Randomized comparison between a forced air system and warm water bath for resuscitation of neonatal hypothermic calves with or without oral administration of caffeine.

BACKGROUND: Hypothermia is a cause of neonatal calf death in cold climates. Practical and effective rewarming methods are important for bovine health within affected regions. HYPOTHESIS/OBJECTIVES: To compare the rewarming rate and blood analytes (glucose, lactate, and cortisol) of calves resuscitated with forced air with warm water bath, with or without oral administration of caffeine. ANIMALS: Twenty healthy neonatal Holstein bull calves. METHODS: In this randomized, prospective study, calves born healthy and without history of dystocia were cooled to 32°C rectal temperature then thermally resuscitated using either forced air rewarming or warm water bath (40°C) with or without oral administration of caffeine. Rectal temperatures were used to quantify recovery rate. Measurements of glucose, lactate, and cortisol were recorded for every 2°C change in rectal temperature. RESULTS: Rectal temperature decline (0.03°C per minute) and total cooling time (191.0 ± 33.3 minutes) did not significantly differ among treatment groups. Calves were successfully resuscitated to 38°C by either method. Time required to euthermia using warm water was significantly faster (0.1°C per minute; 64.3 ± 17.8 minute; P < .05) than forced air (0.05°C per minute; 123.1 ± 20.0 minutes). Caffeine had no significant effect on resuscitation rate (P = .14; 95% CI, -0.002 to 0.024) in either treatment; however, caffeine was associated with reduced time to euthermia by 8.3 and 10.8 minutes, respectively. Changes in metabolic variables (glucose, lactate, and cortisol), were inversely related to rectal temperature with no statistical significance among rewarming methods. CONCLUSIONS AND CLINICAL IMPORTANCE: Although warm water submersion is faster, forced air rewarming is an effective alternative for restoration of euthermia.

Tolerability and the effect on skin Staphylococcus pseudintermedius density of repeated diluted sodium hypochlorite (bleach) baths at 0.005% in healthy dogs.

BACKGROUND: Dilute sodium hypochlorite (bleach) baths at 0.005% concentration twice weekly have been shown to markedly reduce the severity of atopic dermatitis in children, yet no tolerability and efficacy data are available for this treatment in dogs. OBJECTIVES: To determine the local tolerability and the longitudinal effect on the density of Staphylococcus pseudintermedius of repeated diluted bleach baths on healthy dog skin. ANIMALS: Four healthy hound cross-bred dogs. METHODS: Bleach baths (0.005%; twice weekly for 15 min) were applied to four healthy hound cross-bred dogs over four weeks (eight baths). Local tolerability was assessed for axillae, abdomen and legs by an investigator before, immediately after and 24 h after each bath. The longitudinal effect on density of S. pseudintermedius from axillae and groin was analysed through quantitative PCR before treatment [at Day (D)-7 and -3], during treatment on D4, D11 and D25, and on D30. RESULTS: There was no erythema or scaling after the baths in any dog. Copy numbers of S. pseudintermedius in axillae, groin and both (axillae and groin together) were not significantly different at any time point during the study. CONCLUSIONS AND CLINICAL RELEVANCE: Repeated 0.005% hypochlorite bleach baths over four weeks were safe and well-tolerated in healthy dogs without significant changes in the density of S. pseudintermedius.

A preliminary investigation of the impact of artificially carbonated water bathing on canine skin physiological and barrier function.

BACKGROUND: The effect of carbon dioxide (CO2 )-rich water bathing on the skin has been studied extensively in humans. However, there have been few studies evaluating the impact of CO2 -rich water bathing on canine skin physiology and barrier functions. OBJECTIVES: To evaluate the impact of artificially carbonated water (ACW) bathing on skin parameters in healthy beagles. ANIMALS: Six healthy beagles with no history of skin disease. MATERIALS AND METHODS: Body temperature, skin temperature, transepidermal water loss (TEWL), skin hydration and skin blood flow were evaluated before and after single ACW bathing (37°C, 20 min) with a CO2 concentration of >1000 ppm. RESULTS: After ACW bathing, skin blood flow significantly increased (p < 0.0001), yet there were no significant changes in body temperature (p = 0.3124), skin temperature (p = 0.4911), TEWL (p = 0.5167) or skin hydration (p = 0.3084). There were no adverse events during the trials. CONCLUSIONS AND CLINICAL IMPORTANCE: Artificially carbonated water water bathing could potentially increase skin blood flow without affecting skin temperature, body temperature and skin barrier function in dogs, similar to its effects in humans.

