Incidence and characterization of aerophagia in dogs using videofluoroscopic swallow studies.

BACKGROUND: Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or ingested air resulting in gastric distention (>1/3 of end gastric volume). Aerophagia is highlighted during eating and drinking. Videofluoroscopic swallow studies (VFSS) document aerophagia in dogs, but the incidence, clinical signs (CS), and associated disorders are unknown. OBJECTIVES: Identify the incidence of aerophagia, compare CS between dogs with and without aerophagia, and identify associated and predisposing disorders using VFSS. ANIMALS: A total of 120 client-owned dogs. METHODS: Sequential VFSS and associated medical records from dogs presenting to veterinary teaching hospitals at Auburn University and the University of Missouri were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney and chi-squared tests, odds ratios (OR), and multiple logistic regression (P < .05). RESULTS: The incidence (95% confidence interval [CI]) of aerophagia was 40% (31.7-48.9). Dogs with mixed CS (gastrointestinal [GI] and respiratory; P < .001, 58.3%) were more likely to have aerophagia than dogs with exclusively respiratory CS (25%). Aerophagia was significantly more common in brachycephalic dogs (P = .01; 45.8% vs 13.8%), dogs with nonbrachycephalic upper airway obstruction (P < .001; 33.3% vs 4.1%), pathologic penetration and aspiration (P-A) scores (P = .04; 41.6% vs 23.6%), and gagging (P < .001; 25% vs 11.7%). Mixed CS (P = .01), brachycephaly (P < .001), and upper airway obstruction (P < .001) were independent predictors of aerophagia. CONCLUSIONS AND CLINICAL IMPORTANCE: Aerophagia was common, particularly in dogs with mixed CS. Brachycephalic dogs and dogs with upper airway obstruction are predisposed. Aspiration risk was high, emphasizing overlapping upper aerodigestive pathways.

The impact of single-dose trazodone administration on plasma endogenous adrenocorticotropic hormone and serum cortisol concentrations in healthy dogs.

BACKGROUND: Conditions affecting the hypothalamic-pituitary-adrenal (HPA) axis are common in dogs. Testing the function of the HPA axis includes measurement of endogenous adrenocorticotropic hormone (eACTH) and performance of an adrenocorticotropic hormone (ACTH) stimulation test. Trazodone is commonly administered to dogs to decrease stress. In humans, trazodone significantly decreases plasma cortisol concentration via alpha-1 adrenergic activity. OBJECTIVES: Determine the influence of trazodone on eACTH and serum cortisol concentrations in healthy dogs. ANIMALS: Fourteen healthy, adult, companion dogs. METHODS: Prospective, randomized placebo-controlled study. Trazodone (8-10 mg/kg) or placebo was administered PO 1 hour before eACTH measurement and ACTH stimulation testing. After a ≥7-day wash-out period, dogs received the opposite treatment. Differences in eACTH, pre- and post-ACTH stimulation cortisol concentrations, and delta (difference between pre- and post-ACTH) cortisol concentrations were analyzed using a paired t or signed-rank test with a P < .05 significance level. RESULTS: The eACTH concentrations were not significantly different (P = .23) between treatments. Similarly, no significant differences were found in the pre-ACTH cortisol concentrations between treatments (P = .40). Post-ACTH cortisol concentrations (P = .05) and delta cortisol concentrations (P = .04) were significantly lower when the dogs were treated with trazodone. CONCLUSIONS: Preliminary data suggest trazodone administration dampens the adrenocortical response to stimulation in healthy dogs. If similar effects are found in dogs with adrenal disease, the use of trazodone may affect diagnosis and clinical decision making in these populations.

Detection of canine obstructive nasal disease using infrared thermography: A pilot study.

