Canine atopic dermatitis: a retrospective study of 169 cases examined at the University of California, Davis, 1992-1998. Part II. Response to hyposensitization

One hundred and sixty-nine dogs were diagnosed with atopic dermatitis, and treated with hyposensitization for at least 1 year based on the results of either intradermal skin tests (IDST) or enzyme-linked immunosorbant serum assays (ELISA). Excellent (i.e. hyposensitization alone controlled clinical signs), good (> 50% improvement), moderate (< 50% improvement) and no (clinical signs were unchanged) responses were seen in 19.5, 32.5, 20.1 and 27.8%, respectively. Age of onset, age when treatment was initiated or the duration of clinical signs had no influence on response to hyposensitization. Dogs having concurrent flea allergy dermatitis were statistically more likely to respond better than dogs with concurrent food allergies. Although not statistically significant, there were trends for Golden Retriever and male dogs to respond better than other breeds and female dogs, respectively. Dogs having more than 21 positive reactions in allergy tests and treated with more than 21 allergens had lower response scores, and a longer time course before achieving beneficial response. Lower response scores were seen in dogs having positive reactions to cultivated plants, grasses, trees or insects. There was no difference in response to hyposensitization whether based on IDST or ELISA results.     

Advances in methodology for diagnosis of allergic skin disease

Advantages of IDST for diagnosis of atopy and selection of antigens for hyposensitization include the following: 1. The test is widely accepted by clients. 2. The clinician can select individual test allergens based on the patient history and geographic location. 3. It has been the standard for diagnosing atopy in the dog for more than 40 years. Disadvantages of IDST include the following: 1. The test should be performed on a regular basis to maintain reliability. 2. Interpretation of test results is subjective. 3. The test is not standardized on the basis of the examiner, source of the allergen, or reproducibility. 4. There is occasional difficulty in performing the test (e.g., need for sedation). 5. Anaphylaxis is a potential risk. 6. A significant amount of office time is needed to perform the test. 7. Condition of the patient's skin (e.g., lichenification, hyperpigmentation, pyoderma) may preclude its use. 8. There is a possibility of failure to test for appropriate allergens. 9. There may be false-positive and false-negative reactions. 10. Other medications can interfere with the test (e.g., antihistamines, corticosteroids). Advantages of in vitro testing for diagnosis of atopy and selecting antigens for hyposensitization include the following.(ABSTRACT TRUNCATED AT 250 WORDS)     

The impact of oral versus inhaled glucocorticoids on allergen specific IgE testing in experimentally asthmatic cats

Glucocorticoids (GCs) are palliative for allergic asthma, but allergen-specific immunotherapy (ASIT), which relies on identification of allergens, represents a potentially curative treatment. The purpose of this study was to determine if oral or inhaled GCs would interfere with identification of sensitizing allergens. The hypothesis was that oral but not inhaled GCs would interfere with accurate allergen-specific IgE identification determined by skin and serum testing in experimentally asthmatic cats. Asthma was induced in 18 cats using Bermuda grass allergen (BGA). Cats (n=6/group) were randomized to receive oral GCs (10mg prednisolone q 24 h), inhaled GCs (600 μg budesonide q 24 h) or placebo (q 24 h PO) for one month. Intradermal skin testing (IDST) and serum BGA-specific IgE were measured prior to, during and after treatment. A paired t test was used to compare groups pre- and post-treatment (P<0.05 significant). IDST reactivity was eliminated in 4/6, 3/6, and 1/6 cats receiving oral GCs, inhaled GCs, and placebo respectively. Two weeks after stopping treatment, IDST was again positive in all cats. Serum IgE reactivity to BGA was not significantly diminished by any treatment. In conclusion, a two-week withdrawal from GCs is adequate for IDST, but may not be necessary for serum IgE testing.     

