin efficacy in AD.

Clinical efficacy of low-level laser therapy on localized canine atopic dermatitis severity score and localized pruritic visual analog score in pedal pruritus due to canine atopic dermatitis

BACKGROUND

Canine atopic dermatitis is a genetically predisposed inflammatory skin disease often requiring multimodal treatment. There is a need to find further low-risk adjunctive therapies.

HYPOTHESIS/OBJECTIVES

To evaluate the localized effect of low-level laser therapy (LLLT) on the paws of dogs with atopic dermatitis using a localized canine atopic dermatitis severity score (LCADSS) and owner localized pruritic visual analog score (LPVAS) in comparison to treatment with a placebo.

ANIMALS

Thirty client-owned dogs with symmetrical pedal pruritus due to canine atopic dermatitis.

METHODS

Dogs were randomly assigned into two groups. In each group, one paw was treated with LLLT and one paw treated with a placebo laser (comparing either both fore- or hindpaws). Treatments were administered at 4 J/cm(2) (area from carpus/tarsus to distal aspect of digit 3) three times per week for the first 2 weeks and two times per week for the second 2 weeks. Scores were assessed for each paw at weeks 0, 2, 4 and 5.

RESULTS

There were no significant differences in LCADSS or LPVAS between LLLT and placebo treatments between weeks 0 and 5 (P = 0.0856 and 0.5017, respectively). However, LCADSS and LPVAS significantly decreased from week 0 at weeks 2, 4 and 5 in both LLLT and placebo groups (P < 0.0001 for all).

CONCLUSIONS AND CLINICAL IMPORTANCE

Low-level laser therapy is not an effective localized treatment for pedal pruritus in canine atopic dermatitis.

Evaluation of the potential use of adipose-derived mesenchymal stromal cells in the treatment of canine atopic dermatitis: a pilot study

Stem cells and their potential therapeutic uses in human and veterinary medicine have generated considerable interest. These cells have a number of potentially unique immunologic properties; most notable are their reported regenerative and antiinflammatory capabilities. The aim of this prospective pilot study was to evaluate the efficacy of intravenously administered autogenous adipose-derived mesenchymal stem cells (AD-MSCs) in the treatment of canine atopic dermatitis. AD-MSCs administered intravenously at a dose of 1.3 million cells/kg did not significantly reduce the clinical signs of canine atopic dermatitis or the owner-assessed pruritus level.

The effect of otic vehicle and concentration of dexamethasone on liver enzyme activities and adrenal function in small breed healthy dogs

Dexamethasone 0.1% in propylene glycol vehicle has been shown to cause adrenal suppression and increased liver enzyme concentrations in normal dogs. The objectives of this study were to determine if these effects are concentration or vehicle dependent and to evaluate a dexamethasone 0.01% solution. Twenty-one privately owned normal dogs were included in this double-blinded study. Chemistry panels and adrenocorticotropin hormone (ACTH) stimulation tests were performed on day 0 and 15. Dogs were randomly assigned treatment with dexamethasone 0.01% in saline, 0.1% in saline, or 0.1% in a commercial preparation (Tresaderm: Merial, Duluth, GA, USA) in each ear twice daily for 2 weeks. Nineteen dogs completed the study. After 2 weeks of treatment, all dogs receiving dexamethasone 0.01% in saline had normal ACTH stimulation tests and liver enzyme values. In contrast, four of seven dogs (57.14%) receiving dexamethasone 0.1% in saline experienced adrenal suppression, and four of six dogs (66.67%) receiving Tresaderm experienced adrenal suppression with three of those dogs (50%) experiencing marked adrenal suppression. No dogs receiving dexamethasone 0.1% in saline had increased liver enzyme concentration, while one of six dogs (16.67%) experienced a slight elevation in alkaline phosphatase. In conclusion, it appears that adrenal suppression caused by otic dexamethasone is concentration and perhaps vehicle dependent. Veterinarians who formulate dexamethasone 0.1% otic solutions should be cognizant of potential adrenal suppression similar to that seen with Tresaderm although not to the same degree. Dexamethasone at 0.01% did not cause adrenal suppression or liver enzyme alterations after 2 weeks of treatment.

