Effect of topical florfenicol, terbinafine and mometasone furoate ear drops on adrenocortical function in healthy small breed dogs with bilateral otitis externa.

BACKGROUND: Testing for hyperadrenocorticism is commonly pursued in adult dogs with dermatological disease, and adrenocortical suppression has been well-documented following the use of topical corticosteroids in otic preparations. An otic suspension that contains florfenicol, terbinafine and mometasone furoate, and lasts for 30 days after a single application, frequently is used to treat canine otitis externa (OE). This medication was shown to cause adrenocortical suppression on Day (D)2 postadministration and two weeks after two applications two weeks apart. HYPOTHESIS/OBJECTIVES: The objective of this study was to determine if topical florfenicol/terbinafine/mometasone furoate causes adrenocortical suppression in healthy, small-breed dogs with bilateral OE at D28 postapplication. ANIMAL: Seven client-owned dogs weighing <10 kg diagnosed with non-Pseudomonas bilateral OE. MATERIALS AND METHODS: Cortisol was measured pre- and post-adrenocorticotropic (ACTH) stimulation on D0. Topical florfenicol/terbinafine/mometasone furoate was applied in both ears. Dogs were reassessed on D28, and cortisol was measured pre- and post-ACTH stimulation. RESULTS: The median pre- and post-ACTH cortisol concentrations on D28 were 2.5 µg/dL (range 2.0-5.0 µg/dL) and 14.3 µg/dL (range 11.5-23.1 µg/dL), respectively. There was no significant difference (P = 0.85) between post-ACTH cortisol concentrations from D0 to D28. CONCLUSIONS AND CLINICAL RELEVANCE: Results demonstrated no evidence of adrenocortical suppression, suggesting that there is no need to delay adrenocortical function testing in dogs treated with topical florfenicol/terbinafine/mometasone furoate when applied as per the manufacturer's recommendations.

Prevalence of Demodex gatoi in shelter and feral cats in a southeastern region of the United States.

BACKGROUND: Demodex gatoi is a contagious ectoparasite that causes pruritic dermatitis in otherwise healthy cats. The diagnosis of this mite can be difficult, and its prevalence is unknown. OBJECTIVES: The goal of this study was to identify the prevalence of D. gatoi in a population of cats with no known previous exposure to treatments using real-time PCR and superficial skin scrapings. ANIMALS: Fifty cats from shelters and 50 cats from feral populations of eastern Tennessee were included in this study. MATERIALS AND METHODS: To identify the presence of D. gatoi, superficial skin scrapings and plucked hairs were collected from multiple sites for microscopic and PCR evaluation, respectively. RESULTS: Ten of 100 cats were positive for D. gatoi. Nine cats had a positive PCR for D. gatoi with negative skin scrapings. One mite was identified on superficial skin scrapings from one cat, which was negative on PCR. Four of 50 feral cats (8%) were positive for D. gatoi. Of the shelter cats, four of 20 stray cats (20%) and two of 30 owner-surrendered cats (6.67%) were positive. Only one of 10 positive cats had skin lesions. CONCLUSIONS AND CLINICAL RELEVANCE: These findings demonstrate that asymptomatic cats represent a source of infection for D. gatoi to healthy cats. This mite should be considered a differential diagnosis in pruritic cats with a history of potential exposure. Additionally, skin scrapings appear to be insensitive; thus, multiple diagnostic tests, including PCR, should be performed to identify the presence of D. gatoi.

Vitamin A failed to ameliorate clinical signs in dogs with pituitary-dependent hypercortisolaemia.

