A retrospective study of treatment, outcome, recurrence and concurrent diseases in 190 dogs with anal sacculitis.

BACKGROUND: Few studies report the treatment and recurrence rate in anal sacculitis (AS). OBJECTIVES: Retrospective study reporting the management, recurrence and concurrent diseases in dogs with AS in a primary care practice. ANIMALS: One hundred and ninety privately owned dogs in Sweden. MATERIALS AND METHODS: Clinical records of dogs diagnosed with AS between 2018 and 2021 were reviewed, and management, time until clinical resolution, number of recurrent episodes and comorbidites were recorded. RESULTS: The 190 dogs developed 290 episodes of AS. The most common management, in 235 of 290 (81.0%) episodes, was flushing ± infusion of an antimicrobial product into the sacs ± prescription of a nonsteroidal anti-inflammatory drug (NSAID), providing resolution in 213 of 235 (90.6%) episodes. Median time to resolution was one week (range 1-16 weeks), with resolution seen within one week in 205 of 290 (70.7%) episodes. A single episode of AS developed in 126 of 190 (66.3%) dogs. Dogs with concurrent cutaneous allergic disease were more likely (p < 0.001) to have recurrence of AS when compared to dogs with other comorbidities. Cutaneous allergic disease occurred more often (p < 0.001) in dogs with AS than in the practice population. CONCLUSIONS AND CLINICAL RELEVANCE: Local treatment of the anal sacs ± systemic NSAID was the most common treatment, inducing clinical resolution in the majority of dogs. Cutaneous allergic disease was the most common concurrent diagnosis, with higher recurrence rate of AS compared to other diseases and occurring in higher prevalence than in the practice population. Further studies are needed to determine if management of cutaneous allergic disease would reduce the risk of AS.

UK-based multicentre cross-sectional study assessing advice requests veterinary dermatologists received from general practitioners.

BACKGROUND: There is little currently little information available regarding the nature of the advice requests veterinary dermatologists receive from general practitioners. Collation of such data could direct continuing veterinary development in the future. METHODS: Dermatologists completed hand-written recording sheets during or after enquiries. Information recorded included the route of enquiry, nature of advice, material provided, practice type and location, animal signalment, presenting signs, diagnosis/differential diagnosis, treatment and referral recommendations, time taken and if charges were made. RESULTS: Twelve dermatology services recorded 768 advice requests over a 6-month period. Most requests were submitted via email and related to canine dermatology (81%). An average of 9.5 minutes was spent replying to requests. Charges were made in 2% of cases. Advice regarding otitis was most commonly sought, followed by pruritus, alopecia and crusting. The most frequently discussed diagnoses included allergy, otitis, pyoderma, demodicosis, dermatophytosis and neoplasia. Antibiotics, anti-pruritics and topical otic medications were the most commonly discussed therapeutics. LIMITATIONS: This is an initial study and therefore there are limitations involving the depth of the data. Additional studies should be completed which identify why advice is sought, decision-making regarding referral, and if advice should be charged similarly to other disciplines. CONCLUSIONS: These findings highlight that veterinarians mostly frequently seek advice on management of common dermatological problems, including allergy, otitis and pyoderma.

Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019).

BACKGROUND: Pyometra is commonly seen in intact bitches and is usually treated by ovariohysterectomy. Few studies have reported the frequency of postoperative complications, particularly beyond the immediate postoperative period. Swedish national antibiotic prescription guideline provides suggestions about which antibiotics should be used and when in individuals undergoing surgery. Studies on how well clinicians adhere to these guidelines, and on the outcome for these patients, have not been evaluated for cases of canine pyometra. This retrospective study conducted at a private Swedish companion animal hospital assessed complications that developed within 30 days of pyometra surgery, and whether clinicians followed the current national guidelines in regard to antibiotic use. We also assessed whether antibiotic use affected the rate of postoperative complications seen in this cohort of dogs, where antibiotics were predominantly used in cases presenting with a more severely depressed general demeanour. RESULTS: The final analysis included 140 cases, 27 of which developed complications. In total, 50 dogs were treated with antibiotics before or during surgery and in 90 cases, antibiotics were either not given at all or treatment was initiated postoperatively (9/90) due to a perceived risk of infection developing. Superficial surgical site infection was the most common complication, followed by an adverse reaction to the suture material. Three dogs died or were euthanised during the immediate postoperative period. Clinicians adhered to national antibiotic prescription guidelines on when antibiotics should be given in 90% of cases. SSI only developed in dogs that were not given pre- or intra-operative antibiotics, while suture reactions did not appear to be affected by antibiotic use. Ampicillin/ amoxicillin was used in 44/50 cases given antibiotics before or during surgery, including most cases showing signs of concurrent peritonitis. CONCLUSION: Serious complications following the surgical treatment of pyometra were uncommon. Excellent adherence to national prescription guidelines was observed (90% of cases). SSI was relatively common and only seen in dogs that were not given antibiotics before or during surgery (10/90). Ampicillin/ amoxicillin was an effective first choice antimicrobial in cases requiring antibiotic treatment. Further studies are needed to identify cases benefiting from antibiotic treatment, as well as the duration of treatment needed to reduce the infection rate while also avoiding unnecessary preventive treatment.

