P‐5 Importance of psychogenic factors in canine recurrent pyoderma

Recurrent pyoderma is a relapsing bacterial infection of the skin. Evaluation of the primary predisposing factors is essential, but they are not always easy to determine. We reported that psychogenic factors should be considered as one cause of canine dermatoses featuring pruritic behavior such as grooming and scratching, and predicted that it could be added as a cause of recurrent pyoderma. The purpose of this study was to evaluate the roles of psychogenic factors in canine recurrent pyoderma. This study examined 21 dogs with recurrent pyoderma, which showed relapsing but antibiotic‐responsive skin lesions. Predisposing factors, especially allergy, infection, endocrine disorders, congenital factors and improper treatments, were carefully ruled out with standard diagnostic procedures. Diagnosis of psychogenic factors was based on fulfillment of the following features: (1) distinctive area of broken hairs or asymmetric erythema, (2) incidental pruritic behavior related to emotionally unstable situation or physiological intervention, (3) existence of environmental antecedent triggers or concurrent psychiatric symptoms, and (4) requirement for psychogenic treatment, consisting of behavior modification and psychopharmacological therapy in some. The incidence of psychogenic factors and the efficacy of the treatment in recurrent pyoderma were evaluated. In these 21 dogs, 10 cases (47.6%) were compatible with the presence of psychogenic factors, and seven cases (33.3%) were improved with behavioral treatment. Psychogenic factors should be considered in the aetiology of so‐called idiopathic canine recurrent pyoderma. Further investigation is needed to understand the relationship between skin barrier dysfunction and psychogenic factors. Funding: Self‐funded.     

Strategies for management of recurrent pyoderma in dogs

Staphylococcal skin infection (pyoderma) is a common clinical problem in dogs. The infection can be either superficial or deep. Most cases of staphylococcal pyoderma occur secondary to a definable underlying cause. Treatment consists of finding the underlying cause and correcting it, if possible, and treating the pyoderma with antibiotics. Antibacterial shampoos may be used as adjunct treatment, but corticosteroid drugs should not be used. When canine pyoderma recurs in the absence of an identifiable underlying cause, several treatment strategies can be effective in eliminating recurrence or limiting its severity. Frequent antibacterial shampoos are an easy and sometimes effective method. Immunomodulatory drugs are variably effective. Some commercially available bacterins are clearly helpful in treating recurrent pyoderma. As a last resort, the clinician may opt to keep the patient on long-term antibiotic therapy. Such therapy may promote development and dissemination of resistant strains of Staphylococcus and should be used only if absolutely necessary.     

犬瘙痒性皮肤病研究进展

瘙痒是犬皮肤病的典型临床症状之一,通常除瘙痒外还常伴脱毛、红斑等皮肤症状。瘙痒问题不仅困扰动物本身,也影响到饲养者的生活质量。瘙痒的发生机制复杂,目前国内外已有大量对人和犬瘙痒性皮肤病的临床和基础研究,揭示了瘙痒和神经免疫系统之间的关系,引入了“瘙痒-抓挠”循环的概念,且表明了免疫系统、皮肤屏障和神经系统的单独促进作用和交互作用是瘙痒产生的关键因素,任一环节的问题都可开启“瘙痒-抓挠”的恶性循环。临床上引起犬瘙痒的病因复杂,参照2007年由国际瘙痒研究论坛成员提出的瘙痒分类,将引起犬瘙痒的疾病根据病因类比对应分为了六大类,引起皮肤病性瘙痒的疾病分为了感染性、过敏性、肿瘤性等,其中在临床上最主要的是犬过敏性瘙痒。犬瘙痒性皮肤病的诊断方法及鉴别诊断多样,需从多方面对患病犬进行信息收集,按一定顺序进行排查和鉴别诊断。犬瘙痒性皮肤病的治疗周期长且疾病易反复,目前常用的西医药物存在副作用大、靶点单一、价格昂贵等不足,中药方剂成分复杂,有效成分多,可从多通路多途径治疗机制复杂的瘙痒,在犬瘙痒性皮肤病的治疗上具有优势和广阔前景。文章对瘙痒发生的机制、犬瘙痒性疾病的分类、诊断及中西医治疗思路等最新研究...     

