FC‐48 Reliability of the Canine Atopic Dermatitis Extent and Severity Scoring Index

Objective assessment of canine atopic dermatitis severity is very difficult and only a few scoring systems have been developed. The most commonly used is the Canine Atopic Dermatitis Extent and Severity Scoring Index (CADESI), adapted from the human SCORAD. Despite wide use of this score in clinical trials, no validation has been performed to our knowledge. The aim of this study was to determine the reliability of the CADESI in clinical practice. First, a set of 28 pictures taken from dogs diagnosed with atopic dermatitis was scored by six different investigators for three items: erythema, lichenification and excoriation. Next, 23 dogs with clinical signs compatible with atopic dermatitis were graded by two investigators using the CADESI. Erythema, lichenification and excoriation were assessed on 39 areas. With the pictures, significant correlations (Spearman's r, P < 0.05) were found for each combination of investigators for erythema and lichenification, but only in 10 of 15 combinations for excoriation. Interobserver agreement ranged between poor and fair (0.221 < Cohen's κ <0.508, mean = 0.395). For the living animals, significant correlations (P < 0.0001), but poor interobserver agreement, were found for the three items (κ_erythema = 0.366, κ_{lichenification} = 0.385, and κ_excoration = 0.226). A significant correlation (P < 0.05) was found for each location, and interobserver agreement varied between very poor and good (0.16 < κ < 0.66). These results suggest that erythema and lichenification are reliably assessed, but that grading excoriation is more difficult. Also, the assessment of severity varied depending on the site studied. Funding: Self‐funded.     

FC-41 A prospective pilot study on the use of cyclosporin on feline allergic diseases

This study evaluated the efficacy of Phytopica^TM, a proprietary blend of standardised plant extracts, in canine atopic dermatitis (AD). One hundred twenty dogs with perennial AD were recruited on the basis of history and clinical signs, and a positive intradermal allergen test or rFcεRIα serology to perennial allergens. Other pruritic dermatoses were eliminated by antimicrobial treatment, skin scrapings, Sarcoptes serology, flea control and a 6-week food trial. Exclusion criteria included antimicrobial therapy within 7 days, antihistamines within 14 days, oral/topical glucocorticoids or cyclosporin within 28 days, and parenteral glucocorticoids, essential fatty acids or immunotherapy within 56 days of entry into the study. Dogs [minimum Canine Atopic Dermatitis Extent and Severity Index (CADESI) = 25] were randomly allocated to receive placebo, 100, 200 or 400 mg/kg Phytopica^TM daily for 12 weeks. Their CADESI was assessed every 4 weeks. A modified intention-to-treat population was analysed. The mean reductions in CADESI scores at the end of treatment compared to baseline were 4.4% (100 mg/kg; n  = 30), 23.4% (200 mg/kg; n  = 29, P  < 0.01), 8.5% (400 mg/kg; n  = 29) and 3.9% (placebo; n  = 29). For more severely affected dogs (minimum CADESI ≥ 50 at baseline), there was significant reduction in mean CADESI score (29.3%, P  = 0.038) only in the 200 mg/kg treatment group ( n  = 14). In conclusion, this study demonstrates that Phytopica^TM is an effective nonsteroidal treatment for canine AD.
Funding: Phytopharm plc.     

Low-dose recombinant canine interferon-γ for treatment of canine atopic dermatitis: An open randomized comparative trial of two doses

The purpose of this study was to investigate the minimum effective dose of recombinant canine interferon-γ (rCaIFN-γ) for the treatment of dogs with atopic dermatitis (AD). Thirty-four dogs with AD from 17 animal hospitals in Japan were administered half or one-fifth of the approved rCaIFN-γ dose of 10 000 units/kg, three times a week for 4 weeks, followed by once weekly for an additional 4 weeks. Pruritus, excoriation, erythema and alopecia were evaluated and scored by the investigators on weeks 2, 4, 6, 8 and 12. The efficacy rate (number of excellent cases + number of good cases/total number of cases) at week 8 in the 2000 units/kg group was 36.4% for pruritus, 36.4% for excoriation, 45.5% for erythema and 36.4% for alopecia. In contrast, in the 5000 units/kg group, the efficacy rate was 64.3% for pruritus, 57.1% for excoriation, 78.6% for erythema and 78.6% for alopecia. The efficacy rate of the 5000 units/kg group was high for all signs evaluated and comparable to that of the 10 000 units/kg group reported in a previous study. The results of this study showed that 2000 units/kg of rCaIFN-γ is less effective than 5000 units/kg to treat dogs with AD, and the efficacy of the 5000 units/kg dose is comparable to that of 10 000 units/kg at week 8.     

Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo-controlled trial

This study evaluated a 0.0584% hydrocortisone aceponate (HCA) spray (Cortavance®; Virbac SA, Carros, France) in canine atopic dermatitis (AD). Initially, dogs with a canine AD extent and severity index (CADESI-03) ≥ 50 were randomly allocated to receive HCA ( n  = 15) or placebo ( n  = 13) (two sprays from 10 cm away to treat an area of 100 cm²) once daily for 28 days. Twenty-one of the dogs then received HCA spray once daily, reducing to every other day or twice weekly over 42 days if improvement was maintained. CADESI, pruritus (14 cm visual-analogue-scale) and owner satisfaction (5-point scale) were recorded every 14 days. Haematology, biochemistry and adrenocorticotrophic hormone stimulation were performed at baseline, d28 and d70 (HCA n  = 9; placebo n  = 7). Intention-to-treat data were analysed. HCA spray significantly decreased CADESI (–61.4% versus –13.4%, P  = 0.0069) and pruritus (–38.8% versus +57.6%, P  = 0.0015) at d28 compared to placebo. Scores were significantly decreased at d14 (CADESI –50.5%, P  < 0.0021) and d28 (CADESI P  < 0.0001; pruritus P  = 0.018) compared to baseline following HCA but not placebo. At d28 11 of 15 and 7 of 15 HCA dogs had ≥ 50% reductions in CADESI and pruritus compared to 3 of 13 ( P  = 0.02) and 1 of 13 ( P  = 0.04) placebo dogs. Owner satisfaction scores were significantly higher in the HCA group (d28 P  = 0.0001). Daily 3 of the 21 dogs required daily maintenance therapy, 7 every other day, 6 twice weekly and 5 dogs required additional therapy. Coat length did not influence the results. No adverse effects or changes to blood parameters were noted. HCA spray proved safe and effective up to 70 days. It is not, however, licensed for long-term treatment.     

FC-38 Efficacy of conjugated linoleic acid and black currant seed oil in the treatment of canine atopic dermatitis: a double-blinded, randomized, placebo-controlled study

The purpose of this study was to evaluate a combination of immunostimulatory bacterial DNA sequences and allergen-specific immunotherapy for the treatment of canine atopic dermatitis. Seven dogs with nonseasonal atopic dermatitis diagnosed by history, clinical signs and exclusion of differential diagnoses were included. All dogs had been on allergen-specific immunotherapy for at least 12 months with incomplete responses, were on additional antipruritic therapy and showed residual pruritus. Pruritus was marked by the owner on a visual analogue scale, lesions were determined by a clinician using the Canine Atopic Dermatitis Extent and Severity Index (CADESI), and concurrent medications were recorded before entering the study and after 14 weeks of treatment. Peripheral blood mononuclear cells were isolated and cultured; canine cytokine message for IFNγ, IL-4, TNF and IL-10 was quantitated using RT-PCR. A mixture of allergen extract and liposome-DNA complexes was injected intradermally at the beginning of the study and after 2, 4, 6, 10 and 14 weeks. CADESI, pruritus and medication scores, and cytokine messages at the beginning and end of the study were compared with a paired t -test. There were significant improvements in pruritus scores ( P  = 0.0277). Reductions in medication scores and CADESI were not statistically significant. IL-4 production decreased significantly ( P  = 0.0428); decreases in other cytokines were not significant. Although the number of dogs in this pilot study was small, the results warrant further investigation of a combination of immunostimulatory bacterial DNA sequences and allergen-specific immunotherapy for the treatment of canine atopic dermatitis.
Funding: Self-funded.     

