Clinical relevance of intradermal test results in atopic dogs.

TOPIC AND AIMS: Canine atopic dermatitis (AD) is an inflammatory and pruritic skin disease and in most cases associated with IgE antibodies against environmental allergens. To date, the only causative therapeutic option is allergen immunotherapy (AIT). Offending allergens for AIT can be identified by intradermal testing (IDT) or serum allergen-specific IgE testing. The aim of the study was to evaluate positive IDT results considering the atopic dogs' clinical history. MATERIAL AND METHODS: An IDT was performed on 48 atopic dogs and their owners completed a detailed questionnaire about the seasonal course of their pruritus. Results of IDT were correlated with the seasonal occurrence of pruritus. RESULTS: The most common positive IDT reactions were observed to mite allergens (33.3-62.5 %). Prevalence of positive reactions to individual tree, grass and weed pollen ranged between 8.3 % and 25 %. Moulds and epithelial allergens produced positive reactions in only 0-6.3 %. A correlation between positive IDT reactions and course of pruritus could neither be found for perennial nor for seasonal allergens. CONCLUSION: The evaluation of IDT reactions may not be an optimal method for identification of clinically relevant allergens in canine AD. CLINICAL RELEVANCE: The results of this study emphasise the importance of considering clinical history in addition to allergy test results in the formulation of an allergen extract for desensitisation.

Morphological diagnosis and successful treatment of chorioptic mange in 2 South American coatis (Nasua nasua).

Two female South American coatis (Nasua nasua) kept in a zoo in Southern Germany presented with pruritus and moderate hair loss at the dorsal trunk, thigh areas and alongside the tail. Otherwise the animals showed no clinical signs. While the clinical general examination as well as cytology of dermatologic samples showed no pathologic changes, Chorioptes sp. mites could be identified in a superficial skin scraping. Two consecutive topical applications of a selamectin/sarolaner spot-on formulation 4 weeks apart lead to a complete resolution. No side effects were observed.

Clinical effects of 2 commercially available diets on canine atopic dermatitis.

OBJECTIVE: Canine atopic dermatitis (CAD) is a common skin disease in dogs. Prior studies were able to determine beneficial effects of essential fatty acids (EFA) on the clinical signs of CAD. The aim of this study was set to evaluate the effects of a newly designed, EFA-enriched diet on the clinical signs of CAD compared to another EFA-enriched diet. MATERIALS AND METHODS: In this prospective, randomized, double-blinded study, 31 privately owned dogs with atopic dermatitis received either the control diet (diet A, Hill's Prescription Diet™ d/d™ Salmon & Rice, n = 17) or the test diet (diet B, Veterinary HPM™ Dermatology Support D1, Virbac, n = 14) for 12 weeks. At the beginning of the study as well as after 4, 8 and 12 weeks, skin lesions and pruritus were evaluated via validated scores and the administered medication was documented. At the same time, the dogs' coat quality was evaluated via a distinct scoring system. In both groups, a total of 7 dogs each completed the entire study. RESULTS: After 12 weeks, there was a mild improvement in lesion scores, pruritus and coat quality with both diets. CLINICAL RELEVANCE: In this study, both diets improved the patients' skin lesions pruritus and coat quality.

Topical treatment of multiple erosive, ulcerative skin lesions in an Indian rhinoceros (Rhinoceros unicornis).

A 30-year-old, intact female Indian rhinoceros (Rhinocerus unicornis) was presented with ongoing erosive, ulcerative skin lesions over a 4-year-period. The lesions appeared to be non-pruritic and non-seasonal. A systemic antibiotic therapy had been unsuccessful. The dermatological examination showed 8 diffusely demarcated areas of erosion, focal ulceration, mild crusting, and moderate erythema ranging from 8 to 20 cm in diameter, bilaterally on the lateral edges of the torso armor plates. The patient had no other clinical abnormalities. Coccoid and rod-shaped bacteria were identified on cytology and a bacterial culture revealed Escherichia coli spp., Staphylococcus dysgalacticae, Stenotrophomonas maltophilia, Corynebacterium spp. and Micrococus spp. A topical product line containing essential fatty acids and plant extracts was administered daily, using a spot-on, spray and balm. Within 3 weeks a substantial alleviation of clinical signs was observed. Multiple impression smears of the lesions and a bacterial culture were negative by day 21. The patient achieved complete remission within 4 months of treatment and maintained remission for the 2-year observation period with continued use of the medication. Topically administered therapeutics containing essential fatty acids and plant extracts may offer a viable treatment option for recurrent cases of bacterial infectious skin lesions in Indian rhinocerotidae.

