Histopathological differences between canine idiopathic sebaceous adenitis and canine leishmaniosis with sebaceous adenitis

Sebaceous adenitis (SA) may be idiopathic (ISA) or associated with other disorders. The purpose of the present study was to compare the cutaneous histopathology of SA in cases in which Leishmania organisms were detected by immunohistochemistry (IHC) with that of cases diagnosed as ISA. Skin sections of 29 patients were evaluated histologically and divided into two groups, one characterized by several epidermal and subepidermal lesions, a granulomatous to pyogranulomatous nodular to diffuse dermatitis involving the sebaceous glands and a positive IHC for Leishmania spp. The other group was characterized by orthokeratotic hyperkeratosis, follicular keratosis with different degrees of pyogranulomatous to granulomatous SA, lack of nodular dermatitis and a negative IHC for Leishmania spp. Hidradenitis was present in both groups. From these results it can be concluded that SA in canine Leishmaniosis (CL) is usually present together with a nodular to diffuse dermal infiltrate and epidermal and subepidermal lesions, and that SA in the absence of dermal inflammation is probably not associated with or suggestive of CL, even in regions where the disease is endemic.     

Deionised water as an adjunct to surgery for the treatment of canine cutaneous mast cell tumours

Medical records of 55 dogs with a diagnosis of cutaneous mast cell tumour were reviewed. Twenty-seven of the dogs were treated with surgery plus deionised water and the remaining 28 with surgery alone. A survival analysis was performed to determine whether deionised water, as an adjunct to surgery for cutaneous mast cell tumour, affected survival time or time to tumour recurrence. Dogs in which mast cell tumour recurred had a significantly shorter survival time compared with dogs with no recurrence (P=0.05), regardless of the method of treatment. A significant negative association between tumour recurrence and method of treatment (P=0.0097) and clinical stage (P=0.0223) was observed. Dogs treated with surgery and deionised water had a significantly shorter time to recurrence of their mast cell tumour (P=0.0113). Based on these results, deionised water does not appear to be beneficial in prolonging survival time or time to tumour recurrence for dogs with cutaneous mast cell tumours.     

Salmon calcitonin as adjunct treatment for vitamin D toxicosis in a dog

Calcitonin was used in conjunction with saline diuresis, furosemide, and prednisone in treatment of a dog that consumed a rodenticide that contained cholecalciferol and has been touted as safe for nontarget species. This report shows that the rodenticide is toxic to dogs and that salmon calcitonin is a useful treatment for the often refractory hypercalcemia induced by vitamin D toxicosis.     

Successful treatment of sebaceous adenitis in a rabbit with ciclosporin and triglycerides

A 4-year-old rabbit was presented with a chronic exfoliative dermatitis and patchy alopecia. General physical examination revealed no abnormalities. Skin scrapings and fungal culture were negative. A blood sample was obtained for a complete blood cell count and biochemical profile, and yielded results that were within normal limits. Radiographic examination of the thorax excluded the presence of a thymoma. Histopathology of the skin showed orthokeratotic hyperkeratosis, absence of sebaceous glands and mural lymphocytic folliculitis, consistent with sebaceous adenitis. Oral treatment was started with ciclosporin dissolved in a medium-chain triglyceride solution (Miglyol 812), combined with essential fatty acids and topical propylene glycol sprays. Within 2 months of treatment, complete regression of skin lesions and regrowth of hair was observed. Serum chemistry values including kidney and liver function tests remained within reference range during the course of treatment. Histopathological examination of control biopsies of the skin showed presence of normal sebaceous glands and active hair follicles. Treatment was changed to a different pharmaceutical formulation of ciclosporin without Miglyol and deterioration of clinical signs was noticed. Using pure Miglyol 812, however, resulted in a gradual improvement of 60%. A nearly complete response was again observed after re-administration of the combination ciclosporin/Miglyol. It is hypothesized that sebaceous adenitis in the rabbit is most likely due to an autoimmune reaction directed at the sebaceous glands and a defect in lipid metabolism. The outcome indicates that a combination of ciclosporin and Miglyol 812 is a promising new treatment for sebaceous adenitis in rabbits.     