Comparative adrenocortical suppression in dogs with otitis externa following topical otic administration of four different glucocorticoid-containing medications

The safety of using otic formulations is often of concern for practitioners and pet owners alike, with "safe" in this context meaning no adrenocortical suppression. This study evaluated the effect of four glucocorticoid-containing otic formulations on plasma cortisol concentrations, measured by corticotropin stimulation testing (plasma cortisol concentrations before and after corticotropin injection), in dogs presented with otitis externa. Dexamethasone tended to have larger adrenocortical suppression compared with the other three formulations (betamethasone, triamcinolone, and mometasone), but the difference was not statistically significant. The largest difference among the four drugs was observed between dexamethasone and betamethasone (P=.09).

Susceptibility of Pseudomonas isolates from the ears and skin of dogs to enrofloxacin, marbofloxacin, and ciprofloxacin

The purpose of this study was to compare susceptibilities of ear and skin Pseudomonas spp. isolates to enrofloxacin, marbofloxacin, and ciprofloxacin. Specimens were obtained from dogs examined in a veterinary dermatology referral hospital. Susceptibilities of ear isolates to enrofloxacin, marbofloxacin, and ciprofloxacin were 46.9%, 66.7%, and 75.0%, respectively. Susceptibilities of skin isolates to the same drugs were 76.2%, 81.0%, and 80.0%, respectively. Ear isolates were significantly less susceptible to enrofloxacin than to ciprofloxacin (P=0.021), and ear isolates were significantly less susceptible to enrofloxacin than were skin isolates (P=0.034). When fluoroquinolone resistance was present, ear isolates were significantly less susceptible to enrofloxacin than to ciprofloxacin (P<0.001) and marbofloxacin (P=0.014).

Topical 0.1% tacrolimus for the treatment of discoid lupus erythematosus and pemphigus erythematosus in dogs

Topical 0.1% tacrolimus was used for treatment of localized lesions associated with 10 cases of discoid lupus erythematosus (DLE) and two cases of pemphigus erythematosus (PE) either as a sole therapy (n=2) or as an adjunctive treatment (n=10). Eight of 10 dogs with DLE and both dogs with PE were improved following 8 weeks of topical application. In six of the eight dogs that improved, other medications were discontinued. No adverse effects in clinical or laboratory parameters were noted throughout the study.

Feline pyoderma therapy

Feline pyoderma is a disease entity more prevalent than previously described. Diagnosis is made by finding bacteria in the presence of inflammatory cells or bacterial phagocytosis on routine cytological examination. Diseases leading to secondary bacterial pyoderma include allergic and inflammatory skin diseases, parasitosis, feline chin acne, and others. Lesions of feline pyoderma are variable and include crusted and eroded papules, pustules, furuncles, eroded to ulcerated plaques with variable exudation and crusting, and linear to nodular ulcerative granulomatous lesions. Three cases of feline pyoderma responsive to antimicrobial therapy are discussed: case 1, a 10.5-year-old male neutered domestic short hair with eosinophilic lip ulcer, case 2, a 7-year-old male neutered domestic short hair with multiple cutaneous eosinophilic plaques, and case 3, an 8-month-old male neutered domestic short hair cat with Pseudomonas dermatitis, vasculitis, and panniculitis. Antibiotic selection for treatment of feline pyoderma should be based on cytological examination, and culture and sensitivity in unresponsive cases.

Practical cytology for inflammatory skin diseases

Cytology is the most common and immediately informative diagnostic tool in the practice of dermatology. It is simple to perform and requires equipment usually already present in most practices such as a microscope and slides, cotton-tipped applicators and stains. Cytology interpretation is also easily self taught. With little practice the practitioner can easily become familiar with sample interpretation from inflammatory lesions; including recognition of bacteria, yeast, dermatophyte spores and hyphae, deeper fungal elements and parasites. Additionally, the practitioner should become familiar with the variety of inflammatory cells seen with these conditions, as well as keratinocyte morphology. This article provides an overview and the initial steps on how to become a more proficient cytologist in practice.

