Preliminary study of the stability of dexamethasone when added to commercial veterinary ear cleaners over a 90 day period.

BACKGROUND: Topical corticosteroids are commonly used in the management of allergic otitis externa to diminish inflammation. A common strategy is to make compounded solutions of dexamethasone in ear cleaner. HYPOTHESIS/OBJECTIVES: The objective of this study was to determine the stability of dexamethasone when added to four commercial ear cleaners (ec): designated ecA, ecB, ecC and ecD. METHODS AND MATERIALS: Two concentrations (0.1 and 0.25 mg/mL) of dexamethasone were formulated for each cleaner solution from a 2 mg/mL solution and stored in the original manufacturers' bottles at two temperatures: room (22 ËšC) and refrigerated (4 ËšC). Samples were evaluated in triplicate, using liquid chromatography-tandem mass spectrometry at 10 time points over 90 days. The mean and standard deviation were calculated for each time point. RESULTS: A solution was considered stable if the dexamethasone value remained >90% of the target concentration. All dexamethasone solution values were stable to 90 days, except two solutions for ecA; the 0.25 mg/mL dexamethasone concentration was only stable to 14 (4 ËšC) and 21 days (22 ËšC). CONCLUSIONS AND CLINICAL IMPORTANCE: These results provide preliminary evidence in support of pharmaceutical stability data for dexamethasone when included in the above compounded solutions at the noted concentrations and temperatures.

Open trial of Bruton's tyrosine kinase inhibitor (PRN1008) in the treatment of canine pemphigus foliaceus.

BACKGROUND: Bruton's tyrosine kinase (BTK) is important in B-cell signalling. Efficacy has been reported for BTK inhibitors (BTKi) in human autoimmune diseases. Canine pemphigus foliaceus (cPF) is one of the most common canine autoimmune skin diseases. OBJECTIVES: To determine the safety and efficacy of the BTKi PRN1008 in the treatment of cPF. ANIMALS: Four privately owned dogs. METHODS AND MATERIALS: Four dogs diagnosed with PF were administered BTKi PRN1008. Initial dosages approximated to 15 mg/kg once daily, increased to twice daily if inadequate response was seen. Treatment continued for 20 weeks, attempting to decrease to every other day. Dogs were monitored with complete blood counts, serum biochemistry panels and urinalyses, and evaluated with a modified version of a validated human Pemphigus Disease Activity Index (cPDAI). Serum anti-desmocollin-1 (DSC-1) and desmoglein-1 (DSG-1) immunoglobulin (Ig)G titres were performed before and after the treatment period. Drug bound to target was measured in peripheral blood mononuclear cells (PBMC). RESULTS: All four dogs showed reduction in lesions and cPDAI score during the first two weeks of treatment. Three dogs continued to improve and sustained near complete remission by 20 weeks, at which point three responses were considered "good" and one "fair". Final daily dosages were in the range 17-33 mg/kg. Anti-DSC-1 IgG titre decreased dramatically in one dog, was undetectable in two and was uninterpretable in one dog. No dogs had detectable IgG to DSG1. A possible adverse event occurred in one dog. CONCLUSIONS AND CLINICAL IMPORTANCE: BTKi PRN1008 monotherapy may have some beneficial effects in some cases of cPF.

A case of atypical multifocal nodular eosinophilic dermatosis in a Labrador retriever dog.

BACKGROUND: A dog with gastrointestinal signs and a history of administration of multiple drugs developed acute multifocal to coalescing ulcerative nodules and a large plaque. OBJECTIVE: To describe abnormal nodular clinical lesions with an unexpected superficial and deep severe eosinophilic perivascular to interstitial inflammation. ANIMAL: A 7-year-old spayed female Labrador retriever METHODS AND MATERIALS: Blood tests, faecal and urinalysis, and abdominal radiographs were performed; skin biopsy samples were taken for cytological, culture and histopathological analyses. RESULTS: The blood tests, faecal, urinalysis and radiographs were within normal limits. Cytological results revealed inflammatory cells and cultures had no growth. Histopathological evaluation revealed dermal and subcutaneous oedema, mucin deposition and perivascular to interstitial inflammation predominated by eosinophils with occasional very small intralesional dense aggregates of eosinophils centred on collagen bundles, eosinophilic exocytosis and small eosinophilic pustules. Focal subepidermal fibrin exudation and haemorrhage resulted in epidermal detachment and ulceration. Clinical resolution of the dermatological and gastrointestinal signs was seen with the withdrawal of prior medications and administration of a tapering course of anti-inflammatory doses of prednisolone. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is a novel nodular clinical and eosinophilic histopathological pattern combination. This case offers evidence of a spectrum of sterile eosinophilic dermatoses rather than multiple different disease processes.