The usefulness of a hydrolysed fish and rice starch elimination diet for the diagnosis of adverse food reactions in cats: an open clinical trial.

BACKGROUND: Diagnosis of adverse food reaction (AFR) is based on an eight week elimination diet (ED) and is confirmed by relapse upon re-challenge with the previously fed diet. Hydrolysed EDs are commonly used for this purpose. OBJECTIVE: To evaluate the commercially available hydrolysed fish protein and rice starch ED Farmina UltraHypo (FUH) for the diagnosis of feline AFR. ANIMALS: Thirty-two nonseasonally pruritic cats. METHODS AND MATERIALS: Pruritus was assessed with a new dual Visual Analog Scale, lesions with the Scoring Feline Allergic Dermatitis scale and Quality of Life with a validated questionnaire on days 0 and 56. Short-acting corticosteroids or oclacitinib were permitted during the first six weeks. Cats showing 50% pruritus and/or lesional improvement were separately challenged with their prior diet, fish and rice. Cats not responding to the study diet were fed another hydrolysed diet for two months. RESULTS: Twenty-five cats completed the ED: four dropped out due to vomiting and/or diarrhoea, one owing to low palatability and two were lost to follow-up. In 17 cats, pruritus improved by >50% and these underwent dietary challenges. Of these, nine reacted to their prior diet and/or fish and/or rice and were diagnosed with AFR, while eight did not relapse (and a diagnosis of AFR was considered to be doubtful). Of the eight cats in which pruritus did not improve, four underwent a second ED with no improvement. CONCLUSION AND CLINICAL IMPORTANCE: FUH may be a useful ED for the diagnosis of feline AFR, even in cats reacting to fish or rice.

A double-blinded, randomized, methylprednisolone-controlled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfood-induced hypersensitivity dermatitis.

BACKGROUND: Oclacitinib is a Janus-kinase inhibitor that decreases interleukin-31-induced pruritus in cats. At 0.4-0.6 mg/kg/day orally, it decreased pruritus and skin lesions in <50% of allergic cats. HYPOTHESIS/OBJECTIVES: To evaluate efficacy and safety of oclacitinib in feline nonflea nonfood-induced hypersensitivity dermatitis (NFNFIHD). ANIMALS: Forty cats with NFNFIHD. METHODS AND MATERIALS: Cats were randomly assigned to receive oclacitinib (group A, 20 cats, 0.7-1.2 mg/kg) or methylprednisolone (group B, 20 cats, 0.5-1 mg/kg) orally twice daily for 28 days. On day (D)1 and D28, lesions were evaluated using the Scoring Feline Allergic Dermatitis (SCORFAD) scale and owners assessed pruritus using a Visual Analog Scale (VAS) and quality of life (QoL) questionnaire. Results were analysed by General Linear Mixed Model (P < 0.05). Haematochemical analyses were performed on D1 and D28. RESULTS: In both groups all parameters improved significantly, with no difference at either time point. Group A had a 61% mean SCORFAD and 54% pruritus VAS improvement, compared with 69% and 67% in group B; 70% of cats in group A and 75% in group B achieved a ≥ 50% reduction of pruritus VAS scores; with 60% and 80% of SCORFAD. There were five non-responders in group A and three in group B. The QoL score improved in both groups (25 and 21%). Four of 14 cats had mild increases in kidney function tests (oclacitinib group) and three of 12 cats had elevated alanine transferase (methylprednisolone group). CONCLUSIONS AND CLINICAL IMPORTANCE: Oclacitinib appears to be effective for treating pruritus and lesions in cats with NFNFIHD, albeit methylprednisolone seemed to perform better.

Effect of dietary supplementation with ultramicronized palmitoylethanolamide in maintaining remission in cats with nonflea hypersensitivity dermatitis: a double-blind, multicentre, randomized, placebo-controlled study.