Double-blinded, placebo-controlled study to evaluate an antipruritic shampoo for dogs with allergic pruritus

Shampoo therapy is frequently used on pruritic dogs. However, there are few double-blinded, placebo-controlled studies of this form of therapy. This randomised, double-blinded, placebo-controlled study evaluated the efficacy of a commercial medicated shampoo (DermaTopic; Almapharm) containing chlorhexidine, lactoferrin, piroctone olamine, chitosan and essential fatty acids in 27 dogs with mild to moderate allergic pruritus without secondary skin infections. All dogs received shampoo therapy with either DermaTopic or a shampoo vehicle as placebo twice weekly for four weeks. The extent of pruritus was evaluated before the study and then on a daily basis by the owners using a visual analogue scale. Before beginning the treatment and after four weeks, the skin lesions were evaluated by an experienced clinician with a validated lesion score (Canine Atopic Dermatitis Extent and Severity Index - CADESI). The pruritus was reduced significantly by both DermaTopic and placebo. However, there was no significant difference between both groups. There was no statistically significant difference in the CADESI scores pre- and post-treatment in either group or between the two types of treatment. This study provides further evidence of the benefit of shampoo therapy for pruritic dogs.     

P-58 Three cases of pathological dermal deposits associated with internal diseases in dogs (xanthomatosis, calcinosis and amyloidosis)

Intestinal parasites have been anecdotally associated with pruritus in dogs. A relationship was proposed when the elimination of a specific parasite resolved the pruritus, and re-infection with a parasite caused the pruritus to recur. Ascarids, coccidia, hookworms, tapeworms and whipworms have all been incriminated. Recent reports in the human and veterinary literature have suggested that there may be a relationship between Giardia infection and the development of pruritus and other allergic signs. In order to determine if there is an association between infection with Giardia and pruritus in dogs, faecal samples were collected from 71 pruritic dogs and 101 clinically normal dogs. Three faecal samples from each animal were analysed using a zinc-sulphate concentration technique for the presence of Giardia cysts, and one randomly selected faecal sample from each dog was analysed with an ELISA for Giardia -specific antigen. Ten of 101 dogs (9.9%) in the clinically normal group tested positive with the ELISA, and Giardia cysts were detected in the faeces of seven of these antigen-positive dogs. No Giardia cysts were found in the dogs that tested negative with the ELISA. None of the dogs in the pruritic group tested positive for Giardia by either method. The results indicated a negative association between Giardia infection and pruritic skin disease ( P  = 0.006). Cephalexin was commonly used in the pruritic group, but not in the control group, and may therefore be an explanatory variable.
Funding: Ontario Veterinary College Pet Trust.     

Pruritus in rabbits, rodents, and ferrets

This article attempts to cover the more specific pruritic problems encountered in rabbits, rodents, and ferrets. There are certainly other causes of pruritus in these animals. Dermatophytes in guinea pigs are not reported to be pruritic, but because they are pruritic in other species, they should be considered in a differential diagnosis. A cryptococcal dermatitis in a guinea pig that was pruritic has been reported. Although mites were not seen on scraping, the animal was treated for sarcoptid mites and apparently the pruritus lessened. Because the cryptococcis was still present, it is questionable whether it was causing the pruritus. Pruritic ulcerative dermatitis over the back and shoulders has been seen in some lines of rats. Staphylococcus aureus was cultured from many of the lesions. Clipping the toenails on the feet helped lessen the severity of the lesions. Syphacia spp. have been reported in rats, gerbils, and hamsters and should be considered if there is perineal pruritus. MOBS, or "move over buddy syndrome," is seen especially in mice and may be seen in hamsters, gerbils, and rats that are overcrowded or stressed. The lesions are actually bite wounds that have been inflicted around the tail base and the perineum and on the tail, but these wounds can be mistaken for self-inflicted trauma from pruritus. All of the recommended treatments are extralabel, and clients should be informed of this. I have observed a guinea pig become lethargic and anorexic after only one application of a flea powder approved for use in cats. Brushing most of the powder off and offering dandelion greens to stimulate appetite helped. The second dusting was done with the same flea powder diluted with baby powder. Whenever these animals are dipped, it is important to let them dry in a warm, draft-free area. Again, it is important to be aware that the ratio of surface area to body weight is much higher in these small animals than in the species routinely seen in veterinary practice especially to prevent toxicoses from topically applied medications and iatrogenic hypothermia or hyperthermia.     