Reports of zoonotic disease outbreaks associated with animal exhibits and availability of recommendations for preventing zoonotic disease transmission from animals to people in such settings

OBJECTIVE: To assess the number of zoonotic disease outbreaks associated with animal exhibits and identify published recommendations for preventing zoonotic disease transmission from animals to people in exhibit settings. DESIGN: Literature review and survey of state public health veterinarians and state epidemiologists. PROCEDURE: MEDLINE and agriculture databases were searched from 1966 through 2000. Retrieved references and additional resources provided by the authors were reviewed. A survey was sent to state public health veterinarians and state epidemiologists to determine whether their states had written recommendations or guidelines for controlling zoonotic diseases in animal exhibition venues, whether their states maintained a listing of animal exhibitors in the state, and whether they had any information on recent outbreaks involving animals in exhibitions. RESULTS: 11 published outbreaks were identified. These outbreaks occurred in a variety of settings including petting zoos, farms, and a zoological park. An additional episode involving exposure to a potentially rabid bear required extensive public health resources. A survey of state public health veterinarians identified 16 additional unpublished outbreaks or incidents. Most states did not have written recommendations or guidelines for controlling zoonotic diseases or any means to disseminate educational materials to animal exhibitors. CONCLUSIONS: Recent outbreaks of zoonotic diseases associated with contact with animals in exhibition venues highlight concerns for disease transmission to public visitors. Only a handful of states have written guidelines for preventing zoonotic disease transmission in animal exhibition venues, and published recommendations currently available focus on preventing enteric diseases and largely do not address other zoonotic diseases or prevention of bite wounds.     

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.     

Induction of feline flea allergy dermatitis and the incidence and histopathological characteristics of concurrent indolent lip ulcers

The objectives of this study were to characterize the role of intermittent vs. continual flea exposure in the development of flea allergy dermatitis (FAD) in cats, assess the accuracy of intradermal skin testing (IDST) and in vitro testing, and document the incidence and histopathological features of indolent lip ulcers. Ten flea‐naive cats were divided into two groups. One group received intermittent flea exposure for 120 days. Thereafter, both groups of cats received continuous flea exposure for 120 days. In vitro testing for flea salivary antibody and IDST utilizing both whole flea antigen and flea salivary antigen were performed. Eight of 10 cats developed clinical signs of FAD within 3 months and five of these eight cats developed lip ulcers which where characterized histopathologically by ulceration with predominantly neutrophilic inflammation and surface bacterial colonization. There was no association between the presence or absence of clinical signs and positive IDST or in vitro results, and no difference in the development of clinical signs was noted between the two groups of cats.     

Attitudes, procedures, and delivery of behavior services by veterinarians in small animal practice

OBJECTIVE: To survey veterinarians in small animal practice concerning their attitudes about delivery of behavior services, frequency of common behavior problems, manner in which services were provided, confidence in their clinical ability to treat these behavior problems, frequency of use of pharmacologic intervention, and number of dogs and cats euthanatized specifically because of behavior problems. DESIGN: Cross-sectional mail survey. SAMPLE POPULATION: Random sample of veterinarians in small animal practice in the United States. PROCEDURE: A self-administered mail survey was sent to a random sample of 2,000 veterinarians. Results were tabulated and statistically analyzed. RESULTS: It was estimated that approximately 224,000 dogs and cats were euthanatized annually in small animal veterinary practices in the United States because of behavior problems. Although veterinarians seemed unwilling to euthanatize animals for behavior problems solely on the basis of a client's request, many veterinarians did not routinely inquire about animal behavior and often were not confident in their clinical skills to treat behavior problems. Female veterinarians tended to be more proactive in addressing behavior problems and to have more positive attitudes than male veterinarians about the importance of animal behavior. CONCLUSIONS AND CLINICAL RELEVANCE: Efforts are needed to increase the number of veterinarians who systematically incorporate inquiries about animal behavior into routine clinical practice and to build the confidence of veterinarians for diagnosing and treating animal behavior problems.     