Infrared thermography detects variations in heat signature and is utilized in other species to non-invasively identify respiratory disease. This study aimed to determine if infrared thermography could be used to detect nasal disease in dogs. Eight dogs presenting for nasal disease (ND group) and ten healthy control dogs (C group) were enrolled. Dorsal and rostral images of the nose were acquired using a Fluke TiX580 60Hz thermal imaging camera. Images were analyzed using the accompanying software. Regions of interest were defined over the right and left nasal passages to determine the maximum (max), average (avg), and minimum (min) temperatures. Temperatures were compared between ND and C groups, and correlation to disease state (ND or C) was evaluated. Temperature differences and imaging patterns were subjectively compared with diagnosis based on computed tomography (CT) and histopathology. The ND group consisted of 5 spayed females and 3 neutered males. Clinical sings included unilateral epistaxis (n = 4); bilateral serous discharge and sneezing (n = 1); bilateral mucopurulent discharge, epistaxis, and sneezing (n = 1); unilateral mucoid discharge, epistaxis and sneezing (n = 1); and sneezing and unilateral epistaxis (n = 1). Temperatures were significantly different between ND and C groups on dorsal (max p = <0.001, avg p = 0.001, min p = <0.001) and rostral (max p = <0.001, avg p = <0.001, min p = 0.005) images. Temperature positively correlated to disease status (ND vs C group) in both dorsal and rostral images. Subjective analysis of images allowed correct identification of abnormal or normal 27/36 times. Obstructive nasal disease results in a local temperature increase in the affected nasal passage that can be non-invasively detected by infrared thermography.

Evaluation of infrared thermography and 6-minute walk tests to assess airflow limitation, impaired thermoregulation, and exercise intolerance in dogs with brachycephalic obstructive airway syndrome.

Brachycephalic obstructive airway syndrome (BOAS) is associated with significant morbidity and mortality. Routine clinical evaluation fails to detect physiologic consequences of BOAS including airflow limitation, exercise intolerance, and impaired thermoregulation. A six-minute walk test (6MWT) with infrared thermography (IRT) may aid detection and clinical management by assessing the physiologic consequences of BOAS. IRT has been used in dogs to assess thermoregulation and in people with obstructive sleep apnea. Our objectives were to compare 6MWT and IRT parameters between healthy mesaticephalic (Mesa) and brachycephalic (Brachy) dogs, and dogs with BOAS. 6MWT parameters include normalized distance walked (ND), rectal temperature, pulse, respiratory rate, and pulse oximetry (SPO2). Mean (Tmean) and maximum (Tmax) IRT temperatures at 3 regions of interest (ROI) were evaluated. Evaluation timepoints were pre-6MWT, immediately post-6MWT (T0) and 5 (T5) and 15min post-6MWT (T15). No significant difference in ND, SPO2, or temperature were found between groups (p>.05). BOAS dogs had higher dorsal and rostral Tmax and Tmean temperatures compared to Mesa dogs at all timepoints (p < .05). BOAS dogs had higher Tmean temperatures compared to Brachy dogs at baseline and T15 and T5 and T15 for dorsal and rostral ROIs respectively (p < .001). ROC analysis showed significant discrimination between BOAS and non-BOAS (Brachy and Mesa) dogs with areas under the curve between 0.79-0.96. Significant moderate correlations were found between IRT temperatures, ND and rectal temperature. This pilot study demonstrates the potential in pairing the 6MWT and IRT with evaluation of clinical signs as screening tool to identify dogs with BOAS.

Perceptions of Body Condition, Diet and Exercise by Sports Dog Owners and Pet Dog Owners.

The purpose of this study was to investigate the variables that contribute to obesity in pet dogs. The working hypothesis was that sports dog owners will better estimate their dog's body condition and report stronger belief and control over their dogs' feeding and exercise compared to traditional pet owners. We collected data on 171 pet owners (101 participated in canine sports) for this study. Each owner completed the Dog Owner Attitude Questionnaire. Each dog was measured for percent fat and Purina body condition scale. For the pet dogs, the median Purina body condition score was 6 (too heavy), but for the sports dogs it was 5 (ideal) (p < 0.05 different from pet dogs). The average percent fat for the pet dogs was 19.1 ± 8.6%, and for the sports dogs it was 13.8 ± 5.3% (p < 0.05 different from pet dogs). Among pet owners, 52% were able to correctly estimate their dog's body condition. Sports dog owners were 57% correct. Pet dog owners fed approximately 60% more per day compared to sports dog owners. Pet and sports dog owners exercised their dog via walking, but sports dog owners reported more activity with the dog, while pet dog owners reported more activity than the dog did by themselves. Overall, pet and sports dog owners put a high value on their dog's health and well-being, but better education with regard to body condition, feeding and exercise is critical to improve the pet obesity problem.

Analysis of the effects of storage temperature and contamination on aerobic bacterial culture results of bronchoalveolar lavage fluid.