P‐56 Evaluation of the association between Giardia infection and pruritic skin disease in dogs

Intestinal parasites have been anecdotally associated with pruritus in dogs. A relationship was proposed when the elimination of a specific parasite resolved the pruritus, and re‐infection with a parasite caused the pruritus to recur. Ascarids, coccidia, hookworms, tapeworms and whipworms have all been incriminated. Recent reports in the human and veterinary literature have suggested that there may be a relationship between Giardia infection and the development of pruritus and other allergic signs. In order to determine if there is an association between infection with Giardia and pruritus in dogs, faecal samples were collected from 71 pruritic dogs and 101 clinically normal dogs. Three faecal samples from each animal were analysed using a zinc‐sulphate concentration technique for the presence of Giardia cysts, and one randomly selected faecal sample from each dog was analysed with an ELISA for Giardia‐specific antigen. Ten of 101 dogs (9.9%) in the clinically normal group tested positive with the ELISA, and Giardia cysts were detected in the faeces of seven of these antigen‐positive dogs. No Giardia cysts were found in the dogs that tested negative with the ELISA. None of the dogs in the pruritic group tested positive for Giardia by either method. The results indicated a negative association between Giardia infection and pruritic skin disease (P = 0.006). Cephalexin was commonly used in the pruritic group, but not in the control group, and may therefore be an explanatory variable. Funding: Ontario Veterinary College Pet Trust.     

Malassezia dermatitis and otitis.

The incidence of dermatitis and otitis resulting from overgrowth of M. pachydermatis is great enough that cytological sampling techniques should be considered a routine part of the dermatological examination. Because most cases of MD and Malassezia otitis cannot be grossly distinguished from bacterial pyoderma and otitis, respectively, efficiency in performing cytology testing of skin and ear canal exudate is essential to the successful diagnosis and management of pruritic skin diseases and otitis. Although Malassezia infections are rarely primary, therapy can be instituted to remove the yeast as a confounding factor while a differential diagnosis is pursued in evaluating the underlying disease process.     

Adherence of Staphylococcus intermedius to corneocytes of healthy and atopic dogs: effect of pyoderma, pruritus score, treatment and gender

Staphylococcal pyoderma occurs commonly in atopic dogs. Some studies have suggested that adherence of staphylococci to corneocytes of atopic dogs and humans is higher than to corneocytes of healthy individuals. This hypothesis and possible differences resulting from the presence or absence of pyoderma, the severity of pruritus or the effect of treatment or gender, were studied. Adherent bacteria (Staphylococcus intermedius) were quantified by computerized image analysis on corneocytes collected from healthy or atopic dogs using double-sided adhesive tape. The adherence of S. intermedius to the corneocytes of atopic dogs was significantly greater than to those of healthy dogs (P=0.005). Furthermore, adherence was significantly greater in dogs with high levels of pruritus compared to those with low scores. No significant differences were found between atopic dogs with no history of pyoderma, atopic dogs with a history of pyoderma and atopic dogs with pyoderma at the time of sampling (P=0.068), suggesting that factors other than adherence are necessary for clinical pyoderma to develop. Treatment did not generally influence the adherence of S. intermedius to corneocytes of atopic dogs and there was no gender difference in adherence in either healthy or atopic dogs.     