BACKGROUND: In dogs with pituitary-dependent hypercortisolaemia, retinoic acid was shown to lower cortisol, reduce pituitary tumour size and decrease clinical signs when administered for six months. Oral vitamin A (retinol) has been used to treat various canine dermatoses in which retinoic acid has been efficacious. OBJECTIVES: To determine if orally administered vitamin A lowers cortisol and reduces clinical signs in dogs with pituitary-dependent hypercortisolaemia over a five month period. METHODS AND MATERIALS: Five dogs were enrolled in this study. Diagnosis of hypercortisolaemia was based on the presence of at least three clinical signs and one abnormal screening test. Diagnosis of pituitary-dependent disease was based on low dose dexamethasone suppression (LDDS) test results and symmetrical adrenal glands on ultrasound. Adrenocorticotropic hormone (ACTH) stimulation testing and adrenal ultrasound were performed at each visit. Plasma was collected at each visit and stored at -80°C for batch analysis of endogenous ACTH at conclusion of the study. RESULTS: Four dogs completed the study. A fifth dog died from complications of hypercortisolaemia before the third month. One dog showed improvement in clinical signs, yet there was no significant decrease in adrenal gland size or cortisol concentrations. Endogenous ACTH concentrations at the fifth month were decreased from baseline in two dogs and increased from baseline in one dog. The treatment had no adverse effects. CONCLUSIONS AND CLINICAL IMPORTANCE: Results from this study failed to show an improvement in clinical signs or cortisol concentration after five months of oral daily vitamin A in dogs with hypercortisolaemia.

Feline bilateral inflammatory aural polyps: a descriptive retrospective study.

BACKGROUND: Feline inflammatory aural polyps (IP) have been reported as solitary growths, yet bilateral polyps may occur more commonly than described previously. OBJECTIVES: To identify the prevalence and risk factors associated with bilateral feline IP within a population of cats evaluated at a veterinary teaching hospital over a 10 year period. ANIMALS: Twenty-five cats with histologically confirmed IP. METHODS AND MATERIALS: A retrospective study was performed by searching computerized medical records of cats seen at The University of Tennessee Veterinary Teaching Hospital from 2005 to 2015. Keywords used for the search included "feline polyp", "ventral bulla osteotomy", "inflammatory polyp ear canal" and "nasopharyngeal polyp". RESULTS: Cats were separated into groups with unilateral or bilateral disease. Six of 25 (24%) cats had bilateral IP. Twelve cats had computed tomography performed (four of six with bilateral IP; eight of 19 with unilateral IP). Clinical signs, history of upper respiratory infection, post-treatment complications, and IP recurrence with and without local and systemic steroid administration were studied between groups and no differences were identified. In four of six cats with bilateral disease, the second polyp was identified with advanced imaging performed at the time of referral. CONCLUSIONS AND CLINICAL IMPORTANCE: These findings demonstrate that bilateral IP occur more frequently than reported previously and establish a prevalence for bilateral IP. These findings also highlight the value of advanced imaging techniques in diagnosing bilateral IP.

Description and characterization of a hair coat disorder in schipperkes.

BACKGROUND: Schipperkes develop bilaterally symmetrical alopecia preceded by lightening of the hair coat not associated with systemic clinical signs. The alopecia is presumptively diagnosed as Alopecia X but has never been investigated. HYPOTHESIS/OBJECTIVES: The purpose of this study was to describe clinical features, histopathological and laboratory abnormalities associated with symmetrical, noninflammatory alopecia in schipperkes. ANIMALS: Three healthy and eight affected schipperkes. METHODS AND MATERIALS: Complete blood count (CBC), serum chemistry panel, urinalysis (UA), urine cortisol: creatinine ratio (UCCR), total thyroxine (T4 ), free thyroxine by equilibrium dialysis (fT4 ed), thyroid stimulating hormone (TSH) and pre- and post-stimulation cortisol with sex hormone analyses were performed for all dogs. A minimum of two skin biopsy sites were sampled for histopathological evaluation. RESULTS: The CBC, serum chemistry panel, UA, T4 , fT4 ed, TSH and post-ACTH cortisol concentrations were normal for all dogs. Androstenedione concentrations were increased for all dogs; two of three healthy and five of eight affected dogs had increased post-ACTH androstenedione concentrations. Estradiol concentrations were increased for all healthy and four of eight affected dogs, with post-ACTH estradiol concentrations increased for all healthy and five of eight affected dogs. Progesterone concentrations were increased for two of three healthy and four of eight affected dogs. Post-ACTH progesterone concentrations were increased for one of three healthy and four of eight affected dogs. For one of three healthy and two of eight affected dogs, 17-hydroxyprogesterone concentrations were increased; post-ACTH 17-hydroxyprogesterone concentrations were increased in three of eight affected dogs only. Histopathology results from affected dogs were consistent with hair cycle arrest. CONCLUSIONS AND CLINICAL IMPORTANCE: This disorder resembles Alopecia X clinically and histologically.