BACKGROUND: Storage temperature of bronchoalveolar lavage fluid (BALF) impacts cytological evaluation. The effect of storage temperature before bacterial culture has not been evaluated. OBJECTIVES: To assess whether BALF storage temperature alters aerobic bacterial culture results. ANIMALS: Eight healthy, male, intact, purpose-bred Beagles. METHODS: Prospective, controlled investigation. Samples of BALF were collected sterilely. Half of each sample was reserved for controls, and half was inoculated with 104 colony forming units per milliliter (cfu/mL) Bordetella bronchiseptica and 102 cfu/mL Escherichia coli. Control and inoculated samples each were separated into 4 aliquots (1 plated immediately; 3 stored at 4, 24, or 37°C, respectively, for 24 hours before aerobic bacterial culture). Colony counts were compared across treatments for each organism. RESULTS: In inoculated samples, a statistical difference could not be detected in growth of E. coli or B. bronchiseptica between the baseline culture and BALF stored at 4°C for 24 hours before culture. However, for E. coli, growth in cfu/mL at both 24 and 37°C was higher compared to baseline (P < .05) and compared to 4°C (P < .05). For B. bronchiseptica cfu/mL, growth at 37°C was significantly different (P = .003) compared to both baseline and 4°C. CONCLUSIONS AND CLINICAL IMPORTANCE: Samples of BALF may be stored at 4°C for 24 hours before culture without substantially altering culture results. Inappropriate storage or shipment temperature (room temperature or exposure to heat) can result in overgrowth of E. coli or B. bronchiseptica, which could alter clinical decisions.

Feline asthma and heartworm disease: Clinical features, diagnostics and therapeutics.

PRACTICAL RELEVANCE: For feline practitioners, the cat with a cough or respiratory distress and thoracic radiographs with a bronchial or bronchointerstitial pattern suggests lower airway disease. Two important differentials, allergic asthma and heartworm disease (HWD), have many overlapping clinicopathologic features, but also clear and important differences in terms of cause and disease progression, treatment and prognosis. Notably, asthma is readily treatable and HWD is preventable. CLINICAL SIGNIFICANCE: Feline HWD comprises two clinical syndromes: the comparatively recently described heartworm-associated respiratory disease (HARD) and adult HWD. The former is much more common; very few cats with HARD develop adult HWD. In HARD, following death of immature worms, pulmonary lesions may improve over time ('self-cure'). Lesions of adult HWD also improve over time as long as reinfection does not occur; however, with death of adult heartworms, mortality is high, and the prognosis is guarded. In asthma, morbidity is relatively high, but mortality is low, with an overall good to excellent prognosis. DISEASE RECOGNITION: Feline asthma is encountered worldwide. In the authors' impression, feline HWD is often under-recognized. AIMS: The aim of this review is to assist clinicians in differentiating feline asthma from feline HWD; as such, the emphasis is on distinguishing clinical features, as well as on diagnostics, therapy and prognosis. In differentiating these conditions, clinicians can attempt the goal of properly managing these diseases and can best educate owners on prognosis. EVIDENCE BASE: For both feline asthma and feline HWD, the authors have drawn on the available peer-reviewed literature studies involving experimental models as well as spontaneous disease.

Serum theophylline after multiple dosing with transdermal gels in cats.

OBJECTIVES: Our objectives were, first, to determine if therapeutic serum theophylline concentrations could be achieved using long-term, once-daily dosing of transdermal theophylline and, secondarily, to evaluate the difference between two transdermal theophylline formulations. METHODS: Seven healthy cats, 1-10 years of age, were evaluated in a two-way, randomized, double-blinded, crossover study. Participants received transdermal theophylline at 15 mg/kg for 21 days in either pluronic lecithin organogel (PLO) or Lipoderm formulation. On day 22, blood was collected 2, 6, 14 and 24 h after dosing. After a 14 day washout period, blood was collected to verify non-detectible theophylline concentrations. The alternate formulation was administered for 21 days, and sampling was repeated. Serum theophylline concentrations were determined using an automated immunoassay. Serum concentrations were compared between formulations using a two-way random-measures ANOVA and over time within a formulation using a repeated-measures ANOVA. RESULTS: Therapeutic serum theophylline concentrations were achieved for 2/7 cats in each group. Of 56 serum theophylline measurements obtained, only seven (13%) were within the therapeutic range. No significant difference was detected in drug concentrations achieved by the transdermal formulations at any time point. In addition, no significant difference in serum theophylline concentrations was noted between time points for PLO ( P = 0.751) or Lipoderm ( P = 0.107). CONCLUSIONS AND RELEVANCE: Once-daily transdermal dosing of theophylline does not reliably achieve therapeutic concentrations. Individual cats may achieve therapeutic concentrations. No significant difference was noted between PLO and Lipoderm formulations. Therefore, transdermal theophylline formulations should not be considered as a first-line therapy in feline asthma patients.