Feline Immunotherapy

Feline allergen specific immunotherapy (ASIT) is considered to be a safe and effective treatment for feline atopy. ASIT is defined as the practice of administering gradually increasing quantities of an allergen extract to an allergic subject. The purpose of which is to reduce or eliminate the symptoms associated with subsequent exposures to the causative allergen. ASIT offers an effective and safe treatment option for cats. Reported success rates range for 60 to 78% in feline atopic patients. Additionally, the reported incidence of side effects in feline atopic patients undergoing ASIT is very low and mainly anecdotal.

Otitis Techniques to Improve Practice

Successful management of otitis externa requires recognition of changes in the anatomy and physiology of the external and middle ear, as well as the adequate tools and examinations to detect changes from normal. Otoscopy and methods for assessing the normalcy of the tympanum, collection of samples for cytologic evaluation or culture, and myringotomy are diagnostic techniques important in practice. Treatment tubes and intralesional triamcinolone injections are techniques that improve the response in some cases.

Evaluation of otoscope cone cleaning and disinfection procedures commonly used in veterinary medical practices: a pilot study

The objective of this study was to evaluate the relative efficacy of otoscope cone cleaning and disinfection methods commonly used in veterinary practices. Using sterile technique, 60 new gas-sterilized 4-mm otoscope cones were inoculated with a broth culture of 1.5 billion Pseudomonas aeruginosa bacteria per mL then allowed to dry for 10 min. Six study groups of 10 cones each were created. Group 1 served as positive control and received no cleaning or disinfection. Group 2 cones were wiped with sterile cotton-tipped applicators and gauze then rinsed with water. Group 3 cones were wiped with 70% isopropyl alcohol. Group 4 cones were scrubbed in a speculum cleaner with Cetylcide II solution (Cetylite Industries, Inc., Pennsauken, NJ). Groups 5 and 6 cones were soaked for 20 min in Cetylcide II and chlorhexidine gluconate 2% solutions, respectively. Using sterile technique and after 10-15 min drying time, the cones were swabbed in a consistent pattern, and samples were submitted for quantitative culture. Culture results showed no growth from cones soaked in Cetylcide II or chlorhexidine solutions. Two of the 10 cones wiped with alcohol, 3/10 cones wiped then rinsed with water, and 3/10 cones scrubbed with the speculum cleaner showed growth of P. aeruginosa. All (10/10) cones in the control group showed heavy growth of P. aeruginosa. These results show that P. aeruginosa can survive on otoscope cones cleaned and disinfected by several commonly used methods. Further study is needed to determine practical and optimal cleaning and disinfection methods for otoscope cones.

Rush allergen specific immunotherapy protocol in feline atopic dermatitis: a pilot study of four cats

Rush immunotherapy has been shown to be as safe as conventional immunotherapy in canine atopic patients. Rush immunotherapy has not been reported in the feline atopic patient. The purpose of this pilot study was to determine a safe protocol for rush immunotherapy in feline atopic patients. Four atopic cats diagnosed by history, physical examination and exclusion of appropriate differential diagnoses were included in the study. Allergens were identified via liquid phase immunoenzymatic testing (VARL: Veterinary Allergy Reference Labs, Pasadena, CA). Cats were premedicated with 1.5 mg triamcinolone orally 24 and 2 h prior to first injection and 10 mg hydroxyzine PO 24, 12 and 2 h prior to first injection. An intravenous catheter was placed prior to first injection. Allergen extracts (Greer Laboratories, Lenoir, North Carolina) were all administered subcutaneously at increasing protein nitrogen units (pnu) every 30 minutes for 5 h to maintenance dose of 15,000 pnus ml-1. Vital signs were assessed every 15 minutes. Two cats developed mild pruritus and the subsequent injection was delayed 30 minutes. No changes in either cat's vital signs were noted, nor was there any further pruritus. All four cats successfully completed rush immunotherapy. Two cats developed a dermal swelling on the dorsal neck one week later. In these four cats, this protocol appeared to be a safe regimen to reach maintenance therapy. A larger sample of feline patients is needed to determine the incidence of adverse reactions and to follow the success of ASIT based upon this method of induction.