BACKGROUND: Feline nonflea hypersensitivity dermatitis (NFHD) is a frequent cause of over-grooming, scratching and skin lesions. Multimodal therapy often is necessary. HYPOTHESIS/OBJECTIVES: To investigate the efficacy of ultramicronized palmitoylethanolamide (PEA-um) in maintaining methylprednisolone-induced remission in NFHD cats. ANIMALS: Fifty-seven NFHD cats with nonseasonal pruritus were enrolled originally, of which 25 completed all study requirements to be eligible for analysis. METHODS AND MATERIALS: Cats were randomly assigned to PEA-um (15 mg/kg per os, once daily; n = 29) or placebo (n = 28) while receiving a 28 day tapering methylprednisolone course. Cats responding favourably to methylprednisolone were then administered only PEA-um (n = 21) or placebo (n = 23) for another eight weeks, followed by a four week long treatment-free period. Cats were maintained in the study until relapse or study end, whichever came first. Primary outcome was time to relapse. Secondary outcomes were pruritus Visual Analog Scale (pVAS), SCORing Feline Allergic Dermatitis scale (SCORFAD) and owner Global Assessment Score (GAS). RESULTS: Mean relapse time was 40.5 days (±7.8 SE) in PEA-um treated cats (n = 13) and 22.2 days (±3.7 SE) for placebo (n = 12; P = 0.04). On Day 28, the severity of pruritus was lower in the PEA-um treated cats compared to placebo (P = 0.03). Mean worsening of pruritus at the final study day was lower in the PEA-um group compared to placebo (P = 0.04), whereas SCORFAD was not different between groups. Mean owner GAS at the final study day was better in the PEA-um than the placebo-treated group (P = 0.05). CONCLUSION AND CLINICAL IMPORTANCE: Ultramicronized palmitoylethanolamide could represent an effective and safe option to delay relapse in NFHD cats.

An open label clinical trial to evaluate the utility of a hydrolysed fish and rice starch elimination diet for the diagnosis of adverse food reactions in dogs.

BACKGROUND: The diagnosis of adverse food reaction (AFR) is based on an eight week elimination diet (ED) and is confirmed by relapse upon re-challenge with the previously fed diet. Hydrolysed EDs are commonly used for this purpose. OBJECTIVE: To evaluate a commercially available hydrolysed fish protein and rice starch ED for the diagnosis of AFR. ANIMALS: Fifty nonseasonally pruritic dogs. METHODS AND MATERIALS: Pruritus was assessed with a Visual Analog Scale, lesions with the Canine Atopic Dermatitis Lesions Index and quality of life with a validated questionnaire on days 0 and 56. Antimicrobial treatments were permitted during the first four weeks, and corticosteroids and oclacitinib during the first six weeks. Dogs showing at least 50% pruritus improvement were separately challenged with their prior diet, fish and rice. RESULTS: Thirty eight dogs completed the ED, four were dropped out due to worsening clinical signs, three to low palatability and five were lost to follow-up. In 24 dogs, pruritus improved by >50% and 22 underwent dietary challenges. Of these, 15 reacted to their prior diets and were diagnosed with AFR, whereas seven did not relapse (and a diagnosis of AFR was considered to be doubtful). Five dogs reacted to fish and four to rice. Of the 14 dogs in which pruritus did not improve, some underwent a second ED and others were successfully treated for atopic dermatitis. CONCLUSION AND CLINICAL IMPORTANCE: The hydrolysed fish and rice diet seemed to be a useful ED for the diagnosis of AFR, even in dogs allergic to fish or rice.

An assessment of a Western blot method for the investigation of canine cutaneous adverse food reactions.

BACKGROUND: Adverse food reaction (AFR) is diagnosed with a two month elimination diet (ED), followed by challenge with the original food. HYPOTHESIS/OBJECTIVES: To evaluate reactivity of selected EDs and performance of a Western blot serological test for the diagnosis of AFR. ANIMALS: Twenty five food reactive (FR) and 13 non food reactive (NFR) privately owned dogs. METHODS: Sera were tested for antibodies against hydrolyzed poultry feather (RCA), hydrolyzed soy (PHA), hydrolyzed fish (FUH), limited antigen horse and potato (THP), fresh horse meat and the offending food for each FR dog as documented by provocative challenge. RESULTS: Fourteen sera were negative and two positive to all foods. Sera from five of 13 NFR and three of 25 FR dogs were reactive to hydrolyzed foods. The RCA diet was recognized by four of 38, FUH by six of 38 and PHA by one of 28 samples. THP was recognized by 14 of 33 and fresh horse by one of ten dogs that had never eaten horse meat. The test correctly identified one of 15 dogs allergic to FUH. Twenty of 25 FR sera were negative for the dogs' respective offending foods (20% sensitivity), whereas four of 13 NFR sera were positive to the dogs' usual diets (69% specificity). CONCLUSION AND CLINICAL IMPORTANCE: Western blot analysis cannot be considered as a valid tool for the diagnosis of AFR; it may serve as an aid in selecting an ED.