A survey of zoonotic diseases contracted by South African veterinarians

A survey of 88 veterinarians employed at the Faculty of Veterinary Science, University of Pretoria, South Africa, was carried out to investigate the occurrence of zoonotic diseases among South African veterinarians. The survey found that 63.6% of veterinarians interviewed had suffered from a zoonotic disease. Veterinarians predominantly involved in farm animal practice were 3 times more likely to have contracted a zoonotic disease than those working in other veterinary fields. Fifty-six percent of disease incidents were initially diagnosed by the veterinarians themselves. Fifty-three percent of incidents required treatment by a medical practitioner, but the majority (61%) of incidents did not require absence from work. The incidence density rate for contracting a zoonotic disease was 0.06 per person year of exposure. Kaplan-Meier survival analysis estimated that the probability of having contracted a zoonotic disease was 50% after 11 years in practice. The risk of contracting a zoonotic disease appeared to be higher early in practice. The most common mode of transmission was by direct contact. Approximately 46% of South Africans still live in rural areas and regularly come into close contact with farm animals. The implications of this in the light of this survey's results are discussed.     

Academic food-supply veterinarians: future demand and likely shortages

The future demand for and potential shortages of food-supply veterinarians have been the subject of much concern. Using the Delphi forecasting method in a three-phase Web-based survey process, a panel of experts identified the trends and issues shaping the demand for and supply of academic food-animal veterinarians, then forecasted the likely future demand and shortages of food-supply veterinarians employed in academic institutions in the United States and Canada through 2016. The results indicate that there will be increasing future demand and persistent shortages of academic food-supply veterinarians unless current trends are countered with targeted, strategic action. The Delphi panel also evaluated the effectiveness of several strategies for reversing current trends and increasing the number of food-supply veterinarians entering into academic careers. Academic food-supply veterinarians are a key link in the system that produces food-supply veterinarians for all sectors (private practice, government service, etc.); shortages in the academic sector will amplify shortages wherever food-supply veterinarians are needed. Even fairly small shortages have significant public-health, food-safety, animal-welfare, and bio-security implications. Recent events demonstrate that in an increasingly interconnected global economic food supply system, national economies and public health are at risk unless an adequate supply of appropriately trained food-supply veterinarians is available to counter a wide variety of threats ranging from animal and zoonotic diseases to bioterrorism.     

Positive reactions to common allergens in 42 atopic dogs in Japan

Clinically important allergens for the diagnosis and treatment of atopic dermatitis vary geographically. In order to identify the most prevalent allergens in atopic dogs in Japan, 42 dogs with a clinical diagnosis of atopy were tested using both in vivo (intradermal skin test (IDST)) and in vitro (antigen-specific IgE assay) allergy tests. Allergens used for IDST included 26 allergen extracts from eight allergen groups: trees, weeds, grasses, house dust mites (HDM), molds, foods, epithelia, and arthropods. Immunodot assay was used to measure antigen-specific IgE against 24 allergens from these eight groups and against fish such as cod and sole. In the 42 dogs, the most common positive allergen reaction was to HDM on both IDST (29/42 dogs or 69%) and in vitro testing (23/42 or 54.8%). The second most frequent positive allergen reaction was to Japanese cedar pollen (21/42 or 50.0% for IDST and 7/42 or 16.7% for in vitro testing). In both tests, less than 20% of dogs had positive reactions to molds or foods. Positive reactions to cat epithelia were frequently found on IDST, but rarely found on in vitro testing. Agreement between the two tests was found in 26 instances: HDM (21 dogs), Japanese cedar pollen (five dogs) and wheat (one dog). In this study, the two most common allergens involved in atopic dermatitis in dogs in Japan were HDM and Japanese cedar pollen.     

Phytomedicine in dogs and cats: web-based survey among veterinarians in Austria, Germany and Switzerland

In the last decades phytopharmaceuticals have stabilized their significance in human medicine. The aim of this study was to obtain information about the present situation of phytomedicine in three German-speaking countries. For that purpose questionnaires were sent via internet to 2675 veterinarians in Austria, Germany and Switzerland and the collected 189 answers were statistically evaluated. As shown in this paper, there is an increasing interest in veterinary phytotherapy. Presently three-quarters of the veterinarians are using phytoproducts in clinical practice. Herbal medicinal products are only seldom used in eye and ear infections as well as in endo- and ectoparasitoses but more often in diseases of the liver, joints, kidneys, heart and skin. Generally, phytodrugs are more frequently applied in chronic diseases as well as secondary medication, whereas the time of treatment usually exceeds one month. Basic advantages of medicinal phytoproducts have been shown to be the low side effects and the acceptance of the pet-owners and the only disadventage has been reported to be the lack of information. This study clearly shows the upward trend in using herbal drugs by veterinarians but the results also point to the lack of scientific knowledge about phytotherapeuticals in animal health.     