Hot spring bathing accelerates wound healing and enhances heat retention effect in guinea pigs.

This study aimed to demonstrate the effects of hot springs on wound healing and heat retention by performing comparative experiments with tap water. The hot spring water used in this study was from an alkaline hot spring that was rich in sodium and chloride ions and exhibited high reducibility. Guinea pigs were divided into a hot spring bathing group and a tap water bathing group, and a bathing test was conducted for eight consecutive days. A comparison of the plasma amino acid composition between the two groups after the bathing test revealed differences in the concentrations of several amino acids associated with wound healing. Image analysis demonstrated that wounds made on the abdominal skin of guinea pigs were significantly contracted by hot spring bathing compared to that by tap water bathing, and histopathological findings showed that wound healing was accelerated. In the thermography test, changes in body surface temperature after bathing were investigated in both groups. The heat retention effect was not observed in the tap water bathing group after bathing, whereas it was enhanced in the hot spring bathing group until 30 min after bathing. In conclusion, this study demonstrated that hot spring bathing accelerates wound healing and has a more significant heat retention effect than tap water bathing.

Extraction-free detection of amphibian pathogens from water baths.

Detecting and quantifying pathogens with quick, cost-efficient and sensitive methods is needed across disease systems for addressing pertinent epidemiological questions. Typical methods rely on extracting DNA from collected samples. Here we develop and test an extraction-free method from water bath samples that is both sensitive and efficient for 2 major amphibian pathogens-Batrachochytrium dendrobatidis and B. salamandrivorans. We tested mock samples with known pathogen quantities as well as comparatively assessed detection from skin swabs and water baths from field sampled amphibians. Quantitative PCR (qPCR) directly on lyophilized water baths was able to reliably detect low loads of 10 and 1 zoospores for both pathogens, and detection rates were greater than those of swabs from field samples. Further concentration of samples did not improve detection, and collection container type did not influence pathogen load estimates. This method of lyophilization (i.e. freeze-drying) followed by direct qPCR offers an effective and efficient tool from detecting amphibian pathogens, which is crucial for surveillance efforts and estimating shedding rates for robust epidemiological understanding of transmission dynamics. Furthermore, water bath samples have multiple functions and can be used to evaluate mucosal function against pathogens and characterize mucosal components. The multifunctionality of water bath samples and reduced monetary costs and time expenditures make this method an optimal tool for amphibian disease research and may also prove to be useful in other wildlife disease systems.

Does bathing affect tick and flea burdens and ectoparasiticide effectiveness of a spot-on formulation (fipronil + (S)-methoprene) for dogs?

This work evaluated tick and flea burdens and the efficacy of a single topical application of 10% fipronil + 9% (S)-methoprene spot-on against experimental infestations of Rhipicephalus sanguineus sensu lato and Ctenocephalides felis felis on dogs that were submitted to regular baths for 56-days post-treatment. Four treatments (n = 24) were evaluated: no chemical treatment and no bathing (T01); no chemical treatment + bathing (T02); chemical treatment and no bathing (T03) and chemical treatment + bathing (T04). Dogs were infested with adult ticks and fleas seven days pre-treatment (-7). The ectoparasites were then counted and removed on day -5, followed by a new infestation on day -2 and treatment on day 0. Ticks and fleas were then counted without removal on day 1 and counted with removal on day 2. The dogs were then repeatedly infested with both ectoparasites on days 5, 12, 19, 26, 33, 40, 47 and 54 post-treatment. Baths and ectoparasite counts with removal were performed every 48 h before and after experimental infestation, respectively. Animals of T04 had lower (P ≤ 0.05) tick burden than animals from T01 and T02 from day 2 to day 28. For fleas, the counts varied among days of the study. Dogs from T03 presented lower (P ≤ 0.05) flea burden than dogs from T01 from day 1 until day 56. The same was true for T04 when compared to T01 from day 1 to day 42. Animals of T02 greater (P ≤ 0.05) flea burden than animals of T04 in all dates post treatment. In addition, dogs from T02 presented higher (P ≤ 0.05) flea burden than T01 from day 7 to day 28 and from day 49 to day 56. In sum, the efficacy of the spot-on formulation used declined over the time against both ectoparasites. The efficacy for ticks ranged from 0.0 to 96.5% and 0.0 to 98.52% for T03 and T04, respectively. While for fleas, the efficacy of the formulation ranged from 67.41 to 100% for T03 and 40.18 to 100% for T04. So, bathing dogs that were not treated increased C. f. felis burden but not R. sanguineus s. l. burden. The residual efficacy of the product had a shorter duration against these ectoparasites for dogs that received subsequent bathing.