A case series of canine cutaneous inverted papilloma with one case showing evidence of recurrence.

BACKGROUND: This article describes a case of multiple, recurrent, cutaneous inverted papillomas (CIPs) in a German shepherd dog, combined with a retrospective follow-up assessment of eight cases. METHODS: A 3-year-old, black, female German shepherd dog presented with four rapidly growing, alopecic, domed, hyperpigmented, shiny nodules, compatible with CIP. The dog was managed for pruritus, associated with atopic dermatitis, with long-term prednisolone therapy and this therapy was continued after the surgical excision. Twelve months after the initial presentation the dog was represented for two new CIP lesions, coinciding with an increased dosage of prednisolone during an allergic flare-up period. RESULTS: Histopathological evaluation was conducted on both the original and subsequent lesions from the case with recurrence. Eight cases of CIP, based on histopathological findings, were identified retrospectively from the authors' diagnostic pathology service over the previous two years. All nine cases had lesions that exhibited varying degrees of inverted epithelial hyperplasia, multiple, endophytic, papillary epidermal projections, a cup-shaped base with central hyperkeratosis and active viral pathological findings (koilocytes). The submitting veterinarians were contacted and follow-up regarding recurrence and concurrent medications was obtained. CONCLUSIONS AND CLINICAL IMPORTANCE: CIP is uncommonly reported, typically as a single lesion with no previous reports of recurrence, although one group of dogs with severe combined immunodeficiency developed invasive malignancies. In seven of eight retrospective cases no recurrence of CIP was recorded. The authors speculate that the recurrence in the German shepherd dog may have been associated with chronic (although low-dose) glucocorticoid administration.

Recurrent polyp formation with Candida tropicalis infection and otitis in a dog.

To describe a case of a recurrent Candida tropicalis otitis externa, media and interna in a dog with an ear polyp. A 9-year-old Irish Setter was presented with 2 episodes of otitis sinistra, left-sided vestibular syndrome and Horner syndrome 7 months apart. At the first episode a benign ear polyp was extracted and Candida tropicalis cultured from the left middle ear. The neurological signs disappeared within 7 days, the Candida infection was more difficult to treat. Seven months later, a polyp was found in the ear again and cytology was consistent with Candida tropicalis. A unilateral left total ear canal ablation with lateral bulla osteotomy was performed and a middle ear culture confirmed Candida tropicalis. Treatment led to resolution of clinical signs. Candida tropicalis, an emerging pathogen, should be considered in cases of recurrent yeast otitis and may be difficult to treat.

[Effects of a homeopathic medication on clinical signs of canine atopic dermatitis]. / Wirkung eines homöopathischen Arzneimittels auf die klinische Symptomatik von Hunden mit atopischer Dermatitis.

OBJECTIVE: A commercially available medication containing homeopathic ingredients showed first signs of success in atopic dermatitis in dogs. The aim of this case series was to evaluate the effect of the preparation in a larger number of dogs with atopic dermatitis. MATERIAL AND METHODS: Ten atopic dogs received the oral homoeopathic combination preparation daily for 3 weeks according to the manufacturer's specifications. The diagnosis of atopic dermatitis was made previously by medical history, clinical examination and exclusion of differential diagnoses. Skin infections with bacteria and yeasts were excluded by clinical examination and cytological evaluation of impression smears. In food-allergic dogs, an elimination diet was fed at least 2 months prior and during the entire study period. Patients with suspected or confirmed flea allergy received flea control for at least 1 month prior to and during the study. The clinical signs were evaluated before and after therapy using a validated Pruritus Visual Analogue Acale (PVAS) and the Canine Atopic Dermatitis Lesion Index (CADLI). The coat quality was assessed by the owners. Possible adverse effects were recorded at the recheck. RESULTS: There were no significant changes in the lesion score (Wilcoxon test, p = 1.0), pruritus score (paired t test, p = 0.34) and coat quality (paired t test, p = 0.34) over the duration of treatment. Only one patient showed a slight improvement in itching and coat quality. No side effects were observed. CONCLUSION AND CLINICAL RELEVANCE: In this case series, the tested homoeopathic preparation did not show a positive effect on the clinical signs of canine atopic dermatitis.