Pulmonary pythiosis in a canine patient.

A Staffordshire terrier presented for evaluation of a chronic, nonproductive cough that was unresponsive to antibiotic therapy. A large mass identified in the pulmonary hilum was most consistent with tracheobronchial lymphadenopathy on radiographic and computed tomography (CT) images. Bronchoscopy confirmed a mass compressing the dorsal portion of the intrathoracic trachea. Bronchoscopic biopsies of the tracheal mass revealed necrosuppurative and eosinophilic inflammation with intralesional Pythium insidiousum hyphae. Pythiosis should be included as a differential diagnosis for tracheobronchial lymphadenopathy and bronchopneumopathy in dogs, especially when the patient is from or has visited a region endemic for Pythium insidiosum.

Evaluation of Histogel- and Gelfoam-embedded bronchoalveolar lavage and transtracheal wash fluids compared with cytocentrifuged and sediment smear preparations.

BACKGROUND: Storage and temperature significantly impact bronchoalveolar lavage fluid (BALF) analysis, and shipment of samples to diagnostic laboratories is often necessary. Alternative sample preparation methods could limit storage and temperature effects. OBJECTIVES: This study aimed to determine if airway wash samples that were fixed in formalin after being embedded in Histogel or Gelfoam gave comparable results to fresh cytocentrifuged or sediment smear preparations for the evaluation of cell morphology. METHODS: Eleven bronchoalveolar lavage and 3 transtracheal wash fluids were available, including 8 canine, 1 feline, and 5 equine samples. Cytocentrifuged and sediment smear preparations were prepared for routine analysis. Airway fluids were reserved for further evaluation. Total nucleated cell counts (TNCCs) were determined using a hemocytometer. The remaining fluid was used for Histogel and Gelfoam preparations. Each preparation was analyzed by a single board-certified clinical pathologist and assigned cellularity (1-3) and morphology scores (1-4). RESULTS: Cellularity and morphology were significantly worse for the sediment smear, Histogel, and Gelfoam preparations compared with the cytocentrifuged preparations. The Gelfoam preparations had significantly worse cellularity scores than all other methods. Cellularity scores for sediment smears and Histogel preparations were significantly correlated with TNCCs. CONCLUSIONS: TNCCs impacted the cellularity of the sediment smears and Histogel preparations. Cytocentrifuged preparations resulted in the best cellularity and morphology and are, therefore, recommended whenever possible. Neither the Histogel nor the Gelfoam methods demonstrated any advantage over sediment smear preparations, and both performed poorly when compared with cytocentrifuged preparations. Therefore, we do not recommend the use of these methods.

High-resolution CT evaluation of bronchial lumen to vertebral body, pulmonary artery to vertebral body and bronchial lumen to pulmonary artery ratios in Dirofilaria immitis-infected cats with and without selamectin administration.

Objectives The bronchial lumen to pulmonary artery (BA) ratio is utilized to evaluate pulmonary pathology on CT images. The BA ratio may be unreliable when changes are present in bronchial and pulmonary arteries concurrently. Bronchial lumen to vertebral body (BV) and pulmonary artery to vertebral body (AV) ratios have been established in normal cats and may serve as an alternative. This study aimed to evaluate the BV, AV and BA ratios in cats before and after infection with Dirofilaria immitis, with and without selamectin administration, and to characterize the distribution of disease. Methods Archived CT images were reviewed from three groups of cats: D immitis-infected untreated (n = 6); infected pretreated with selamectin (n = 6); and uninfected untreated (n = 5). The BV, AV and BA ratios were calculated for all lung lobes for baseline (D0) and day 240 (D240) postinfection. Ratios and percentage change from baseline were compared between lobes and between groups. Results BV and AV ratios were more consistent in identifying abnormalities when disease was present in bronchial and arteries concurrently than BA ratios. Infected untreated cats had significant changes in both BV and AV ratios and percentage change from baseline. Abnormal BV and AV ratios were noted in the infected selamectin group, although less widely distributed. Conclusions and relevance The BV and AV ratios more accurately identified bronchial and pulmonary artery abnormalities in D immitis-infected cats. Both bronchial and pulmonary artery changes were present in infected cats, decreasing the diagnostic application of the BA ratio. Pulmonary artery changes were more widely distributed than bronchial changes in the lung. Heartworm-infected cats receiving selamectin had bronchial and pulmonary artery changes but to a lesser extent than untreated heartworm-infected cats. The CT-derived BV and AV ratios are a useful measure to evaluate lung disease of cats.