[Footbath as treatment of footrot in sheep. Current -situation on Swiss sheep farms]. / Klauenbad zur Bekämpfung der ­Moderhinke bei Schafen. Eine Bestandes­aufnahme bei Schweizer Schafhaltern.

INTRODUCTION: Footrot in sheep should be eradicated in Switzerland in the future. Based on scientific findings, this can be achieved with disinfectant footbaths. It is unknown how many sheep farmers are already using this means and how it is used. The current study evaluated the farm operation, the design of the footbath, the use of disinfectants and footbath with a written survey of a representative sample of all sheep farmers. The sample population was selected randomly, however stratified by language region and herdsize to control for differences between these groups. 45.3% (n=1134) of the distributed questionnaires were received for evaluation. On average 32.8% of the respondents used a footbath. Even on large farms (> 50 animals), which were more frequently affected by footrot, a footbath was available only in 52.6% of the farms in the French-speaking part and 67.7% in the German/Italian speaking part of Switzerland. The footbaths were correctly applied in most respects (e.g., pre-claw cleaning, liquid level and concentration of disinfectants, time in the footbath, post-bath drying phase) in the current study. Most commonly mobile plastic baths were in use. The disinfectants used were mainly formalin, copper and zinc sulfate. The incorrect disposal of the heavy-metal containing copper and zinc sulfate solutions was identified as an important problem: In 59% of the sheep farms the remaining footbath solutions were disposed in the slurry pit or manure storage. In summary the current study recommends (i) to motivate sheep farmers to use a footbath for the treatment and prevention of footrot, and (ii) to replace the currently used disinfectants with substances that are non-toxic to humans, animals and the environment.

INTRODUCTION: Le piétin du mouton doit être, à l'avenir, combattu sur l'ensemble du territoire suisse. Sur la base des connaissances scientifiques, cela peut être fait avec un bain désinfectant pour les onglons. On ignore combien d'éleveurs utilisent déjà cette mesure et comment elle est utilisée. On a cherché, au moyen d'un sondage d'un échantillon représentatif d'éleveurs de moutons, à obtenir la réponse à quatre groupes de questions sur l'exploitation, la construction du pédiluve, l'utilisation de désinfectants et l'usage du bain des onglons. La stratification concernant la région linguistique d'une part et la taille du troupeau d'autre part, permettait de donner la meilleure image possible dans l'échantillon. Avec l'évaluation de 1134 des questionnaires évaluables (45,3% de ceux initialement envoyés) ont a constaté qu'en moyenne 32,8% seulement des exploitants utilisaient un bain des onglons. Même avec les grands troupeaux avec > 50 animaux, qui sont donc plus fréquemment touchés par le piétain, seuls 52,6% des exploitants francophones respectivement 67,7% des germanophones ou des italophones disposent d'un bain. D'autre part, les utilisateurs de bain des onglons appliquent dans la plupart des cas correctement les aspects principaux (par ex.: prélavage des onglons, niveau de liquide et concentration des désinfectants, temps passé dans le bain, phase de séchage après le bain). Les installations les plus communément utilisées étaient les bains mobiles en plastique. La formaline, le sulfate de cuivre et de zinc étaient principalement utilisés comme désinfectants. On constatait un grand manque quant à l'élimination des désinfectants, en particulier des solutions contenant des métaux lourds comme le cuivre ou le zinc. Ainsi, 59,4% des éleveurs ont déclaré jeter les liquides dans la fosse à lisier ou sur le tas de fumier. Les constatations principales sont donc: (i) que les éleveurs de moutons devraient être motivés à utiliser un bain des onglons pour le traitement et la prévention du piétain, et (ii) que le remplacement des désinfectants actuellement utilisés par des substances non toxiques pour l'homme, l'animal et l'environnement est absolument nécessaire.

