Diagnosis of erythema multiforme associated with thymoma in a dog and treated with thymectomy

A 7 yr old Labrador retriever initially presented for severe halitosis, mild ptylism, and depigmentation of the nasal planum. Erythema multiforme was diagnosed based on clinical signs and dermatopathology. Treatment was initiated but the condition did not resolve. Six months later, the dog was diagnosed with a mediastinal mass. Trucut biopsy was performed and histopathologic diagnosis was consistent with a thymoma. A median sternotomy was performed, the thymoma was excised, and the dog recovered well. Four months postoperatively, there were no longer any obvious erythema multiforme lesions and the skin condition was controlled without medication. Erythema multiforme may be a paraneoplastic disorder associated with thymoma in the dog, similar to thymoma-associated exfoliative dermatitis in the cat. Clinical signs of erythema multiforme may warrant performing thoracic radiographs or thoracic CT to rule out thymoma as an underlying cause.     

Spontaneous antenatal resolution of canine hydrops fetalis diagnosed by ultrasound

A previously unreported syndrome of transient mid-gestational hydrops fetalis identified by ultrasound was diagnosed in 16 litters of 16 different dogs between November 1999 and May 2002. During this study period, a total of 161 canine pregnancies were diagnosed by ultrasound. A 17th litter of eight fetuses developed similar ultrasonographic changes concurrently with maternal systemic mastocytosis and subsequently spontaneously aborted. No pups were born with clinical signs of hydrops fetalis. Fetal resorption in the affected litters was 7/95 (7.4 per cent) and 8/95 (8.4 per cent) aborted. Of the fetuses that survived to term, there were 7/88 (8 per cent) stillbirths. Neonatal mortality rate in the affected litters was 15 per cent (11/73) and the incidence of congenital abnormalities was 7/73 (9.6 per cent). Pugs were significantly (22.8 times) more likely to be affected than other breeds.     

Prospective study of bacterial overgrowth syndrome in eight dogs

Eight dogs with cutaneous lesions, clinical signs and cytological findings compatible with bacterial overgrowth syndrome were compared with four healthy dogs. The affected dogs were treated for 28 days with 30 mg/kg/day cephalexin. The results showed that the syndrome was a superficial cutaneous disorder characterised by marked pruritus, greasy seborrhoea, offensive odour, erythema, lichenification, hyperpigmentation, excoriations and alopecia involving principally the ventral aspect of the body, but no papules, pustules, epidermal collarettes or crusts; it was caused by overgrowths of Staphylococcus intermedius all over the body surface. Histopathological findings included a superficial, perivascular, hyperplastic and spongiotic dermatitis with a mixed inflammatory infiltrate, but no lesions suggestive of a true pyoderma. In the affected dogs, anti-staphylococcal immunoglobulin G levels were high, but anti-staphylococcal immunoglobulin E levels were low, suggesting that staphylococcal hypersensitivity is not the underlying pathogenic process. The antibiotic treatment improved the condition of all the dogs, but five of the eight had an underlying allergic skin disease.     

Comparison of two shampoos as sole treatment for canine bacterial overgrowth syndrome

Two antibacterial shampoos for the treatment of canine bacterial overgrowth syndrome (BOGS) were compared in a prospective controlled clinical trial. Forty dogs with clinical signs (pruritus, erythema and excoriations without pustules and/or collarettes) and cytological findings compatible with bacterial overgrowth were treated twice weekly with 3 per cent chlorhexidine shampoo (3 per cent CHX) or 2.5 per cent benzoyl peroxide shampoo (2.5 per cent BPO) and evaluated every two weeks for up to six weeks until cytological cure. Pruritus, erythema, greasy seborrhoea, malodour, excoriations, secondary hair loss, lichenification, hyperpigmentation and lesion extent were each scored on a 0 to 3 severity scale and combined to calculate an aggregate score. Among the 34 dogs with good compliance to treatment, reduction of cocci counts of at least 90 per cent was recorded in 11 of 18 dogs after 3 per cent CHX and nine of 16 dogs after 2.5 per cent BPO, with no significant difference between the two products (P=0.98). Lesion score was significantly reduced in both groups (63.48 (34.45)) per cent with 3 per cent CHX v 54.45 (33.61) per cent with 2.5 per cent BPO, P=0.36) and time to cytological cure was not significantly different between groups (P=0.13), at the end of the treatment. In the present study, 3 per cent CHX and 2.5 per cent BPO were similarly effective in the treatment of canine BOGS.     