Evaluation of the value of staining hair samples with a modified Wright-Giemsa stain and/or showing illustrated guidelines for the microscopic diagnosis of dermatophytosis in cats.

BACKGROUND: Direct examination of the hair is a simple diagnostic test for the diagnosis of dermatophytosis; training is needed to use this test. HYPOTHESIS/OBJECTIVES: To evaluate whether use of modified Wright-Giemsa blue stain and/or photographic images of infected and uninfected hairs improved the user's ability to identify infected or uninfected hairs. ANIMALS: Ten cats with, and 10 cats without, dermatophytosis due to Microsporum canis (n = 20). MATERIALS AND METHODS: Twenty unstained and 20 stained hair samples from each group (n = 40) were anonymized and examined by veterinarians using a light microscope. Participants recorded samples as "infected" or "uninfected". Participants were then shown and allowed to use photographic images while examining the same 40 samples. RESULTS: Without staining, investigators correctly identified 12.7 ± 4 of the 20 samples (mean ± SD) and with staining 13.6 (±3). After illustrative guidelines were shown, they correctly identified a mean of 16.9 (±2.5) unstained slides and 15.8 (±2.3) stained slides. "Illustrated guidelines" and "hair infection" significantly increased the probability of a correct answer, whereas "staining" did not. Logistic regression determined that "study participant", "illustrated guidelines" (OR = 2.6) and "hair infection" (OR = 2.1) had a significant influence on the results, whereas "staining" did not. Sensitivity and specificity of direct examination were 70.5% and 56%, respectively, compared with culture status. CONCLUSIONS AND CLINICAL IMPORTANCE: When examining hairs for the presence or absence of infected dermatophyte hairs, diagnostic accuracy was improved when observers used illustrated guides compared with just examining stained slides.

The comparative efficacy of afoxolaner, spinosad, milbemycin, spinosad plus milbemycin, and nitenpyram for the treatment of canine cutaneous myiasis.

BACKGROUND: Canine screw-worm myiasis due to Cochliomyia hominivorax or Chrysomya bezziana has traditionally been treated with extra-label use of ivermectin. The larvicidal activities of nitenpyram and spinosad/milbemycin also have been described, but there have been no reports to describe the efficacy of isoxazolines such as afoxolaner. OBJECTIVES: To evaluate and compare the efficacy of spinosad, spinosad/milbemycin, milbemycin, nitenpyram and afoxolaner for the treatment of canine screw-worm myiasis. ANIMALS: Forty client-owned and naturally infested dogs. METHODS: Cases were randomized into five groups of eight dogs, with each receiving an insecticide at the dose recommended by the manufacturer. Each case was evaluated hourly for 7 h and then again 24 h after treatment. Scores of 0 (no visualized effect), 0.5 (partial eradication) or 1 (complete kill and eradication) were recorded at each observation and compared between groups. Time to complete killing of all larvae was recorded for each dog and compared between treatment groups. RESULTS: Nitenpyram killed all larvae at 6 h post-consumption and spinosad/milbemycin at 7 h. In groups receiving afoxolaner or spinosad, all larvae were killed within 24 h. For those receiving milbemycin, two cases were still infested with live larvae at 24 h. Shih tzus and their crosses were most commonly affected. CONCLUSION: Spinosad/milbemycin or nitenpyram seem to be effective drugs for the treatment of canine screw-worm myiasis. Afoxolaner and milbemycin are effective but exhibited slower larvicidal activity. Synergism between spinosad and milbemycin was observed.

Impact of a terbinafine-florfenicol-betamethasone acetate otic gel on the quality of life of dogs with acute otitis externa and their owners.