Evaluation of a biocide footbath solution in the occurrence and healing of digital dermatitis lesions in dairy cows: A clinical trial.

The objective of this study was to evaluate the effect of the implementation of different footbathing practices using a new biocide solution (Pink-Step™, Qalian, France) in the healing and the occurrence of bovine digital dermatitis (bDD) lesions. The investigation was conducted through a controlled within cow clinical trial in which the hind feet of cows from each farm were allocated either to the control group or to a moderate (MR) or (IR) intensive footbath-regimen groups. The trial involved 1036 cows (2072 feet) from 10 dairy farms located in western France where bDD was endemic. Split-footbaths were placed at the exit of the milking parlor of each farm, allowing the biocide to be administered to one side of the cows while using the other empty side as a negative control. The administration frequency for MR was of 2 days/week/1st-month, then 2 days/2 weeks/2nd-month, and then 2 days/month, and for IR was of 2 days/week/1st-2nd months, and then 2 days/2 weeks. Footbaths were administered during 140 days (approx.), and feet were evaluated for the at least once a month in the milking parlor. Nested survival models were used to estimate the relative impact of the footbath regimens and other concomitant risk factors on the time that bDD lesions occurred or healed. No effect of Pink-Step™ was evidenced on the bDD occurrence during the trial. The risk for bDD occurrence was increased by poor feet cleanliness at both the cow (HR 1.69, CI 1.21-2.39) and farm level (HR 2.06, CI 1.44-2.94). Otherwise, the use of Pink-Step™ in an IR was effective in improving the healing of bDD lesions (HR 1.79, CI 1.12-2.88). The time to healing was also improved in inactive lesions (HR 2.19, CI 1.42-3.37). Conversely, the time to healing was delayed in feet receiving hoof-trimming (HR 0.41, CI 0.26-0.62), in cows with a contralateral bDD lesion (HR 0.32, CI 0.22-0.46) or in late lactation (HR 0.61, CI 0.43-0.85), and finally in farms with more than 100 cows (HR 0.48, CI 0.34-0.67). These findings reinforce the crucial role of hygiene in bDD dynamics and highlight the importance of implementing multiple control measures simultaneously, such as hygiene improvements in the barn, early detection and treatment of bDD lesions and the correct usage of individual and collective treatments. The implementation of Pink-Step™ represents a promising strategy for reducing the persistence of bDD lesions in affected herds.

Current recommendations for footbath solutions renewal rates in dairy cattle: the need for adaptation?

Footbaths represent a potentially useful strategy for the prevention of claw infectious diseases by treating a large number of animals concomitantly. Nevertheless, under field conditions, footbath solutions are exposed to increasing number of animal passages and therefore, to different volume losses and concentrations of manure contamination which could alter their presumed bactericidal activity. Across increasing number of cow passages, the organic matter (OM) concentration, the microbial load (ML) and the residual volumes were assessed in six commercial farms. The results indicate that the OM concentration and ML increased linearly with the number of passages of animals, and with the number of defecations in the footbath. The OM concentrations and the ML were not impacted by the farm's feet hygiene status (clean, fair and dirty), suggesting that probably the increasing number of cow passages and defecations influenced more the contamination of footbaths than the hygiene of the feet. In all the farms the volumes decreased drastically after 200 cow passages (50%). The OM concentrations after 150 and 200 cow passages did not exceed the regulatory concentrations in which disinfectant products should demonstrate to still be effective (20 g/l), and coincide with the often advised renewal rates. The findings of this study suggested that beyond the footbath contamination by OM, the renewal rates must be mainly adapted according to the remaining volume to guarantee that the entire foot is covered and therefore assure the topical action of the solution. This study highlights the importance of footbath designs for the successful implementation of these strategies in practice.

Efficacy of a commercial glutaraldehyde footbath product for the control of bovine digital dermatitis.