Pradofloxacin in the treatment of canine deep pyoderma: a multicentred, blinded, randomized parallel trial

A multicentre, randomized, blinded study compared the efficacy of pradofloxacin with that of a combination of amoxycillin/clavulanic acid in the treatment of deep pyoderma in dogs. Dogs with clinical lesions of deep pyoderma and a positive bacterial culture were included in the study. At each visit, they were evaluated with lesion, pruritus and general condition scores. Dogs were treated either with pradofloxacin at 3 mg kg-1 once daily or with amoxycillin at 10 mg kg-1 and clavulanic acid at 2.5 mg kg-1 twice daily and evaluated weekly for 3 weeks and every 2 weeks thereafter until 2 weeks past clinical remission. Maximal treatment duration was 9 weeks, and maximal evaluation period was 11 weeks. Of the 56 dogs treated with pradofloxacin (group 1), 48 dogs (86%) achieved clinical remission, four dogs improved, four dogs did not respond and a recurrence of clinical signs was not seen in any patient after 11 weeks. Of the 51 dogs treated with amoxycillin/clavulanic acid (group 2), 37 dogs achieved clinical remission (73%), three dogs showed improvement, five dogs showed no response and in six dogs, clinical signs recurred within 2 weeks of cessation of therapy. These results indicate that pradofloxacin is an efficacious therapy comparable to amoxycillin/clavulanic acid for deep bacterial pyoderma in dogs.     

Cheyletiellosis and scabies

Cheyletiellosis and scabies can cause pruritus in dogs and cats. Cheyletiellosis is variably pruritic, whereas scabies is usually intensely pruritic. Hypersensitivity reactions are described in both of these parasitic dermatoses and probably contribute to the development of lesions and pruritus. Both parasites are readily eradicated with insecticides.     

Long-term management of atopic disease in the dog

Canine atopy is a common dermatologic disorder. Because the disease most frequently strikes young dogs, lifetime management strategies are necessary. Consideration must be given to the treatment of pruritus and secondary manifestations of the allergy, such as pyoderma, otitis externa, and seborrhea, to manage these patients successfully. The use of glucocorticoid therapy and hyposensitization are discussed.     

Dermatitis associated with the use of primidone in a dog

A 9-year-old female dog with progressive pruritic dermatitis was examined 9 months after primidone treatment had been initiated. Alopecia, scaling, ulceration, pigmentation, and fissuring were evident over the dorsal trunk, head, perineum, caudal aspect of the thighs, hocks, elbows, and paws. Hydropic degeneration of epidermal basal cells, mononuclear lichenoid infiltrate in the superficial dermis, and marked parakeratotic hyperkeratosis were evident on biopsy. Antinuclear antibody in the serum was not detected and specific patterns of immunoglobulin deposition in the epidermis or basement membrane zone were lacking. Primidone-induced dermatitis was presumptively diagnosed. Successful treatment involved withdrawal of the primidone and administration of corticosteroids and antibiotics to relieve the pruritus and to eliminate the secondary pyoderma.     

Interleukin 31 and targeted vaccination in a case series of six horses with chronic pruritus

