Cephalosporins – pharmacological basis of clinical use in veterinary dermatology

Cephalosporins form a large group of β-lactam antibiotics which are used extensively in human medicine and to a lesser extent in domestic animals. In veterinary dermatology, the principle use for the cephalosporins is the clinical management of canine pyoderma associated with Staphylococcus intermedius . In practice, the use of orally administered first generation cephalosporin drugs to affected dogs is well tolerated and highly efficacious. Bacterial drug resistance appears to occur rarely.     

Adherence by Staphylococcus intermedius to canine keratinocytes in atopic dermatitis

The adherence of Staphylococcus intermedius to canine keratinocytes in normal dogs was compared to that in dogs suffering from atopic dermatitis, primary seborrhoea and bacterial pyoderma. Statistically significant greater adherence by S. intermedius to keratinocytes occurred in atopic dogs and dogs suffering from pyoderma when compared with the normal group (P < 0.01) and dogs suffering from primary seborrhoea (P < 0.05). This is similar to the results of a study of human atopic dermatitis by Cole and Silverberg (1986) who demonstrated increased adherence by S. aureus to keratinocytes from atopic dermatitis patients when compared with adherence to keratinocytes in a variety of non-atopic dermatoses. This increased adherence by pathogenic staphylococci to keratinocytes may in part explain the high incidence of staphylococcal pyoderma seen in both canine and human patients suffering from atopic dermatitis.     

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.     

Efficacy of cefadroxil in the treatment of bacterial dermatitis in dogs

Cefadroxil was found to be an effective antibiotic for the treatment of canine bacterial pyoderma. Bacterial pyoderma was diagnosed in 30 dogs, which were treated with cefadroxil administered orally at 22 mg/kg of body weight, q 12 h, for 21 to 30 days. Dogs were reexamined at the conclusion of antibiotic treatment, and 29 were found to have good to excellent response. On the basis of this study, cefadroxil is a good choice in the treatment of canine pyoderma when cephalosporins are necessary. Efficacy, frequency of administration, cost, and veterinary approval are the major advantages.     

Prevalence of methicillin-resistant staphylococci in canine pyoderma cases in primary care veterinary practices in Canada: A preliminary study

Pyoderma in dogs is most commonly caused by Staphylococcus spp., and significant emergence of methicillin resistance in staphylococcal pyoderma has been reported. This preliminary study of the prevalence of methicillin resistance in canine pyoderma cases in Canadian primary care veterinary practices revealed that methicillin-resistant Staphylococcus spp. were present in 12.1% of 149 staphylococcal positive skin culture cases.     

Skin disorders of small mammals

Small mammals are frequently presented to the veterinary surgeon for skin disorders as children's pets, laboratory animals or commercial breeding groups. The role of the veterinary surgeon in these different categories is examined. Investigation and management of these disorders is discussed placing particular emphasis on a diagnostic approach and highlighting those areas which differ from canine and feline dermatology. Common dermatoses of these animals are described on an aetiological basis.     

The use of fluoroquinolones in veterinary dermatology

The fluoroquinolones are a group of antibiotics with considerable application for use in veterinary dermatology. They are rapidly bactericidal against a wide variety of clinically important organisms including Staphylococcus intermedius and gram-negative enteric bacilli by virtue of interference with the supercoiling of bacterial chromosomal material. Their favourable pharmacokinetic features make them applicable in many animal species, and in a range of dose formulations. The only major clinical contraindication is that fluoroquinolones should not be given to young, rapidly growing dogs as they can induce a noninflammatory, erosive arthropathy. For many years the only veterinary-labelled fluoroquinolone available was enrofloxacin. The selection of a fluoroquinolone has become more complex now that there are more choices available. Orbifloxacin, difloxacin and marbofloxacin now join enrofloxacin on the veterinary market, although not all of these are licensed in every country. The use of fluoroquinolones in dermatology remains controversial. The authors recommend that fluoroquinolones be considered in circumstances where canine pyoderma has been refractory to appropriate 'first line' antibiotics. They are most useful in the management of recurrent pyoderma and in chronic, deep pyoderma with extensive scar tissue. In addition, fluouroquinolones frequently are the drugs of choice for canine ear infections caused by Pseudomonas aeruginosa.     

