Veterinary dermatology最新文献

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.

Background: Tympanic membrane epithelial migration (TMEM) protects the external ear canal from infections and aids in the removal of keratin. Epidermal growth factor (EGF) accelerates tissue regeneration by stimulating cell proliferation and migration.

Hypothesis/objectives: Topical application of EGF will accelerate the canine TMEM rate.

Animals: Three male beagle dogs.

Materials and methods: Six TMs were divided into control and experimental phases. The experimental phase was assessed 2 weeks after the control phase and involved weekly EGF applications (0.5 mg/mL; 25 μg in 50 μL of phosphate-buffered saline), while the control phase involved no treatment. TMEM was assessed by applying ink spots to the TM and tracking migration on Day (D)0, D7, D14 and D21. A paired Student's t-test was used to compare the daily TMEM rates between phases.

Results: The EGF-treated phase had a significantly higher mean TMEM rate (235.0 ± 91.76 μm/day) than the control phase (146.83 ± 69.95 μm/day), showing a 60.1% increase (p < 0.05). The mean difference was 88.2 μm/day (95% confidence interval [CI]: 36.8-139.5). This difference was statistically significant based on both the paired t-test (p = 0.020) and Wilcoxon signed-rank test (p = 0.031). No differences were noted between the left and right ears, and no adverse effects occurred.

Conclusions and clinical relevance: These results suggest that EGF increases TMEM in dogs. These initial findings suggest potential clinical applications of EGF. Further studies are needed to validate these findings and evaluate their therapeutic potential.

Background: DNA-based vaccination rapidly induces strong cellular and humoral immune responses, which may be enhanced by inclusion of lysosomal-associated membrane protein-1 (LAMP).

Objectives: This proof-of-concept study evaluated the efficacy and safety of a Der f 2/Zen 1-LAMP-based DNA vaccine immunotherapy in client-owned dogs with nonseasonal AD sensitised to Dermatophagoides farinae (Df).

Animals: Fifteen dogs positive for Df only and 20 dogs with reactivity to additional environmental allergens received either a low (0.5 mg/0.1 mL) or high (2 mg/0.4 mL) dose of the vaccine intradermally.

Materials and methods: Four doses of vaccine were administered every 2 weeks. Pruritus, Canine Atopic Dermatitis Extent and Severity Index (CADESI)-04, average daily medication scores (AvdMS) and adverse events (AE) were recorded over 24 weeks. Owner perception of treatment efficacy (OGATE) was assessed at the end.

Results: Pruritus and CADESI-04 improved regardless of the sensitisation profile and the vaccine dose. After 24 weeks, despite a statistically insignificant reduction of AvdMS, 71%, 46% and 86% of dogs reached PVAS < 3.6, PVAS < 2 and CADESI-04 < 10, respectively. There was no statistically significant effect of AvdMS on PVAS or CADESI-04, meaning that the concurrently administered topical and/or systemic treatment(s) were unlikely to have been responsible for the observed PVAS and CADESI-04 reduction. Twenty-one owners (60%) rated the vaccine efficacy as good-to-excellent. No severe AEs were reported.

Conclusions and clinical relevance: These results of this proof-of-concept study support not only the safety of DNA vaccine immunotherapy in dogs with AD, but also its potential clinical benefits. A double-blinded, ≥ 12 month long, controlled study with more subjects should follow to further confirm the true efficacy of this vaccine.

Background: Cytological examination of the ear canal is essential for evaluating dogs with otitis externa (OE). The conventional sampling method uses a swab. However, the cytobrush (gynaecological cervical brush), already used for cytological collection from other anatomical sites, has not been adequately investigated for this purpose in dogs with OE.

Objectives: To compare the cytobrush as a sampling tool for the ear canal of dogs with OE and compare it with the swab technique.

Animals: Thirty ears from 17 dogs with OE, presented at a veterinary teaching hospital, were included for sampling.

Materials and methods: Cytological samples were collected using both a cytobrush and a swab in random order. Two independent and blinded evaluators quantified micro-organisms (cocci, bacilli, yeasts), mononuclear cells, polymorphonuclear cells and epithelial cells. Animal discomfort during sampling was assessed using a scoring system.

Results: No significant differences were found between the methods regarding the presence of micro-organisms or inflammatory and epithelial cells (p > 0.05), indicating equivalence between techniques. The intraclass correlation coefficient (ICC > 0.9) demonstrated high reproducibility between evaluators. Although the oto-podal reflex was more frequent with the cytobrush, it did not significantly impact overall animal discomfort.

Conclusions and clinical relevance: The cytobrush is an effective, safe and well-tolerated sampling method, and may be considered a viable alternative to the swab for collecting samples from the ear canal of dogs with OE.