Canine discoid lupus erythematosus

Two dogs were found to have clinical, histopathological and immunofluorescent findings compatible with a diagnosis of canine discoid lupus erythematosus. The primary lesions included erythema and depigmentation of the nasal planum. Both dogs responded favorably to systemic corticosteroid therapy.

Efficacy of Boric-Complexed Zinc and Acetic-Complexed Zinc Otic Preparations for Canine Yeast Otitis Externa

The purpose of this 2-week, double-blinded, controlled clinical trial was to evaluate the efficacy of topical amino acid-complexed zinc gluconate formulated with boric acid (ZGB) or acetic acid (ZGA) versus a topical placebo in the treatment of yeast otitis externa in dogs. Included in the study were dogs with otitis externa and a cytopathological finding of yeast organisms in the affected ear. Ears were treated with the placebo, ZGA, or ZGB medications. Yeast counts as well as clinical appearance of the ears were monitored. Results revealed that ZGB significantly reduced the number of yeast organisms in cases of otitis externa.

Identification of snails within the Bulinus africanus group from East Africa by multiplex SNaPshot trade mark analysis of single nucleotide polymorphisms within the cytochrome oxidase subunit I

Identification of populations of Bulinus nasutus and B. globosus from East Africa is unreliable using characters of the shell. In this paper, a molecular method of identification is presented for each species based on DNA sequence variation within the mitochondrial cytochrome oxidase subunit I (COI) as detected by a novel multiplexed SNaPshotTM assay. In total, snails from 7 localities from coastal Kenya were typed using this assay and variation within shell morphology was compared to reference material from Zanzibar. Four locations were found to contain B. nasutus and 2 locations were found to contain B. globosus. A mixed population containing both B. nasutus and B. globosus was found at Kinango. Morphometric variation between samples was considerable and UPGMA cluster analysis failed to differentiate species. The multiplex SNaPshotTM assay is an important development for more precise methods of identification of B. africanus group snails. The assay could be further broadened for identification of other snail intermediate host species.

The ACVD task force on canine atopic dermatitis (XXI): antihistamine pharmacotherapy

Antihistamines frequently are recommended by veterinary dermatologists for symptomatic treatment of pruritus associated with canine atopic dermatitis (AD), perhaps because of their moderate success in some human patients with AD. A critical review of the literature describing antihistamine use in canine AD reveals that the majority of published, peer-reviewed studies are open, uncontrolled or partially-controlled trials. Such studies vary widely in reported efficacy, from perhaps 0 to 75% of patients, even using the same drug. The few blinded placebo-controlled trials available have failed to confirm efficacy of these drugs to relieve the pruritus of canine AD. Some studies indicate that synergistic effects could occur with concurrent use of essential fatty acid supplements. Consequently, at the time of this writing, there is insufficient evidence to conclude for or against the efficacy of antihistamines for treatment of canine AD. Additional blinded, randomized and controlled trials with larger numbers of patients are necessary to establish which of the antihistamine drugs currently available, if any, are truly efficacious for canine AD. Nevertheless, present clinician consensus suggests that several different antihistamine drugs should be evaluated in sequence, for 7-14 days each, in canine patients with AD.

The ACVD task force on canine atopic dermatitis (I): incidence and prevalence

There is an increasing incidence of atopic diseases (asthma, allergic rhinitis and atopic dermatitis) in humans, especially in developed countries. Although there is a genetic predisposition to the development of these diseases, the rapid rise in incidence is suspected to be caused by environmental rather than genetic factors. Neither the incidence nor the prevalence of atopic dermatitis in the general canine population has been studied. As many of the environmental factors associated with the increasing incidence of atopic dermatitis in humans are consistently found in the environment of dogs, it would seem likely that a similar increase in the incidence of this disease would be occurring also in dogs. Epidemiological studies of canine atopic dermatitis are needed to characterize the incidence and prevalence of atopic dermatitis, and to further study the factors that contribute to the development of this disease.