Evaluation of the expectations, learning and competencies of surgical skills by undergraduate veterinary students performing canine ovariohysterectomies

Objectives : To investigate the development of surgical skills of veterinary undergraduates and determine the number of canine ovariohysterectomies required to achieve competency and reduce levels of student concern. This was compared to student expectations and that of employers regarding surgical ability and provision of support to new graduates. Methods : A questionnaire regarding surgical concerns was sent to final year veterinary students enrolled within the University of Bristol, UK. A questionnaire was also sent to 200 UK veterinary practices regarding their impressions of surgical competence of new graduates and their provision of supervision. The responses were compared. Eleven additional final year students performed five canine ovariohysterectomies and graded their concerns. The number of supervised canine ovariohysterectomies required until competency was determined. Results : 80·4% of final year veterinary undergraduates replied that the surgical procedure which they were most concerned about their ability to perform was canine ovariohysterectomy. Students and veterinary practitioners differed in their opinions regarding whether they considered canine ovariohysterectomy to be a “day one skill” and what were desirable levels of supervision. Completing a minimum of four canine ovariohysterectomies led to 81·8% of students being assessed as competent. Clinical Significance : An unrealistically high expectation of competency by students may be a source of stress and concern. Employers should aim to provide hands‐on support whilst new graduates complete at least four canine ovariohysterectomies. Postoperative haemorrhage is uncommon but is the main concern for students.     

The effectiveness of systemic antimicrobial treatment in canine superficial and deep pyoderma: a systematic review

Aim – To identify and evaluate existing evidence for the effectiveness of systemic antimicrobial treatments for naturally occurring superficial and deep canine pyoderma. Method – Electronic searches of PubMed, MEDLINE and CAB Direct were carried out (25 May 2011) without date or language restrictions. Proceedings of ESVD/ECVD, AAVD/ACVD, NAVDF and WCVD annual congresses were searched. Unpublished studies were sought via the Veterinary Dermatology discussion list and Veterinary Information Network. Results – Seventeen full‐length, peer‐reviewed controlled trials reporting clinical outcomes of systemic antimicrobial treatment for canine pyoderma were identified. Outcomes specific to superficial or deep pyoderma were reported in nine and five studies, respectively. Five studies reported outcomes only for nondifferentiated pyoderma depth. Heterogeneity of study designs and outcome measures made meta‐analysis inappropriate. A good level of evidence was identified supporting the high efficacy of subcutaneously injected cefovecin in superficial pyoderma and for oral amoxicillin–clavulanic acid in deep pyoderma. A fair level of evidence was identified for moderate to high efficacy of oral amoxicillin–clavulanic acid, clindamycin, cefadroxil, trimethoprim–sulphamethoxazole and sulfadimethoxine–ormetoprim in superficial pyoderma and oral pradofloxacin, oral cefadroxil and subcutaneously injected cefovecin in deep pyoderma. Eleven trials reported observations of adverse effects in treated pyoderma cases by intervention group; four dogs were withdrawn owing to the severity of adverse effects. Conclusions – There is a need for greater numbers of adequately sized, blinded, randomized controlled trials evaluating systemic antimicrobial interventions for canine pyoderma. Improved differentiation between superficial and deep pyoderma in outcome reporting, outcome measure standardization and association of outcomes with causative bacterial species and their resistance patterns are required.     

犬脓皮病诊疗研究进展

犬脓皮病是犬最常见的皮肤病,不仅影响犬的外观,而且致犬瘙痒及疼痛,显著增加犬饲主患脓皮病几率,严重危害动物及人类健康。临床上可根据脓皮病患犬病史调查、临床检查、皮肤细胞学分析、病原分离鉴定、皮肤组织病理学诊断等进行确诊。通过局部用药结合全身疗法,科学合理选用抗生素,加强饲养管理等措施综合防制犬脓皮病。     