High-resolution computed tomography evaluation of the bronchial lumen to vertebral body diameter and pulmonary artery to vertebral body diameter ratios in anesthetized ventilated normal cats.

Objectives Bronchial lumen to pulmonary artery diameter (BA) ratio has been utilized to investigate pulmonary pathology on high-resolution CT images. Diseases affecting both the bronchi and pulmonary arteries render the BA ratio less useful. The purpose of the study was to establish bronchial lumen diameter to vertebral body diameter (BV) and pulmonary artery diameter to vertebral body diameter (AV) ratios in normal cats. Methods Using high-resolution CT images, 16 sets of measurements (sixth thoracic vertebral body [mid-body], each lobar bronchi and companion pulmonary artery diameter) were acquired from young adult female cats and 41 sets from pubertal female cats. Results Young adult and pubertal cat BV ratios were not statistically different from each other in any lung lobe. Significant differences between individual lung lobe BV ratios were noted on combined age group analysis. Caudal lung lobe AV ratios were significantly different between young adult and pubertal cats. All other lung lobe AV ratios were not significantly different. Caudal lung lobe AV ratios were significantly different from all other lung lobes but not from each other in both the young adult and pubertal cats. Conclusions and relevance BV ratio reference intervals determined for individual lung lobes could be applied to both young adult and pubertal cats. Separate AV ratios for individual lung lobes would be required for young adult and pubertal cats. These ratios should allow more accurate evaluation of cats with concurrent bronchial and pulmonary arterial disease.

Effects of oral administration of metronidazole and doxycycline on olfactory capabilities of explosives detection dogs.

OBJECTIVE To determine effects of oral administration of metronidazole or doxycycline on olfactory function in explosives detection (ED) dogs. ANIMALS 18 ED dogs. PROCEDURES Metronidazole was administered (25 mg/kg, PO, q 12 h for 10 days); the day prior to drug administration was designated day 0. Odor detection threshold was measured with a standard scent wheel and 3 explosives (ammonium nitrate, trinitrotoluene, and smokeless powder; weight, 1 to 500 mg) on days 0, 5, and 10. Lowest repeatable weight detected was recorded as the detection threshold. There was a 10-day washout period, and doxycycline was administered (5 mg/kg, PO, q 12 h for 10 days) and the testing protocol repeated. Degradation changes in the detection threshold for dogs were assessed. RESULTS Metronidazole administration resulted in degradation of the detection threshold for 2 of 3 explosives (ammonium nitrate and trinitrotoluene). Nine of 18 dogs had a degradation of performance in response to 1 or more explosives (5 dogs had degradation on day 5 or 10 and 4 dogs had degradation on both days 5 and 10). There was no significant degradation during doxycycline administration. CONCLUSIONS AND CLINICAL RELEVANCE Degradation in the ability to detect odors of explosives during metronidazole administration at 25 mg/kg, PO, every 12 hours, indicated a potential risk for use of this drug in ED dogs. Additional studies will be needed to determine whether lower doses would have the same effect. Doxycycline administered at the tested dose appeared to be safe for use in ED dogs.

Feline respiratory disease: what is the role of Mycoplasma species?