Assessment of a correlation between Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and selected biophysical skin measures (skin hydration,pH, and erythema intensity) in dogs with naturally occurring atopic dermatitis

Atopic dermatitis is a common allergic skin disease in dogs. The aim of this study was to examine the possibility of a correlation between biophysical skin variables: skin hydration (SH), skin pH, and erythema intensity measured in 10 different body regions and both total Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and CADESI measured in a given region (CADESI L). The study was conducted using 33 dogs with atopic dermatitis. The assessment of the biophysical variables was done in 10 body regions: the lumbar region, right axillary fossa, right inguinal region, ventral abdominal region, right lateral thorax region, internal surface of the auricle, interdigital region of right forelimb, cheek, bridge of nose, and lateral site of antebrachum. Positive correlations were found between SH and CADESI L for the following regions: the inguinal region (r = 0.73) and the interdigital region (r = 0.82), as well as between total CADESI and SH on digital region (r = 0.52). Also, positive correlations were reported for skin pH and CADESI L in the lumbar region (r = 0.57), the right lateral thorax region (r = 0.40), and the lateral antebrachum (r = 0.35). Positive correlations were found in the interdigital region between erythema intensity and the total CADESI-03 (r = 0.60) as well as the CADESI L (r = 0.7). The results obtained suggest that it may be possible to use skin hydration, pH, and erythema intensity to assess the severity of skin lesion but positive correlation was only found in < 13.3% of possible correlations and usage of these measures in dogs is limited.     

MYELOGRAPHY VS. COMPUTED TOMOGRAPHY IN THE EVALUATION OF ACUTE THORACOLUMBAR INTERVERTEBRAL DISK EXTRUSION IN CHONDRODYSTROPHIC DOGS

Myelography and/or computed tomography (CT) are commonly used to evaluate acute intervertebral disk extrusion in chondrodystrophic dogs. The purpose of this study was to evaluate the sensitivity of myelography and two different CT protocols in determining level and lateralization of acute thoracolumbar intervertebral disk extrusion in comparison with surgical findings, investigate interobserver variability, and determine examination duration times. Results of conventional CT, helical CT, and myelography were compared with surgical findings in 19 chondrodystrophic dogs with acute thoracolumbar intervertebral disk extrusion. Agreement among investigators was determined for different imaging modalities, and examination times were recorded. In the diagnosis of level of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 94.7%, 100%, and 94.7% of dogs, respectively ( P =0.144). In the diagnosis of level and lateralization of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 78.9%, 87.4%, and 85.3% of dogs, respectively ( P =0.328). Interobserver agreement was very good for all imaging modalities (myelography κ=0.87; conventional CT κ=0.86; helical CT κ=0.95). There were significant differences in median examination duration times between helical CT (4 min), conventional CT (8 min), and myelography (32 min) ( P <0.001). Both helical and conventional CT appear to be accurate for evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs and are faster to perform than myelography.     

Ovarian Structure in Mice Lines Selected for Weight

Selection for body weight at 49 day of age ( s and h , downward selected lines; s' and h' , upward selected lines) affected reproductive traits in CF1 mice lines. The objective of this study was to compare ovarian structures in females of these lines, as well as in unselected controls (Line t ). The number of ovarian follicles ( N ), follicle diameter (FD), number of corpora lutea (CL), litter size (LS), and body weight ( W ), were recorded. There were significant differences among lines for N , FD, CL, LS and W ; means values for the lines with the greatest difference for post-pubertal females were: N _s  = 19.3 and N _s'  = 32.7; FD _h'   = 161.7 and FD _s'  = 178.2; CL _h  = 10.3 and CL _s'  = 21.9; LS _s  = 6.0 and LS _h'  = 11.1; W _h  = 18.9 and W _s'  = 32.4. There were also differences between positive lines; Line s' had a higher proportion of large follicles in pre-pubertal females, a greater capacity to convert these follicles into CL, but a lower capacity to maintain embryos until term than Line h' . For negative lines, Line h apparently had a reduced incidence of embryonic loss when compared with Line s . In conclusion, selection for body weight modified ovarian structure, as well as reproductive efficiency.     