Immunomodulation and immunodeficiency

This article briefly reviews the concepts of immunodeficiency and immunomodulation as they relate to selected skin diseases in the dog and cat. Immunodeficiency states are uncommon and may be associated with a subnormal or down-regulated immune system, including humoral deficiencies, such as IgA, and abnormal lymphocyte or neutrophil function. Establishing a causal relationship between a skin disease and presumed immunodeficient state has been difficult due to the rarity of such conditions, and the limited nature of the techniques used to characterise the immune system response. Severe combined immunodeficiency in dogs is a well characterised primary immunodeficiency state involving lymphocytes; retrovirus infection in cats may lead to an acquired immunodeficient state with some association with certain dermatological conditions although it remains unclear that infection is causally linked with disease. Immunomodulation usually implies stimulating the immune system along a beneficial pathway. Such a therapeutic approach may involve a wide variety of agents, for example intravenous immunoglobulin. There are few randomised controlled trials with veterinary patients that unequivocally demonstrate beneficial responses to immunomodulatory agents. Interferons are cytokines of major interest in human and veterinary medicine for their antiviral, anti-tumour and immunomodulatory effects. The advent of veterinary-licensed products containing recombinant interferon may enable demonstration of the efficacy of interferons for conditions such as canine papillomatosis and feline eosinophilic granuloma complex. Canine pyoderma has been treated with a number of presumed immunomodulatory agents with limited success. With more detailed knowledge of the pathogenesis of pyoderma it may be possible to develop efficacious immunomodulators.     

Research Progress on Diagnosis and Treatment of Canine Pyoderma

Canine pyoderma is the most common skin disease in dogs, which not only affects the appearance of the dog, but also leads to itching or pain, and even increases the risk of dog owners suffering from pyoderma.Canine pyoderma is harmful to health of animals and human beings.Canine pyoderma could be diagnosed according to illness history survey, clinical symptoms, clinical cytology, isolation and identification of pathogens and histopathological examination.In order to curing canine pyoderma effectively, systemic therapy combined with topical administration, scientific and rational use of antibiotics, and improvement of canine feeding management should be carried.     

Topical treatment of canine and feline pyoderma

Abstract This paper is a review of commonly used topical antibacterial medications: benzoyl peroxide, chlorhexidine, povidone iodine, ethyl lactate, triclosan, mupirocin, neomycin, polymyxin B, bacitracin and fusidic acid. Included is a review of the pharmacokinetics, modes of action, adverse effects and clinical uses in veterinary dermatology. General recommendations for topical antibacterial therapy are presented. Résumé— Cet article est une revue des topiques antibactériens les plus couramment utilisés: peroxyde de benzoyle, chlorhexidine, povidone iodée, lactate d'éthyle, triclosan, mupirocine, néomycine, polymyxine B, bacitracine et acide fucidique. Il inclut notamment une revue des pharmacocinétiques, des modes d'action, des effets secondaires et des indications thérapeutiques de ces produits en dermatologie vétérinaire. Les indications générales du traitement topique antibactérien sont présentées. [Guaguere, E. Topical treatment of canine and feline pyoderma. (Traitement topique des pyodermites canines et félines). Veterinary Dermatology 1996; 7 : 145–151.] Resumen Este articulo es una revisión de los productos tópicos antibacterianos más frecuentemente utilizados: peróxido de benzoilo, clorhexidina, povidona yodada, etillactato, triclosan, mupirocina, neomicina, polimixina B, bacitracina y ácido fusidico. Se incluye una revisión de la farmacocinética, mecanismos de acción, efectos colaterales y sus usos clínicos en dermatologia veterinaria. Se presentan recomendaciones generales para la terapia antibacteriana tópica. [Guaguere, E. Topical treatment of canine and feline pyoderma. (Tratamiento topico de la pioderma canina y felina). Veterinary Dermatology 1996; 7 : 145–151.] Zusammenfassung— Diese Veröffentlichung besteht in einer Übersicht von häufig verwendeten topischen antibakteriellen Arzneimitteln: Benzoylperoxid, Chlorhexidin, Povidon-Jod, Ethyllaktat, Triklosan, Mupirocin, Neomycin, Polymyxin B, Bacitracin und Fusidinsäure. Mit eingeschlossen ist eine Übersicht über Pharmakokinetik, Wirkungsweise, Nebenwirkungen und klinische Anwendung in der Veterinärdermatologie. Allgemeine Empfehlungen für die lokale antibakterielle Therapie werden dargestellt. [Guaguere, E. Topical treatment of canine and feline pyoderma (Lokale Behandlung von kaninen und felinen Pyodermien). Veterinary Dermatology 1996; 7 : 145–151.]     

