Allergy Testing for Skin Disease in the Cat In Vivo vs In Vitro Tests

Abstract— The results of in vitro and in vivo tests for 36 cats with signs suggestive of allergic skin disease were compared. The cats were presented to the dermatology section of the Department of Veterinary Medicine, University of Bristol, with a variety of skin conditions. Intradermal skin testing with flea extract alone (six cats) or combined with a panel of 40 inhalant altergens (30 cats) was employed. Serum samples were tested with a commercial IgE ELISA against flea extract and 36 inhalant allergens. A diagnosis of flea bite hypersensitivity was made in 18 cats, atopic disease in nine cats and food hypersensitivity in one cat. Intradermal skin testing gave a positive predictive value in over 85 per cent of flea allergic cases and 100 per cent of atopic cases; the IgE ELISA test demonstrated relatively low predictive values for flea allergy and atopic disease and was not considered to be a useful diagnostic test. Résumé— Les résultats de tests in vitro et in vivo faits chez 36 chats ayant des symptômes évocateurs d'une dermite allergique ont été comparés. Des tests cutanés à la seule puce (six chats) ou combinés avec un panel de pneumallergènes (30 chats) ont été utilisés. Les sérums ont été testés avec un kit commercial de dosages d'IgE spécifiques de la puce et de 36 pneumallergènes par technique EIA. Un diagnostic de dermite par hyperseensibilité aux piqùres de puce a été fait chez 18 chats, une atopie chez neuf et une hypersensibilité d'origine alimentaire chez un. Les tests cutanés avaient une valeur prédictive de 85% pour les allergies à la puce et 100% pour les cas d'atopie; les tests IgE EIA avaient une valeur prédictive assez faible et n'ont pas été considérés comme étant un test utilisable en diagnostic. Resumen En este artículo se comparan los resultados de pruebas in vivo e in vitro efectuadas en 36 gatos con cuadro clínico indicativo de alergias cutáneas. Éstos animales fueron presentados en la sección de Dermatología del departamento de medicina de la Universidad de Bristol con una variedad de condiciones cutäneas. En las pruebas de invecciones intradérmicas se utilizaron alergenos de extracto de pulga solos o combinados con un panel de 40 alergenos inhalatorios (30 gatos). También se llevaron a cabo pruebas de suero con el test comercial de IgE ELISA para el extracho de pulga y 36 de los alergenos inhalatorios. En 18 de los gatos se diagnostico hipersensitividad a las pulgas, en nueve atopía y solo uno hipersensitividad a los alimentos. Las pruebas intradérmicas produjeron una predictividad positiva en 85% de los casos de alergia a las pulgas y 100% de los casos de atopía. Sin embargo el test ELISA de IgE produjo una baja predictividad relativa en los casos de hipersensitividad a las pulgas y casos de atopía y no se consideró como un test de gran utilidad diagnóstica.     

Exercising Blood Gas Analysis, Dynamic Upper Respiratory Tract Obstruction, and Postexercising Bronchoalveolar Lavage Cytology—A Comparative Study in Poor Performing Horses

Respiratory abnormalities are common causes of decreased performance in horses presumably because of impaired pulmonary gas exchange. The objectives of the present study were to describe respiratory abnormalities in poorly performing horses and to investigate the relationships between dynamic upper respiratory tract (URT) videoendoscopy, postexercising bronchoalveolar lavage (BAL) cytology, and exercising arterial blood gas analysis. Medical records of 93 horses with exercise intolerance, which presented for treadmill evaluation, were reviewed. Relationships between horse demographics, treadmill endoscopic findings, exercising blood gas values, and BAL cytology results were examined. A total of 25 (27%) horses had a URT obstruction and 91 (98%) horses had abnormal BAL cytology; 73 (78%) had evidence of inflammatory airway disease (IAD) and 83 (89%) had exercise-induced pulmonary hemorrhage (EIPH). In all, 39 (42%) horses had abnormal blood gas values. Dynamic URT obstruction was significantly associated with exercising hypoxemia (P = .036). There were no significant relationships between gas exchange and IAD or between EIPH. Out of 24 (26%) horses with combined URT obstruction and abnormal BAL, horses with URT obstruction and EIPH were more likely to be hypoxic during exercise (P = .037). It was concluded that horses with dynamic URT abnormalities are likely to have exercising hypoxemia. Although IAD and EIPH were commonly indentified in poor performers, they were not significantly associated with abnormal exercising blood gas analysis.     

Increased Parasite Resistance and Recurrent Airway Obstruction in Horses of a High‐Prevalence Family

Background: Equine recurrent airway obstruction (RAO) shares many characteristics with human asthma. In humans, an inverse relationship between susceptibility to asthma and resistance to parasites is suspected. Hypothesis/Objectives: Members of a high‐incidence RAO half‐sibling family (F) shed fewer strongylid eggs compared with RAO‐unaffected pasture mates (PM) and that RAO‐affected horses shed fewer eggs than RAO‐unaffected half‐siblings. Animals: Seventy‐three F and 73 unrelated, age matched PM. Methods: Cases and controls kept under the same management and deworming regime were examined. Each individual was classified as RAO affected or RAO unaffected and fecal samples were collected before and 1–3 weeks and 3 months after deworming. Samples were analyzed by combined sedimentation‐flotation and modified McMaster methods and classified into 3 categories of 0 eggs per gram of feces (EpG), 1–100 EpG, and >100 EpG, respectively. Results: PM compared with RAO‐affected F had a 16.7 (95% confidence interval [CI]: 2.0–136.3) times higher risk for shedding > 100 EpG compared with 0 EpG and a 5.3 (95% CI: 1.0–27.4) times higher risk for shedding >100 EpG compared with 0 EpG. There was no significant effect when RAO‐unaffected F were compared with their PM. RAO‐unaffected compared with RAO‐affected offspring had a 5.8 (95% CI: 0.0–1.0) times higher risk for shedding 1–100 EpG. Age, sex, breed, and sharing pastures with other species had no significant confounding effects. Conclusion and Clinical Importance: RAO is associated with resistance against strongylid parasites in a high‐prevalence family.     

A Comparison of Multiple Allergen Simultaneous Tests Using Allergen-Specific IgE Concentration and Intradermal Skin Tests in Atopic Horses With Pollen Allergy

Intradermal tests (IDTs) and measurement of specific immunoglobulin E class (sIgE) levels in sera are the most common and reliable methods used in allergological clinical practice. The purpose of this study was to explore the sensitization of pollen allergy in atopic horses with pollinosis and to assess the diagnostic value of the multiple allergen simultaneous tests (MASTs) compared with that of the IDT. Twenty-one Malopolski horses with typical skin hypersensitivity symptoms during pollen seasons were enrolled. Intradermal tests were performed, and allergen-specific IgE concentrations in sera were measured using a monoclonal anti-IgE antibody to pollens of grass, weeds, trees, and cultivated plants. The highest sensitization rate was for Secale cereale (IDT, 76%; MAST, 66.7%), grass (IDT, 71%; MAST, 57%), and Brassica napus (IDT, 52.4%; MAST, 57%). Receiver operating characteristic (ROC) curve analysis and the area under the ROC curve (AUC) showed that Betula spp., Alnus spp., and Corylus spp. had the highest AUC at 0.854, followed by Secale cereale (AUC = 0.796), Plantago lanceolata (AUC = 0.726), Brassica napus (AUC = 0.704), and a grass allergen mixture (AUC = 0.695). The mean AUC for all allergens was 0.712 (0.604–0.867). The overall sensitivity of the sIgE plant horse panel was 78% (range, 68%–90%), the specificity was 86.3% (range, 64%–100%), and the accuracy was 79% (range, 64%–87%). Statistical kappa (κ) agreement between the MAST and IDT was reached for tree (κ = 0.767), rye (κ = 0.687), colza (κ = 0.671), and grass (κ = 0.664) pollen. The MAST showed a favorable agreement with the IDT and can be used for the detection of sIgE in atopic horses with pollinosis.     

Tissue Doppler Imaging and Two-dimensional Speckle Tracking of Left Ventricular Function in Horses Affected with Recurrent Airway Obstruction before and after Clenbuterol Treatment

Cardiac effects of the β₂-adrenergic agent clenbuterol have been the focus of many studies, but effects on myocardial velocities and myocardial deformation parameters have not yet been evaluated in horses affected with recurrent airway obstruction (RAO) using tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2DST). In our study, 7 horses affected by RAO were treated over 14 days with clenbuterol, 0.8 μg/kg every 12 hours. Standard echocardiographic, TDI (pulsed wave and color TDI), and 2DST examinations were performed before and after the treatment period. Myocardial function was recorded in the right parasternal short-axis view. Percent of fractional shortening and two-dimensional echocardiography (2DE) measurements did not show any significant changes after 2 weeks of treatment. Early diastolic velocity, E, increased significantly after clenbuterol in the left ventricular free wall (LVFW; P = .001). The E/late diastolic velocity (A) quotient (P = .003) and the isovolumetric contractility (P = .035) also increased significantly after treatment. Time parameters, particularly the time interval between the Q-wave in the echocardiograph and atrial release, the time of diastole and Tei index (parameter of global ventricular function), decreased significantly after clenbuterol administration in the LVFW (P = .014/P = .028/P = .015, respectively). The 2DE speckle tracking revealed a significant increase of the early diastolic systolic strain rate (P = .01) in the LVFW after therapy. In conclusion, 2 weeks of treatment with clenbuterol at a dosage of 0.8 μg/kg every 12 hours led to improved cardiac function in severely RAO-affected horses. This could be a sign of myocardial restoration (re-remodeling) after therapy.     

An In Vitro Investigation into the Effects of a Marine-Derived,Multimineral Supplement in Simulated Equine Stomach and Hindgut Environments

Management of the performance horse often incorporates meal feeding of highly digestible starches and reduced access to high-fiber forage. Such regimens are associated with equine gastric ulceration syndrome (EGUS) and can alter hindgut homeostasis. In-feed buffering of gastric contents and promotion of energy derivation from high-fiber forage in the hindgut are therefore desirable properties of a nutritional supplement. A marine-derived, multimineral supplement with known buffering properties containing calcium, magnesium, and short-chain fructo-oligosaccharides (scFOS) was tested under in vitro simulations of equine stomach and hindgut conditions. Six fiber:concentrate diets were incubated for 4 hours with or without the supplement at 37°C in pepsin HCl solution adjusted to pH 4.1 and 2.6. pH was measured at 1, 2, and 4 hours postincubation. Highest overall pH values were observed with the high cereal feeds; however, the supplement significantly increased (P < .001) the pH across all feeds by 0.17 and 0.19 for feeds incubated at pH 4.1 and 2.6, respectively. A gas production technique was used to measure the fermentation of four fiber:concentrate diets with and without additional supplement, using equine feces as the microbial inoculum. Addition of the supplement decreased (P < .05) the lag time and increased the initial fermentation rate, although as the incubation continued, this effect was reduced. These results demonstrate that the supplement had a significant buffering action for 4-6 hours under simulated in vitro stomach digestion conditions and also stimulated in vitro hindgut fermentation activities.