The Use of Adaptive Learning Technology to Enhance Learning in Clinical Veterinary Dermatology.

Clinical teaching in veterinary medicine is challenging for both educators and students. There is an increasing interest in the use of technology-based techniques using adaptive learning to provide students with additional learning experiences. Few studies have evaluated the use of this technique in veterinary medical education. We hypothesized that students with access to adaptive learning modules during dermatology rotation would have significantly higher dermatology test scores compared to students who did not have access to the adaptive learning modules on the same rotation. Incoming third and fourth-year veterinary students to the dermatology rotation, who agreed to participate, were randomly assigned to treatment (provided access to 10 modules using adaptive technology during the rotation) or control group (provided no access to the modules). Study participants completed a pretest two weeks before the rotation start date and a post-test near the rotation end date and a questionnaire to assess students' learning experience using adaptive learning modules. Students in the treatment group scored significantly higher on the posttest (p = .019) compared to students in the control group, with an effect size of d = 0.83. Students in both groups scored significantly higher at post-test (p < .001; d = 1.52 treatment and p = .002; d = 0.74 control) when compared to their pretest. This study shows that the tested adaptive learning platform may be an effective method to augment clinical teaching in veterinary dermatology. This study also indicates that veterinary students perceive the use of adaptive learning technology as beneficial for their education.

THE USE OF INTRADERMAL ALLERGY TESTING FOR ALLERGIC DERMATITIS IN PTEROPID BATS AND TREATMENT WITH ALLERGEN SPECIFIC IMMUNOTHERAPY: A CASE SERIES.

This case series describes the diagnosis of allergic dermatitis and management with allergen-specific immunotherapy (ASIT) based on intradermal allergy testing (IDAT) and adjunctive medical therapy in six pteropid bats; five large flying foxes (Pteropus vampyrus); and one variable flying fox (Pteropus hypomelanus). The cases ranged from 2 to 15 yr of age at the time of presentation. Clinical signs varied between individuals and included moist ulcerative cutaneous lesions in nonhaired skin, blepharoconjunctivitis, alopecia, and pruritus. All bats underwent IDAT under general anesthesia, and reactive allergens included a mixture of grasses, trees, weeds, and biting insects. Three of the six cases (50%) had reformulation of the ASIT before control of clinical signs was seen, and two bats were treated with the addition of oclacitinib (Apoquel). Severe adverse effects were not identified; however, one bat had self-limiting swelling at the immunotherapy injection site. All six cases showed improvement of clinical signs and perceived comfort level, including in subsequent allergy seasons.

Noninvasive evaluation of vascular endothelial growth factor-A (VEGF-A) protein concentrations in the stratum corneum and serum of healthy and atopic dogs.

BACKGROUND: Vascular endothelial growth factor (VEGF) is a cytokine involved primarily in angiogenesis. In human atopic dermatitis (AD), VEGF has been detected in the stratum corneum and blood. OBJECTIVE: To evaluate VEGF-A expression in the serum and stratum corneum of healthy and atopic dogs, and its possible correlation with disease severity in atopic dogs. ANIMAL: Fifteen atopic and 15 healthy, privately owned dogs. METHODS AND MATERIALS: The severity of clinical signs associated with AD was evaluated with the Canine Atopic Dermatitis Extent and Severity Index (CADESI-04). For all dogs, a single blood sample was performed and serum collected. Tape stripping (15 times) was performed on the left periocular area (lesional skin). A commercially available canine-specific VEGF-A enzyme-linked immunosorbent assay was performed with all samples. RESULTS: Vascular endothelial growth factor-A was undetectable in the serum. In the stratum corneum, there was no significant difference in VEGF-A concentrations between healthy (mean 89.4 ± 59.5 pg/ml) and atopic dogs (mean 100.3 ± 77.1pg/ml) (P = 0.71). There was no correlation between stratum corneum VEGF-A concentrations and CADESI-04 scores. CONCLUSIONS AND CLINICAL IMPORTANCE: The role of VEGF in canine AD is unclear. Because of many variants, VEGF-C and VEGF-D or VEGF-A isotopes should be explored in the skin to better evaluate the role of VEGF in canine atopy. Full-thickness skin biopsy, molecular biology and histopathological investigation may be necessary to further assess cutaneous VEGF expression.