PRACTICAL RELEVANCE: Non-hemotropic Mycoplasma species are frequently implicated in cases of respiratory disease, and also conjunctivitis, in cats. CLINICAL CHALLENGES: Mycoplasma species are considered commensal bacteria of the conjunctiva and the upper respiratory tract of cats, and hence their role as a primary pathogen is difficult to determine. These organisms certainly appear to play a significant role as a secondary pathogen in the upper airways, and there is increasing evidence that in some animals they may represent a primary infection. However, mycoplasmas have not been found in the lower airways of clinically healthy cats - suggesting that, when present, they likely represent a pathologic process. Diagnostic challenges exist as well; Mycoplasma species are not typically identified via cytology due to their small size, and culture of these organisms requires special media and handling. Although PCR has improved identification and allowed for speciation, conflicting culture and PCR results can create a dilemma regarding the clinical relevance of infection. EVIDENCE BASE: This article draws on original research and case reports to provide information about the role of Mycoplasma species in the feline upper and lower respiratory tract, diagnostic methods and associated challenges, and treatment options. AUDIENCE: The goal is to provide small animal practitioners with a current and organized review of the often-conflicting literature regarding the role of Mycoplasma species in feline respiratory infections.

Nebulized lidocaine blunts airway hyper-responsiveness in experimental feline asthma.

Nebulized lidocaine may be a corticosteroid-sparing drug in human asthmatics, reducing airway resistance and peripheral blood eosinophilia. We hypothesized that inhaled lidocaine would be safe in healthy and experimentally asthmatic cats, diminishing airflow limitation and eosinophilic airway inflammation in the latter population. Healthy (n = 5) and experimentally asthmatic (n = 9) research cats were administered 2 weeks of nebulized lidocaine (2 mg/kg q8h) or placebo (saline) followed by a 2-week washout and crossover to the alternate treatment. Cats were anesthetized to measure the response to inhaled methacholine (MCh) after each treatment. Placebo and doubling doses of methacholine (0.0625-32.0000 mg/ml) were delivered and results were expressed as the concentration of MCh increasing baseline airway resistance by 200% (EC200Raw). Bronchoalveolar lavage was performed after each treatment and eosinophil numbers quantified. Bronchoalveolar lavage fluid (BALF) % eosinophils and EC200Raw within groups after each treatment were compared using a paired t-test (P <0.05 significant). No adverse effects were noted. In healthy cats, lidocaine did not significantly alter BALF eosinophilia or the EC200Raw. There was no difference in %BALF eosinophils in asthmatic cats treated with lidocaine (36±10%) or placebo (33 ± 6%). However, lidocaine increased the EC200Raw compared with placebo 10 ± 2 versus 5 ± 1 mg/ml; P = 0.043). Chronic nebulized lidocaine was well-tolerated in all cats, and lidocaine did not induce airway inflammation or airway hyper-responsiveness in healthy cats. Lidocaine decreased airway response to MCh in asthmatic cats without reducing airway eosinophilia, making it unsuitable for monotherapy. However, lidocaine may serve as a novel adjunctive therapy in feline asthmatics with beneficial effects on airflow obstruction.

The tyrosine kinase inhibitor masitinib blunts airway inflammation and improves associated lung mechanics in a feline model of chronic allergic asthma.

BACKGROUND: Blockade of tyrosine kinase signaling by masitinib, a c-kit/PDGF receptor tyrosine kinase inhibitor, can modulate allergic airway inflammation, but effects on lung mechanics have not been well characterized. We hypothesized masitinib would decrease airway eosinophilia and consequently improve pulmonary mechanics in a feline allergic asthma model. METHODS: Asthma was induced in 12 cats using Bermuda grass allergen (BGA). Cats received 50 mg/day oral masitinib or placebo. Bronchoalveolar lavage fluid (BALF) was analyzed for eosinophils, total protein (TP) and BGA-specific IgE. Ventilator-acquired mechanics after methacholine (MCh) challenge determined MCh concentration needed to increase baseline airway resistance by 200% (EC(200)R(aw)), positive end expiratory occlusion pressure (PEEP) and end inspiratory breath hold pressure (P(plat)). An inverse correlate of respiratory system compliance P(plat)-PEEP was also calculated. Data were analyzed using the Wilcoxon test, with one-tailed significance set at p < 0.1. RESULTS: After 4 weeks, percent eosinophils in BALF was lower in masitinib-treated cats (7 ± 9%) versus controls (30 ± 27%, p = 0.023). BALF TP significantly differed (p = 0.047) between groups, decreasing with masitinib and increasing with placebo. BALF BGA-specific IgE was unaffected by masitinib. Both groups showed an improvement in EC(200)R(aw) (masitinib, p = 0.015; control, p = 0.078) but no significant change in PEEP after 4 weeks. Masitinib-treated cats demonstrated decreased P(plat) (p = 0.033) and P(plat)-PEEP (p = 0.075) at week 4, suggesting an improvement in respiratory compliance. CONCLUSIONS: Masitinib reduced BALF eosinophilia and TP, indicating improved airway inflammation and edema, and improved P(plat) and P(plat)-PEEP, suggesting benefit to respiratory compliance influenced by airway inflammation/edema. Masitinib deserves further study in humans with chronic allergic asthma.