BACKGROUND: Treatment of canine otitis externa with owner-administered products can be difficult. OBJECTIVES: To evaluate otic treatment administered by a veterinarian on quality of life (QoL) of dogs with otitis externa and their owners, and on clinical and cytology parameters of otitis; compared to an owner-administered treatment. ANIMALS: Fifty client-owned dogs randomly randomized into two groups and treated for 2 weeks. METHODS: Veterinarians treated Group A dogs with a veterinary licensed otic gel on two occasions at a 1 week interval; owners treated Group B dogs once daily with a veterinary licensed otic drop based product along with twice weekly cleaning. Veterinarians evaluated otitis with the OTI-3 scale and semi-quantitative cytological examination on days 0, 7, 14 and 28. At each visit, owners assessed QoL with a validated questionnaire and pruritus with a Visual Analog Scale. Scores before and after treatment of each group, and differences between groups were analysed statistically. RESULTS: In both groups, all parameters improved significantly. There was a significantly higher improvement of QoL scores, for dogs and owners, in Group A, compared to Group B at all time points (P < 0.05), except for owner QoL on Day 28. There was no difference in improvement of OTI-3 between groups at any time point, whereas Group A cytology scores and pruritus improved significantly more by Day 7 (P = 0.0026 and P = 0.0294, respectively). CONCLUSION: A veterinarian-administered otic gel provided equivalent efficacy and higher QoL to dogs with otitis externa and their owners, compared to an owner-administered topical otic therapy.

Trichoscopic diagnosis of cutaneous Pelodera strongyloides infestation in a dog.

BACKGROUND: Pelodera strongyloides infestation has rarely been reported in dogs. It is a saprophytic free-living nematode, found in moist decaying organic matter, whose L3 larval stages occasionally can invade the skin of dogs and humans. Larvae penetrate the follicular infundibula causing an erythematous and pruritic dermatitis. The disease is usually diagnosed by deep skin scraping or histopathology, with large numbers of parasites readily identified in hair follicles. CASE REPORT: Pelodera strongyloides dermatitis was diagnosed in a six-year-old mixed breed dog presenting with alopecia, erythema and severe pruritus on the ventrum and limbs. The infestation was diagnosed by microscopic examination of plucked hair shafts and confirmed on microscopic examination of skin biopsies collected for histopathology. Only two of 10 deep skin scrapings gave positive findings. The nematode infestation was eradicated following two applications, 2 weeks apart, of a moxidectin/imidacloprid spot-on product. CONCLUSION AND CLINICAL IMPORTANCE: Skin scrapings are considered the diagnostic test of choice for P. strongyloides infestations. In this case, parasites were identified by hair trichograms more readily than by skin scrapings.

Chrysomya bezziana (Diptera: Calliphoridae) infestation: case report of three dogs in Malaysia treated with spinosad/milbemycin.

BACKGROUND: Infestation of wounds with the larvae of Callophorid flies is relatively common in countries where these parasites are found. The most common species associated with infections in Southeast Asia is Chrysomya bezziana (Ch. bezziana), the Old World screw worm. Treatment consists of either subcutaneous injection of ivermectin or oral administration of nitenpyram combined with aggressive tissue debridement under general anaesthesia. OBJECTIVES: To describe the treatment of cutaneous myiasis in three dogs caused by the larvae of Ch. bezziana in Malaysia and their treatment with spinosad plus milbemycin. RESULTS: In all dogs, a single oral dose of spinosad plus milbemycin at the recommended dosage of 31-62 mg/kg and 0.5-1.0 mg/kg, respectively, was able to kill all larvae within 8 h. Most dead larvae fell off the host and those remaining on the host were dead and easily removed with simple saline flushing and gentle debridement. Neither general anaesthesia nor aggressive mechanical debridement were needed in any patient. CONCLUSIONS AND CLINICAL IMPORTANCE: Oral spinosad plus milbemycin is a safe, licensed and effective treatment at the recommended dose for the rapid elimination of Ch. bezziana myiasis, with no need for sedation or anaesthesia.

Comparison of two in vitro antifungal sensitivity tests and monitoring during therapy of Sporothrix schenckii sensu stricto in Malaysian cats.