A randomized comparative clinical trial of recombinant canine interferon-gamma (KT-100) in atopic dogs using antihistamine as control

Recombinant canine interferon-gamma (KT-100) or topical antihistamine (diphenhydramine: DH) was administered to dogs with atopic dermatitis (AD) for 4 weeks and their efficacies were compared using pruritus, excoriation, erythema and alopecia as evaluation criteria. Clinical studies on 92 atopic dogs (KT-100 group: 63, DH group: 29) were conducted at 18 animal hospitals in Japan. KT-100 was administered subcutaneously once a day three times a week on alternating days for 4 weeks. DH was administered topically twice daily for 4 weeks. The efficacy rates of the KT-100 group on day 28 were 72.1% for pruritus, 73.8% for excoriation, 75.4% for erythema and 60.7% for alopecia, which were significantly higher than those of the DH group (20.7% for pruritus, 27.6% for excoriation, 24.1% for erythema and 24.1% for alopecia).     

Malassezia dermatitis in dogs in Brazil: diagnosis,evaluation of clinical signs and molecular identification

Skin carriage and quantification of Malassezia yeasts were evaluated in 180 healthy dogs (group 1) and 117 dogs with clinical signs (pruritus, erythema, lichenification/seborrhoea, excoriations and alopecia) that could be related to Malassezia dermatitis (group 2) in Brazil. The lesions in the group 2 dogs were evaluated using CADESI‐03 scores. Samples were collected from five different anatomical areas. Direct examination was performed using the tape strip technique, and results were expressed as the mean number of yeasts per ×1000 microscopic field per dog. For mycological culture, a single piece of sterilized carpet was applied to the same areas sampled for cytology, and transferred onto Dixon’s modified medium. Yeast populations were expressed as mean colony forming units (CFU)/plate. Malassezia isolates were characterized by polymerase chain reaction–restriction endonuclease analysis of the large subunit (LSU) of ribosomal RNA gene. The probability of culturing Malassezia from dogs with skin lesions was significantly higher (P < 0.001) than from healthy dogs. There was a linear trend between CADESI‐03 score and mean CFU/plate. Group 2 dogs with positive cultures had higher CADESI‐03 scores than those with negative cultures (P < 0.05). Almost all isolates were identified as Malassezia pachydermatis. Only one isolate (group 2) was identified as Malassezia furfur. These data suggest that dogs with skin disorders harbouring Malassezia yeasts in quantities higher than 120 mean CFU/plate should be considered as having Malassezia dermatitis. The presence of Malassezia appears to exacerbate clinical lesions in dogs.     

Pharmacokinetics of indomethacin in sheep after intravenous and intramuscular administration

The pharmacokinetics of indomethacin (1mg/kg) was determined in six adult sheep after intravenous (i.v.) and intramuscular (i.m.) injection. Plasma concentrations were maintained within the therapeutic range (0.3–3.0 μg/mL) from 5 to 50 min after i.v. and from 5 to 60–90 min after i.m. administration. After two trials, indomethacin best fitted an open two-compartment model. The mean (±SD) volumes of distribution at steady state ( V d_ss) were 4.10 ± 1.40 and 4.21 ± 1.93 L/kg and the mean clearance values ( C l_B) were 0.17 ± 0.06 and 0.22 ± 0.12 L/h.kg for i.v. and i.m. routes, respectively. The elimination phase half-lives did not show any significant difference between routes of injection ( t _½β = 17.4 ± 4.6 and 21.25 ± 4.44 h, i.v. and i.m. respectively). After i.m. administration, plasma maximum concentration ( C _max =  1.10 ± 0.68 μg/mL) was reached 10 min after dosing; the absorption phase was fast ( K _ab = 26 ± 18 h-1) and short ( t _½ab = 2.33 ± 1.51 min) and the mean bioavailability was 91.0 ± 32.8%, although there was considerable interanimal variation. In some individuals, bioavailability was higher than 100%. This fact combined with the slower elimination phase after i.m. than after i.v. administration, could be related with enterohepatic recycling.     

