Veterinary dermatology最新文献

Background: Split paw pad dermatosis (SPPD) in dogs is characterised clinically by horizontal splitting and peeling of the paw pads with frequent recurrence. There is currently no published study characterising the history, clinical signs and management of the disease.

Objectives: To gather clinical information on affected dogs, including: signalment, possible risk or predisposing factors, disease progression and response to therapy.

Material and methods: Retrospective questionnaire-based evaluation of client-owned dogs.

Results: Fourteen dogs were included with histologically compatible paw pad biopsies. The most frequent presenting signs were pain, lameness, pruritus and licking, and in most dogs, all four paws were affected during the course of the disease. Eight of 13 (61%) of dogs weighed > 20 kg (mean 24.6 kg, median 28 kg). Of the 14 dogs, three were German shepherd dogs, five had a seasonal occurrence, and four had concurrent canine atopic dermatitis. No single treatment was effective in preventing relapses, although a small subgroup responded to anti-inflammatory medication. Supportive paw pad-protective measures showed positive results in some dogs.

Conclusions and clinical relevance: The collected information failed to identify a single factor contributing to the development of SPPD. Clinicians should therefore investigate multiple aetiologies, including hypersensitivity diseases, excessive shearing force movement, moisture, heat, seasonality and excessive weight. Treatment supportive of the skin barrier may be of benefit. Owing to the substantial variability of characteristics in this study, we propose to change the term to split paw pad dermatosis.

Background: Canine leishmaniosis (CanL) due to Leishmania infantum remains common, and veterinarians do not always follow scientifically sound approaches for diagnosis, treatment and prevention.

Objectives: To provide consensus guidelines for diagnosis and evidence-based guidelines for treatment and prevention of CanL.

Methods and material: Clinical consensus guidelines for the diagnosis were structured based on literature and authors' experience. Three electronic databases were searched for randomised controlled trials, systematic reviews and meta-analyses on treatment and prevention.

Results, conclusions and clinical importance: Diagnosis should be based on compatible clinical signs and/or clinicopathologic abnormalities, exclusion of differentials, demonstration of infection and increased concentration of anti-Leishmania IgG (quantitative serology). Euthanasia for public health purposes is not recommended and drugs with anti-Leishmania activity should be avoided in subclinically infected dogs. Recommended treatments include meglumine antimoniate-allopurinol (first-line treatment), miltefosine-allopurinol (first-line treatment) and aminosidine-allopurinol (second-line treatment); marbofloxacin may be considered in dogs with advanced chronic kidney disease. In endemic areas, recommended measures for prevention include deltamethrin 4% collar, flumethrin 4.5%-imidacloprid 10% collar or permethrin 50%-imidacloprid 10% spot-on, not using infected blood products for transfusion, not breeding seropositive bitches or dogs with CanL, administration of domperidone (seronegative dogs) and dietary nucleotides-active hexose correlated compound (subclinically infected, seropositive dogs). Vaccination with LiESP with MDP may be considered, whereas protein Q vaccine is recommended in areas with very high rates of seroconversion. In non-endemic areas, recommended measures include not using infected blood products for transfusion and removal of infected female dogs from reproduction.

Background: Cutaneous toxic shock syndrome (CTSS), attributed to staphylococcal and streptococcal exotoxins, causes diffuse erythroderma and peripheral oedema with fatal systemic complications. In human medicine, a published list of scoring criteria exists where higher scores correlate with an increased likelihood of CTSS.

Objectives: To describe clinical and clinicopathological findings in canine CTSS and to determine the validity of the human TSS criteria score in dogs.

Animals: Seven client-owned dogs were treated at two veterinary teaching hospitals between 2003 and 2023.

Methods: Dogs with histopathological lesions of coalescing panepidermal cytotoxic dermatitis with neutrophilic satellitosis were included.

Results: Diagnosis was made antemortem in four of seven and postmortem in three of seven. Prodromal clinical signs included lethargy (seven of seven), vomiting and/or diarrhoea (three of seven) and inappetence (three of seven). Primary skin lesions included diffuse erythroderma (seven of seven), ventral oedema (seven of seven), distal limb oedema (six of seven) and vesicles/bullae of the concave pinnae (three of seven), ventrum (one of seven) and perianally (one of seven). Clinicopathological changes included anaemia (seven of seven), neutropaenia (two of seven), neutrophilia (five of seven), hypoalbuminaemia (seven of seven), thrombocytopaenia (seven of seven), increased liver enzymes (six of seven) and azotaemia (four of seven). Blood cultures were negative in five of five dogs and the source of infection was not identified in any dog. Five of seven dogs died or were euthanised and had higher scores using human criteria than the remaining two dogs; these two survived with supportive care and antibiotics.