BACKGROUND: Feline sporotrichosis is common in Malaysia. Thermosensitivity and effects of azole treatment on fungal susceptibility are unknown. OBJECTIVES: To evaluate thermotolerance and antifungal susceptibility of feline Malaysian Sporothrix isolates, compare microdilution (MD) and E-test results, and investigate changes in susceptibility during azole therapy. METHODS: Sporothrix schenckii sensu stricto was isolated from 44 cats. Thermotolerance was determined via culture at 37°C for 7 days. Susceptibility to itraconazole (ITZ), ketoconazole (KTZ) and terbinafine (TRB) was assessed in 40 isolates by MD; to amphotericin B (AMB), KTZ, ITZ, fluconazole (FLC) and posaconazole (POS) by E-test. Results were statistically compared by Pearson's Product Moment. In eight ketoconazole treated cats, susceptibility testing to itraconazole and ketoconazole was repeated every two months for six months. RESULTS: Thermotolerance was observed in 36 of 44 (82%) isolates. Assuming that isolates growing at antifungal concentrations ≥4 mg/mL were resistant, all were resistant on E-test to FLC and AMB, 11 (28%) to POS, 6 (15%) to ITZ and 1 (3%) to KTZ. On MD, 27 of 40 (68%) were resistant to TRB, 2 (5%) to ITZ and 3 (8%) to KTZ. There was no correlation between E-test and MD results (KTZ r = 0.10, P = 0.54, and ITZ r = 0.11, P = 0.48). MD values for ITZ and KTZ did not exceed 4 mg/L during KTZ therapy. CONCLUSION: The majority of feline isolates in Malaysia are thermosensitive. Lack of correlation between E-test and MD suggests that the E-test is unreliable to test antifungal susceptibility for Sporothrix spp. compared to MD. KTZ was the antifungal drug with the lowest MIC. Prolonged KTZ administration may not induce changes in antifungal susceptibility.

Development and validation of a questionnaire to evaluate the Quality of Life of cats with skin disease and their owners, and its use in 185 cats with skin disease.

BACKGROUND: Skin disease can negatively affect the Quality of Life (QoL) of cats and of their owners. OBJECTIVES: To develop and evaluate a questionnaire on QoL of cats with skin disease and their owners. METHODS: Following interviews with owners of cats with severe skin disease and elaboration of a preliminary 19 item questionnaire, a final 15 item (score 0-3) questionnaire was developed. This was administered to owners of 45 cats with allergic dermatitis and 39 healthy cats, to assess its ability to differentiate between diseased and healthy subjects. In allergic cats, owners evaluated overall disease severity (S) and pruritus with a Visual Analog Scale (VAS); veterinarians evaluated skin lesions [SCORing Feline Allergic Dermatitis (SCORFAD) and Feline Dermatitis Extent and Severity Index (FeDESI)]. The correlation with QoL was analysed by Spearman's rank test. In 31 allergic cats, SCORFAD, FeDESI, pruritus VAS, S and QoL scores were obtained before and after therapy, and their improvement evaluated statistically. RESULTS: QoL scores in allergic cats were significantly higher than in healthy cats (P=<0.0001). Severity correlated well and significantly with both cat's and owner's QoL (r = 0.51 and 0.64, P = 0.0003 and <0.0001, respectively). Correlation of QoL with pruritus VAS was moderate and significant (r = 0.3, P = 0.03), whereas with SCORFAD and FeDESI it was low and not significant. With therapy all scores decreased significantly (P < 0.0001); however, QoL was not influenced by improvement of clinical scores. Questions related to the burden of therapy showed the smallest improvements. CONCLUSIONS: This QoL questionnaire could be a useful tool in evaluating cats with skin disease.

Efficacy and duration of action of oral fluralaner and spot-on moxidectin/imidacloprid in cats infested with Lynxacarus radovskyi.