Background: Canine atopic dermatitis (cAD) is a common, chronic skin condition characterised by epidermal barrier dysfunction, immune dysregulation and cutaneous dysbiosis. While 'emollient plus' formulations are widely used in human atopic dermatitis (hAD), their role in cAD remains underexplored.

Hypothesis/objectives: To evaluate the clinical efficacy and owner-perceived value of a novel emollient plus formulation as a co-adjuvant treatment for cAD.

Animals: Twenty-one client-owned dogs with controlled, nonseasonal cAD completed the study.

Materials and methods: A proof-of-concept, bench-to-bedside study was conducted over 30 days. Dogs received a once-daily application of a novel emollient plus formulation developed in-house. Clinical outcomes were assessed using pruritus Visual Analog Scale (pVAS)10 and Canine Atopic Dermatitis Extent and Severity Index (CADESI)-04 scores, alongside skin barrier function parameters (trans epidermal water loss [TEWL] and pH) at the pinnae and inguinal areas. Owners evaluated therapeutic efficacy via the Owner Global Assessment of Treatment Efficacy (OGATE) questionnaire and sensorial acceptability through a survey.

Results: Significant reductions were observed in pVAS10 (4.25 ± 1.85 to 3.38 ± 1.79; p = 0.016) and CADESI-04 (24.62 ± 18.48 to 13.43 ± 7.44; p = 0.02) scores. TEWL (18.63 ± 17.33 to 9.56 ± 10.75; p = 0.049) and pH (6.07 ± 0.97 to 5.41 ± 0.71; p = 0.01) only had significant reductions at the pinnae. Owner satisfaction was exceptionally high, with 90.47% rating treatment efficacy as 'good to excellent'. The sensorial properties of the formulation also received consistently positive ratings.

Conclusions and clinical relevance: This cAD-targeted emollient product demonstrated promising efficacy in reducing pruritus and skin lesions while possibly improving skin barrier function. Its favourable safety profile and high owner satisfaction suggest strong potential for routine clinical use in the management of cAD. Further controlled studies are warranted to confirm efficacy and optimised treatment protocols.

Background: Oclacitinib and lokivetmab are generally effective monotherapies for the treatment of canine allergic dermatitis yet treatment failures may occur.

Objective: To evaluate the efficacy of the combination of oclacitinib-lokivetmab therapy (COLT) in dogs that previously failed monotherapy.

Animals: Forty-four client-owned dogs diagnosed with allergic dermatitis that did not respond to both oclacitinib and lokivetmab as monotherapies were then treated with COLT.

Results: Twenty-seven of 44 (61.4%) dogs responded adequately to COLT based on a ≥ 2 cm reduction in the pruritus Visual Analog Scale (pVAS) score from baseline and client/clinician consensus on improvement. In dogs that responded, the mean pVAS for monotherapy (oclacitinib and lokivetmab group data combined) was 6.87 of 10 and fell to 2.67 of 10 after COLT (61.1% decrease; p < 0.0001). No adverse effects were noted with COLT.

Conclusions and clinical relevance: This study suggests that in dogs not adequately responsive to oclacitinib or lokivetmab monotherapy, COLT may provide superior control of pruritus.

Background: Meticillin-resistant Staphylococcus pseudintermedius (MRSP) is often resistant to multiple antibiotics. Rifampicin is effective against most MRSP isolates, yet the potential for the development of rapid resistance raises questions regarding its suitability as an antibiotic monotherapy for MRSP pyoderma.

Objectives: To describe the: (i) clinical outcome of rifampicin antibiotic monotherapy in MRSP pyoderma; (ii) frequency of adverse effects; and (iii) development of rifampicin resistance among dogs considered nonresponders to therapy.

Materials and methods: A retrospective study of medical records from 1/1/2013 to 1/12/2022 of client-owned dogs with MRSP pyoderma treated with oral rifampicin as a systemic antibiotic monotherapy for 21 days.

Results: 104 dogs were included; 77 cases of superficial pyoderma (74%) and 27 cases of deep pyoderma (26%). The mean daily rifampicin dose was 6 mg/kg. Rifampicin was clinically effective in 86 cases (82.7%). Eleven of 18 nonresponding dogs demonstrated rapidly acquired rifampicin resistance (10.6%). Eighty-two (78.8%), 17 (16.3%), two (1.9%) and three (2.9%) dogs experienced zero, mild, moderate and severe adverse effects, respectively.

Conclusions and clinical relevance: Rifampicin at 6 mg/kg is an effective and mostly well-tolerated monotherapy for treating MRSP pyoderma. However, in this study, it was associated with rapid development of resistance in ≥ 10% of treated dogs. Inadequate clinical response occurred without demonstrable resistance in 6.7% of cases. Concurrent use of ciclosporin or fluconazole with rifampicin increased the odds of severe adverse reactions.