A retrospective case series of the postoperative outcome for 30 dogs with inflammatory interdigital nodules, surgically treated with carbon dioxide laser and a nonantimicrobial wound-healing protocol.

BACKGROUND: Inflammatory interdigital nodules (IIN) affecting the paws of dogs is a multifactorial and painful condition. Surgery using carbon dioxide (CO 2 ) laser has been shown to be helpful in the management. HYPOTHESIS/OBJECTIVES: To assess a postoperative treatment protocol without use of antibiotics following CO2 laser surgery for IIN treatment. ANIMALS: Forty-seven paws, in 30 client-owned dogs, with IINs affecting the interdigital web between the 4th and 5th digits of the forepaws, surgically treated using CO2 laser, were included. MATERIALS AND METHODS: Medical records were reviewed for demographic details, medication use and wound healing using a set wound care protocol. Time to resolution of the surgical wounds and the postoperative outcome were assessed. RESULTS: The mean healing time was 34 days. Resolution was seen in 42 of 47 paws with complications in five paws (11%), including development of new fistulae or nonhealing granulation tissue. Surgery was repeated in those five cases. Relapse occurred during the follow-up period of five-19 months in six paws (13%). CONCLUSIONS AND CLINICAL RELEVANCE: This study shows that surgical treatment with CO2 laser for interdigital nodules is successful in most cases. The postoperative outcome using a wound-healing protocol avoiding use of antimicrobials can be used without compromising patient care whilst following antimicrobial stewardship guidelines.

Epilepsy in British Shorthair cats in Sweden.

OBJECTIVES: The primary objective of this study was to investigate the prevalence of epileptic seizures and of presumed idiopathic epilepsy (PIE, describing epilepsy of unknown origin) in a cohort of British Shorthair (BSH) cats in Sweden. The secondary objective was to describe epileptic seizure characteristics and outcome for cats with PIE. METHODS: Owners of BSH cats born between 2006 and 2016 and registered with SVERAK (the Swedish Cat Clubs' National Association) were invited to reply to a questionnaire about their cat's general health. Owners who indicated that their cat had experienced epileptic seizures were invited to participate in an in-depth telephone interview about the epileptic seizures. The clinical characteristics of epileptic seizures in BSH cats were determined from the results of the interview. RESULTS: In this population comprising 1645 BSH cats (representing 28% of registered BSHs), the prevalence of epileptic seizures was 0.9% and for PIE it was 0.7%. BSH cats with PIE presented with infrequent but consistent epileptic seizures. Twenty-seven percent of BSH cats with epileptic seizures had cluster seizures but none presented with status epilepticus. None of the BSH cats was treated with antiepileptic drugs, and none of the owners reported epileptic seizure remission in their cat. CONCLUSIONS AND RELEVANCE: The prevalence of PIE in this population of BSH cats was 0.7%. The prevalence of epileptic seizures was 0.9%. In general, PIE in the BSH cat displayed a relatively benign phenotype where progression of epileptic seizures was uncommon.

Evaluation of antibodies in cerebrospinal fluid for the diagnosis of tick-borne encephalitis in dogs.

Tick-borne encephalitis (TBE) is caused by the neurotropic tick-borne encephalitis virus (TBEV). In dogs, this virus may affect the central nervous system (CNS), causing meningoencephalitis, meningomyelitis, radiculitis or any combination of these. Diagnosis of TBE relies on a combination of clinical signs of CNS disease and laboratory findings, including CSF pleocytosis and serum TBEV antibody titers. Exposure to TBEV does not necessarily cause clinical disease, and seroprevalence has been reported as high as 40% in endemic areas. This causes concerns of over-diagnosing TBE in dogs with CNS disease. By examining TBEV antibodies in dogs with and without neurological disease in a TBEV endemic area, this study aimed to evaluate the diagnostic value of TBEV antibodies in the cerebrospinal fluid (CSF) in dogs. Eighty-nine dogs were included in the study, 56 with neurological disease and 33 neurologically normal control dogs. A positive TBEV CSF and serum IgG antibody titer (> 126 U/mL) was found in 3/89 dogs (3.4%). A positive serum TBEV antibody titer was found in 11 of the 89 dogs (12.4%). None of the control dogs showed a positive CSF antibody titer, whilst two showed positive serum concentrations. A positive CSF IgG antibody titer supports a clinical diagnosis of TBE in patients with acute onset of CNS disease and may help reduce the risk of over-diagnosis.