BACKGROUND: Lynxacarus radovskyi has been observed in cats in Malaysia; previously treatment with fipronil and moxidectin/imidacloprid spot-on has been described. OBJECTIVES: To compare the efficacy of two spot-on treatments of moxidectin/imidacloprid, two weeks apart to a single oral dose of fluralaner against Lynxacarus radovskyi and evaluate time to re-infestation. METHODS: Thirty cats were assigned to three groups of ten cats each. Group 1 received one 250 mg fluralaner tablet. Group 2 received two doses of moxidectin/imidacloprid spot-on two weeks apart. Group 3 consisted of untreated controls. For each cat, three plucks of about 50 hairs each were collected from three sites (dorsal neck, lateral thigh and perineal/tail region) for a total of nine pluckings every two weeks. Severity of infestation was scored from 0 (no parasite), to 1 (only nonhatched eggs), 2 (both hatched and nonhatched eggs), 3 (<50 mites) and 4 (>50 mites). Efficacy was compared between treatment groups and over time in the same group, and results analysed statistically. Re-infestation was defined as the identification of new eggs or mites on hair pluckings. RESULTS: Moxidectin/imidacloprid spot-on and oral fluralaner achieved 100% eradication within 28 days. No significant difference was observed between groups 1 and 2; re-infestation occurred by Day 56 in both treatment groups. CONCLUSION: A single dose of oral fluralaner or two moxidectin/imidacloprid spot-on treatments two weeks apart are efficacious in the eradication of L. radovskyi in cats and able to prevent re-infestation for at least 42 days post-treatment.

Pustular dermatitis in dogs affected by leishmaniosis: 22 cases.

BACKGROUND: Skin lesions in canine leishmaniosis (CanL) are diverse, including exfoliative, ulcerative, nodular and papular dermatitides. An uncommon pustular form has also been reported. HYPOTHESES/OBJECTIVES: We hypothesized that CanL infection can produce a pustular reaction pattern in the skin of dogs. The aim of this retrospective study was to describe the clinicopathological features of dogs with CanL infection and pustular dermatitis, and correlate them with response to therapy. ANIMALS: Twenty two affected dogs. METHODS: Retrospective review of medical records and examination of archived biopsy materials or previously processed glass slides was performed. Cytological examinations had been recorded for all cases. Specimens were available for histopathological examination in 17 of 22 cases and for immunohistochemical detection of Leishmania amastigotes in 13 of 22 cases. RESULTS: All dogs presented with multifocal to diffuse pustular dermatitis. CanL was diagnosed by IFAT serology (20 cases), bone marrow cytology (one case) or bone marrow PCR (one case). Cytological and/or histopathological examinations revealed acantholytic keratinocytes within pustules in 18 of 22 cases. Bacterial and fungal cultures were not performed. Leishmania amastigotes were identified by histopathology within the dermis in three cases; immunohistochemistry was positive in four cases. All dogs underwent concurrent anti-leishmanial and immunosuppressive therapy to control the pustular dermatitis, with favourable outcome in 11 of 22 cases. CONCLUSIONS AND CLINICAL IMPORTANCE: Due to the retrospective nature of this study it is not possible to either accept or reject the hypothesis that CanL is the direct cause of pustular dermatitis.

Comparison of FEDESI and SCORFAD scoring systems for the evaluation of skin lesions in allergic cats.

BACKGROUND: Feline Dermatitis Extent and Severity Index (FeDESI) and Scoring Feline Allergic Dermatitis (SCORFAD) are two different scoring systems for the evaluation of feline allergic dermatitis. OBJECTIVES: To evaluate the correlation between FeDESI and SCORFAD and pruritus. ANIMALS AND METHODS: The dermatological lesions of 32 cats affected by feline allergic dermatitis were evaluated with both FeDESI and SCORFAD before treatment and once monthly during treatment where ciclosporin was administered at 7 mg/kg orally once daily for 1 month then tapered, when possible, in the subsequent 2 months. Pruritus was scored by pet owners with a Visual Analog Scale (VAS). Correlation between scores at Visit 1, and between absolute and percentage score improvements at visits 1, 2 and 3, were analysed statistically using a nonparametric Spearman's rank correlation test. RESULTS: Correlation between FeDESI, SCORFAD and VAS pruritus scores at baseline was low and nonsignificant for all combinations. The correlation of absolute score improvement was moderate and significant only between FeDESI and VAS pruritus at Visit 3. Correlation of improvement percentage was moderate and significant between FeDESI and SCORFAD and between FeDESI and VAS pruritus at Visit 2, whereas at visits 3 and 4 it was high and significant for each combination. CONCLUSION: Only improvement percentage of FeDESI and SCORFAD scores seem to correlate well. SCORFAD is the only scoring system to have been validated, although it seems to correlate less with pruritus and may be more difficult to use than FeDESI. The latter could thus be more appropriate for use, but further studies are needed especially in regard to its validation.

Oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis: results of a small prospective pilot study of client-owned cats.

BACKGROUND: Oclacitinib is a Janus kinase inhibitor that decreases pruritus and lesions in allergic dogs. In cats, it is able to inhibit interleukin-31-induced pruritus; no information is available on its clinical effectiveness. HYPOTHESIS/OBJECTIVES: To evaluate the efficacy, ease of administration and tolerability of oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis. METHODS: Cats >12 months of age and >3 kg body weight with a diagnosis of nonflea-, nonfood-induced hypersensitivity dermatitis were treated with oclacitinib, 0.4-0.6 mg/kg orally (p.o.) twice daily for 2 weeks, then once daily for an additional 14 days. Clinical lesions were evaluated with the Scoring Feline Allergic Dermatitis (SCORFAD) system and pruritus was evaluated with a 10-cm-long visual analog scale (VAS) before and at the end of the study. Owners assessed global efficacy, ease of administration and tolerability with a four-point scale. RESULTS: Twelve cats were treated with a mean initial oclacitinib dose of 0.47 mg/kg p.o. twice daily. There was good improvement in SCORFAD and VAS pruritus scores in five of 12 cases, while the other cats were unchanged, deteriorated or dropped out due to treatment failure. Owners scored global efficacy as good/excellent in four of 12 cases and ease of administration and tolerability as good/excellent in 10 of 12. CONCLUSIONS AND CLINICAL IMPORTANCE: Oclacitinib at 0.4-0.6 mg/kg p.o. may be an effective and safe drug for some cats with nonflea-, nonfood-induced hypersensitivity dermatitis. Further studies are needed to identify the most effective dose range for this species.

Efficacy of ultra-micronized palmitoylethanolamide in canine atopic dermatitis: an open-label multi-centre study.

BACKGROUND: Palmitoylethanolamide is a naturally occurring bioactive lipid, produced on-demand by damage-exposed cells. Palmitoylethanolamide is documented to counteract inflammation, itch and pain. OBJECTIVE: The aim of this 8-week study was to evaluate the efficacy of oral ultra-micronized palmitoylethanolamide (PEA-um) in dogs with moderate atopic dermatitis. ANIMALS: Clinicians from 39 veterinary clinics enrolled 160 dogs with nonseasonal atopic dermatitis and moderate pruritus. METHODS: This was a multi-centre open-label study. On days 0 (D0) and 56 (D56), owners evaluated pruritus with a Visual Analog Scale (VAS) and completed a validated Quality of Life (QoL) questionnaire. Veterinarians assessed the severity of skin lesions using the Canine Atopic Dermatitis Lesion Index (CADLI). RESULTS: Mean pruritus VAS score decreased from 5.7 ± 0.08 cm (range 3.8-7.9 cm) to 3.63 ± 0.19 cm (range 0.1-9.2 cm) (P < 0.0001). At D56, 58% of dogs showed a greater than 2 cm reduction from baseline and 30% showed an absent-to-very mild pruritus (VAS ≤ 2 cm). Mean total CADLI at D56 decreased significantly (P < 0.0001); in 62% of dogs this score reached a value in the remission range (≤5). Mean total QoL score was significantly decreased (P < 0.0001) with 45% of dogs reaching QoL values described for healthy animals. Tolerability was good-to-excellent with only four dogs reporting treatment associated reversible adverse events. CONCLUSIONS AND CLINICAL IMPORTANCE: PEA-um appears to be effective and safe in reducing pruritus and skin lesions, and in improving QoL in dogs with moderate atopic dermatitis and moderate pruritus.

Perianal pruritus in dogs with skin disease.

