Long-term use of lokivetmab in dogs with atopic dermatitis.

BACKGROUND: Lokivetmab, a caninised monoclonal antibody against interleukin (IL)-31, is an effective treatment for the pruritus associated with canine atopic dermatitis (cAD). OBJECTIVES: To investigate the efficacy and safety of lokivetmab during long-term treatment defined as at least three consecutive lokivetmab injections in atopic dogs under field conditions. To assess individual factors influencing treatment outcome and adverse events. ANIMALS: 150 dogs with cAD. MATERIALS AND METHODS: Medical records of dogs treated with lokivetmab were reviewed, and owners and/or veterinarians were contacted as needed for follow-up. A decrease of the pruritus Visual Analog Scale (PVAS) score by ≥2 or a PVAS score ≤2 after treatment was considered as treatment success. Logistic regression was used to investigate the influence of a variety of factors on outcome: type of cAD (food versus environment), age at first lokivetmab administration, disease chronicity, dosage and/or secondary infection. Any adverse event that occurred during the study period was recorded. RESULTS: Lokivetmab reduced the PVAS score with long-term use (p < 0.01); the success rate was 53 of 69 total dogs (77%). The probability of treatment failure decreased with increasing treatment duration. None of the factors investigated influenced the treatment outcome. Twelve dogs of 150 (8%) showed adverse events such as gastrointestinal signs or lethargy. CONCLUSION AND CLINICAL RELEVANCE: Lokivetmab appears to be an effective and safe long-term anti-itch therapy for dogs with cAD.

Evaluation of hypochlorous acid as an ear flush in dogs with chronic otitis externa.

BACKGROUND: Chronic otitis externa (OE) in dogs frequently requires anaesthetised ear flushing. OBJECTIVES: To evaluate hypochlorous acid as an ear flushing and antimicrobial agent in dogs with chronic OE. ANIMALS: Twenty dogs with chronic OE caused by the same organisms bilaterally. MATERIALS AND METHODS: One ear was flushed under anaesthesia with hypochlorous acid, the other with saline solution. Subsequently, the ear flushed with hypochlorous acid was cleaned with the same solution twice daily for 2 weeks, the other ear with a commercial ear cleaner. An ear medication containing miconazole, polymyxin B and prednisolone was used once daily in both ears. Clinical scores were determined before the flush. Ear cytological results were obtained, a hearing test was conducted before and after the ear flush, and a culture was taken directly after flushing. Ears were evaluated after 2 weeks of therapy. RESULTS: Yeast was present in the ears of 11, cocci in one and a mixed infection in eight dogs. Five ears were negative on culture after flushing with hypochlorous acid, one after the saline flush. Clinical and cytological scores decreased significantly with both solutions after 2 weeks of treatment. There was no difference between treatments in any of the scores at any time point between treatments and in the results of the hearing test before and after the flushing procedure. Adverse effects were not seen. CONCLUSIONS AND CLINICAL RELEVANCE: Hypochlorous acid is a suitable cleaning solution for canine OE.

A randomised, double-blinded comparison between subcutaneous rush and intralympathic allergen immunotherapy induction in atopic dogs.

BACKGROUND: Atopic dermatitis (AD) is one of the most common skin diseases in small animal practice. Allergen immunotherapy (AIT) is the only curative treatment for the disease, and oral, subcutaneous and intralymphatic administration of allergens are commonly employed. OBJECTIVES: To compare the efficacy of AIT following an induction phase with intralymphatic injections (ILIT) or rush immunotherapy (RIT). ANIMALS: Fifty privately owned dogs with AD. MATERIALS AND METHODS: In a double-blinded study, dogs were randomly assigned to either four monthly ILIT of allergen extract or RIT with five injections administered subcutaneously at hourly intervals on the first day. They were assessed by validated scores; Canine Atopic Dermatitis Lesion Index (CADLI) and pruritus Visual Analog Scale (PVAS) at the beginning of the study and after 1, 3, 6 and 12 months. The latter were performed daily for 7 days before each revisit. Medication scores and a total clinical score were calculated and compared between each group and time point. RESULTS: There was no significant difference in CADLI and PVAS scores, or CADLI and medication scores between groups at any of the time points. A significant improvement with both ILIT and RIT was seen in total and pruritus scores, respectively. An owner global assessment of good-to-excellent treatment efficacy was seen in 40% of the dogs; total scores improved by 27% and 35% in the RIT and ILIT group, respectively. Adverse effects were not seen. CONCLUSIONS AND CLINICAL RELEVANCE: Induction of AIT can be conducted either as RIT or ILIT with no loss in efficacy.

Cross-reactive carbohydrate determinants in atopic and healthy dogs and their influence on allergy test specificity.

BACKGROUND: The selection of allergens for immunotherapy in atopic dogs is often based on serum allergy testing. Cross-reactive carbohydrate determinants (CCDs) are common structures in plant and insect allergens that reportedly induce polysensitisation, reduce agreement between intradermal and serum tests and complicate allergen selection. METHODS: Thirty-four dogs with diagnosed atopic dermatitis and 10 healthy dogs were included in the study. An intradermal test was conducted in atopic dogs, and serum samples from allergic and healthy dogs were analysed for allergen-specific immunoglobulin E (IgE) before and after inhibition of detectable anti-CCD-IgE antibodies. RESULTS: Anti-CCD-IgE antibodies were not found in any of the healthy dogs and no polysensitisation to plant and insect allergens was detected. The agreement between intradermal and serum allergy test results in the atopic dogs with anti-CCD-IgE antibodies improved from slight to fair after blocking the anti-CCD-IgE antibodies. In addition, blocking clearly reduced polysensitisation to plant allergens but not to acarid allergens. LIMITATIONS: Only a limited number of healthy dogs were tested in this study. A gold standard for determining the clinical relevance of IgE sensitisation does not exist. CONCLUSION: Inhibition of anti-CCD-IgE antibodies seems to be of importance to improve serum test specificity for allergen-specific IgE in atopic dogs in relation to intradermal allergy testing.