Successful treatment of a mucous membrane pemphigoid in a young dog.

Mucous membrane pemphigoid was diagnosed in a 2.5-year-old male intact foxhound-beagle cross which was presented with an acute onset of non-pruritic, multifocal, slowly progressive erosive-ulcerative dermatitis predominantly affecting the nasal planum, eyelids and muzzle with multiple vesicles on the inner pinnae, oral mucosa and tongue. The diagnosis was based on clinical signs and histological examination of skin biopsies. The patient did not respond to immunosuppressive prednisolone therapy, but went into complete remission with oral doxycycline and niacinamide and stayed in remission on long-term exclusive niacinamide treatment.

[Successful treatment of a mucous membrane pemphigoid in a young dog]. / Erfolgreiche Behandlung eines mukokutanen Pemphigoids bei einem jungen Hund.

Mucous membrane pemphigoid was diagnosed in a 2.5-year-old male intact foxhound-beagle cross which was presented with an acute onset of non-pruritic, multifocal, slowly progressive erosive-ulcerative dermatitis predominantly affecting the nasal planum, eyelids and muzzle with multiple vesicles on the inner pinnae, oral mucosa and tongue. The diagnosis was based on clinical signs and histological examination of skin biopsies. The patient did not respond to immunosuppressive prednisolone therapy, but went into complete remission with oral doxycycline and niacinamide and stayed in remission on long-term exclusive niacinamide treatment.

Agreement of serum allergen test results with unblocked and blocked IgE against cross-reactive carbohydrate determinants (CCD) and intradermal test results in atopic dogs.

BACKGROUND: Tests for allergen-specific immunoglobulin E (IgE) are used to select allergens for immunotherapy in atopic dogs. Antibodies against cross-reactive carbohydrate determinants (anti-CCD IgE) have been identified in serum samples of atopic dogs. Their presence in humans is a known cause of clinically irrelevant polysensitization to plant allergens. OBJECTIVES: To compare the results of an intradermal test (IDT) and a serum test for allergen-specific IgE, with and without blocking anti-CCD IgE, before testing in dogs. ANIMALS: Thirty-one privately owned dogs with atopic dermatitis. METHODS AND MATERIALS: Dogs were prospectively skin tested and their serum samples were analysed for anti-CCD IgE. An Fc-ε receptor-based serum test for allergen-specific IgE was performed with and without blocking anti-CCD IgE. RESULTS: In dogs with negative anti-CCD IgE samples, the agreement between the results of the serum test and the IDT was substantial (κ = 0.71). Dogs with positive anti-CCD IgE samples (38.7%) showed no agreement between serum and skin testing (κ = -0.35), blocking anti-CCD IgE in those samples resulted in a fair agreement (κ = 0.43). Anti-CCD IgE positive sera had multiple positive results for grass and weed allergens, and blocking decreased them markedly. CONCLUSION AND CLINICAL IMPORTANCE: Intradermal testing agreed best with serum testing in dogs with no detectable anti-CCD IgE. Sera containing anti-CCD IgE had no agreement with IDT. Test agreement was improved by blocking the anti-CCD IgE. Apparent serum test polysensitization to plant allergens was associated with anti-CCD IgE.

Effect of an insect protein-based diet on clinical signs of dogs with cutaneous adverse food reactions. / Effekt eines Insektenprotein-basierten Futters auf die Symptomatik von futtermittelallergischen Hunden.