Feline osteoarthritis: a prospective study of 28 cases

OBJECTIVES: To identify a cohort of cats with clinical osteoarthritis and to report on the clinical signs, the frequency of joints affected and the possible aetiopathogenesis within this population. METHODS: Inclusion criteria for this prospective study were presence of historical evidence and/or clinical signs of osteoarthritis, together with radiographic evidence of osteoarthritis. Patients showed clinical improvement within four weeks of analgesic administration and were free from other disease processes, which might explain the clinical signs and/or their response to analgesia. RESULTS: Twenty-eight cases were included in the cohort. The elbow (45 per cent) and the hip (38 per cent) were the most frequently affected joints. Seventy-one per cent of cases had primary/idiopathic aetiology. Alterations in both the ability to jump (71 per cent) and the height (67 per cent) of jump (lifestyle changes) were the most frequent signs of disease. Sixty-one per cent of owners felt that their pet had made a marked improvement following administration of an analgesic/anti-inflammatory drug. There were statistically significant improvements in the ability to jump (P < 0.001), the height of jump (P < 0.001), lameness (P = 0.03), stiff gait (P = 0.04) and the activity level (P = 0.02) when compared with the start and the end of the study period. CLINICAL SIGNIFICANCE: Osteoarthritis is a clinical problem in cats, but overt lameness is not the most common clinical feature.     

Canine dilated cardiomyopathy: a retrospective study of signalment, presentation and clinical findings in 369 cases

O bjective : To review the clinical and diagnostic findings and survival of dilated cardiomyopathy from a large population of dogs in England.
M ethods : A retrospective study of the case records of dogs with dilated cardiomyopathy collected between January 1993 and May 2006.
R esults : There were 369 dogs with dilated cardiomyopathy of which all were pure-bred dogs except for four. The most commonly affected breeds were dobermanns and boxers. Over 95 per cent of dogs weighed more than 15 kg and 73 per cent were male. The median duration of signs before referral was three weeks with 65 per cent presenting in stage 3 heart failure. The most common signs were breathlessness (67 per cent) and coughing (64 per cent). The majority of dogs (89 per cent) had an arrhythmia at presentation and 74 per cent of dogs had radiographic signs of pulmonary oedema or pleural effusion. The median survival time was 19 weeks.
C linical S ignificance : Dilated cardiomyopathy occurs primarily in medium to large breed pure-bred dogs, and males are more frequently affected than females. The duration of clinical signs before referral is often short and the survival times are poor. Greater awareness of affected breeds, clinical signs and diagnostic findings may help in early recognition of this disease which often has a short clinical phase.     

Erythema multiforme in dogs and cats: literature review and case material from the Cornell University College of Veterinary Medicine (1988–96)

A review of case material from the Cornell University College of Veterinary Medicine from 1988 to 1996 identified 20 dogs and one cat with definitive or presumed erythema multiforme. An additional 24 dogs and five cats with definitive or presumed erythema multiforme were found in the veterinary literature. Erythema multiforme accounted for only 0.40% and 0.11%, respectively, of all the canine and feline dermatology cases examined over a 9-year period. German Shepherd dogs and Pembroke Welsh Corgis appeared predisposed. The condition was manifested as a vesiculobullous and/or ulcerative dermatosis in the majority of dogs and cats. In dogs, the most commonly affected body sites included the ventrum (especially axillae and groin), mucocutaneous junctions, oral cavity, pinnae, and footpads. Histopathological findings in cutaneous and mucocutaneous biopsy specimens were consistent with previously published criteria. In dogs, erythema multiforme occurred more frequently in patients receiving drug therapy. In cats, all cases of erythema multiforme were presumed to be drug related. Elimination of the associated trigger factor and supportive care usually resulted in resolution of the erythema multiforme within 1–2 weeks. Four dogs with severe idiopathic erythema multiforme were successfully managed with glucocorticoids or azathioprine.     

Parasitic otitis in sheep associated with psoroptes infestation: a clinical and epidemiological study.