湘桂地区犬皮肤病流行病学调查

对来自湘桂地区6个宠物医院的48 127个确诊病例进行调查,对犬皮肤病的种类、发病率及其与年龄和季节的相关性进行分析。结果表明,皮肤病发病率为28.53%。在皮肤病中,脓皮病和疥螨最为常见,分别占28.03%和26.18%。皮肤病的发病率随着年龄增长而下降。不同季节流行的皮肤病种类也有区别,但各皮肤病在冬季发病率最低。     

The role of allergy in the development of canine pyoderma

Pyoderma is commonly seen in canine veterinary practice and usually occurs as a complicating factor in other primary conditions. Allergic skin disease is often the underlying cause but the precise relationship between allergy and infection is unknown. Our studies have investigated the relationship between bacterial proliferation at the skin surface and hypersensitivity reactions with the skin. Hypersensitive dogs were shown to have significantly higher surface counts of staphylococci than normal controls and these bacteria were concentrated in the more superficial layers of the stratum corneum. Intradermal injection of staphlococcal antigens in normal dogs elicited epidermal damage similar to that seen in clinical disease. Preliminary autoradiographic studies using a model of canine skin hypersensitivity reactions showed that percutaneous absorption of radiolabelled staphylococcal antigens was increased by mast cell degranulation. These findings suggest that a major role of hypersensitivity reactions in the pathogenesis of pyoderma may be via an effect on epidermal permeability, promoting penetration of staphylococcal antigens from the stratum corneum which then cause the lesions of pyoderma. Hypersensitivity reactions may also lead to changes in the skin surface microclimate leading to increased bacterial counts on the skin surface, so exacerbating the condition.     

Transmission of multiple antimicrobial-resistant Staphylococcus intermedius between dogs affected by deep pyoderma and their owners

The occurrence of antimicrobial-resistant Staphylococcus intermedius strains was investigated in 13 dogs affected by deep pyoderma, their owners and 13 individuals without daily contact with dogs (control group). A total of 90 canine and 33 human S. intermedius isolates were typed by pulsed field gel electrophoresis (PFGE) to determine their possible identity. The occurrence of S. intermedius in dog-owners was significantly higher compared with the control group (Fisher's exact test, P=0.03), with S. intermedius being detected in seven dog-owners and in one individual not exposed to dogs. The results of the PFGE analysis showed that six out of 13 (46%) owners carried strains identical to those isolated from their dogs. Strains detected in both dogs and humans were resistant up to five different antimicrobial classes, including penicillins, fusidic acid, macrolides/lincosamides, tetracycline and chloramphenicol. Based on the results of this study, owners of dogs affected by deep pyoderma often carry multiple antimicrobial-resistant strains of S. intermedius occurring in their dogs. Independent of the direction and modalities of transmission, this finding raises questions concerning the possible transfer of resistance genes from canine S. intermedius to human pathogenic staphylococci.     

Antimicrobial resistance in staphylococci from canine pyoderma: a prospective study of first-time and recurrent cases in Sweden

In a prospective study involving eight veterinary clinics during 1995 and 1996, samples from first-time and recurrent cases of canine pyoderma were collected by a needle technique. Three hundred and ninety-four staphylococci were isolated and their susceptibility to various antimicrobial drugs was assessed by a microdilution technique. Resistance to macrolides, lincosamides, fusidic add, tetracycline and streptomycin was significantly more common in isolates from the recurrent cases than from the first-time cases; 20 per cent of the isolates from the first-time cases were resistant to three or more of the antimicrobials tested, compared with 45 per cent of those from the recurrent cases. Coresistance between macrolide-lincosamides, tetracyclines and streptomycin was common. No resistance to penicillinase-stable beta-lactams was observed. A comparison with earlier studies indicated that there had been a marked increase in resistance during the previous five years.     