Lymphocytic Mural Folliculitis Resembling Epitheliotropic Lymphoma in Tigers ( Panthera tigris).

A striking form of lymphocytic mural folliculitis is described in 6 tigers ( Panthera tigris). Clinically, all tigers exhibited regionally extensive chronic, variably waxing and waning alopecia with minimal scaling and crusting most pronounced over the head, neck, and shoulders. More severely affected tigers exhibited marked hyperpigmentation and lichenification. Pruritus was not a feature. Tigers generally lacked signs of systemic illness and clinical pathology findings were unremarkable. Histologic examination of skin biopsies revealed infiltrative lymphocytic mural folliculitis extending the length of the hair follicle. Mild epidermal lymphocytic infiltrates were frequent. The surrounding dermis was histologically unremarkable in 4 of 6 tigers or associated with mild perifollicular and periadnexal mixed inflammation in 2 of 6 tigers. The cause of the mural folliculitis was not identified, and tigers responded poorly to immunomodulatory therapy. Lymphocytic mural folliculitis might be a nonspecific hypersensitivity reaction pattern in tigers, and care should be taken to differentiate this reaction pattern from epitheliotropic T-cell lymphoma.

The prevalence of Dermatophilus congolensis in horses with pastern dermatitis using PCR to diagnose infection in a population of horses in southern USA.

BACKGROUND: Dermatophilus congolensis is a facultative anaerobic actinomycete that causes papular to exudative dermatitis with crusting in horses. This organism is frequently implicated as a cause of pastern dermatitis, but few data are available validating the organism's association with this disease. HYPOTHESIS/OBJECTIVES: The aim of this study was to evaluate if D. congolensis is associated with pastern dermatitis in horses utilizing RT-qPCR. ANIMALS: Fifteen client-owned horses diagnosed with pastern dermatitis and eight client-owned unaffected control horses were utilized for this study. METHODS: A cross-sectional study was performed. History and physical examination findings were recorded, and samples were collected and tested for D. congolensis utilizing cytological evaluation and RT-qPCR. Dermatophyte culture and superficial skin scrapings were also performed. RESULTS: Ten of 15 horses with pastern dermatitis had feathered pasterns. Dermatophilus congolensis was identified by RT-qPCR from one nonfeathered horse but none with feathered pasterns. Cytological evaluation identified bacteria in all horses but failed to identify organisms resembling D. congolensis in any horse. Four of 15 horses, all feathered, were positive for Chorioptes mites. Fungal culture was negative for dermatophytes in all horses. All test results were negative for the eight control horses. CONCLUSIONS AND CLINICAL IMPORTANCE: Dermatophilus congolensis was uncommonly associated with pastern dermatitis in horses in this population. However, chorioptic mange was commonly associated with pastern dermatitis in feathered horses and represented an important differential diagnosis for this clinical presentation.

PCR analysis of a prescription vegetarian diet and use in three dogs with cutaneous adverse food reactions.

BACKGROUND: Cutaneous adverse food reaction (CAFR) is diagnosed by performing an elimination diet trial utilizing prescription or home-cooked diets followed by provocative challenge. OBJECTIVES: To report findings of PCR analysis of a prescription vegetarian diet (RCV) for undeclared proteins of animal origin, as well as to describe its utilization for diagnosis and management of dogs suspected of having CAFR. ANIMALS: Three client-owned dogs. METHODS: PCR analysis of RCV for 11 mammalian species and poultry. In three dogs, clinical examination, cytology, aerobic culture (if indicated) and at least one elimination diet trial with RCV. RESULTS: In our case series, all dogs had a history of pruritus and recurrent pyoderma that resolved with infection control and an elimination diet trial. In cases 1 and 2, a diagnosis of CAFR was made following an elimination trial with RCV and provocative challenge. Case 3 had a previously confirmed diagnosis of CAFR and RCV was successfully used to maintain remission of CAFR-related signs. PCR testing of RCV was negative for 11 mammalian species and poultry. CONCLUSIONS AND CLINICAL IMPORTANCE: The RCV diet was found not to contain any undeclared mammalian or avian proteins. In this case series, the RCV was successfully used to diagnose and maintain three dogs with CAFR.