Parasitic otitis associated with psoroptes infestation was diagnosed in a small pedigree flock of sheep with aural haematomas, abscessation and cauliflower ears. Thirteen of the 15 lambs were affected but the clinical signs were mild; small, discrete, crusty lesions on the inner aspect of the ear at the junction of its anterior and posterior borders were typical. Nine of the 20 adults were affected but the lesions were more severe. Eighteen of the 64 members of the breed society who responded to a telephone survey reported sheep with similar clinical signs in their flocks. The proportion of animals affected ranged from 1 to 60 per cent with a median value of 16 per cent.     

Retrospective evaluation of the long-term outcome of non-surgical management of 74 dogs with clinical hip dysplasia

The long-term outcome for dogs treated non-surgically for clinical signs of canine hip dysplasia were evaluated retrospectively; 74 dogs were evaluated by a postal questionnaire sent to their owners, and 24 of these were also evaluated by a veterinary clinical examination. A total of 11 outcome variables were evaluated. Depending on the variable assessed, between 31 (41.9 per cent) and 49 (66.2 per cent) of the dogs remained clinically affected according to their owner's assessment, and between 17 (70.8 per cent) and 23 (95.8 per cent) of the 24 dogs had abnormalities attributed to hip osteoarthritis according to the veterinary assessment. Orthopaedic abnormalities other than hip dysplasia affected 17 of the 24 dogs. Long-term medications had been prescribed for the treatment of clinical signs associated with hip dysplasia in 41 of the 74 dogs.     

Use of human immunoglobulin for treatment of severe erythema multiforme in a cat

A 5-month old female domestic shorthair cat developed lethargy and severe ulcerative skin lesions that covered more than half of its body after routine administration of rabies vaccine, anthelmintic, and ear medication. Clinical and histologic findings were consistent with a severe cutaneous drug reaction or erythema multiforme. The cat's condition continued to deteriorate despite drug withdrawal and supportive care. Administration of human intravenous immunoglobulin was well tolerated by the cat and led to rapid resolution of ulcerative cutaneous lesions, accompanied by substantial improvement in the cat's demeanor within 8 days. Human intravenous immunoglobulin appears to be a novel promising treatment for life-threatening cutaneous drug reactions.     

Putative drug-related pemphigus foliaceus in four dogs

Four dogs developed cutaneous lesions following the administration of various antibiotics. Histopathology of the lesions was compatible with pemphigus foliaceus, although apoptotic cells suggestive of erythema multiforme were seen in two cases. In two dogs the lesions resolved after 7.5-8.5 months of immune-suppressive treatment. No recurrence was seen during the follow-up period (3 and 4.5 years). The lesions in the other two dogs resolved within 3 weeks to 3 months following discontinuation of the antibiotic. No recurrence of clinical signs occurred during the follow-up period (1 and 4 years, respectively).     

Efficacy and safety of a new 450 mg/ml florfenicol formulation administered intramuscularly in the treatment of bacterial bovine respiratory disease

The objective of the study was the safety and efficacy evaluation of a new 450 mg/ml florfenicol formulation in the treatment of naturally occurring respiratory disease when administered intramuscularly, compared with a positive control group treated with the well-established 300 mg/ml formulation. A total of 174 calves, selected from five sites in France and Spain, aged from 1 to 17 months, showing severe signs of respiratory disease, were randomly assigned to treatment with either the 300 mg/ml (3 ml/45 kg; Nuflor; MSD Animal Health) or 450 mg/ml (2 ml/45 kg; Nuflor Minidose; MSD Animal Health) florfenicol formulation, both administered intramuscularly twice, two days apart. Animals were clinically observed daily for 14 days following treatment initiation. The predominant pathogens present in pretreatment respiratory tract samples were Mannheimia haemolytica and Pasteurella multocida. Mycoplasma bovis and Histophilus somni were also present. All isolates were subjected to in vitro sensitivity testing and found susceptible to florfenicol. In both treatment groups, rectal temperature dropped and clinical index (depression and respiratory signs) significantly improved (P<0.05) after treatment. As a result, 97.7 per cent of the 450 mg/ml florfenicol formulation-treated animals were considered treatment successes on day 5. On day 14, 67.82 per cent of the animals were classified as treatment successes and among them 63.22 per cent were cured. The intramuscular injection of the new 450 mg/ml florfenicol formulation was found equally efficacious as the original 300 mg/ml formulation.     