Beneficial cross-protection of allergen-specific immunotherapy on airway eosinophilia using unrelated or a partial repertoire of allergen(s) implicated in experimental feline asthma.

The study hypothesis was that in experimentally asthmatic cats rush immunotherapy (RIT) using allergens not completely matched with sensitizing allergen(s) would at least partially attenuate the asthmatic phenotype and modulate the aberrant immune response. In phase I, cats sensitized to Bermuda grass allergen (BGA), house dust mite allergen (HDMA) or placebo received BGA RIT. In phase II, cats dually sensitized to BGA and HDMA received RIT using BGA, HDMA or placebo. Efficacy of RIT was assessed using percentage bronchoalveolar lavage fluid (BALF) eosinophils. Additionally, a variety of immunologic assays were performed. Eosinophilic airway inflammation significantly decreased over time in asthmatic cats given RIT using sensitizing allergen or unrelated allergen (P<0.001). In dually sensitized cats, single allergen RIT but not placebo reduced airway eosinophilia (P=0.038). Differences in allergen-specific lymphocyte proliferation, in the number of IL-10 producing cells and in the percentage T regulatory cells were detected between asthmatic cats getting RIT and controls. Cross-protection manifested by reduced airway eosinophilia was noted in cats treated with RIT allergens which did not completely match allergen used in asthma induction. However, the mechanism of immunologic tolerance may differ when improperly matched allergens to the sensitizing allergens are used in RIT.

The impact of oral versus inhaled glucocorticoids on allergen specific IgE testing in experimentally asthmatic cats.

Glucocorticoids (GCs) are palliative for allergic asthma, but allergen-specific immunotherapy (ASIT), which relies on identification of allergens, represents a potentially curative treatment. The purpose of this study was to determine if oral or inhaled GCs would interfere with identification of sensitizing allergens. The hypothesis was that oral but not inhaled GCs would interfere with accurate allergen-specific IgE identification determined by skin and serum testing in experimentally asthmatic cats. Asthma was induced in 18 cats using Bermuda grass allergen (BGA). Cats (n=6/group) were randomized to receive oral GCs (10mg prednisolone q 24 h), inhaled GCs (600 µg budesonide q 24 h) or placebo (q 24 h PO) for one month. Intradermal skin testing (IDST) and serum BGA-specific IgE were measured prior to, during and after treatment. A paired t test was used to compare groups pre- and post-treatment (P<0.05 significant). IDST reactivity was eliminated in 4/6, 3/6, and 1/6 cats receiving oral GCs, inhaled GCs, and placebo respectively. Two weeks after stopping treatment, IDST was again positive in all cats. Serum IgE reactivity to BGA was not significantly diminished by any treatment. In conclusion, a two-week withdrawal from GCs is adequate for IDST, but may not be necessary for serum IgE testing.

Endotracheal nebulization of N-acetylcysteine increases airway resistance in cats with experimental asthma.

N-acetylcysteine (NAC), a mucolytic and antioxidant, is speculated to cause bronchoconstriction in cats when delivered via aerosol. We hypothesized that in cats with experimental asthma, aerosol delivery of NAC (400mg cumulative dose) via an endotracheal tube would increase airflow limitation as measured by ventilator-acquired mechanics. After endotracheal drug delivery, airway resistance and inspiratory plateau pressure (Pplat) measurements were obtained in six mechanically ventilated asthmatic cats. Results demonstrated significantly increased airway resistance (P=0.0007) compared with aerosolized saline control; Pplats were not significantly different (P=0.059). All cats exhibited at least one adverse effect: excessive airway secretions (n=3), spontaneous cough (n=2), unilateral strabismus (n=1) and post-anesthetic death (n=1). No adverse reactions were noted with saline aerosol; cough was noted in one cat with methacholine challenge. In conclusion, airway resistance and adverse reactions were documented in all cats after NAC aerosol delivery. Further studies must be performed to evaluate if it is an effective mucolytic and/or antioxidant in cats and to determine if bronchodilator pre-treatment will negate NAC-induced bronchoconstriction.