Use of mycophenolate mofetil to treat immune-mediated skin disease in 14 dogs - a retrospective evaluation.

BACKGROUND: Mycophenolate mofetil (MMF) is a lymphocytotoxic immunosuppressive agent used in human and companion animal medicine for the treatment of immune-mediated disease. Mycophenolate mofetil is reported to have reduced myelotoxicity and hepatotoxicity when compared to azathioprine. OBJECTIVES: It was hypothesized that treatment with MMF as a secondary agent with glucocorticoids would be effective in treating immune-mediated skin disease. In addition, adverse effects associated with the drug are reported. ANIMALS: Fourteen dogs from a hospital population diagnosed with immune-mediated skin disease. METHODS: A retrospective review of medical records from 2010 to 2015 was used to identify dogs with immune-mediated skin disease that were treated with MMF. RESULTS: All dogs were treated with MMF (mean dose 14.7 mg/kg twice daily) in conjunction with glucocorticoids. Ten of 14 cases showed positive results, with complete remission in eight cases and partial remission in two cases. Mean time to remission was 5.7 weeks. Therapy was discontinued in one case (perianal fistula) due to lack of response. Adverse events were noted in six cases and included diarrhoea (n = 6), haematochezia (n = 2), vomiting (n = 3) and papilloma formation (n = 1). Therapy was discontinued in two cases with diarrhoea. Mycophenolate mofetil was discontinued in an additional case because of a diagnosis of neoplasia. All other adverse events were self-limiting or easily medically managed. No hepatotoxicity or bone marrow suppression was noted. CONCLUSION: This study supports the use of MMF as a second-line immunotherapeutic in immune-mediated skin disease in dogs.

Mycoplasma infection of the middle ear in three cats.

BACKGROUND: Mycoplasma spp. are commensal organisms found in association with the mucus membranes of all mammalian species and are implicated in bacterial infections of many different locations. Mycoplasma spp. as a primary pathogen associated with otitis media in cats has not been reported. OBJECTIVES: To describe three cats with Mycoplasma infection of the middle ear associated with various underlying disease processes. ANIMALS: Three client-owned cats. METHODS: Clinical examination, aerobic culture of the middle ear and computed tomography or magnetic resonance imaging of the skull. RESULTS: Mycoplasma spp. were grown on aerobic culture from the middle ear of three cats. In Case 1, concurrent neoplasia of the bulla was identified. Mycoplasma alone was cultured in Case 2 and Mycoplasma was grown in addition to Bordetella in Case 3. Case 1 was euthanized, Case 2 responded to Mycoplasma targeted therapy and Case 3 responded to Bordetella targeted therapy. CONCLUSIONS AND CLINICAL IMPORTANCE: Mycoplasma infections of the middle ear may be clinically important and require targeted treatment in some cases.

RT-qPCR for the diagnosis of dermatophilosis in horses.

BACKGROUND: Dermatophilus congolensis causes a crusting dermatitis that affects horses. Diagnosis requires the identification of the organism with cytological evaluation of crust samples. This method can lack sensitivity in chronic cases. HYPOTHESIS/OBJECTIVES: To develop a probe-based real time quantitative polymerase chain reaction (RT-qPCR) test to assist with the diagnosis of dermatophilosis in horses. ANIMALS: Twenty six privately owned horses and seven horses from a research colony were used. METHODS: Crust samples, collected from 14 horses with suspected dermatophilosis and 12 horses with crusting skin disease not characteristic of dermatophilosis, were evaluated by cytological evaluation and RT-qPCR; the latter was also performed on hair samples collected from seven healthy horses. RESULTS: Cytological evaluation revealed organisms consistent with Dermatophilus congolensis from nine horses with suspected dermatophilosis, with only a few organisms seen from five samples. Cytological evaluation of all other crusts was negative for Dermatophilus. Other bacterial organisms were detected on cytological evaluation from 15 samples. RT-qPCR for Dermatophilus was positive from 11 crusts, whereas all other samples were negative. Two samples were cytologically negative but RT-qPCR positive for Dermatophilus. No samples were cytologically positive but RT-qPCR negative for Dermatophilus. CONCLUSION: Results of this study show that RT-qPCR may be a more sensitive and easier method than cytological evaluation for the diagnosis of dermatophilosis in horses.