The ACVD task force on canine atopic dermatitis (XIV): clinical manifestations of canine atopic dermatitis

Canine atopic diseases, including those with skin lesions, have been described for many years. Unfortunately, early descriptions often failed to establish definitive guidelines for considering a patient atopic, and criteria for diagnosing atopic dermatitis (AD) have varied from author to author. Larger case-series published from the 1960s to the 1980s suggested that the most common clinical manifestation of AD was pruritus, particularly of the face, ears, paws, extremities, and/or ventrum. It is not always clear that testing to eliminate other differential diagnoses was always carefully performed on patients in early reports; therefore, some descriptions could include patients affected with diseases other than or in addition to AD. Points of consensus regarding clinical manifestations of AD in case-series include the presence of pruritus beginning at a young age, possibly seasonally; and a prominent lesional involvement of the face, extremities, axillae or ventrum. Conflicting information on breed and sex predispositions is present, perhaps representing regional or temporal variability. Clinical reports vary, in regard to the description of lesions seen in dogs with AD. This reflects a possible confusion with lesions of secondary complications, and highlights the fact that the existence and nature of primary lesions of canine AD are not truly known.

The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy

Allergen-specific immunotherapy (ASIT) has been used for years to treat dogs with atopic dermatitis (AD) and humans with atopic diseases. The efficacy of ASIT has been well documented for humans with respiratory atopic diseases and stinging insect allergy, but its effectiveness seems more controversial for patients with AD. In spite of insufficient evidence derived from randomized controlled trials, multiple open studies and a large body of clinical observations suggest that ASIT is effective in controlling the clinical signs of dogs with AD. As a result of the scarcity of evidence from controlled trials, the true efficacy of ASIT, and the optimal protocols for allergen dose and frequency of injection are currently unknown. Allergen-specific immunotherapy nevertheless may be included in the treatment of canine AD because of its potential advantages and limited disadvantages compared to other forms of therapy. There is no evidence, however, for the preference of any specific treatment protocol. The predictive value of historical, clinical and immunologic features related to the efficacy of ASIT in dogs with AD are discussed in this paper. Adverse reactions, and the requirements for monitoring of patients receiving ASIT, then are reviewed and detailed. Finally, this review highlights aspects of ASIT where further research and controlled studies are needed.

The ACVD task force on canine atopic dermatitis (X): is there a relationship between canine atopic dermatitis and cutaneous adverse food reactions?

In humans, allergies to foods are known to induce skin lesions in some patients with atopic dermatitis. This is particularly evident in infants with severe atopic dermatitis. Food allergy in humans is an IgE-mediated hypersensitivity in most cases, and thus has the same (or very similar) pathogenic mechanism of disease induction as environmental allergen-induced atopic dermatitis. Cutaneous adverse food reactions and atopic dermatitis in dogs are often indistinguishable from each other on historical and clinical grounds alone. Limited current evidence suggests that dogs with cutaneous adverse food reactions may be predisposed to developing atopic dermatitis. However, confirmation of any association between these two diseases in dogs awaits further elucidation of the pathogenic mechanism of cutaneous adverse food reactions, and epidemiological studies of the relative prevalence of these diseases in relation to each other and the general population.

Onychectomy as a therapy for symmetric claw and claw fold disease in the dog

Chronic onychodystrophies are a group of diseases that are frustrating and potentially expensive to manage. Despite appropriate diagnostics, an underlying etiology may not be identified. Long-term therapy may result in resolution or remission; however, relapses are common. In many cases, the disease persists in the face of appropriate therapy. Seven dogs with chronic onychodystrophies were treated with onychectomies. Treatment resolved the clinical signs for a follow-up period of four months to six years.

Factors associated with and prevalence of high Malassezia pachydermatis numbers on dog skin

The prevalence of cutaneous Malassezia spp was evaluated in a semiquantitative fashion at 3 sites on 98 dogs examined because of various dermatoses. Thirty (10.2%) of the sites and 19 (19.4%) of the dogs had Malassezia spp amounts higher than that found on grossly normal skin. The prevalence of higher than normal amounts did not correlate significantly with sample site, sex, or age. The factors associated with an increased prevalence of increased Malassezia spp counts were seborrheic dermatitis, recent antibiotic treatment, and breed.