The first Polish animal contagious disease act of 1844

The Veterinary Control Act of 1844 was the first to regulate in entirety the control of infectious diseases in animals and questions of sanitary inspection of animal food products in the Kingdom of Poland. The act listed explicit procedures regarding diagnostics, control and eradication of diseases as well as concerning animal food product inspection. The act required that animal owners become familiar with symptoms of animal diseases, their methods of control and that they prevent their spreading. The obligations of veterinarians, state physicians and administrative control bodies in the control of animal diseases were specified by the act. Besides the main text on the control of diseases and meat inspection the act also contains elements of food law, some norms concerning public law and order (e.g. requirements concerning dogs) and even some regulations on animal protection.     

A survey concerning the equine fescue toxicosis malady

The objective of this research was to determine the scope of equine fescue toxicosis, current procedures to control the disease, and to gain veterinary insight to possible new therapies. A survey was developed with help form experts in the area of fescue toxicosis. From a list of members of the American Veterinary Medical Association (AVMA), a sample was obtained by selecting large animal/equine veterinarians from states where fescue toxicosis is common. These states included: Alabama, Arkansas, Georgia, Illinois, Indiana, Kentucky, Missouri, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Virginia, and West Virginia. One-fifteenth of the veterinarians (515 total) were mailed questionnaires; 207 responded. Veterinarians were grouped into regions based on latitude. Region 1 included veterinarians practicing north of 39.0° latitude; Region 2 included veterinarians practicing between 36.5° and 39.0° latitude; and Region 3 included veterinarians practicing south of 36.5° latitude.A majority of horse pasture in the area of the survey is comprised of at least 50% fescue, with approximately 70% of the pasture being at least partially comprised, of fescue.Almost 50% of the brood mares in the area of the survey are exposed to endophyte-infected fescue. Many gravid brood mares in the area of the survey were suffering from acute and subacute symptoms, with over 43% warranting some kind of management technique to prevent toxicity from occurring. A large majority of veterinarians in the area of the survey feel that fescue toxicosis is, to some level, a problem. Current management techniques can be tedious and expensive. New management techniques and/or therapies are needed to handle the problems associated with equine fescue toxicosis. A large majority of veterinarians in the area of the survey feel an effective drug therapy would be valuable in treating equine fescue toxicosis. If a drug therapy were developed, a daily feed additive or an oral gel would be the most popular method of dosing with veterinarians.As a result of trends noticed in the rates of equine fescue toxicosis in different areas, statistical analyses were conducted on data generated from this survey along regions that seemed to have different infection rates. There was no difference (P>0.05) in levels of fescue in pastures, mare exposure to the endophyte, and mare expression of acute or subacute symptoms between regions 2 and 3. There was a difference (P<0.05) between region 1 and regions 2 and 3 for all of the factors tested except for number of mares seen by veterinarians.     

Clinical and histological evaluation of immediate and delayed flea antigen intradermal skin test and flea bite sites in normal and flea-allergic cats

