Remission of the clinical signs of atopic dermatitis in dogs after cessation of treatment with cyclosporin A or methylprednisolone

Seventy-eight dogs with atopic dermatitis were treated for four months with either cyclosporin A or methylprednisolone. During the two months after the treatment ceased, 87 per cent of the dogs treated with methylprednisolone relapsed after a mean period of 27.9 days, whereas only 62 per cent of the dogs treated with cyclosporin A relapsed after a mean period of 40.7 days (P < .0.001). The clinical condition of the dogs was evaluated either when they relapsed, or two months after the treatment ceased if they had not relapsed. Both the skin lesions and pruritus increased significantly more markedly in the dogs treated with methylprednisolone than in those treated with cyclosporin A. At the end of the study the skin lesions were markedly less severe than before the therapy; in the dogs in both groups that did not relapse, the lesion score was improved by 77 per cent two months after the treatment had stopped, and in the dogs that did relapse the lesion scores had improved by 45 per cent and 35 per cent in the dogs treated with cyclosporin A and methylprednisolone, respectively. Pruritus remained well controlled in the dogs that did not relapse, but increased to baseline levels or close to baseline in the dogs that relapsed.     

Hemilaminectomy for the treatment of thoracolumbar disc disease in the dog: a follow-uo studv of 40 cases

A study was made of dogs with Hansen type I thoracolumbar disc extrusions that had been treated by hemilaminectomy and fenestration of the affected disc. Follow-up information was available for 40 dogs undergoing treatment over a five-year period. The follow-up period ranged from 12 to 72 months (mean 34 months). The case details and the results of treatment of these 40 dogs are presented. All dogs were graded according to the degree of neurological dysfunction at the time of initial presentation and at the conclusion of the study period. Twenty-seven dogs (68 per cent) had no detectable signs of neurological dysfunction or thoracolumbar pain at the final assessment and a further eight dogs (20 per cent) had mild ambulatory paraparesis but were regarded by their owners as functional pets. Recurrence of neurological signs consistent with thoracolumbar disc disease was seen in five dogs (13 per cent) and was successfully resolved completely in one of three dogs that were treated.     

Results of non-selective adrenocorticolysis by o,p'-DDD in 129 dogs with pituitary-dependent hyperadrenocorticism

One hundred and twenty-nine dogs with pituitary-dependent hyperadrenocorticism were treated according to a protocol aimed at the complete destruction of the adrenal cortices by the administration of o,p'-DDD (mitotane) at a daily dose of 50 to 75 mg/kg bodyweight for 25 days. On the third day, glucocorticoid and mineralocorticoid supplementation was begun for the induced adrenocortical insufficiency. The first followup examination after completion of the 25-day course and the subsequent twice-yearly follow-up examinations included physical examination and measurements of plasma concentrations of sodium and potassium to optimise substitution therapy. In 19 dogs the full course of 25 days treatment could not be completed. Of the 110 dogs which received the full course of treatment, the administration had to be stopped temporarily in 32 because of side-effects, such as anorexia and vomiting. The actual dose of o,p'-DDD administered was not significantly different in the dogs with and without these side-effects. Clinical remission occurred in 111 dogs (86 per cent), of which 43 (39 per cent) had a relapse. The estimated one-year disease-free fraction was 77 per cent (95 per cent confidence interval [CI]: 67 to 85 per cent). The estimated one-year survival fraction was 80 per cent (95 per cent CI: 71 to 87 per cent), the two-year survival was 69 per cent (95 per cent CI: 59 to 78 per cent), and the three-year survival was 61 per cent (95 per cent CI: 49 to 71 per cent). The bodyweight and age of the dog, and vomiting occurring during the period of treatment, were positively correlated with the length of the disease-free period, whereas weakness during the treatment and resistance to dexamethasone suppression of the urinary corticoid/creatinine ratios at the start of the treatment were associated with a relatively short survival time.     