Pharmacokinetics of ketamine and its metabolite norketamine administered at a sub-anesthetic dose together with xylazine to calves prior to castration

The objective of this study was to evaluate the plasma pharmacokinetics of ketamine and its active metabolite norketamine administered intravenously at a dose of 0.1 mg/kg together with xylazine (0.05 mg/kg) to control the pain associated with castration in calves. A two-compartment model with an additional metabolite compartment linked to the central compartment was used to simultaneously describe the time-concentration profiles of both ketamine and its major metabolite norketamine. Parameter values estimated from the time-concentration profiles observed in this study were volume of the central compartment (V_c = 132.82 ± 68.23 mL/kg), distribution clearance (CL_D = 15.49 ± 2.56 mL/min/kg), volume of the peripheral compartment (V_T = 257.05 ± 41.65 mL/kg), ketamine clearance by the formation of the norketamine metabolite (CL_2M = 8.56 ± 7.37 mL/kg/min) and ketamine clearance by other routes (CL_o = 16.41 ± 3.42 mL/kg/min). Previously published data from rats suggest that the metabolite norketamine contributes to the analgesic effect of ketamine, with a potency that is one-third of the parent drug. An understanding of the time-concentration relationships and the disposition of the parent drug and its metabolite is therefore important for a better understanding of the analgesic potential of ketamine in cattle.     

Are transepidermal water loss and clinical signs correlated in canine atopic dermatitis? A compilation of studies

Background – Cutaneous impairment plays a crucial role in atopic dermatitis (AD). Transepidermal water loss (TEWL) measurement is an indirect assessment of skin barrier function and correlates with disease severity in humans. Skin impairment also exists in canine AD; however, concerns exist regarding variability and reliability of TEWL measurements in dogs. Hypothesis/Objectives – The purposes of this retrospective study were twofold: first, to investigate the correlation between severity of dermatitis [measured by Canine Atopic Dermatitis Extent and Severity Index (CADESI)] and TEWL; and second, to evaluate whether increased TEWL at a young age correlates with disease severity later in life. Methods – Data from atopic beagles and dogs with natural AD were analysed. Transepidermal water loss was measured in atopic beagles (n = 24) with an open chamber and in dogs with naturally occurring AD with a closed chamber device (two studies, with n = 14 and n = 18). Pearson product–moment correlation was used for analyses. Transepidermal water loss of the inguinal region, axilla, antebrachial flexure and pinna was analysed. Correlations were investigated for each study, separately first and then jointly. They included CADESI and TEWL of individual regions, total CADESI and total TEWL of all measured regions, and total CADESI and TEWL of key regions. Results – In atopic beagles, TEWL measured at 1 year of age pre‐ and post‐allergen challenge was correlated with CADESI at 1, 3 and 6 years of age. Overall, low correlation coefficients were found; therefore, a biologically relevant connection could not be demonstrated. The main significant positive correlation was found between TEWL in the pinna and total CADESI. Conclusions and clinical importance – It is concluded that TEWL does not correlate with disease severity.     

A randomized, double-blind, placebo-controlled study to evaluate the effect of EFF1001, an Actinidia arguta (hardy kiwi) preparation, on CADESI score and pruritus in dogs with mild to moderate atopic dermatitis