Seven cats diagnosed as flea allergic by specific criteria and seven normal control cats were exposed to flea bites in a controlled manner and were given intradermal injections of 1:1000 w/v flea antigen. Subjective evaluation of gross lesions and documentation of histological changes at flea antigen intradermal skin test (IDST) and flea bite sites were performed at 15 min, 24 h and 48 h after IDST or flea exposure. Control cats did not develop an immediate gross reaction to either flea bites or the intradermal injection of flea antigen. All seven flea-allergic cats had an immediate gross reaction at the site of IDST with flea antigen; five of these cats also developed immediate gross reactions to flea bites. Three of seven flea-allergic cats developed a gross 24 h and/or 48 h delayed reaction at the flea antigen IDST sites. These three and one other cat had both an immediate and delayed gross reaction to flea bites. Histological examination of 15 min skin specimens from IDST and flea bite sites of flea-allergic cats were similar with a mild lymphocytic, histiocytic and mastocytic superficial perivascular dermatitis. Histological examination of 24 h and 48 h skin specimens from IDST and flea bite sites of flea-allergic cats showed that they were often indistinguishable. Histological features of IDST and flea bite sites of flea-allergic cats at 24 h consisted of a perivascular to diffuse predominately eosinophilic dermatitis and mural folliculitis with variable epidermal necrosis and ulceration.     

Comparison between an intradermal skin test and allergen-specific IgE-ELISA for canine atopic dermatitis

The aim of this study was to compare the results of an intradermal skin test (IDST) with those of an allergen-specific IgE-ELISA in 210 dogs with atopic dermatitis. All the dogs had a clinical diagnosis of atopic dermatitis and underwent an IDST. The sera of all dogs were analysed for allergen-specific IgE by ELISA using the monoclonal antibody D9 against dog IgE. IDST was used as the standard assay. In both methods, the following antigens provided a positive test result: Dermatophagoides farinae, Acarus siro, Tyrophagus putrescentiae, ragweed, mugwort and Lepidoglyphus destructor. ELISA had an overall sensitivity of 82.4% and an overall specificity of 93.8%. The overall accuracy of the ELISA was 91.3%. The evaluated monoclonal D9 ELISA was found to be a reliable tool for the diagnosis of those allergens that cause clinical atopy, and can be recommended for use in dogs when immunotherapy is a therapeutic option.     

Intradermal skin testing in Icelandic horses in Austria

Icelandic horses in Austria are commonly affected by an allergic inflammatory skin disease recurring during the summer seasons, which shares characteristic features with Culicoides hypersensitivity. However, the causative agents have not yet been identified. Therefore, intradermal skin testing (IDST) with a standardised extract of Culicoides variipennis and 21 other allergens relevant within Austria was performed in 81 Icelandic horses. All horses included into the study were treated regularly with ivermectin and had no history of administration of anti-inflammatory drugs. Forty-three of these horses were affected by summer seasonal recurrent dermatitis (SSRD). No history or signs of any other disease were evident in any horse. Pruritic dermatitis due to ectoparasites, bacteria and dermatophytes were ruled out by means of fungal culture, skin scraping and biopsy. Culicoides variipennis antigens evoked a positive cutaneous reaction in 1 of 38 normal and 3 of 43 SSRD horses at the proposed dilution of 1:50,000 or 1:25,000, and in 24 of 38 normal and 13 of 43 SSRD horses at a dilution of 1:10,000. Furthermore, no significant differences in onset or intensity of skin reactions to the 21 other allergens, including pollens, moulds, mites and insects, except deerfly and horsefly, were obvious between the 2 groups. Efficiency (percentage of correct results) for the used antigens in the skin test was 0.47-0.60. Maximal sensitivity was 0.51. Altogether, 38 of 43 SSRD horses and 28 of 38 normal horses were positive 4 h after allergen administration. The divergence between IDST results and manifestation of clinical signs found in this study underlines the difficulties associated with establishing a skin test protocol in horses within a geographic area. Whether the outcome of this study would have been influenced significantly by using Culicoides spp. present in Austria has to be clarified in future research.     

IgE sensitivity and cross-reactivity to crude and purified mite allergens (Der f 1, Der f 2, Der p 1, Der p 2) in atopic dogs sensitive to Dermatophagoides mite allergens