Isolation of a virus serologically related to the bluetongue group from an outbreak of haemorrhagic disease among exotic deer in Saudi Arabia.

In February 1991 a severe haemorrhagic disease affected exotic deer aged over six months in the Al-Hofuf area of the eastern region of Saudi Arabia. The morbidity rate was 40 per cent and the case fatality rate was 60 per cent. The clinical signs were high temperature (up to 41.5 degrees C), nasal discharge, slight salivation and lacrimation, congestion of the conjunctivae, torticollis, tremors when trying to stand, recumbency and coma leading to death. Post mortem examination revealed a severe haemorrhagic disease. A virus, serologically related to the bluetongue serogroup, was isolated from the deer. Sheep and goats kept on the same farm did not show any clinical signs. The epidemiology of the outbreak is discussed.     

Osteoarthritis in cats: a retrospective radiological study

OBJECTIVES: To provide basic information about natural feline osteoarthritis (OA) as part of more extensive studies. METHODS: A retrospective study of cats (greater than one year of age) radiographed for any reason at a first opinion and referral veterinary practice was performed. Cats were classified as either having or not having radiographic OA. Computerised histories were searched for records of potential causes and clinical signs of OA. The genders and ages of the affected cats were compared with a control population using chi-squared tests. RESULTS: Of 491 cats, 292 (59 per cent) had undergone a diagnostic radiograph of at least one synovial joint. Sixty-three of 292 cats (22 per cent) showed evidence of radiographic OA; 21 (33 per cent) of which also had clinically evident OA. A potential cause of OA had been recorded in only seven of 63 cats (11 per cent). The population of cats with radiographic evidence of OA was older than the control population (P<0.001). CLINICAL SIGNIFICANCE: Radiographic OA was found in 22 per cent of the test population. In many cases there was no clinical evidence of OA recorded in the history, suggesting that either there is little correlation between clinical and radiographic OA or that clinical signs of OA in cats may not have been observed or recorded. Idiopathic/primary OA was common.     

Immunologic diseases

Selected equine cutaneous diseases for which there is strong evidence of an immunological aetiology are discussed in this section. The reactive disorders of urticaria, Culicoides hypersensitivity, erythema multiforme, drug eruptions and systemic granulomatous disease are included. The autoimmune diseases of the horse with cutaneous manifestations (pemphigus foliaceus, pemphigus vulgaris, bullous pemphigoid and cutaneous lupus erythematosus) are discussed. The clinical signs and diagnostic features of these immunologically induced equine dermatoses are defined, and the challenges in making a definitive diagnosis and managing the clinical signs are confirmed.     

Observational study of 14 cases of chronic pancreatitis in dogs

This study reports the clinical, clinicopathological and ultrasonographic findings from dogs with chronic pancreatitis (CP). Fourteen dogs with clinical signs consistent with CP and histological confirmation of the disease were evaluated. Abdominal ultrasound and clinical pathology results were recorded. Sensitivities of pancreatic enzymes for diagnosis of CP were calculated with two different cut-off values. The mean age of affected dogs was 9.1 years. Spaniels were the most common breed with CP, representing seven of the 14 dogs in this study. CP was histologically severe in nine cases. Most dogs showed chronic low-grade gastrointestinal signs and abdominal pain. Five dogs had exocrine pancreatic insufficiency and five dogs had diabetes mellitus. The sensitivity of elevated trypsin-like immunoreactivity for CP was 17 per cent. The sensitivities of canine pancreatic lipase immunoreactivity, lipase and amylase for CP were 44 to 67 per cent or 14 to 28 per cent depending on the cut-off value used. Cholesterol was elevated in 58 per cent of samples. Liver enzymes were often elevated. The pancreas appeared abnormal on 56 per cent of ultrasound examinations. Ten dogs had died by the end of the study period; only one case was due to CP.     

Evaluation of fipronil spot-on in the treatment of flea allergic dermatitis in dogs

The purpose of this study was to evaluate the effectiveness of treatment with 10 per cent fipronil solution for controlling signs of flea allergic dermatitis in dogs under field conditions. Thirty-one client-owned dogs with flea allergic dermatitis were treated with three monthly applications of 10 per cent fipronil solution. Flea counts and pruritus were significantly reduced at all post-treatment visits. At the final visit, on day 90, flea counts were reduced by 98 per cent, and pruritus was reduced or eliminated in 84 per cent of the study dogs. Dermatological lesion scores for erythema, crusts, scales and papules were also significantly improved by the final visit. The overall assessment of efficacy on day 90 was 'excellent' to 'good' for 87 per cent of the study dogs. The results demonstrate that treatment with monthly topical applications of 10 per cent fipronil solution is effective in reducing the prevalence and severity of signs of flea allergic dermatitis in dogs.     