Conclusions and clinical relevance: CTSS should be a differential diagnosis in dogs with the above prodromal signs before sudden onset of erythroderma, because early diagnosis is critical to survival. The human TSS criteria score could aid in earlier detection of canine CTSS.

Background: Chronic cases of canine otitis externa (OE) often develop infections with Pseudomonas aeruginosa (PA). Given the organism's high level of resistance, veterinary surgeons often turn to compounded solutions. Limited data describing the stability and potency of compounded ceftazidime (CAZ) solutions are available, which may affect clinical outcome.

Hypothesis/objectives: To evaluate the chemical stability of compounded glycerin (GLY) and dexamethasone sodium phosphate (DEX-SP) CAZ solutions in three different storage temperatures over a 60-day period. Based on previous evaluations, CAZ concentrations would decrease with increased temperature and time.

Materials and methods: Ceftazidime was compounded at 10 mg/mL with 100 mL 0.9% sodium chloride (NA + CAZ), 100 mL glycerin +0.9% sodium chloride (GLY + CAZ) and 100 mL dexamethasone sodium phosphate +0.9% sodium chloride (DEX-SP + CAZ), stored at -20°C, 4°C and 25°C for 60 days. Mass spectrometry was used to analyse CAZ stability at specific time points (Day[D]0, D7, D14, D28, D60).

Results: Chemical stability of CAZ concentrations was affected by storage time, temperature and diluent. CAZ concentrations decreased over time with increased temperature; frozen CAZ concentrations remained stable over time for all solutions.

Conclusions and clinical relevance: Compounded CAZ stability varies by diluent, storage temperature and storage duration. NA + CAZ and DEX-SP + CAZ solutions are stable for ≤ 28 days refrigerated and retain potency for ≥ 60 days if stored frozen. These solutions offer alternative options for treatment of PA OE.

Background: Inhibition of the Janus kinase pathway is an established treatment for allergic dermatitis.

Objective: To evaluate the efficacy and safety of ilunocitinib for control of pruritus in dogs with allergic dermatitis in a randomised, double-masked clinical trial.

Animals: Three-hundred-and-six dogs at 15 veterinary clinics.

Materials and methods: Enrolled client-owned dogs with severe pruritus and a presumptive diagnosis of allergic dermatitis were randomised to receive either ilunocitinib (n = 206; 0.6-0.8 mg/kg) or placebo (n = 100; 0 mg/kg) once daily for 28 days. Pruritus was assessed by owners using a pruritus Visual Analog Scale (PVAS). Treatment success was defined as ≥ 50% reduction from baseline PVAS on at least five of seven initial treatment days. Clinical remission from pruritus was considered achieved when PVAS < 2. Safety assessments were conducted over 112 days.

Results: On Day (D)7, 25.4% of ilunocitinib-treated dogs achieved treatment success compared to 7.7% of placebo dogs (p = 0.006). Starting on D3, the proportion of dogs with a ≥ 50% reduction from baseline PVAS was significantly higher in the ilunocitinib group (p < 0.01) and by D28, a significantly higher percentage of ilunocitinib-treated dogs (51.8%) achieved clinical remission compared to placebo dogs (12.7%; p < 0.05). Signs of dermatitis improved within 7 days. The 112-day ilunocitinib treatment was well-tolerated.

Conclusions and clinical relevance: Ilunocitinib administered once a day was well tolerated and effective at rapidly reducing pruritus, with steady and continuous improvement over time. Clinical remission of pruritus was achieved by 51.8% of ilunocitinib-treated dogs by D28, regardless of allergic aetiology.

Background: Diagnosing sarcoptic mange in dogs can be challenging because the clinical signs overlap with those of other pruritic conditions. Entodermoscopy has emerged as a promising technique for the rapid confirmation of suspected scabies mite infestation.

Objective: To describe the dermoscopic features of sarcoptic mange in a dog.

Animals: A dog with sarcoptic mange was examined via dermoscopy after skin scraping confirmation.

Results: Distinctive dermoscopic features included: the mite-gallery unit (MGU) and specific mite structures, such as characteristic 'Δ'-shaped gnathosomes, eggs and burrows. Stercoraceous bullets, wake signs and grey-edged line signs also were observed. Polarised and non-polarised light exhibited distinct diagnostic capabilities. Digitally enhanced dermoscopy provided additional details.

Conclusions and clinical relevance: The MGU describes the anatomical and functional aspects of scabies mites as epidermal parasites and qualifies dermoscopy as a non-invasive diagnostic tool.

Background: Pre-consultation client-completed history questionnaires are used in veterinary dermatology to improve consultation efficiency. The agreement between such a questionnaire and verbal history has not been evaluated.