Chronic pruritus is defined as prolonged itching symptoms associated with a variety of skin conditions. These pruritic conditions clinically manifest in a dermatitis phenotype and commonly are of allergic origin with hypersensitivities towards environmental allergens. Interleukin-31 (IL-31) is a common player in allergic pruritus across species. The objective of the study was evaluation of the clinical efficacy of a therapeutic vaccine targeting IL-31 in horses with chronic pruritus of unknown origin (CPUO) and that could not be explained by insect bite hypersensitivity (IBH). This consecutive case series pilot study included client-owned horses with a long history of CPUO. Four horses affected by year-round CPUO were vaccinated with a vaccine consisting of equine IL-31 (eIL-31) covalently coupled to a virus-like particle (VLP) derived from cucumber mosaic virus containing a tetanus toxoid universal T cell epitope (CuMV_TT). Clinical signs and pruritic behaviour were documented by photography and owner questionnaire pre and post vaccination. In addition, in three CPUO horses, levels of IL-31, thymic stromal lymphopoietin (TSLP) and monocyte chemoattractant protein 1 (MCP-1) were quantified from skin punch biopsies. IL-31, TSLP and MCP-1 levels were upregulated in pruritic, alopecic skin lesions compared to healthy skin of the same horse. Clinical signs and pruritic behaviour improved in all four horses upon vaccination with eIL-31-CuMV_TT vaccine. The vaccine was well tolerated without safety concerns throughout the study. The main limitations of this study are the absence control treated horses and allergy diagnostics. It was concluded that Anti-IL-31 therapy might be applied as an allergen-independent treatment option for horses with CPUO overcoming the challenges of identifying the allergic trigger.     

Antibiotic-responsive generalized nonlesional pruritus in a dog

A 15-year-old dog was evaluated for a nonresponsive generalized pruritic condition of 5 months duration. Routine diagnostic testing, including intradermal testing with 63 inhaled allergens and the feeding of a home-cooked hypoallergenic diet, failed to define the cause of the pruritus. An intradermal skin test with a staphylococcal cell wall/toxoid mixture and a skin biopsy of the skin test site suggested that the dog had a bacterial hypersensitivity. Antibiotic therapy eliminated the pruritus and the dog's pruritus was successfully managed for 3 years with the combined use of subtherapeutic dosages of antibiotics and a commercial staphylococcal vaccine.     

Phytotherapy of chronic dermatitis and pruritus of dogs with a topical preparation containing tea tree oil (Bogaskin)

Localised dermatitis, for example unspecific eczema or skinfold pyoderma, is a very common diagnosis in dogs. Typical and impressive complaints are pruritus, erythema, erosion and oozing surface. With respect to the underlying disease dermatological treatment is indicated, usually based on antimicrobial and antipruriginous active substances, it can include transient glucocorticoids. An effective and safe alternative might be a phytotherapeutic topical preparation containing tea tree oil. Tea tree oil exerts both antimicrobial and antipruriginous effects. In an open multicenter study efficacy and safety of a standardized 10% tea tree oil cream applied thinly and twice daily for 4 weeks was tested in 53 dogs with chronic dermatitis, particularly non-specific eczema, allergic dermatitis, interdigital pyoderma, acral lick dermatitis and skinfold pyoderma. Analysis of efficacy assessed by investigating veterinarians showed a good or very good response to treatment for 82% of the dogs, significant at a 5% level (p = 0.05). At the end of the study a strong and significant reduction (p = 0.001) as well as disappearance of major symptoms were observed. Only two adverse events (local reactions) possibly related to tea tree oil occurred during therapy. Consequently the tested study medication (Bogaskin) can be considered an alternative for uncomplicated and localised dermatitis in dogs. Bogaskin might allow reduction of other pharmaceutical products, perhaps even replace standard therapy.     

Canine pyoderma

Bacterial skin disease (or pyoderma) is a common canine disorder. It is usually associated with coagulase-positive staphylococci which multiply on skin and induce disease as a result of a number of poorly understood mechanisms. Pyoderma usually occurs as a result of another underlying disorder. Primary causes include hypersensitivity, ectoparasites and metabolic and immunological disorders. A detailed and systematic investigation is mandatory so that the underlying cause is discovered if possible. A number of cases are idiopathic. Pyodermas may be classified according to depth of infection as this affects the type and duration of therapy required and the prognosis. Deeper forms require more aggressive and prolonged therapy. Management of pyodermas depends on the identification and correction of the underlying cause along with adjunct therapy using systemic and topical antimicrobial agents. Idiopathic cases may require protracted or even lifelong therapy with such medicaments. Glucocorticoids are generally contraindicated in the management of pyoderma.     