Isolation of Neisseria dumasiana from a deep bite wound infection in a dog.

BACKGROUND: Neisseria spp. is a common inhabitant of the oral flora of cats and dogs; it is a potential cause of cutaneous infections in people secondary to animal bites. Neisseria dumasiana is a new species identified in the oral cavity of dogs. It has not been linked to cutaneous infections in people. OBJECTIVE: To describe the clinical and microbiological features of Neisseria dumasiana isolated from the skin of a dog. ANIMAL: A 3-year-old male neutered mixed breed dog from Florida, USA. METHODS AND MATERIALS: The dog had no travel history within or outside the United States; the dog was presented with draining tracts on the dorsum. Five months before the initial examination the dog was involved in a fight with another dog. RESULTS: An aerobic bacterial culture was performed and isolated multiple small, grey, moist, circular, convex and nonhaemolytic colonies. A Gram stain showed Gram-negative coccobacilli present in pairs. The bacteria were oxidase- and catalase-positive and negative for indole and fermentation of fructose, xylose, sucrose, mannitol and sorbitol. Polymerase chain reaction, using 16S rDNA sequencing, was positive for Neisseria dumasiana. Clinical and microbiological resolution occurred within three months of treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first report of a deep cutaneous dermatitis associated with Neisseria dumasiana in a dog. This case should stimulate veterinary clinicians and microbiologists to consider Neisseria spp. among the differential diagnoses of nonhealing wounds in dogs, particularly those associated with bite wounds.

In vitro antimicrobial activity of topical otological antimicrobials and Tris-EDTA against resistant Staphylococcus pseudintermedius and Pseudomonas aeruginosa isolates from dogs.

BACKGROUND: The value of susceptibility tests for the selection of topical otological antimicrobial agents is unclear. Laboratories test antibiotic concentrations substantially lower than concentrations supplied in topical formulations. Additionally, microbiological consensus statements are not available for topical antimicrobials. HYPOTHESIS/OBJECTIVES: The primary aim of this study was to measure the minimum inhibitory and bactericidal concentrations of enrofloxacin, gentamicin, marbofloxacin, neomycin, orbifloxacin, polymyxin B and silver sulfadiazine from concentrations available in otological formulations (COF) to 1:59,000 dilution. The secondary aim was to evaluate the effect of Tris-EDTA in conjunction with these antimicrobial agents. METHODS AND MATERIALS: Twenty resistant clinical isolates [Staphylococcus pseudintermedius (n = 10) and Pseudomonas aeruginosa (n = 10)] were tested by broth microdilution using a concentrated inoculum (3.75 × 107 cfu/mL). RESULTS: Concentrations available in otological formulations were at least 26× greater than the MICs for S. pseudintermedius and P. aeruginosa. COFs of polymyxin B and SSD were 27× greater than the MBCs for P. aeruginosa, whereas all other antimicrobial COFs were equal to or less than the MBCs for both organisms. Tris-EDTA significantly reduced the MICs of all antimicrobials, except with SSD for P. aeruginosa, and it significantly increased the MIC of SSD for S. pseudintermedius. CONCLUSIONS AND CLINICAL IMPORTANCE: Further studies are warranted to validate the present results in vivo. COFs are inhibitory and less likely bactericidal, with few exceptions, against resistant strains of these organisms. Tris-EDTA may be advantageous for P. aeruginosa whereas no additional benefit is afforded against S. pseudintermedius. Susceptibility tests may not be useful for the selection of topical otological antimicrobial agents.

Can ultraviolet light C decrease the environmental burden of antimicrobial-resistant and -sensitive bacteria on textiles?