Objectives: To evaluate the level of agreement between responses on a pre-consultation client-completed history questionnaire and the verbal history obtained by multiple clinicians during an initial veterinary dermatology consultation.

Materials and methods: A cross-sectional study was conducted, enrolling 130 canine cases by 7 clinicians from 4 different veterinary dermatology specialty clinics. A 16-question online questionnaire was completed by the client. Agreement between the client-completed questionnaire responses and verbal history regarding the same questions obtained by the clinician was determined using a 95% confidence interval. A nonvalidated scoring system categorised agreement as excellent (≥ 90% agreement) and nonexcellent (< 90% agreement). Agreement between clinicians for all questions was calculated using chi-square tests or, if any expected cell counts were < 5, a Fisher's exact test. A significance level of p < 0.05 was used.

Results: One of the 16 questions showed excellent and the remaining questions non-excellent agreement. There was significant variation in agreement between clinicians for all questions (p < 0.001).

Conclusions and clinical relevance: This study revealed varying levels of agreement between questionnaire responses and verbal histories. Multiple questions on the questionnaire may require modification, with most or all requiring further verification during the verbal history. Although questionnaires are useful, they cannot replace thorough verbal history-taking. The observed interclinician variability suggests that clinicians are likely to influence the accuracy and utility of pre-consultation questionnaires.

Background: Otitis media (OM) is diagnosed via imaging or, in some cases, otoscopic evaluation, by detecting fluid in the tympanic bulla (TB). In cats, the bulla septum divides the TB into ventromedial (VMC) and dorsolateral (DLC) compartments, with ultrasound restricted to imaging the VMC only.

Hypothesis/objectives: To evaluate the accuracy and feasibility of ultrasound in diagnosing naturally occurring OM in cats, using computed tomography (CT) or magnetic resonance imaging (MRI) as the reference standard.

Animals: Thirty-two privately owned cats (64 ears) with and without OM were enrolled in the study.

Materials and methods: In this cross-sectional study, CT or MRI confirmed fluid (OM) or air (normal) in the TB, while ultrasound imaged the VMC for air or fluid. Performance statistics for ultrasound in diagnosing OM were calculated.

Results: Bulla ultrasound took an average of 3.5 min to complete and 23 cats were awake. Ultrasound detected air in the VMC in 41 ears, fluid in 22 ears and acoustic shadowing in one ear owing to TB wall thickening, precluding the detection of gas or fluid. Thirty-nine middle ears were air-filled and 25 ears had fluid based on CT/MRI. Two false negatives resulted from undetectable scant fluid lines. Ultrasonographic data of 63 ears (ear with acoustic shadow was excluded) showed the following: sensitivity (92%), specificity (100%), positive predictive value (100%), negative predictive value (95%) and accuracy (97%).

Conclusions and clinical relevance: Ultrasound was rapid, well-tolerated and reliably differentiated fluid from air in the VMC, diagnosing OM in most cats. False negatives arose from scant fluid. Acoustic shadowing may represent chronic OM.

Background: Effective management of otitis externa (OE) requires addressing all contributing factors to prevent chronicity and recurrence. Evidence on the long-term efficacy of topical corticosteroids in preventing recurrence and secondary infections remains limited.

Objectives: This retrospective noncontrolled study evaluated the efficacy of hydrocortisone aceponate (HCA) in resolving non-infectious chronic or recurrent (CR)-OE with or without proliferative changes, and preventing recurrence of acute episodes and secondary infections.

Animals: A total of 63 owned dogs (115 ears) with unilateral or bilateral non-infectious CR-OE were included. Most ears were enrolled after resolving infectious otitis, as persistent inflammation or recurrence required further management.

Materials and methods: Clinical records from two dermatology referral centres (February 2022-July 2023) were reviewed. Dogs were included if they had recurrent otitis for over a year (≥ 1 year) or chronic otitis (≥ 1 month). Otitis severity was assessed using the Otitis Index Score (OTIS3) scale, and by grading stenosis and hyperplasia severity. Enrolled patients received HCA 0.584 mg/mL at weight-adjusted doses. A reactive phase continued until OTIS3 < 2, followed by a proactive phase with regimens adapted to otitis severity. Concurrent treatments were recorded.

Results: Recurrence was not observed in 79.1% of ears (mean follow-up 202.6 days). Among 24 relapsed ears, 29.17% recurred after treatment discontinuation. Higher recurrence was associated with stopping therapy (p < 0.001) and recent bacterial otitis (p = 0.015). No adverse effects were noted.

Conclusions and clinical relevance: The use of HCA appears to be an effective and safe option for reactive and proactive management of non-infectious CRC-OE, reducing recurrences and improving patient and owner quality-of-life.