A multicentre placebo‐controlled clinical trial on the efficacy of oral ciclosporin A in the treatment of canine idiopathic sebaceous adenitis in comparison with conventional topical treatment

Canine idiopathic sebaceous adenitis (ISA) is an inflammatory reaction of sebaceous glands, potentially resulting in their complete loss. It is considered a T‐cell‐mediated disease, but its precise pathogenesis is still unknown. Topical treatment with oil soaks, humectants and shampoos is effective but laborious. Ciclosporin A (CsA), an immunomodulatory drug, has recently been shown to ameliorate the clinical picture of ISA and to reduce inflammation greatly. It is, however, an expensive treatment option. The objective of this multicentre, partly double‐blinded, randomized controlled study was to evaluate the efficacy of ciclosporin A, either alone or with topical therapy, in comparison to conventional topical treatment alone, as measured by the primary end‐points alopecia and scaling, and multiple histopathological secondary objectives. Thirty‐four dogs with an established diagnosis were treated for 4–6 months and were evaluated before, during and after therapy. Both CsA and topical therapy demonstrated efficacy in this study. Differences between the treatment protocols were marginal. Topical treatment, both alone and in combination with CsA, appeared to reduce scaling more effectively than CsA alone. Both therapies reduced alopecia. There is evidence of a synergistic benefit on both scaling and alopecia, if both treatment options are combined. Inflammation of the sebaceous glands is also best reduced by a combination of both CsA and topical therapy. There is evidence that regeneration of sebaceous glands is best achieved by CsA, either given alone or in combination with topical treatment.     

Effects of cyclosporine A on clinical and histologic abnormalities in dogs with sebaceous adenitis

OBJECTIVE: To evaluate the effects of cyclosporine A in the treatment of sebaceous adenitis in dogs. DESIGN: Open-label clinical trial. ANIMALS: 12 dogs with sebaceous adenitis. PROCEDURE: Dogs were treated with cyclosporine A at a dosage of 5 mg/kg/d (2.3 mg/lb/d), PO, for 12 months and reevaluated every 4 months. A clinical score was calculated by grading the extent of alopecia and severity of follicular casts as absent, mild, moderate, or severe in each of 17 body regions. Biopsy specimens were obtained and examined histologically and by means of immunohistochemical staining. RESULTS: Mean clinical score was significantly decreased, compared with baseline score, after 4 months of treatment and remained low after 8 and 12 months. Histologically, the severity of inflammation was significantly decreased, as were numbers of macrophages, CD3+ T cells, and major histocompatibility complex class II-expressing cells. The percentage of hair follicles with sebaceous glands increased, suggesting regeneration of sebaceous glands. Clinical signs recurred when cyclosporine administration was discontinued. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that administration of cyclosporine A at a dosage of 5 mg/kg/d may reduce the inflammation associated with sebaceous adenitis in dogs. Long-term treatment appears to be neccessary to control the disease.     

Evaluation of flunixin meglumine as an adjunct treatment for diarrhea in dairy calves