Clinical and laboratory findings in cases of toxic mastitis in cows in Northern Ireland

This paper describes the clinical and laboratory findings from 264 cases of toxic mastitis in cows in Northern Ireland between October 1995 and May 1997. Nearly all the cases occurred during the winter housing period, with 84 per cent occurring between November and March inclusive, and 30 per cent in March. Sixty per cent of the cases occurred within one month of calving, and 29 per cent within four days of calving. The most common clinical signs were lethargy (92 per cent), discoloured milk (90 per cent), anorexia (72 per cent), tachypnoea (23 per cent), diarrhoea (23 per cent), recumbency (18 per cent) and staggering (15 per cent). Severe pyrexia (18 per cent) and clinical dehydration (44 per cent) were relatively common findings. Pure growths of Escherichia coli were isolated from 50 per cent of the milk samples, but 11 per cent yielded no bacterial growth. In vitro sensitivity tests indicated that enrofloxacin was effective against 98 per cent of the bacteria isolated, and framycetin and amoxycillin/clavulanic acid against 91 per cent. Abnormally high blood urea levels were observed in 31 per cent of cases, high blood creatinine levels in 42 per cent, and severe leucopenia in 56 per cent. Of the cases which were followed up, 14 per cent died, 21 per cent were culled early and a further 22 per cent lost milk production from the affected quarter.     

Prospective open pilot study on the use of ciclosporin for feline allergic skin disease

OBJECTIVES: To evaluate the efficacy of ciclosporin in cats with allergic skin disease. METHODS: Ten cats with signs of allergic skin disease were administered ciclosporin daily at a dose of 3.6 to 8.3 mg/kg for one month. None of these cats had previously responded to a hypoallergenic diet trial, and all animals had previously been treated with endectoparasiticidal drugs, with no improvement two weeks before entering the trial. On days 0 and 30, owners assessed pruritus with a visual analogue scale, and veterinarians evaluated cutaneous lesions. RESULTS: All the cats had pruritus and erythema, five had alopecia, two had an eosinophilic plaque, one had miliary dermatitis and two had both alopecia and an eosinophilic plaque. Good or excellent improvement was observed in 40 per cent of cats for pruritus, 57 per cent of cats for alopecia and 60 per cent of cats for erythema. A significant decrease in mean scores was observed for pruritus only, while for erythema and alopecia, it was close to being significant (P < 0.052). CLINICAL SIGNIFICANCE: Ciclosporin may be helpful in symptomatically treating signs of feline allergic skin disease. However, it is important to remember that ciclosporin is not licensed for use in cats.     

Detection and distribution of toxigenic Pasteurella multocida in pig herds with different degrees of atrophic rhinitis

Four herds of pigs were selected which had different degrees of clinical atrophic rhinitis and used different specific counter-measures. In two of them, the clinical signs occurred spasmodically and were slight. The sows, suckling pigs and growing pigs in all the herds were sampled for toxigenic Pasteurella multocida. In one of the slightly affected herds (herd D), the weaners were moved to a second farm for finishing. No toxigenic P multocida were found at the breeding farm, but 50 per cent of the large growing pigs were positive. It seemed that the organism had entered only at the finishing farm and that the mild clinical signs were due to the infection starting in older pigs than usual. In the second mildly affected herd, 47 per cent of the sows and 42 per cent of the growers were infected. Three toxigenic isolates from this herd produced as severe turbinate damage experimentally in specific-pathogen-free pigs as a stock pathogenic strain. Except in herd D, toxigenic P multocida were found in all the age groups of pigs sampled. However, the pattern of distribution of the organism within the herds was not obviously correlated with the severity of the disease. In a fifth herd there were obvious cases of clinical atrophic rhinitis, with marked turbinate atrophy, from which toxi-genic P multocida were recovered in abundance. Subsequently, the clinical disease disappeared and, despite extensive and repeated sampling, the organism was not found again.