Association of pruritus with anxiety or aggression in dogs

OBJECTIVE: To evaluate the association between pruritus and anxiety-related and aggressive behaviors in dogs. DESIGN: Cross-sectional survey. ANIMALS: 238 dogs between 1 and 8 years old. PROCEDURES: Information including a score for general degree of pruritus (visual analogue scale from 0 to 10) and frequency of anxiety-related and aggressive behaviors was collected via a survey distributed to clients at 3 privately owned practices. RESULTS: Median score for pruritus was 2.4. Dogs were assigned to 2 groups on the basis of pruritus score (nonpruritic [0 to 2.4] and pruritic [2.5 to 10]). There was no significant difference between pruritic and nonpruritic dogs with regard to aggression or with regard to reactivity to being alone; to thunderstorms or noises; or to unfamiliar people, animals, or objects. Post hoc analysis revealed significantly more reactivity to thunderstorms or noises in dogs treated with glucocorticoids (18/37 [49%]) than in those not administered glucocorticoids (57/197 [29%]). CONCLUSIONS AND CLINICAL RELEVANCE: An association was not detected between pruritus and aggressive, anxious, or fearful behavior in dogs. There was greater reactivity to thunderstorms or noises in glucocorticoid-treated dogs. These findings do not preclude the possibility of a relationship between certain dermatoses or pruritic conditions and behavior. However, a concurrent behavioral abnormality cannot be assumed to result from a dermatosis and be expected to resolve with treatment of only the skin disease. Dogs with behavioral disorders and pruritic disease require primary treatment of both conditions. Additional studies to examine the effect of disease and glucocorticoids on canine behavior are warranted.     

The efficacy of a commercial shampoo and whirlpooling in the treatment of canine pruritus - a double-blinded, randomized, placebo-controlled study

Twenty‐two dogs with a history of at least 4 weeks pruritus were studied to determine the effect of whirlpool use on the efficacy of topical therapy with an antipruritic shampoo (Allermyl®, Virbac; Bad Oldesloe, Germany). Dogs in group 1 received initially topical therapy with conventional shampooing (2 mL shampoo per kilogram bodyweight) once weekly for 4 weeks. Dogs in group 2 received the same therapy using a whirlpool (Sanwhirl, Peter Aschauer GmbH; Gräfelfing, Germany). The treatments were crossed between the groups resulting in each dog in groups 1 and 2 receiving both therapies. Group 3 was the control group and was treated once weekly in the whirlpool without any shampoo during the 8 weeks of study. Prior to each therapy, dogs were evaluated by a clinician not aware of the type of treatment using a clinical scoring system (Canine Atopic Dermatitis Extent and Severity Index – CADESI). Owners evaluated the pruritus daily on a visual analogue scale. There was a significant difference in pruritus scores but not CADESI scores after therapy between the control treatment and the conventional shampoo therapy or shampoo treatment in the whirlpool. These results provide evidence for the short‐term benefit of shampoo therapy for canine pruritus.     

Canine eosinophilic folliculitis and furunculosis in three cases

The historical, clinical and histopathological features of three dogs with eosinophilic folliculitis and furunculosis are described. The disease was characterised by the rapid development of pruritic, papular, pustular and ulcerative lesions on the dorsum of the muzzle. Skin lesions were confined to the face in two cases. The third dog had more generalised pustular lesions. Skin biopsy specimens showed marked eosinophil infiltration particularly centred on pilosebaceous units. Dermal collagen necrosis was evident in two cases. Similar facial lesions have previously been described as ‘nasal pyoderma’. The three dogs failed to respond to initial antibacterial therapy but showed a rapid clinical response when prednisolone was given orally at doses ranging from 1 to 2-2 mg/kg, in addition to the antibacterial therapy, suggesting that glucocorticoids are indicated for the treatment of eosinophilic folliculitis and furunculosis. The aetiology of the disease was not determined.