Complications following full-thickness small intestinal biopsy in 66 dogs: a retrospective study

OBJECTIVES: To retrospectively report the complications seen after full-thickness multiple small intestinal biopsies were performed in 66 dogs. METHODS: Animals that died as a result of enteric wound breakdown were compared with the surviving population to identify fatal risk factors. RESULTS: Seventeen dogs had hypoalbuminaemia and eight had albumin levels below 20 g/I at surgery. Twelve dogs had concurrent disease, of which seven had skin disease. Seven dogs suffered minor complications which resolved with treatment. Eight dogs (12 per cent) died or were euthanased between three and nine days postoperatively (mean [sd] 4.5 [2.1]) due to enteric wound breakdown. Seven of these dogs developed septic peritonitis and one died of haemorrhage. No statistically significant differences were identified in any of the parameters examined for the development of fatal enteric wound dehiscence. CLINICAL SIGNIFICANCE: Full-thickness intestinal biopsy is not a benign procedure. However, this study concludes that there are no consistent predictors for patients at increased risk of enteric wound breakdown.     

Serial monitoring of clinical, haematological and immunological parameters in canine autoimmune haemolytic anaemia

Clinical, haematological and immunological data are presented from 14 dogs with autoimmune haemolytic anaemia (AIHA) serially monitored for up to 945 days after initial presentation. At the time of diagnosis, all dogs had severe anaemia (mean packed cell volume [PCV] 17.6±7.1 per cent) with leucocytosis in seven cases and thrombocytopenia in four dogs. The Coombs' test was positive in all cases. Immunoglobulin G (IgG) autoantibody alone was identified in eight cases, a combination of IgG and IgM autoantibodies was recognised in three cases, and in two dogs only IgM autoantibody was recorded (complement fixing in one of these dogs). All dogs were treated with immunosuppressive doses of corticosteroids and some animals also received cyclophosphamide (four cases), azathio-prine (two cases), blood transfusion (four cases) or underwent splenectomy (two cases). Two dogs died during the initial episode of AIHA. In 12 dogs, the anaemia was resolved by an average of 36.3 ±16.0 days after initial presentation, but autoantibody titre often persisted after clinical improvement and normalisation of PCV. Four dogs had a clinical relapse 67 to 170 days after initial presentation and one of these dogs subsequently died from thromboembolic disease. One dog developed lymphocytic thyroiditis and serum antinuclear antibody at day 691 after initial presentation, and two cases developed disease consistent with autoimmune thrombocytopenia (AITP) at 365 and 618 days post initial presentation. In one of these dogs, AITP was concurrent with multicentric lymphoma. No correlation was recorded between haematological and immunological parameters at presentation and subsequent response to therapy or long-term clinical behaviour.     

Fusion podoplasty for the management of chronic pedal conditions in seven dogs and one cat

Eight animals underwent fusion podoplasties for the treatment of chronic interdigital furunculosis (n=3), ectrodactyly (n=1), digit abnormalities associated with tendonectomy (n=1), redundant indertigital skin (n=1), conformational deformity (n=1), and necrotizing fasciitis of the paw (n=1). Median duration of bandaging was 14 days, and median duration of hospitalization was 5 days. Four dogs had dehiscence, which occurred at a mean time of 11 days after surgery. Clinical abnormalities necessitating podoplasty resolved in six animals and improved in two. Six animals had normal ambulation and two dogs had slight weight-bearing lameness after a median follow-up time of 29 mo. Fusion podoplasty may be recommended as a salvage procedure for the treatment of various chronic pedal diseases in dogs and cats.     

Cyclosporine treatment of anal furunculosis in 26 dogs

OBJECTIVES: To evaluate the effect of cyclosporine on anal furunculosis lesions in 26 dogs. METHODS: Lesions were graded as mild in 11 dogs, moderate in eight and severe in seven. Each dog was treated with approximately 4 mg/kg cyclosporine orally every 12 hours until the lesions resolved or showed no further improvement. Residual lesions were resected surgically. RESULTS: Eighteen dogs (69 per cent) experienced complete resolution, seven (27 per cent) improved but had residual lesions and one (4 per cent) showed no improvement. The mean duration of treatment until resolution or no further improvement was 8.8 weeks (range four to 24 weeks). Nine dogs (35 per cent) experienced recurrence. Six were from the group that had shown complete resolution and three were from the group that had surgery. Fifteen dogs (58 per cent) developed side effects to cyclosporine, although none required treatment to be discontinued. Mean duration of follow-up was 6.8 months (range one to 20 months). CLINICAL SIGNIFICANCE: Cyclosporine was effective at resolving or reducing anal furunculosis lesions in 25 of 26 dogs (96 per cent). However, residual or recurrent lesions remain a potential problem, and surgical resection or long-term cyclosporine treatment may be necessary in some dogs.     