BACKGROUND: The environment is important in transmission of bacteria. Textiles are difficult and time consuming to clean; ultraviolet light C (UVC) is germicidal and may be an effective disinfection method for textile surfaces. OBJECTIVE: This study evaluated the efficacy of UVC, a commercial quaternary ammonium compound antimicrobial spray (FAS) and UVC+FAS combined for reducing bacterial colonization on experimentally contaminated textiles. METHODS: Microfibre, cotton and polyester were inoculated with meticillin-sensitive and -resistant Staphylococcus aureus (MSSA and MRSA), Staphylococcus pseudintermedius (MSSP and MRSP), Pseudomonas aeruginosa or Escherichia coli. ATCC® strains were used except for MRSP, for which ten canine clinical isolates were collected. Textiles were treated with three doses of UVC (13 mJ/cm2 , 54 mJ/cm2 or 270 mJ/cm2 ), FAS or both (FAS and UVC at 270 mJ/cm2 ). UVC was delivered using a modified mercury-based lamp. Bleach (8.25%) was used as a positive control. Negative controls received no treatment. Surface bacterial counts were determined 24 h post-treatment. RESULTS: The lower dosages (13 mJ/cm2 and 54 mJ/cm2 ) of UVC had >90% colony forming unit (CFU) reduction, 270 mJ/cm2 had >99% CFU reduction and combined UVC+FAS had 100% CFU reduction against all bacterial strains on all surfaces (P < 0.05). Ten experiments showed that treatment with UVC had a greater CFU reduction when compared to FAS alone (P < 0.05). A majority of those experiments (seven of 10) involved Gram-negative species (P. aeruginosa or E. coli). CONCLUSION: UVC quickly reduced the bacterial burden on textiles to greater than 90%; UVC may be a better disinfecting agent than FAS for Gram-negative species.

Successful Treatment of Demodex gatoi with 10% Imidacloprid/1% Moxidectin.

Demodex gatoi is a transmissible, short-bodied mite found in the stratum corneum of cats. It is known to cause moderate to intense pruritus, often manifested as self-induced alopecia and excoriations. 10% imidacloprid/1% moxidectin (a) is a monthly, topical solution indicated for the treatment and/or prevention of fleas, heartworms, intestinal parasites, and ear mites. A household of cats was presented for pruritus that ranged from mild to severe in 8 of the 13 felines. The most common clinical signs included miliary-type papular dermatitis and focal areas of erythema associated with alopecia. Multiple skin scrapings of each animal revealed Demodex gatoi mites in only two cats. Weekly topical administration of 10% imidacloprid/1% moxidectin was used on all cats in the household for a total of ten doses. Skin scrapings following treatment were negative, and all cats in the house improved. Based on the successful treatment of this small number of cats, weekly application of 10% imidacloprid/1% moxidectin should be considered for the clinical resolution of cats affected by D. gatoi.

Urticaria pigmentosa-like disease in a dog.

Urticaria pigmentosa is a rare dermatologic syndrome in humans, cats, and dogs. This report documents a case of canine urticaria pigmentosa-like disease with unusual features and no C-kit mutation.

Maladie s'apparentant à l'urticaire pigmentaire chez un chien. L'urticaire pigmentaire est un syndrome dermatologique rare chez les humains, les chats et les chiens. Ce rapport documente un cas canin s'apparentant à l'urticaire pigmentaire comportant des caractéristiques inhabituelles et l'absence de mutation C-kit.(Traduit par Isabelle Vallières).

Feline cutaneous lymphocytosis: case report and summary of the literature.

PRACTICAL RELEVANCE: Feline cutaneous lymphocytosis is a rare disease characterized by proliferation of T and/or B lymphocytes in the dermis. Although some of the clinical and histopathologic findings of this condition can overlap with cutaneous lymphoma, it is important to distinguish these entities since their treatment and clinical outcomes vary greatly. SCOPE: This report presents a summary of the literature on feline cutaneous lymphocytosis and describes a case of this condition which showed some unique clinical features and was successfully controlled with oral glucocorticoids.