OBJECTIVE: To evaluate the relative efficacy of a novel, commercially available disinfecting agent containing ≥ 15 to < 20 % glutaraldehyde in a hydro-colloid matrix ("EIMÜ Klauen Sprint®"; Eimermacher, Nordwalde, Germany, Biozid-Desinfektionsmittel, BAuA Nr. N-57213) as a walkthrough footbath in order to treat digital dermatitis of dairy cattle. MATERIAL AND METHODS: The study was conducted in a dairy farm located in northern Germany from June 1st, 2015 to September 5th, 2015. Eighty-eight cows were enrolled in this study. In both trials of the study, a walkthrough footbath was applied on five consecutive milking times per week. Trial 1 was a blinded, randomised and controlled intervention study. The therapy group (n = 40) received the novel glutaraldehyde product in a 2 % solution while the control group (n = 40) was led through a footbath containing pure water. Trial 2 was a longitudinal study to investigate the development of claw health over a longer time period regarding the use of the new footbath solution. In trial 2 the disinfecting footbath was applied to all trial cows (therapy and control group) of trial 1. The development of claw health and lameness was systematically monitored in the two groups on days 0, 9, 17, 29, 35 (trial 1) and days 42, 68, 94 (trial 2), respectively. The adjusted odds of digital dermatitis lesions (DDL) throughout the study were analysed by mixed logistic regression models. RESULTS: The odds of DDL were 0.15 for the glutaraldehyde foot-bath group compared to the control group. Hence, the disinfecting footbath significantly reduced the DDL prevalence and increased the cure rate of DDL. However, no preventive effect on new digital dermatitis (DD) cases could be identified. CONCLUSION: The efficacy of the novel glutaraldehyde footbath was evaluated and it was concluded that "EIMÜ Klauen Sprint®" was well tolerated over a longer period of time and might therefore be an effective tool to control DD. CLINICAL RELEVANCE: In future, "EIMÜ Klauen Sprint®" could be used within a Mortellaro sanitation concept and thereby might help to solve a major problem of dairy cattle farms.

Comparison of the efficacy of a commercial footbath product with copper sulfate for the control of digital dermatitis.

Digital dermatitis (DD) is the most prevalent foot lesion affecting dairy herds worldwide. Its implications include production losses and decreased animal welfare. Footbathing is the most common herd-level prevention strategy for DD. Because many common footbath products have negative environmental and health consequences, replacement products expected to have improved safety but equal efficacy are being developed. Therefore, the aim of this study was to evaluate the efficacy of a new quaternary ammonium-based commercial footbath product (QAC) for reducing the prevalence of active DD lesions compared with an industry standard (copper sulfate; CuSO4) and typical on-farm footbath practices. A controlled intervention trial was conducted on 19 Alberta dairy farms over 12 wk, with 9 farms allocated to the QAC group (1% QAC daily, 5 d/wk), 5 to the CuSO4 group (5% CuSO4 daily, 5 d/wk), and 5 to a noninterference group (maintained typical footbath practices). A total of 22,285 observations on 3,465 lactating cows were assessed for DD lesions and leg cleanliness in the milking parlor. Five farms discontinued use of the QAC product for various reasons. Noninferiority analysis was used to assess QAC ability to decrease the proportion of cows with 1 or more active DD lesions compared with CuSO4 after 6 wk. Multilevel logistic regression models for repeated measures were used to evaluate efficacy of QAC compared with CuSO4 and noninterference farms in reducing the prevalence of active DD lesions at the foot level over 12 wk. The noninferiority analysis determined that the proportion of cows with 1 or more active DD lesion decreased 2.19 (95% CI: 1.39-3.46) times less after 6 wk of study on the QAC farms compared with CuSO4 farms, making QAC inferior to CuSO4. The multilevel logistic regression models determined that the proportion of active DD lesions increased in the QAC herds, whereas this proportion decreased in the CuSO4 and noninterference herds over 12 wk. Additionally, cows in mid- and late-lactation had a higher odds of having active DD compared with fresh cows. Older cows (parity 3 and ≥4) had a decreased odds of active DD compared with first-parity cows. At the farm level, a higher baseline active DD prevalence resulted in increased odds of active DD; however, this did not modify the effect of treatment or week of study. We concluded that QAC was inferior to CuSO4 and typical on-farm footbath practices, and further development of novel footbath products is required to develop an ideal alternative.