OBJECTIVE: To assess the use of flunixin meglumine as an adjunct treatment for diarrhea in calves. DESIGN: Clinical trial. ANIMALS: 115 calves with diarrhea that were 1 to 21 days old at enrollment. PROCEDURE: Calves that developed diarrhea were randomly assigned to receive no flunixin meglumine (controls), a single dose of flunixin meglumine (2.2 mg/kg [1.0 mg/lb]), or 2 doses of flunixin meglumine administered 24 hours apart. Serum IgG concentration and PCV were measured prior to enrollment in the trial. Calves were evaluated daily to determine rectal temperature, fecal consistency, demeanor, and skin elasticity score. The primary analytic outcome was days of sickness (morbid-days). RESULTS: Calves with fecal blood and treated with a single dose of flunixin meglumine had fewer morbid-days and antimicrobial treatments, compared with controls. Although not significant, calves given 2 doses of flunixin meglumine in 24 hours had fewer morbid-days than untreated control calves. Regardless of severity of diarrhea, calves without fecal blood did not benefit from the use of flunixin. For calves with fecal blood, failure of passive transfer (low serum IgG concentration) was an independent risk factor for increased morbid-days. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with a single dose of flunixin meglumine resulted in fewer antimicrobial treatments and morbid-days in calves with fecal blood. As observed in other studies, calves with failure of passive transfer were at high risk for poor outcomes. This emphasizes the importance of developing and implementing effective colostrum delivery programs on dairy farms.     

Oral melphalan for the treatment of relapsed canine lymphoma

Oral melphalan has been included in multi‐agent rescue protocols for canine lymphoma but its activity as a single‐agent for this purpose has not been established. Inexpensive cost, ease of administration and tolerability make oral melphalan an attractive candidate for single‐agent rescue therapy of canine lymphoma. Retrospective evaluation of 19 cases of relapsed canine lymphoma treated with oral melphalan was performed. Melphalan was primarily administered (n = 16) via a high dose protocol (HDM ) with a median dosage of 19.4 mg m^?2. Fifteen dogs (78.9%) were treated concurrently with corticosteroids. Response evaluation was possible for all dogs with a calculated overall clinical benefit (partial response [PR ] + stable disease [SD ]) of 31.6% (PR 3/19; SD 3/19). Times to progression following melphalan (TTP ‐M) were 14, 24 and 34 days for responders and 20, 28 and 103 days for dogs experiencing SD . Twelve of 17 dogs evaluable for toxicity experienced an adverse event (AE ) with only 3 dogs experiencing a grade III or higher AE . Haematologic toxicity was common (11/17) while gastrointestinal toxicity was rare (1/17). Although treatment resulted in limited clinical benefit and non‐durable responses, oral melphalan was well‐tolerated and may be a reasonable rescue option in cases where minimal effective agents remain.     

Urinary cytology as an adjunct to bacteriology in the laboratory investigation of canine bladder disease

The results of cytological and bacteriological examination of 73 urine samples from dogs are presented. In 37 cases bacteria of potential clinical significance were isolated, a further six were considered to be contaminated, and from the remaining 30 either only a very scant growth or none at all was obtained. Cytology supported a diagnosis of cystitis in 28 cases and was highly suggestive of malignancy in another five. There were eight cases of bacteriuria where the cytological evidence was not indicative of cystitis. None of the 36 cases from which no potentially significant bacteria were isolated had a cytological profile suggesting an inflammatory process. It is proposed that urinary cytology may be a useful adjunct to bacteriology, especially where the significance of a bacteriuria cannot be assessed by quantitative counts. Cytology may also be of value for the early detection of urothelial carcinoma.     

Hyaluronidase as an adjunct in an immobilizing mixture for moose

Hyaluronidase was put into immobilizing syringes for 58 of 104 moose captured with a fentanyl/xylazine mixture. Induction times were measured for both groups and were related to injection site as well as drug mixture. Hyaluronidase-treated moose had significantly shorter induction times than others. Injection site also had a significant effect on induction times.     

A retrospective analysis of the efficacy of Oncept vaccine for the adjunct treatment of canine oral malignant melanoma

Oral malignant melanoma (OMM) in the dog is often locally aggressive with a high metastatic potential and there are few treatment options that have been demonstrated to improve outcome of this disease. The purpose of this study was to determine whether adjunctive treatment with the Oncept melanoma vaccine affected the outcome of dogs with OMM that had achieved loco‐regional cancer control. Medical records from 45 dogs that presented to the Animal Cancer and Imaging Center were reviewed, including 30 dogs with stage II and III disease. Dogs that received the vaccine did not achieve a greater progression‐free survival, disease‐free interval or median survival time than dogs that did not receive the vaccine.     