Dorsal black skin necrosis in a Vietnamese pot-bellied pig.

BACKGROUND: Thermal burns are an uncommon cause of injury in large animals. CASE REPORT: A 10-month-old pet female black and white Vietnamese pot-bellied pig presented to the emergency service with fever and erythematous to purpuric skin lesions affecting the intermandibular space and hocks. One week prior to the emergency visit, she had appeared restless and in pain. Two weeks following the emergency visit, she again presented to the large animal clinic with sloughing of the pigmented skin on her head, face, dorsal and lateral trunk sparing the nonpigmented skin and pigmented ears. The affected skin constituted ~40% of her total skin. Histopathological findings for affected skin included full-thickness epidermal and partial to full-thickness dermal coagulative necrosis with follicular epithelial mineralization, while that from normal-appearing pigmented skin was within normal limits. A culture from a skin biopsy yielded meticillin-resistant Staphylococcus aureus (ST-72). Treatments included oral antibiotics, pain management, hyperbaric oxygen therapy and general anaesthesia to facilitate debridement. Healthy skin was often present when the necrotic skin was debrided, although in some areas the necrosis extended into the underlying fat. Complications that occurred during rehabilitation included intense pruritus that resulted in self-trauma and the formation of a nasal fistula, which was later surgically corrected. CONCLUSIONS AND CLINICAL IMPORTANCE: Cases of dorsal thermal necrosis in pot-bellied pigs are uncommon in the literature. Based on the clinical presentation and lack of another identifying cause, the lesions were attributed to a sun-induced thermal burn.

Erythema multiforme associated with zonisamide in a dog.

This report describes a dog that developed erythema multiforme in temporal association with administration of the sulphonamide-based anticonvulsant drug zonisamide. Similar adverse drug reactions have been associated with sulphonamide antimicrobial drugs. Caution should be exercised when prescribing this medication for dogs with known hypersensitivity to sulphonamides.

PCR amplification and DNA sequence identification of an unusual morphological form of Demodex cati in a cat.

BACKGROUND: Molecular characterization of Demodex mites is being used to identify mite species in dogs. This technique is now being applied to cat Demodex species, allowing for better characterization of the mites. HYPOTHESIS/OBJECTIVES: Molecular diagnostics will clarify the existence of diverse Demodex mites identified morphologically. ANIMALS: A cat with generalized demodicosis secondary to chronic steroid treatment for erythroid dysplasia. METHODS: Skin scrapings demonstrated large numbers of follicular mites consistent with Demodex cati as well as a morphologically different Demodex mite with a blunted abdomen. The 16S rRNA DNA was amplified by PCR, sequenced and compared with available Demodex sequences, including Demodex cati, Demodex gatoi and an unnamed Demodex sp. RESULTS: A single PCR product was obtained, the DNA sequence of which was an exact match with D. cati. CONCLUSIONS AND CLINICAL IMPORTANCE: The shorter unnamed mite was not a different species in this case, but a different morphological form of D. cati. This report demonstrates the utility of molecular diagnostics to clarify the identity of mites that differ morphologically.

Treatment of alopecia X with medroxyprogesterone acetate.

BACKGROUND: Alopecia X is a common cause of noninflammatory alopecia in Pomeranian dogs. In the past, treatment with growth hormone injections resulted in hair regrowth in many individuals. Progesterone can induce mammary-derived growth hormone and is used to treat dogs with congenital growth hormone deficiency. HYPOTHESIS/OBJECTIVES: To determine whether progesterone induces endogenous insulin-like growth factor-1 (IGF-1) and causes hair regrowth in dogs with alopecia X. ANIMALS: Eight neutered Pomeranian dogs with alopecia X for 1-2 years. METHODS: In part 1, two male and three female dogs received 5 mg/kg medroxyprogesterone acetate injected subcutaneously (s.c.) every 4 weeks for a total of four injections. In part 2, one male and two female dogs received 10 mg/kg medroxyprogesterone acetate injected s.c. every 4 weeks for four injections. Dogs were monitored monthly with physical examinations and complete blood counts, chemistry panels and urinalyses. In part 3, two coated Pomeranian dogs and two normal-coated small breed dogs received two s.c. injections of 10 mg/kg medroxyprogesterone acetate. Serum was saved from each visit for IGF-1 analysis. RESULTS: In part 1, two dogs had partial hair regrowth of ~40-60%. In part 2, one dog had partial hair regrowth and one dog had complete hair regrowth 2 months after completion of the study. Unlike the normal-coated dogs, whose IGF-1 concentrations increased, the IGF-1 concentrations in alopecic and coated Pomeranian dogs were low and remained unchanged. No adverse effects were noted. CONCLUSIONS AND CLINICAL IMPORTANCE: Results of this study showed that medroxyprogesterone injections resulted in partial hair regrowth in three and complete hair regrowth in one of eight Pomeranian dogs with alopecia X.