Systemic Mycobacterium kansasii Infection in Two Related Cats.

Mycobacterial infections are a major concern in veterinary medicine because of the difficulty achieving an etiological diagnosis, the challenges and concerns of treatment, and the potential zoonotic risk. Mycobacterium kansasii, a slow-growing non-tuberculous mycobacteria, causes disease in both humans and animals. While infections have been well described in humans, where it may be misdiagnosed as tuberculosis, there are fewer reports in animals. Only four cases have been reported in the domestic cat. This case report describes systemic M. kansasii infection in two sibling indoor-only cats that presented two and half years apart with cutaneous disease that was found to be associated with osteolytic and pulmonary pathology. Infection with M. kansasii was confirmed in both cats by polymerase chain reaction on fine-needle aspirate of a lumbosacral soft tissue mass in one cat and on a tissue punch biopsy of a skin lesion in the other; interferon-gamma release assay inferred M. avium-complex and M. tuberculosis-complex infection in the two cats, respectively. Both patients made a full recovery following antimicrobial therapy with rifampicin, azithromycin, and pradofloxacin (plus N-acetyl cysteine in cat 2). This report highlights successful treatment of systemic M. kansasii mycobacteriosis in the cat and the challenge of accurately diagnosing this infection.

Staphylococcal-Produced Bacteriocins and Antimicrobial Peptides: Their Potential as Alternative Treatments for Staphylococcus aureus Infections.

Staphylococcus aureus is an important pathogen of both humans and animals, implicated in a wide range of infections. The emergence of antibiotic resistance has resulted in S. aureus strains that are resistant to almost all available antibiotics, making treatment a clinical challenge. Development of novel antimicrobial approaches is now a priority worldwide. Bacteria produce a range of antimicrobial peptides; the most diverse of these being bacteriocins. Bacteriocins are ribosomally synthesised peptides, displaying potent antimicrobial activity usually against bacteria phylogenetically related to the producer strain. Several bacteriocins have been isolated from commensal coagulase-negative staphylococci, many of which display inhibitory activity against S. aureus in vitro and in vivo. The ability of these bacteriocins to target biofilm formation and their novel mechanisms of action with efficacy against antibiotic-resistant bacteria make them strong candidates as novel therapeutic antimicrobials. The use of genome-mining tools will help to advance identification and classification of bacteriocins. This review discusses the staphylococcal-derived antimicrobial peptides displaying promise as novel treatments for S. aureus infections.

Efficacy of a Bruton's Tyrosine Kinase Inhibitor (PRN-473) in the treatment of canine pemphigus foliaceus.

BACKGROUND: Bruton's tyrosine kinase (BTK) is important in B-cell signalling. Efficacy has been reported for BTK inhibitors (BTKi) in human autoimmune diseases. Canine pemphigus foliaceus (cPF) is the most common canine autoimmune skin disease. OBJECTIVES: To determine the safety and efficacy of a BTKi in cPF treatment. ANIMALS: Nine privately owned dogs. METHODS AND MATERIALS: Nine dogs diagnosed with PF were administered BTKi PRN473. Initial dosages were ≈15 mg/kg once daily, increased to twice daily if inadequate response was seen. Treatment continued for a maximum of 20 weeks, attempting decrease to every other day. Dogs were monitored with complete blood counts, serum biochemistry panels, urinalyses and evaluated with a modified version of a validated human Pemphigus Disease Activity Index (cPDAI). Anti-desmocollin-1 (DSC-1) and desmoglein-1 (DSG-1) immunoglobulin G (IgG) titres were performed before and after the treatment period. Drug bound to target was measured in peripheral blood mononuclear cells. RESULTS: All nine dogs showed reduction in lesions and cPDAI score during the first two weeks of treatment. At the end of the study, four responses were considered "good", two "fair", two "poor" and one dog withdrawn due to recurrence of a previously excised mast cell tumour. Four dogs continued to improve by Week 4; three sustained near complete remission by study's end. The anti-DSC-1 IgG titre decreased in three dogs, increased in two, was undetected in three and was not performed in the withdrawn dog. No dogs had detectable IgG to DSG1. Possible adverse effects occurred in three dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Bruton's tyrosine kinase inhibitor monotherapy may have beneficial effects in some cases of cPF.

A previously undescribed cutaneous paraneoplastic syndrome in a cat with thymoma.