Canine atopic dermatitis (AD) is common and new therapies are beneficial. This multicentric, randomized, double-blind, placebo-controlled study tested the efficacy of Actinidia arguta (hardy kiwi) (EFF1001) in dogs with mild/moderate AD. The study was divided into two stages. Stage 1 lasted 6 weeks. In the first 2 weeks prednisolone [days 1–3: 0.2 mg/kg twice daily (BID), days 4–14: 0.2 mg/kg every other day (EOD)] was administered. Responsive dogs were placed on prednisolone 0.2 mg/kg EOD + assigned test article [either placebo or EFF1001 (30 mg/kg)] once daily for 4 weeks. Stage 1 responders were advanced to stage 2, which involved 4 weeks of just EFF1001. Clinicians scored lesions using Canine Atopic Dermatitis Extent and Severity Index (CADESI) and owners scored pruritus using a Pruritus Visual Analogue Scale. Seventy-seven dogs were enrolled, 76 were randomized on day 14, and 57 (57/76 = 75%) completed stage 1 (27 in EFF1001 and 30 in placebo). At the end of stage 1, 35 of 57 dogs (35/57 = 61%) responded (18 in EFF1001 and 17 in placebo) and advanced to stage 2. At completion of stage 1, CADESI scores did not significantly differ between groups while pruritus decreased in EFF1001 group and approached significance. At completion of stage 2, 19 dogs (19/35 = 54%) responded (15/19 = 79% had received EFF1001 and 4/19 = 21% placebo in stage 1). After completing stage 2, dogs placed on EFF1001 throughout the study were 3.5 times more likely to either maintain or improve scores than those that started it in stage 2. It is concluded that EFF1001 is beneficial adjunctive therapy after prolonged use.     

Improving the estimation of realized effective population sizes in farm animals

Computation of inbreeding rate (Δ F ) must consider that inbreeding is delayed with one generation with respect to the idealized population when addressed using individual inbreeding coefficients. The expression relating inbreeding in generation t with inbreeding rate F _t  = 1 – (1– ΔF ) ^t should be more correctly written in real animal populations as F _t  = 1 – (1– ΔF ) ^{t −1}, as changes in allele frequencies occur in the equivalent co-ancestries in the previous generation. This simple approach is tested on simulated and real pedigrees thus demonstrating that: (i) the adjusted individual increase in inbreeding becomes stable in populations under random mating while the unadjusted parameter does not; (ii) regression of the unadjusted parameter over generations in pedigrees under random mating is highly significant while after correction it is not significant; and (iii) the variance of the adjusted parameter is reduced with the generations.     

Ultrastructural findings of feline eosinophilic dermatoses

The objectives of this multicentre study were to describe demographics and clinical findings of a group of 63 dogs with nonseasonal atopic dermatitis (AD), where concurrent flea allergy dermatitis, ectoparasite infestation, food adverse reactions and secondary infections had been ruled out. The breed, sex, age of onset, distribution of skin lesions, prevalence of otitis externa, secondary skin infections and additional noncutaneous clinical signs were recorded. A veterinarian recorded skin lesions from 15 different body regions. Each body region was scored according to degree of erythema, alopecia, excoriations, scale, crusts, lichenification and hyperpigmentation that was present. An early age of onset (37% of the dogs being less than 1 year old) was more common in this group of dogs than described in the literature. The German shepherd breed was over-represented (21% as compared with 7–9.9% of the veterinary clinic population) and approximately half of the German shepherd dogs (46%) started showing clinical signs before 1 year of age. Erythema was the overall most common type of skin lesion, with facial erythema and conjunctivitis being less commonly reported than in other studies. Feet, ears and groin were the most common sites for skin lesions. This study indicates that it is not uncommon for dogs with nonseasonal AD to have the onset of clinical signs start at a younger age (less than 1 year of age) and have clinical lesions that vary from previously published reports. This discrepancy might be allergen-dependent or breed-related.
  The study was funded by Boehringer Ingelheim Vetmedica, Denmark.     