OBJECTIVE: Edible insects (like mealworms, locusts and crickets) contain energy, protein, fatty acids, minerals and trace elements and have been found to be high quality food sources. They could provide a new food source for patients with adverse food reactions, as well as being of ecological and ethical interest. The aim of this study was to evaluate the effect of a new commercially available, insect protein-based diet on the clinical signs in those dogs via Canine Atopic Dermatitis Lesion Index (CADLI), Pruritus Visual Analogue Scale (PVAS) and coat quality score. MATERIALS AND METHODS: A total of 20 dogs with atopic dermatitis due to previously diagnosed adverse food reaction were included in this study. This food was the only food fed to the patients for 2 weeks. RESULTS: The lesion score improved in 12 out of 20 dogs in. Only two dogs out of 15, which completed the study, showed mild deterioration of their lesions (on average by 1.5 CADLI points). One dog's skin lesions were unchanged. Pruritus could be reduced in eight patients but remained unchanged in four dogs. Two further patients deteriorated minimally (on average by 1.5 pruritus score points) and one dramatically (8 pruritus score points). The coat quality was only evaluated in 14 dogs. Six of 14 dogs showed an improvement in coat quality. The improvement of the lesion scores (Wilcoxon test, p = 0.007) and coat quality (Wilcoxon test, p = 0.01) was significant, there was no significant change in pruritus scores (p = 0.53). The palatability was very good the compatibility was except for one patient very good. CONCLUSION AND CLINICAL RELEVANCE: Based on these results, the investigated insect protein-based diet is an interesting alternative for dogs with food intolerance.

Vitamin D shows in vivo efficacy in a placebo-controlled, double-blinded, randomised clinical trial on canine atopic dermatitis.

Atopic dermatitis (AD) in dogs is among the most common skin diseases in small animal practice. It is an inflammatory disease based on a genetic predisposition to develop hypersensitivity against environmental and food allergens and typical clinical signs up exposure. Treatment sometimes can be difficult and associated with adverse effects. Previous studies evaluating cholecalciferol as treatment for human AD have shown promising results. With canine AD being a good animal model for its human counterpart, it was hypothesised that cholecalciferol might have beneficial clinical effects in dogs, too. In this randomised, placebo-controlled, double-blinded eight-week cross-over study, 23 client-owned dogs received either systemic cholecalciferol (n=16), a vitamin D receptor analogue (n=8) or placebo (n=13). Blood samples for ionised calcium were obtained regularly during the study, and Canine Atopic Dermatitis Extent and Severity Index and pruritus scores, blood levels of vitamin D metabolites, measurements of skin pH and transepidermal water loss were determined before and after. Pruritus and lesion scores decreased significantly in the cholecalciferol group versus placebo. No differences in water loss or skin pH were observed. An increase in serum 25-hydroxycholecalciferol strongly correlated with a reduction in pruritus. Systemic cholecalciferol may be a viable treatment option for canine AD.

[Targeting the skin - erythema multiforme in dogs and cats]. / Die Haut als Zielscheibe ­ Erythema multiforme bei Hund und Katze.

This review article will describe the complex nature of erythema multiforme in dogs and cats. The disease pattern will be illustrated in terms of etiology, pathogenesis, clinical signs, diagnostics and therapy. Erythema multiforme is a rare, immune-mediated skin disorder with an acute specific reaction pattern of skin and mucous membranes against different underlying causes. Reported triggering factors include drugs, food ingredients and neoplasias, but viral or bacterial infections and vaccine reactions were also identified. In over 20% of the cases the cause cannot be identified. The German Shepherd dog and Pembroke Welsh Corgi seem to be predisposed. Erythematous macules, slightly elevated and peripherally spreading papules as well as circular to arciform patterns were described frequently in the dog. Wheals, plaques, vesicles and bullae that develop into ulcers, are also seen. Frequently affected areas in the dog are the ventrum, mucocutaneous junctions, mouth, pinnae and foot pads. Histopathological findings include single cell necrosis in all layers of the epidermis with lymphocytic satellitosis and a cell-poor interface dermatitis. Elimination of the causative factors and concurrent symptomatic therapy are recommended. The prognosis varies from guarded to fair, depending on the underlying cause, presenting clinical signs and response to therapy.

Cutaneous alternariosis in an immunocompromised dog successfully treated with cold plasma and cessation of immunosuppressive medication.

A cutaneous infection with Alternaria spp. was diagnosed in a 2-year-old male intact Irish setter dog, presenting with multifocal papules, plaques and ulcerations involving all four distal limbs, shoulder blades, scrotum, pinnae and nasal mucous membranes. The dog had been treated for inflammatory bowel disease and lymphangiectasia with immunosuppressive doses of cyclosporine and prednisolone for approximately 3 months. The diagnosis was based on clinical signs, the demonstration of fungal elements within skin biopsies, deep fungal culture and fungal PCR from a formalin-fixed tissue specimen. Complete clinical remission was achieved by tapering and cessation of the immunosuppressive medication, treatment with cold atmospheric-pressure plasma (CAPP) and topical enilconazole within 8 weeks.