An in vitro study to determine the minimal bactericidal concentration of sodium hypochlorite (bleach) required to inhibit meticillin-resistant Staphylococcus pseudintermedius strains isolated from canine skin.

BACKGROUND: Meticillin-resistant Staphylococcus pseudintermedius (MRSP) is becoming a more common pathogen in animals treated in veterinary hospitals, raising concerns for transmission and possible contamination of the hospital itself. The identification of effective agents for the decontamination of veterinary patients and hospitals is crucial. Sodium hypochlorite (6.15%) or 'bleach' is an inexpensive and frequently used decontamination agent in human and veterinary hospitals and an adjunctive treatment for human patients. There are no published data on the minimal bactericidal concentration (MBC) of sodium hypochlorite (6.15%) for MRSP. HYPOTHESIS/OBJECTIVES: The objective of this study was to determine the MBC of sodium hypochlorite (6.15%) against MRSP strains isolated from canine skin. METHODS: In this in vitro study, 12 canine skin isolates were obtained from the Antech Diagnostics microbiology department. Twofold serial dilutions of sodium hypochlorite (6.15%) were allowed to react with each of the MRSP strains for 15 min, followed by overnight incubation on agar plates. Colonies on each plate were counted. This process was repeated in triplicate. RESULTS: The overall MBC for the canine skin-isolated MRSP strains was 1:32, but most strains had an MBC between 1:64 and 1:128 dilution. CONCLUSIONS AND CLINICAL IMPORTANCE: This study shows that sodium hypochlorite (6.15%) is an effective agent for decontamination at easily achievable concentrations.

Abnormal sebaceous gland differentiation in 10 kittens ('sebaceous gland dysplasia') associated with generalized hypotrichosis and scaling.

A rare congenital dermatosis, characterized by progressive hypotrichosis with variable scaling and crusting, occurred in 10 short-haired kittens in North America and Europe. Lesions appeared at between 4 and 12 weeks of age, commencing on the head and becoming generalized. The tail was spared in two kittens. Generalized scaling was mild to moderate, often with prominent follicular casts. Periocular, perioral, pinnal and ear canal crusting was occasionally severe. The skin was thick and wrinkled in two kittens. Histologically, the main lesion was abnormal sebaceous gland morphology. Instead of regular differentiation from basal cells to mature sebocytes, the glands were composed of a haphazard collection of undifferentiated basaloid cells, some partly vacuolated and a few containing eosinophilic globules. Mitotic figures and apoptotic cells were present in an irregularly thickened follicular isthmus. Lymphocytic mural folliculitis and mild sebaceous adenitis were rare. Orthokeratotic hyperkeratosis and follicular casts were present. Hair follicles were of normal density and were mostly in anagen, but some contained malacic hair shafts. Perforating folliculitis, leading to dermal trichogranuloma formation, occurred occasionally. Further biopsy samples taken at 2 years and at 3 and 4 years, respectively, from two kittens revealed similar but often more severe sebaceous gland lesions. Hair follicles were smaller, with many in telogen. The young age of onset suggests a genetic defect interfering with sebaceous and, possibly, follicular development. These lesions are discussed with reference to studies of mouse mutants in which genetic defects in sebaceous differentiation cause a similar phenotype of hyperkeratosis and progressive alopecia.

Prevalence of fur mites in pet rabbits in South Korea.

The prevalence of fur mites, Cheyletiella parasitovorax and Leporacarus gibbus, in pet rabbits in South Korea was investigated by a diagnostic evaluation of skin surface tape strips and hair coat combings. C. parasitovorax was found in 80 of 140 rabbits (57.1%) and L. gibbus in six of 140 rabbits (4.3%). Clinical signs of pruritus and scaling were observed in 17 of 80 and 76 of 80 infested rabbits, respectively.