FC‐36 The use of immunostimulatory bacterial DNA sequences in allergen‐specific immunotherapy of canine atopic dermatitis

The purpose of this study was to evaluate a combination of immunostimulatory bacterial DNA sequences and allergen‐specific immunotherapy for the treatment of canine atopic dermatitis. Seven dogs with nonseasonal atopic dermatitis diagnosed by history, clinical signs and exclusion of differential diagnoses were included. All dogs had been on allergen‐specific immunotherapy for at least 12 months with incomplete responses, were on additional antipruritic therapy and showed residual pruritus. Pruritus was marked by the owner on a visual analogue scale, lesions were determined by a clinician using the Canine Atopic Dermatitis Extent and Severity Index (CADESI), and concurrent medications were recorded before entering the study and after 14 weeks of treatment. Peripheral blood mononuclear cells were isolated and cultured; canine cytokine message for IFNγ, IL‐4, TNF and IL‐10 was quantitated using RT‐PCR. A mixture of allergen extract and liposome‐DNA complexes was injected intradermally at the beginning of the study and after 2, 4, 6, 10 and 14 weeks. CADESI, pruritus and medication scores, and cytokine messages at the beginning and end of the study were compared with a paired t‐test. There were significant improvements in pruritus scores (P = 0.0277). Reductions in medication scores and CADESI were not statistically significant. IL‐4 production decreased significantly (P = 0.0428); decreases in other cytokines were not significant. Although the number of dogs in this pilot study was small, the results warrant further investigation of a combination of immunostimulatory bacterial DNA sequences and allergen‐specific immunotherapy for the treatment of canine atopic dermatitis. Funding: Self‐funded.     

Treatment of localized lesions of canine atopic dermatitis with tacrolimus ointment: a blinded randomized controlled trial

This investigator-blinded randomized controlled trial was designed to determine whether tacrolimus ointment (Protopic, Fujisawa Healthcare) decreased the severity of localized lesions of canine atopic dermatitis (AD). Twenty dogs with AD were enrolled if they exhibited lesions on both front metacarpi. Each foot was randomized to be treated with 0.1% tacrolimus or placebo (vaseline) ointment twice daily for 6 weeks. Before, and every 2 weeks during the study, erythema, lichenification, oozing and excoriations each were graded on a 10-point scale (maximal total score: 40). The primary outcome measures were the percentage reduction from baseline of lesional scores and the number of subjects whose scores had decreased by 50% or greater at study end. Intention-to-treat analyses were used. At study onset, lesional scores were not significantly different between sites treated with tacrolimus or placebo. After 6 weeks, the percentage reduction from baseline scores was higher for tacrolimus-treated sites (median: 63%; 95% confidence interval: 39-67) than for placebo-treated feet (median: 3%; confidence interval: -2-13) (Wilcoxon test; P = 0.0003). When tacrolimus was applied, lesions decreased by 50% or greater in 15/20 dogs (75%); these dogs were those that completed the study. In contrast, this benchmark was not reached for any placebo-treated feet (Fisher's test; P < 0.0001). Adverse drug events consisted of minor irritation in some lesional areas treated with tacrolimus. Results of this trial suggest that the application of 0.1% tacrolimus ointment is useful for reducing the severity of localized skin lesions of canine AD.     

Clinical use of a ceramide-based moisturizer for treating dogs with atopic dermatitis

In humans, skin barrier dysfunction is thought to be responsible for enhanced penetration of allergens. Similar to conditions seen in humans, canine atopic dermatitis (CAD) is characterized by derangement of corneocytes and disorganization of intercellular lipids in the stratum corenum (SC) with decreased ceramide levels. This study was designed to evaluate the effects of a moisturizer containing ceramide on dogs with CAD. Dogs (n = 20, 3~8 years old) with mild to moderate clinical signs were recruited and applied a moisturizer containing ceramide for 4 weeks. Transepidermal water loss (TEWL), skin hydration, pruritus index for canine atopic dermatitis (PICAD) scores, and canine atopic dermatitis extent and severity index (CADESI) scores of all dogs were evaluated. Skin samples from five dogs were also examined with transmission electron microscopy (TEM) using ruthenium tetroxide. TEWL, PICAD, and CADESI values decreased (p < 0.05) and skin hydration increased dramatically over time (p < 0.05). Electron micrographs showed that the skin barrier of all five dogs was partially restored (p < 0.05). In conclusion, these results demonstrated that moisturizer containing ceramide was effective for treating skin barrier dysfunction and CAD symptoms.