PCR amplification and DNA sequencing of Demodex injai from otic secretions of a dog.

BACKGROUND: The identification of Demodex mites from dogs is usually based on morphology and location. Mites with uncharacteristic features or from unusual locations, hosts or disease manifestations could represent new species not previously described; however, this is difficult to determine based on morphology alone. HYPOTHESIS/OBJECTIVES: The goal of this study was to identify and confirm Demodex injai in association with otitis externa in a dog using PCR amplification and DNA sequencing. METHODS: Otic samples were obtained from a beagle in which a long-bodied Demodex mite was identified. For comparison, Demodex mite samples were collected from a swab and scraping of the dorsal skin of a wire-haired fox terrier and an otic sample from a dog with generalized and otic demodicosis. To identify the Demodex mite, DNA was extracted, and 16S rRNA was amplified by PCR, sequenced and compared with Demodex sequences available in public databases and from separate samples morphologically diagnosed as D. injai and Demodex canis. RESULTS: PCR amplification of the long-bodied mite rRNA DNA obtained from otic samples was approximately 330 bp and was identical to that from the mite morphologically identified as D. injai obtained from the dorsal skin of a dog. Furthermore, the examined mite did not have any significant homology to any of the reported genes from Demodex spp. CONCLUSIONS: These results confirmed that the demodex mites in this case were D. injai.

A molecular technique for the detection and differentiation of Demodex mites on cats.

BACKGROUND: Demodex gatoi causes a pruritic dermatitis in cats. Diagnosis requires the demonstration of mites using superficial skin scrapings or faecal flotation, which can be insensitive. HYPOTHESIS/OBJECTIVES: The goal of this study was to develop a molecular method to diagnose D. gatoi infection in cats and distinguish these mites from Demodex cati. ANIMALS: Fifty-three shelter cats, 11 cats from a closed research colony and 12 privately owned cats were used. METHODS: Demodex gatoi and D. cati were obtained from scrapings of cat skin. The 16S rRNA DNA was amplified by PCR, sequenced and compared with available Demodex sequences. Hair and skin samples were also collected for microscopic examination and DNA isolation. RESULTS: DNA sequences were obtained from D. gatoi and D. cati. qPCR with D. gatoi specific primers and probe amplified DNA isolated from D. gatoi and not D. cati. Conversely, D. cati qPCR primers and probe amplified D. cati DNA and not D. gatoi. Five of the shelter cats were positive for D. gatoi. Two of these cats were pruritic, and the other three were in contact with these cats. Only one cat was positive for D. gatoi on skin scraping but was negative for D. gatoi or D. cati DNA. CONCLUSION: Results from this study show D. gatoi and D. cati to be distinct species. A novel qPCR test for the identification and differentiation of D. gatoi and D. cati was developed. Once optimized, this test could provide a valuable technique for the diagnosis of D. gatoi infection.

Effects of butorphanol versus dexmedetomidine sedation on intradermal allergen and histamine responses in dogs with atopic dermatitis.