犬脓皮病病原菌的分离鉴定及耐药性分析

为了研究犬脓皮病致病菌的种类及其对抗生素的敏感性,采用细菌培养、分离、革兰染色和生化试验等方法鉴别病原菌;采用Kirby-Bauer药物纸片琼脂扩散法对病原菌进行药敏试验。结果表明：病犬发病部位的病原菌为中间型葡萄球菌和金黄色葡萄球菌。中间型葡萄球菌对头孢拉啶和头孢氨苄敏感,敏感率为20%;对羧苄西林和头孢他啶中度敏感,中度敏感率为20%;对红霉素、卡那霉素、复方新诺明、哌拉西林、青霉素和苯唑西林产生耐药,耐药率为60%。金黄色葡萄球菌对头孢拉啶和头孢氨苄敏感,敏感率为20%;对羧苄西林和哌拉西林中度敏感,中度敏感率为20%;对红霉素、卡那霉素、复方新诺明、头孢他啶、青霉素和苯唑西林产生耐药,耐药率为60%。     

Prevalence of meticillin-resistant Staphylococcus pseudintermedius (MRSP) from skin and carriage sites of dogs after treatment of their meticillin-resistant or meticillin-sensitive staphylococcal pyoderma

Background – Meticillin‐resistant staphylococci are significant pathogens in veterinary dermatology, yet longitudinal studies of the impact of routine antimicrobial therapy on emergence or resolution of resistance are lacking. Objectives – To determine the prevalence of meticillin‐resistant staphylococci on skin and carriage sites in dogs with bacterial pyoderma and evaluate the prevalence of meticillin‐resistant Staphylococcus pseudintermedius (MRSP) colonization after successful treatment of pyoderma. Animals – One hundred and seventy‐three dogs that presented to a dermatology referral service with pyoderma and 41 healthy control dogs. Methods – Skin, nasal and rectal swabs for bacterial culture were collected at the time of referral and after clinical resolution of the pyoderma. Meticillin resistance was confirmed by demonstration of penicillin binding protein 2a antigen. Results – Initially, skin cultures yielded MRSP in 70 (40.5%) dogs, meticillin‐resistant Staphylococcus aureus (MRSA) in three (1.7%) and meticillin‐resistant Staphylococcus schleiferi ssp. coagulans (MRSScoag) in five (2.9%). Samples collected from the nose and rectum (carriage sites) yielded MRSP in 59 (34.1%) dogs, MRSA in 11 (6.4%) and MRSScoag in seven (4.0%). One hundred and two dogs were available for follow‐up cultures after clinical cure. Of 42 dogs initially diagnosed with MRSP pyoderma, MRSP was isolated at follow‐up from skin in 19 (45.2%) and carriage sites in 20 (47.6%). Of 60 dogs that did not have MRSP pyoderma initially, MRSP was isolated post‐treatment from the skin in 17 (28.3%), and MRSP from carriage sites increased from 7.8% (initially) to 26.7% (P = 0.0022). Conclusions and clinical importance – Colonization by MRSP often persists after resolution of MRSP pyoderma. Acquisition of MRSP during treatment appears to be common.     

Adherence of Staphylococcus intermedius to canine corneocytes in vitro

This study investigated the in vitro adherence of Staphylococcus intermedius to canine corneocytes, collected from a healthy dog using double-sided adhesive tape. Adherence was shown to depend on duration (P < 0.001) and temperature of incubation (P < 0.001) and the concentration of bacteria (P < 0.001). Isolates of S. intermedius from lesions of pyoderma were not generally more adherent to healthy canine skin than were isolates from healthy dogs. Significant differences in adherence were demonstrated between individual isolates within both groups (P < 0.001). The study suggests that among S. intermedius there is no correlation between virulence and adherence to canine corneocytes in vitro. The finding may be important for the potential use of avirulent variants of S. intermedius as antagonistic strains against canine pyoderma. However, more studies are needed to compare the adherence of the isolates to skin cells obtained from dogs with diseases predisposed to pyoderma.