Nuclear survivin expression as a potentially useful tool for the diagnosis of canine cutaneous sebaceous lesions

Background – Sebaceous glands are specialized cutaneous adnexal glands, which work under constant hormonal control to produce sebum. They can give rise to several proliferative lesions, such as hamartoma, hyperplasia and neoplasms (adenoma, epithelioma and carcinoma). Their nomenclature is currently confusing, both in veterinary and in human medicine, owing to the difficulty of differentiating between some of these lesions. Methods – The present study used immunohistochemistry to determine the expression levels and patterns of survivin and Ki67 in five samples of normal canine skin and 44 cases of canine cutaneous lesions with sebaceous differentiation (10 hamartomas, nine hyperplasia, eight adenomas, eight epitheliomas and nine carcinomas). Results – In normal glands, survivin, as well as Ki67, was expressed in scattered reserve cells. In hamartomas, survivin was more highly expressed than in normal skin, indicating a possible role of this molecule in the pathogenesis of these congenital lesions. In tumours, a moderate or high level of survivin and Ki67 expression (more than two and four and more than two positive cells, respectively) were significantly correlated with a malignant histotype, infiltrative growth and a moderate or high number of mitoses (more than two). Conclusions and clinical importance – The level of survivin expression increased with increasing malignancy, designating survivin as a new diagnostic marker in the assessment of malignancy of sebaceous tumours.     

Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy

OBJECTIVE: To assess pharmacokinetics, efficacy, and tolerability of oral levetiracetam administered as an adjunct to phenobarbital treatment in cats with poorly controlled suspected idiopathic epilepsy. DESIGN-Open-label, noncomparative clinical trial. ANIMALS: 12 cats suspected to have idiopathic epilepsy that was poorly controlled with phenobarbital or that had unacceptable adverse effects when treated with phenobarbital. PROCEDURES: Cats were treated with levetiracetam (20 mg/kg [9.1 mg/lb], PO, q 8 h). After a minimum of 1 week of treatment, serum levetiracetam concentrations were measured before and 2, 4, and 6 hours after drug administration, and maximum and minimum serum concentrations and elimination half-life were calculated. Seizure frequencies before and after initiation of levetiracetam treatment were compared, and adverse effects were recorded. RESULTS: Median maximum serum levetiracetam concentration was 25.5 microg/mL, median minimum serum levetiracetam concentration was 8.3 microg/mL, and median elimination half-life was 2.9 hours. Median seizure frequency prior to treatment with levetiracetam (2.1 seizures/mo) was significantly higher than median seizure frequency after initiation of levetiracetam treatment (0.42 seizures/mo), and 7 of 10 cats were classified as having responded to levetiracetam treatment (ie, reduction in seizure frequency of >or=50%). Two cats had transient lethargy and inappetence. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that levetiracetam is well tolerated in cats and may be useful as an adjunct to phenobarbital treatment in cats with idiopathic epilepsy.     

Regional anesthesia as an adjunct for eyelid surgery in dogs

Eyelid surgery plays an important role in the management of a variety of ophthalmic diseases. Surgery on the adnexa and eye is routinely performed on an anesthetized patient. Minor procedures, such as conjunctival biopsy, may be performed in an awake patient using only topical anesthesia. Retrobulbar, peribulbar, and local anesthesia are less commonly used in general practice; however, they can provide significant advantages when used appropriately. Advantages to local anesthesia/sedation include being able to perform some ophthalmic procedures without having to place the patient under general anesthesia, ability to maintain the patient under a lighter plane of general anesthesia, improved postoperative comfort, and potentially smoother recoveries from general anesthesia. This article reviews this author's current indications and techniques for regional anesthesia as an adjunct to eyelid surgery in dogs.