BACKGROUND: Sedation is commonly used during intradermal testing (IDT). Morphine and its derivatives have long been avoided because of their histamine-releasing effects. HYPOTHESIS/OBJECTIVES: Butorphanol, an opioid agonist/antagonist, will not adversely affect IDT in dogs. ANIMALS: Ten client-owned dogs diagnosed with atopic dermatitis. METHODS: Dogs were randomized to be sedated with butorphanol (0.4 mg/kg) or dexmedetomidine (5 µg/kg). Routine IDT along with intradermal injections of various dilutions of histamine were performed on the lateral thorax, followed 7 days later by the alternative sedative and IDT on the opposite side. The injection sites were subjectively scored and objectively measured by one investigator, blinded to the sedatives, and compared between groups. RESULTS: When the mean wheal diameters from the objective measurements of all antigens, including saline and histamine dilutions, were compared, butorphanol was associated with significantly smaller reactions than dexmedetomidine (P = 0.0001). There was a high level of agreement between sedatives when positive reactions subjectively scored as ≥3+ were compared (κ = 0.91). When mean wheal diameters of histamine at concentrations of 1:100,000, 1:400,000, 1:1,600,000 and 1:6,400,000 were compared, there were no significant differences between sedative types. Moreover, the percentage agreement when comparing subjective interpretation of all histamine dilutions between sedations was high (κ = 0.90). However, there was only 69% agreement beyond chance when objective and subjective interpretations of all antigens were compared between sedative groups. CONCLUSIONS: Although butorphanol resulted in significantly smaller wheal size in comparison to dexmedetomidine, it did not affect the overall subjective interpretation of the results of IDT.

Vulvar pythiosis in two captive camels (Camelus dromedarius).

Two camels (Camelus dromedarius), 3- and 4-years-old, respectively, from an eastern Tennessee wildlife farm presented with persistent weight loss and large vulvar masses. An initial biopsy of the vulvar mass of one of the camels performed by a local veterinarian showed eosinophilic dermatitis. An allergic or parasitic dermatitis was suspected. The two camels were treated with one dose of sodium iodide (66 mg/kg, in 1.0 L of normosolR, IV) and ivermectin 1% (200 ug/kg PO). Upon presentation at the Veterinary Teaching Hospital, University of Tennessee, additional biopsies of the masses again revealed eosinophilic dermatitis. Microscopic examination of a Gomori methenamine silver (GMS)-stained section prepared from the biopsy of one of the camels revealed the presence of fungal-like hyphae of a mold which was suspected to be Pythium insidiosum. The vulvar masses were surgically debulked in both animals and sodium iodide and Pythium-immunotherapy prescribed. Pythium insidiosum was isolated in culture and hyphae elements were detected in histological sections confirming the diagnosis of pythiosis in both animals. Despite signs of progressive healing of the vulvar surgical areas, postoperative persistent weight lost in one of the camels suggested the possibility of gastro intestinal (GI) tract pythiosis. This camel died 5 months after the first onset of clinical signs and unfortunately a necropsy was not performed. The other camel responded well to the combination of surgery, iodides, and immunotherapy and has currently rejoined the other members of the herd.

Meticillin-resistant Staphylococcus pseudintermedius: clinical challenge and treatment options.

Meticillin-resistant Staphylococcus pseudintermedius (MRSP) has emerged as a major therapeutic challenge for small animal veterinarians over the past 10 years and continues to spread worryingly in many countries. This review focuses on the clinical aspects of MRSP infections seen in patients with skin disease and on currently available treatment options. In addition, it discusses the implications for in-contact people, other animals and the environment, because infection control strategies are likely to have a significant impact on treatment success and prevention of spread. There is currently no indication that MRSP is more virulent than meticillin-susceptible S. pseudintermedius, and reported infections have mostly been treated successfully, although possibly with a longer time to resolution than infections with more susceptible S. pseudintermedius. However, in vitro testing of MRSP isolates indicates resistance to most or all antibacterial agents licensed for use in pets. Based on susceptibility results, the most useful systemic antimicrobials may include chloramphenicol, rifampicin, amikacin, clindamycin and/or minocycline. Adverse effects of some of these medications may limit their usefulness. While in vitro susceptibility to vancomycin and linezolid is reported by some laboratories, use of these drugs in animals is strongly discouraged because of ethical considerations. Aggressive topical therapy has been effective as the only treatment in certain cases. Awareness, continued research and comprehensive management of infections are required by veterinary practitioners not only to help treat infected animals but also to limit the spread and prevent the establishment of this highly drug-resistant and zoonotic pathogen in veterinary facilities and in the community.