The prevalence of bacterial infections during cyclosporine therapy in dogs: A critically appraised topic

Cyclosporine is used to treat immune-mediated and allergic conditions and to prevent transplant rejection. To determine the prevalence of bacterial infections during cyclosporine therapy in dogs, 2 databases were searched and 14 articles reporting usable data were identified. In 828 dogs with atopic dermatitis receiving anti-allergic dosages of cyclosporine, the prevalence of bacterial infections was 11%; these occurred most often in the integument and urinary systems and not in multiple systems. In 95 dogs receiving cyclosporine at higher dosages for other conditions, the prevalence of bacterial infection was 17%, and these infections occurred most often in the gastrointestinal, urinary, and respiratory systems, often occurring at more than one body site. The prevalence of bacterial infections in atopic dogs treated with cyclosporine is low and occurs most often in the skin. When given for immunosuppression, the prevalence of bacterial infections is higher and can affect one or more body systems.

Rapid response of hyperkeratotic erythema multiforme to oclacitinib in two dogs

BACKGROUND

Hyperkeratotic erythema multiforme (HKEM) is a clinically distinct dermatosis and poorly characterized syndrome, comprised of hyperkeratotic plaques with variable symmetry and apoptosis similar to "classic" erosive canine EM. Hyperkeratotic EM has a protracted clinical course and, although treatments with glucocorticoids, azathioprine and/or ciclosporin have been tried, rates of remission are low.

OBJECTIVES

To describe successful treatment of HKEM in two dogs using oclacitinib.

ANIMALS

A 7-year-old, spayed Havanese dog (Case 1) and a 1-year-old, intact cryptorchid Dachshund dog (Case 2).

METHODS

Case characterization and clinical diagnoses were based on lesion character, surgical biopsy, cytological evaluation, culture, direct immunofluorescence (DIF) and expected responses to treatments.

RESULTS

Both cases exhibited multifocal, often symmetrical hyperkeratotic plaques with adherent scale. Histological findings revealed prominent epidermal hyperplasia, parakeratotic hyperkeratosis, lymphocytic dermatitis and transepidermal apoptosis with lymphocytic satellitosis. DIF revealed fine, patchy IgG, IgM and IgA basement membrane deposits (Case 2). Both dogs exhibited rapid improvement with oral oclacitinib (0.6-0.9 mg/kg twice daily) with a complete remission of clinical signs observed in 12 and seven weeks in cases 1 and 2, respectively.

CONCLUSION AND CLINICAL IMPORTANCE

Oclacitinib could be considered as a fast-acting and effective treatment option for HKEM in dogs.

Development and validation of a graphic 2D investigator's global assessment instrument for grading the overall severity of atopic dermatitis in dogs

BACKGROUND

Clinical trials enrolling dogs with atopic dermatitis (AD) use validated instruments that aggregate the extent and severity of selected skin lesions; none of these provides a global assessment of the severity of all lesions.

OBJECTIVES

To validate an Investigator Global Assessment (IGA) instrument to globally evaluate the severity of skin lesions in dogs with AD.

ANIMALS

Forty dogs with AD.

METHODS AND MATERIALS

A 2D graphic IGA (2D-IGA) instrument was created to subjectively score, with a single dot, the overall extent and severity of all canine AD lesions. This tool was tested for its validity (content, construct and criterion), reliability (inter- and intraobserver) and sensitivity to change.

RESULTS

The content of the 2D-IGA was first validated by a supportive vote by the International Committee of Allergic Diseases of Animals (ICADA) membership. Its construct was verified by positive correlations between the 2D-IGA scores and those of the Canine Atopic Dermatitis Extent and Severity Index, 4^th iteration (CADESI-04) and the Canine Atopic Dermatitis Lesion Index (CADLI) (Spearman's rank-order correlation, P < 0.0001). The positive correlation (P < 0.0001) between an Owner Global Assessment of Disease Severity (OGADS) and the 2D-IGA indirectly satisfied its criterion. Scores graded by the same investigator hours apart and those between investigators were positively correlated (P < 0.0001), thereby validating this scale's intra- and interobserver reliabilities. Finally, the changes in 2D-IGA values during treatment were correlated positively with scores of an Owner Global Assessment of Treatment Efficacy (OGATE; P < 0.0001), thus showing its sensitivity to change.

CONCLUSIONS AND CLINICAL IMPORTANCE

This novel 2D-IGA is a simple static graphic instrument that could be useful for clinical trials testing the efficacy of interventions for canine AD.