BACKGROUND: Perianal pruritus has been reported in dogs with anal sac disease but not in healthy dogs. Some authors describe it as typical of allergy, but there is little evidence in support of this. HYPOTHESIS/OBJECTIVES: The aim was to investigate the association between perianal pruritus and canine atopic dermatitis (CAD), adverse food reaction (ARF) and other skin diseases in dogs. ANIMALS: Two hundred and fifty privately owned dogs with skin disease and without anal sac disease. METHODS: The presence or absence of perianal pruritus, macroscopic and cytological evaluation of the perianal skin surface and the macroscopic appearance of anal sac contents were assessed. Chi-square and Fisher's exact tests were performed to compare the frequency of perianal pruritus with the clinical diagnoses and with clinical and cytological parameters. RESULTS: Perianal pruritus was seen in 39 of 75 dogs with CAD, in 29 of 57 dogs with ARF and in only 24 of 118 dogs with other conditions. The frequency of perianal pruritus in dogs with CAD and/or ARF was significantly higher than that in dogs with other diagnoses (P < 0.0001). No other disease was significantly associated with perianal pruritus. Perianal pruritus was significantly associated with signs of perianal alopecia, erythema, excoriations, lichenification and hyperpigmentation; it was not associated with the presence of bacteria or yeasts or with anal sac impaction. CONCLUSIONS AND CLINICAL IMPORTANCE: Perianal pruritus was seen more frequently in dogs with AFR/CAD than with other dermatological diseases. This is the first study to evaluate perianal pruritus in dogs with skin disease and without anal sac disease.

Effects of a Protocol Combining a Non-Irritating Shampoo and an Adelmidrol-Based Adsorbent Mousse on Seborrhoea and Other Signs and Symptoms Secondary to Canine Atopic Dermatitis: A Multicenter, Open-Label Uncontrolled Clinical Trial.

The present study aimed at evaluating the effect of a gentle shampoo and a mousse containing Adelmidrol, tapioca starch and a non-prescription antimicrobial complex on seborrhoea and other clinical signs secondary to canine atopic dermatitis (cAD). Forty-six dogs with cAD-associated seborrhoea and/or pruritus > 4 cm on the pruritus visual analogue scale (P-VAS) and/or bacterial/Malassezia overgrowth were enrolled. The mousse was applied twice daily, and dogs were evaluated at days (D)0, 7, 14 and optionally 28, by means of a skin seborrheic index (SSI), P-VAS, cAD lesion index (CADLI), and a semiquantitative cytological score. The mean SSI value improved during the first two weeks (4.1 ± 0.37 to 1.9 ± 0.30; p < 0.0001). The mean P-VAS score (cm) decreased from 6.6 ± 0.19 at D0 to 3.8 ± 0.31 at D14 (p < 0.0001). The mean CADLI score dropped from 13.7 ± 1.24 to 8.5 ± 1.14 at D14 (p < 0.001). The cytological score for bacteria and Malassezia decreased from 3.2 ± 0.10 and 3.2 ± 0.11, respectively, to 1.2 ± 0.19 and 1.2 ± 0.24 (p < 0.0001). All the investigated signs further improved at D28. Altogether, these observations suggest that the tested protocol might be useful in managing cAD-associated signs.

Analysis of Intestinal Microbiota and Metabolic Pathways before and after a 2-Month-Long Hydrolyzed Fish and Rice Starch Hypoallergenic Diet Trial in Pruritic Dogs.

Intestinal microbiota alterations were described in allergic individuals and may improve with diets. Farmina Ultra Hypo (FUH), a hydrolyzed fish/rice starch hypoallergenic diet, is able to improve clinical signs in allergic dogs. Study objectives were to determine microbiota differences in allergic dogs before and after feeding with FUH for eight weeks. Forty skin allergic dogs were evaluated clinically before and after the diet. Unresponsive dogs were classified as canine atopic dermatitis (CAD); responsive dogs relapsing after challenge with previous foods were classified as being food reactive (AFR), and those not relapsing as doubtful (D). Sequencing of feces collected pre- and post-diet was performed, with comparisons between and within groups, pre- and post-diet, and correlations to possible altered metabolic pathways were sought. Microbiota in all dogs was dominated by Bacteroidota, Fusobacteriota, Firmicutes and Proteobacteria, albeit with large interindividual variations and with some prevalence changes after the diet. In general, bacteria producing short-chain fatty acids were increased in all samples. CAD dogs showed pre-and post-diet microbiota patterns different from the other two groups. Bacteria taxa were enriched post-diet only in the AFR group. Changes in metabolic pathways were observed mainly in the CAD group. FUH may be able to improve intestinal microbiota and thus clinical signs of skin allergy.