A Review of the Design and Management of Footbaths for Dairy Cattle.

This article summarizes current footbath practices, questions the mechanism by which footbaths function, and reviews the available scientific literature testing footbaths in the field. Copper sulfate appears the most efficacious agent to include in a footbath program, but disposal concerns should limit the frequency of its use. Other agents such as formaldehyde have some merit when used with care. Use of water alone in a flush bath appears to have minimal impact. Footbaths should be used as infrequently as possible to achieve lameness prevention goals for the herd.

Pseudomonas aeruginosa mastitis in two goats associated with an essential oil-based teat dip.

Pseudomonas aeruginosa is an opportunistic pathogen that has been associated with mastitis in dairy animals, including goats. Often, the environmental sources of the bacteria are water-related (such as hoses and muddy pastures). Mastitis attributable to P. aeruginosa was identified in 2 goats in a small herd. Efforts were made to identify environmental sources of the pathogen. Multiple samples from the goats' environment were cultured, including water from the trough, bedding, the hose used to wash udders, and the teat dip and teat dip containers. The bacterium was isolated from the teat dip and the teat dip container. The teat dip consisted of water, liquid soap, and several drops of essential oils (including tea tree, lavender, and peppermint). This case illustrates a potential problem that may arise as a result of the use of unconventional ingredients in teat dips. The use of alternative products by goat producers is likely to increase in the future.

Development and evaluation of a protocol for control of Giardia duodenalis in a colony of group-housed dogs at a veterinary medical college.

OBJECTIVE To develop and evaluate a protocol for control of Giardia duodenalis in naturally infected group-housed dogs at a veterinary medical college. DESIGN Prospective evaluation study. ANIMALS 34 dogs. PROCEDURES All dogs were tested for evidence of G duodenalis infection. Dogs were treated with fenbendazole on study days 1 through 10. On day 5, dogs were bathed and moved into clean, disinfected kennels in a different room to allow for disinfection and drying of their assigned kennels at 26.7°C (80°F) for 24 hours on day 6. After treatment, dogs were returned to their original housing; fecal samples were collected weekly from days 8 through 41 and then every 3 weeks until day 209. Samples were fixed in formalin and examined by direct immunofluorescence assay. Additionally, 1 pretreatment sample underwent PCR assay and DNA sequencing to determine the assemblage (genotype) of the organism. Normal handling routines for the dogs and their use in teaching activities were not changed. RESULTS Initially, all dogs in the colony shed G duodenalis cysts. During and immediately after treatment (days 8 and 13), no cysts were detected in any dogs. On day 20, 1 cyst was observed in the fecal sample from 1 dog; results for all subsequent fecal analyses were negative. The G duodenalis cysts collected from the pretreatment sample had an assemblage C genotype. CONCLUSIONS AND CLINICAL RELEVANCE The integrated protocol was successful in controlling G duodenalis infection in this dog colony, despite exposure of dogs to a variety of environments and frequent handling by multiple individuals. Sequence analysis identified an assemblage typically found in dogs but not in people, indicating that zoonotic transmission would be unlikely.

Evaluation of weekly bathing in allergic dogs with methicillin-resistant Staphylococcal colonization.

We evaluated the efficacy of weekly bathing in reducing methicillin-resistant Staphylococcus (MRS) colonization in canine allergic dermatitis in a pilot clinical trial. Six dogs with allergic dermatitis controlled by prescription medications were treated with weekly bathing for 1 month. The Canine Atopic Dermatitis Extent and Severity Index version 3 (CADESI-03) and pruritus scores and frequency of mecA-positive Staphylococcus spp. isolated from three body sites between weeks 0 and 4 were compared. There was no significant difference in CADESI-03 scores with bathing, whereas the pruritus scores were significantly reduced (p < 0.05). Furthermore, MRS frequency was decreased in four of the six dogs (p < 0.05). In conclusion, weekly bathing should be considered for reducing MRS colonization in canine allergic dermatitis.

Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA).

BACKGROUND: In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document. RESULTS: The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD. CONCLUSIONS: This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages.