Effects of propofol-induced sedation on intradermal test reactions in dogs with atopic dermatitis

We compared the effect of propofol and saline control on intradermal test reactions in dogs with atopic dermatitis undergoing outpatient intradermal testing (IDT). Nineteen dogs were used in this clinical study. Patients were randomly allocated to receive either intravenous (IV) propofol or IV 0.9% saline, and IDT was performed on the right or left (randomized) lateral thorax. One investigator, unaware of the treatments, interpreted all IDT results. Injection sites were analysed using a subjective and objective method. A value of P or= 1+ on all dogs, significantly more positive sites were apparent during propofol sedation than during saline administration. In addition, the greater number of individual dogs experiencing more positive reactions >or= 1+ during propofol sedation was significant. When subjectively analysing reactions >or= 2+, the greater number of positive reactions and the greater number of dogs with more positive reactions observed during propofol treatment was not significantly different from the saline control. When analysed objectively, the greater number of positive reactions observed during propofol sedation was not significant. A greater number of dogs had higher subjective scores and larger objective measurements during propofol sedation compared with saline administration. In summary, propofol sedation was associated with an overall greater number of positive IDT reactions compared with the saline control. Although not always significant, this difference should be considered when choosing propofol for skin testing dogs with atopic dermatitis.     

The prevalence of positive intradermal allergy tests in 114 dogs with atopic dermatitis in the Bangkok metropolis, Thailand

Intradermal allergy tests using 47 selected local aero-allergens were performed on 114 dogs with atopic dermatitis. The subject animals visited the Dermatology Unit at the Veterinary Teaching Hospital of Kasetsart University or the SLV Pet Hospital with chronic pruritus and various skin lesions. Allergen extracts were composed of: 4 house dust and house dust mites, 7 household insects, 24 pollens, 11 mold spores, and Kapok. The prevalence of sensitization to various allergens were as follows: Dermatophagoides farinae (74.56%), Dermatophagoides pteronyssinus (53.51%), house dust (26.32%), American cockroach (Periplaneta americana) (23.68%), Para glass (21.93%) and mixed ants (20.18%). No relationship was noted between the various allergen groups and the location of the skin lesions except for those animals that reacted to pollens which appeared to have be more likely to have lesion affecting the perineum and tail area (p=0.022; OR, 6.429; 95% CI, 1.003-40.292).     

Comparison of subjective and objective intradermal allergy test scoring methods in dogs with atopic dermatitis

An intradermal allergy test (IDT) is an important diagnostic tool for identifying offending allergens in canine atopic dermatitis. No standardized method of scoring an IDT has been described. The purpose of this study was to determine whether there is a correlation between a conventional, subjective IDT scoring method based on perceived wheal diameter, erythema, and turgor (0-4+) and an objective scoring method based on measuring wheal diameter alone. Thirty-four atopic dogs were skin tested with 68 different allergens. All skin tests were performed according to standard procedures, and any IDT score ≥2+ was considered clinically significant. When the subjective IDT scores were compared with the objective IDT scores in all dogs, there was a moderate level of correlation overall (r=0.457; P <0.0001). The highest level of agreement between subjective and objective scores was noted with the reactions assigned subjective scores of "0" and "2+." Overall, there was a slight level of agreement between subjective and objective scores based on clinical significance (i.e., subjective scores ≥2+; κ=0.20; P <0.0001). In conclusion, the authors believe that the objective scoring method used in this study may provide a point of reference for inexperienced individuals (dermatology residents, veterinarians, technicians) when learning to grade an IDT.     

Canine idiopathic thrombocytopenia: clinical observations and long-term follow-up in 54 cases

Idiopathic thrombocytopenia purpura (ITP) was diagnosed in 54 dogs. Bleeding was associated with platelet counts less than or equal to 30,000/mm3, and occurred most frequently at mucosal surfaces and in the skin. Other hematologic changes were variable, the most common being regenerative anemia with leukocytosis. Bone marrow examination revealed variable megakaryocyte numbers, but hyperplasia was most commonly observed. Results of the platelet factor 3 test were positive in only 7 of 25 dogs so tested. Treatment included various combinations of corticosteroid, vincristine, cyclophosphamide, and splenectomy. The dogs could be classified into 4 groups on the basis of the course of disease: (1) 14 dogs that died or were euthanatized during the first episode of thrombocytopenia, (2) 17 dogs that recovered after a single episode of thrombocytopenia (acute ITP), (3) 8 dogs in which thrombocytopenia recurred over a period of up to 8 months before recovering (acute, recurrent ITP), and (4) 15 dogs that experienced repeated episodes of ITP for periods of up to 8 years (chronic ITP).     

Canine and feline atopic dermatitis: A review of the diagnostic options

Atopic dermatitis is an inherited pruritic skin disease in dogs and cats. This pruritic skin condition is due to the animal having an allergic reaction to environmental allergens. The environmental allergens that an individual dog or cat is allergic to are specific for that individual animal. Management options for affected dogs and cats include identification of the offending environmental allergens and subsequent avoidance of that allergen, or allergen-specific immunotherapy. Several diagnostic tests are available to veterinarians to try to identify these allergens. The pros and cons of each of these diagnostic tests will be addressed.     

Late-phase reactions to intradermal testing with Dermatophagoides farinae in healthy dogs and dogs with house dust mite-induced atopic dermatitis

OBJECTIVE: To determine the prevalence of late-phase reactions to intradermal testing with Dermatophagoides farinae in healthy dogs and dogs with atopic dermatitis and an immediate reaction to D farinae. ANIMALS: 6 healthy dogs and 20 dogs with atopic dermatitis and immediate reactions to D farinae. PROCEDURE: ntradermal tests were performed with D farinae at 1:1,000 wt/vol and 1:50,000 wt/vol concentrations, and skin reactivity was evaluated after 0.25, 6, and 24 hours. Serum D farinae-specific IgE antibodies were assayed. Extent of lesions (atopy index) and pruritus (visual analogue scale) were evaluated in dogs with atopic dermatitis. RESULTS: Late-phase reactions were observed in healthy dogs at 6 hours (n = 2 dogs) and 24 hours (1) with the 1:1,000 wt/vol concentration, and at 6 hours (1) and 24 hours (1) with the 1:50,000 wt/vol concentration of allergen. Late-phase reactions in healthy dogs were only observed in dogs with an immediate reaction to D farinae. Late-phase reactions were observed in 11 of 20 dogs with atopic dermatitis at 6 and 24 hours with the 1:1,000 wt/vol concentration and in 10 of 20 at 6 and 24 hours with the 1:50,000 wt/vol concentration of allergen. There was no difference in mean atopy index, mean visual analogue scale of pruritus, or mean serum D farinae-specific IgE concentration of dogs with a late-phase reaction, compared to dogs without a late-phase reaction. CONCLUSIONS AND CLINICAL RELEVANCE: Late-phase reactions may be observed after an immediate reaction to intradermal skin testing in healthy and allergic dogs but are more commonly observed in dogs with atopic dermatitis.     

Common allergens of atopic dermatitis in dogs: comparative findings based on intradermal tests

Intradermal tests were performed on 58 dogs diagnosed with atopic dermatitis from 2004~2008 at the Veterinary Medical Teaching Hospital of Konkuk University, Korea. To compare the allergen distribution observed in the present investigation to the results from other studies conducted in Korea and elsewhere, the allergens were grouped according to their kinds. There was no significant difference in gender distribution among the dogs. The most common breeds among the 58 dogs were Maltese (n = 11) and Shih-tzu (n = 11). The average age was 4.8 years. The most frequently produced a positive reaction on the intradermal tests was mold (67.3%) followed by house dust (54.5%) and house dust mites (49.1%). The present study found a low distribution of dogs allergic to various outdoor allergens compared to studies performed in other countries; this may reflect differences in living conditions for dogs living in Korea.     

Comparison between IMMUNODOT tests and the intradermal skin test in atopic dogs

This study evaluated a new perspective in the diagnosis of dermatitis in dogs with signs suggestive of allergic skin disease. The results obtained with CMG IMMUNODOT tests using the technique of allergen-specific strip tests, as employed for human allergy diagnosis, were compared with those obtained by the intradermal skin test (IDST). Forty-eight cases completed the diagnostic evaluation, which included IDST, flea-control program, exclusion of sarcoptes and, for some cases, a 1- to 2-month stabilization period on a restricted protein source diet and testing the serum in the presence of allergen-specific IgE and total IgE. The most common disorders included house and storage dust mites, allergic dermatitis and flea-allergic dermatitis together with atopy. This was confirmed serologically. In the case of positive IDST to pollens, Aspergillus spp. and cat epithelium, CMG IMMUNODOT strip tests were negative. A total of 25% of cases were considered to be primarily associated with food hypersensitivity, but only 4% were confirmed serologically. This study emphasizes the value of CMG IMMUNODOT tests as a support in the diagnosis of dog allergy.     

Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis

Atopic dermatitis (AD) is a common chronic relapsing pruritic skin disease of dogs for which treatment has varied over time and geographical location. Recent high quality randomized controlled trials and systematic reviews have established which drugs are likely to offer consistent benefit. The International Task Force for Canine AD currently recommends a multi‐faceted approach to treat dogs with AD. Acute flares should be treated with a combination of nonirritating baths and topical glucocorticoids, once an attempt has been made to identify and remove the suspected causes of the flare. Oral glucocorticoids and antimicrobial therapy must be added when needed. In dogs with chronic AD, a combination of interventions should be considered. Again, factors that trigger flares of AD must be identified and, if possible, avoided. Currently recognized flare factors include food, flea and environmental allergens, Staphylococcus bacteria and Malassezia yeast. Skin and coat hygiene and care must be improved by bathing with nonirritating shampoos and dietary supplementation with essential fatty acids. The severity of pruritus and skin lesions can be reduced with a combination of anti‐inflammatory drugs. Currently, medications with good evidence of high efficacy include topical and oral glucocorticoids, and calcineurin inhibitors such as oral ciclosporin and topical tacrolimus. The dose and frequency of administration of these drugs should be tailored to each patient considering each drug’s efficacy, adverse effects and cost. Allergen‐specific immunotherapy should be offered, whenever feasible, in an attempt to prevent recurrence of clinical signs upon further exposure to environmental allergens to which the patient is hypersensitive.     

Results of intradermal tests in horses without atopy and horses with atopic dermatitis or recurrent urticaria.

OBJECTIVE: To compare results of intradermal tests (IDT) for environmental allergens at 30 minutes and 4, 6, and 24 hours after injection in horses without atopy and horses with atopic dermatitis (AD) or recurrent urticaria (RU). ANIMALS: 22 horses without atopy, 10 horses with RU, and 7 horses with AD. PROCEDURE: In all horses, medical history was obtained, and results of physical examination, hematologic examination, serum biochemical analyses, examination of bronchoalveolar lavage fluid, and IDT with 73 allergens were examined. RESULTS: Horses with AD or RU had a significantly greater mean number of positive reactions for IDT, compared with horses without atopy. Horses with AD had a significantly greater number of positive reactions than horses without atopy in every allergen group at all time periods, except for molds at 4 and 24 hours. Horses with RU had a significantly greater number of positive reactions than horses without atopy in every allergen group, except for molds at 30 minutes and 4 and 6 hours, trees at 4 and 6 hours, and grasses at 4 hours. CONCLUSIONS AND CLINICAL RELEVANCE: A significantly greater number of positive reactions for IDT in horses with AD or RU, compared with horses without atopy, provides evidence of type-I IgE-mediated hypersensitivity for these diseases. Evaluation of results of IDT performed in horses with AD or RU is useful in determining specific allergens for the formulation of immunotherapy along with providing identification of allergens that could be useful when creating avoidance strategies.     

Altered spontaneous and histamine-induced in vitro suppressor-cell function in dogs with atopic dermatitis.

Spontaneous, histamine-induced and Concanavalin A (Con A)-induced suppression of Con A mitogenesis of autologous responder cells was studied in normal dogs and in dogs with atopic dermatitis. Histamine-induced suppression was significantly decreased in the atopic dogs, as was the Con A-induced suppression, at supraoptimal concentration of Con A, to a lesser extent. Total numbers of histamine type 1 or type 2 receptors were not different for cells from atopic or normal dogs. The spontaneous suppression was significantly greater for the atopic dogs and this was not accounted for by the effect of non-specific dermatitis, increased macrophage-induced suppression or increased induction by mitogenic factors in the culture medium. Some possible mechanisms for these results are discussed, and the similarities to suppressor cell function in humans with atopic disease are noted.     

The ACVD task force on canine atopic dermatitis (VI): IgE-induced immediate and late-phase reactions, two inflammatory sequences at sites of intradermal allergen injections.

Intradermal testing is a common diagnostic procedure used in the evaluation of dogs with suspected atopic dermatitis (AD). To do this, most investigators assess the appearance of wheals that develop at the sites of intradermal allergen injections. However, wheals are rarely seen in dogs with naturally occurring AD. Furthermore, infiltration of inflammatory cells into the injection sites can occur 6-24h later, a phenomenon known as the late-phase reaction. The histological appearance of these late-phase reactions closely approximates that seen in the natural disease, suggesting that they might be more relevant than the immediate reactions. In this paper, we review the literature on immediate and late-phase reactions and re-assess the evidence for using current intradermal testing procedures as a diagnostic test in dogs.     

The ACVD task force on canine atopic dermatitis (I): incidence and prevalence.

There is an increasing incidence of atopic diseases (asthma, allergic rhinitis and atopic dermatitis) in humans, especially in developed countries. Although there is a genetic predisposition to the development of these diseases, the rapid rise in incidence is suspected to be caused by environmental rather than genetic factors. Neither the incidence nor the prevalence of atopic dermatitis in the general canine population has been studied. As many of the environmental factors associated with the increasing incidence of atopic dermatitis in humans are consistently found in the environment of dogs, it would seem likely that a similar increase in the incidence of this disease would be occurring also in dogs. Epidemiological studies of canine atopic dermatitis are needed to characterize the incidence and prevalence of atopic dermatitis, and to further study the factors that contribute to the development of this disease.     

Canine hyperadrenocorticism: pretreatment clinical and laboratory evaluation of 117 cases.

The physical findings, clinical signs, age, breed and sex distributions, and laboratory data of 117 dogs with untreated Cushing's syndrome were reviewed. Poodles, Dachshunds, and Boxers of all ages were found to be at increased risk, as were dogs of all breeds greater than or equal to 6 years old. Polydipsia, polyuria, progressive bilaterally symmetric alopecia, and abdominal distention were the most frequently observed clinical signs and physical findings. Lymphopenia, eosinopenia, above normal values of serum alkaline phosphatase, serum cholesterol, and sulfobromphthalein dye retention, and below normal urine specific gravity were the most frequent abnormalities found in the laboratory data. About 50% of the dogs had urinary tract infections. Final diagnosis was established on the basis of abnormally high plasma corticosteroid values in response to an intramuscular injection of adrenocorticotropic hormone.