BACKGROUND: Exfoliative dermatitis is a well-recognized cutaneous paraneoplastic syndrome (PNS) associated with thymoma in cats, of which the clinical and histopathological presentation has been well-characterized. OBJECTIVES: To describe a novel clinical skin manifestation associated with thymoma in a cat. ANIMAL: A 14-year-old neutered female domestic short hair cat. METHODS AND MATERIALS: Physical, abdominal ultrasonographic, thoracic radiographic, ultrasonographic and computed tomographic examinations, histopathological assessment of the skin and mediastinal mass. RESULTS: The cat was presented with noninflammatory alopecia, with a dorsal multifocal distribution. Examination of the alopecic areas using a dermascope indicated an apparent lack of follicular ostia. Histopathological assessment of alopecic areas confirmed follicular and epidermal atrophy, trichilemmal keratinization and mild orthokeratotic hyperkeratosis. Diagnostic imaging revealed a mediastinal mass, which was surgically removed. Histopathological and immunohistopathological examination of the mass was consistent with a thymoma, associated with multiloculated cyst formation and multifocal cholesterol granulomas. Following surgery, hair re-growth was noted in the previously alopecic areas. The cat was euthanized 3.5 months later because of recurrent chylothorax suspected to be a postoperative complication. The alopecic lesions had improved markedly. CONCLUSIONS AND CLINICAL IMPORTANCE: Thymoma-associated PNS might not always manifest as an exfoliative dermatitis and should be considered in the differential diagnosis of multifocal noninflammatory alopecia.

Results of allergen-specific immunotherapy in atopic dogs with Malassezia hypersensitivity: a retrospective study of 16 cases.

BACKGROUND: Hypersensitivity reactions to Malassezia spp have been shown to occur in dogs with atopic dermatitis (AD) and to cause exacerbation of clinical signs. Improvement of clinical signs following use of antifungal medication is seen with both Malassezia overgrowth or Malassezia hypersensitivity (MHS). Subcutaneous immunotherapy (SCIT) is considered a safe and effective treatment for management of canine AD. Adverse effects are considered rare. OBJECTIVES: To report on the use of SCIT with Malassezia extracts in mono-sensitized dogs. ANIMALS: Sixteen client owned dogs diagnosed with MHS and treated with SCIT. METHODS: A retrospective review of medical records of atopic dogs diagnosed with MHS, mono-sensitized for Malassezia allergens on intradermal test and treated with SCIT for more than 10 months. Efficacy was measured by decreasing use of anti-inflammatory and antifungal medication by ≥50% and by decreasing pruritus by ≥50% as assessed by owners, using a pruritus score. RESULTS: Good response to SCIT was seen in nine of 16 cases (56%) with both a reduction in use of anti-inflammatory and antifungal medication as well as a reduction in pruritus scores by ≥50%. No adverse effects were reported. CONCLUSION: Allergen-specific immunotherapy was a safe treatment for dogs with Malassezia hypersensitivity. The efficacy of Malassezia immunotherapy corresponds well to the results of previous studies of immunotherapy with other environmental allergens.

Malassezia pachydermatis and M nana predominate amongst the cutaneous mycobiota of Sphynx cats.

Carriage of Malassezia species yeasts in healthy Sphynx cats was compared with that in Devon Rex cats (DRC), Cornish Rex cats (CRC) and domestic shorthair (DSH) cats. Swab samples from the external ear, anus and claw folds, and contact plate samples from the axillae and groins, were incubated on modified Dixon's agar at 32°C for 7 days. Malassezia species were isolated from all 18 Sphynx cats; M pachydermatis accounted for 118/140 isolates. Of 20 isolates of M nana, 16 were recovered from the ear canal. M slooffiae was isolated from the claw fold of one cat and the left groin of another. The high counts of M pachydermatis obtained from the axillae, groins and claw folds of the Sphynx cats exceeded those of healthy DSH, CRC and DRC; axillary populations were comparable to those of seborrhoeic DRC. These data support recent reports of high Malassezia species colonisation in Sphynx cats.

Alopecia in a black Labrador retriever associated with focal sub-follicular panniculitis and sebaceous adenitis.

A 6-year-old entire male black Labrador retriever was presented with nonpruritic multicentric, well-demarcated alopecia of 12-weeks duration. Skin biopsies from the margins of alopecic regions showed sebaceous adenitis and sub-follicular panniculitis. Biopsies from alopecic areas showed severe follicular atrophy with residual fibrous tracts, loss of sebaceous glands and lymphohistiocytic panniculitis beneath individual atrophic hair follicle groups. These features differed from previous reports of pilosebaceous diseases of dogs and appeared to extend the spectrum of inflammatory patterns in presumed immune-mediated adnexal diseases of this species. During the 12-month follow-up, there was partial hair regrowth without treatment but alopecia was permanent in the centre of larger lesions.