The present study investigates IgE-reactivity to crude and purified mite allergens by intradermal skin test (IDST), Immunodot method, and ELISA in atopic dogs sensitive to mite allergens, as well as the allergenic cross-reactivity between Dermatophgoides (D) farinae (DF) and D. pteronyssinus (DP) in dogs by IgE-ELISA inhibition. IDST and Immunodot method for crude mite allergens were performed for atopic dogs and 16 atopic dogs showed sensitivity to mite allergens. Of the 16 dogs, all dogs had anti-DF IgE and 11 had anti-DP IgE. We measured specific IgE to purified major allergens (Der f 1, Der f 2, Der p 1, Der p 2). Of the 16 atopic dogs, six had anti-Der f 1 IgE and seven had anti-Der f 2 IgE. Similarly, of the 16 dogs, six had anti-Der p 1 IgE and seven had anti-Der p 2 IgE. However, eight dogs had no specific IgE to these mite allergens. These dogs may be sensitive to other major mite allergens except Der 1 and Der 2. In the dogs that had both anti-DF and DP IgE, IgE binding to DF was greatly inhibited by DP, and reciprocal inhibition was observed. Based on these data, it appears that there is a strong cross-reactivity between DF and DP in dogs. Similarly, a cross-reactivity between DF and DP in purified allergens was also observed. IDST and Immunodot method are useful methods for the diagnosis of atopic diseases in dogs, and ELISA is a useful method for further investigation of IgE-reactivity for the allergens.     

Discussing overweight in dogs during a regular consultation in general practice in the Netherlands

In previous studies, it has been demonstrated that, similar to general practitioners, veterinarians find it difficult to discuss overweight in dogs. This study aimed to provide insight in the barriers and motivators for veterinarians to discuss overweight in dogs and to compare the results with findings from human medicine. Sub-hypotheses were postulated based on existing literature to investigate if lack of time, fear of offending clients, or lack of skills were potential barriers, and if feeling responsible and feeling compassion were potential motivators for veterinarians to discuss overweight in dogs. To this end, an online survey (n = 59) was conducted. Furthermore, 15 small animal clinicians working in general practice were interviewed by semi-structured face-to-face interviews. Results from the online survey indicated that veterinarians find it sometimes difficult to discuss overweight in dogs. Veterinarians who responded to the online survey did not experience strong barriers but did make use of motivators (e.g. feeling responsible and feeling compassion) when discussing overweight in dogs. Interestingly, results from the semi-structured face-to-face interviews showed that the responding veterinarians did experience strong barriers, as well as motivators, when discussing overweight in dogs with their clients. The most prominent barrier was customer dissatisfaction, whereas lack of time and lack of skills were also experienced. The most prominent motivator was feeling responsible for animal health and preventive veterinary medicine. These findings were strikingly similar to previous research on discussing childhood overweight by general practitioners. To improve treatment and prevention of overweight in dogs, veterinarians need more communication skills and should be more aware of the motivators that drive their self-motivation. Improving awareness on overweight and its comorbidities should be a One Health issue.     

Advances in the diagnosis and treatment of atopy.

Regarding the diagnosis of atopy, the emphasis in this article has been on how to use the initial history and physical examination findings to lead the clinician towards this diagnosis. After a systematic approach to the differential diagnosis of pruritus in the dog has been completed, the diagnosis of atopy can be further evaluated using one of the specific allergy tests available. The author's preference is the IDST to aid in the confirmation of the presence of atopy. Regarding the treatment of atopy, the emphasis in this article has been on the use of immunotherapy as the specific treatment for this disease. Careful monitoring of dogs on immunotherapy is essential to obtain optimum results, and response rates to treatment may be significantly improved by implementing various modifications in the standard hyposensitization protocol being used by the clinician.     

Knowledge and attitudes of Australian veterinarians to animal abuse and human interpersonal violence

A survey of Australian veterinarians was undertaken to assess their amount of knowledge about, and their attitudes towards animal abuse, human violence and the link between the two. Results from the 185 respondents to a questionnaire that was either mailed out or hand delivered revealed a wide variety of definitions and attitudes towards abuse, with the majority of veterinarians recognising the link between human and animal abuse. The overwhelming majority of veterinarians believed that they should intervene in some way when confronted with either animal or human abuse, although most felt ill-equipped to deal with suspected human abuse. Almost 20% of cases of animal abuse had associated suspected or known human abuse. It is suggested that veterinarians need more resources made available to them to be able to deal more effectively with these situations.