The anti-emetic efficacy of maropitant (Cerenia) in the treatment of ongoing emesis caused by a wide range of underlying clinical aetiologies in canine patients in Europe

OBJECTIVES: The efficacy of maropitant (Cerenia; Pfizer Inc.) as an anti-emetic for use in dogs with ongoing emesis was evaluated in a two-phase multi-centric study conducted at veterinary clinics in France, Italy, Slovakia and the UK. METHODS: In phase I, dogs with ongoing emesis were randomised in a 1:1 ratio to either maropitant (32 dogs) or metoclopramide (34 dogs). In phase II, dogs were randomised in a 2:1 ratio to maropitant (77 dogs) or metoclopramide (40 dogs). Maropitant was administered subcutaneously at 1 mg/kg/day for up to five days. Metoclopramide was administered as recommended on the product labels as licensed at 0.5 to 1 mg/kg/day subcutaneously or orally with the daily dose divided over two to three administrations per day for up to three to five days. RESULTS: In phase I, 97 per cent of dogs treated with maropitant and 71 per cent of dogs treated with metoclopramide did not vomit after treatment (P<0.01). The mean number of emetic events after maropitant treatment was significantly reduced compared with that after metoclopramide treatment (P=0.01). In phase II, the occurrence of emesis was lower for maropitant during the first 24 hours (P<0.0001) and for each day thereafter. CLINICAL SIGNIFICANCE: A single daily dose of maropitant was more effective than metoclopramide administered two or three times daily in the treatment of emesis caused by various aetiologies in dogs.     

Comparison of a chlorhexidine and a benzoyl peroxide shampoo as sole treatment in canine superficial pyoderma

The clinical and antibacterial efficacy of two shampoos used as a sole antibacterial treatment in dogs with superficial pyoderma were investigated and compared. In a randomised, partially blinded study, a 3 per cent chlorhexidine gluconate shampoo (Chlorhex 3; Leo Animal Health) was compared against a 2.5 per cent benzoyl peroxide shampoo (Paxcutol; Virbac) in 22 dogs with superficial pyoderma. Dogs were washed two to three times weekly with a 10-minute contact time over 21 days. Clinical scores and bacterial counts were assessed on days 1, 8 and 22 and compared within and between treatment groups; overall response was assessed at the end of the study. Twenty dogs completed the study; 15 (68.2 per cent) showed an overall clinical improvement and the clinical signs resolved in three chlorhexidine-treated dogs. In the chlorhexidine-treated group, scores for papules/pustules (P<0.001), investigator-assessed pruritus (P=0.003), total bacterial counts (P=0.003) and counts for coagulase-positive staphylococci (P=0.003) were reduced after three weeks. Scores and bacterial counts did not vary significantly in the benzoyl peroxide-treated group.     

Bone allografts and adjuvant cisplatin for the treatment of canine appendicular osteosarcoma in 18 dogs

The results achieved in 18 dogs following the use of frozen bone cortical allografts for limb-sparing resection of non-metastatic canine appendicular osteosarcoma are presented. Three to five cisplatin doses (70 mg/m2) were administered, starting the day after surgery. The mean and median survival times were 478 and 266 days (range 80 to 2,611 days), respectively. The survival rate was 94 per cent at three months, 78 per cent at six months, 35 per cent at 12 months, 23 per cent at 18 months and 19 per cent at 24 months; the disease-free interval was 80 to 1,246 days (mean 365 days, median 266 days). Lung metastasis developed in 55 per cent of the dogs within one year. Complications were observed in 14/18 dogs (78 per cent), comprising local recurrence (28 per cent), allograft infection (39 per cent) and implant failure (11 per cent). Despite complications, limb sparing is a useful alternative to amputation in selected cases of appendicular osteosarcoma.     

Management of 49 antebrachial and crural fractures in dogs using circular external fixators

Objectives : To evaluate frame constructs, postoperative fracture reduction, postoperative care, complications, treatment duration and outcome of circular external fixation for management of 49 antebrachial and crural fractures in dogs. Methods : Medical records of dogs that underwent surgery with circular external fixation were examined for fracture location, frame configuration, postoperative fracture reduction, treatment duration, complications and outcome. Results : Forty‐nine fractures in 48 dogs were stabilised using circular external fixation. Frame removal occurred on average 61 days after surgery (median±sd, 52±30 days). Minor complications were observed in 35 cases (71 per cent) and major complications in seven (14 per cent). Radiographic outcome at frame removal was judged as excellent in 18 cases (37 per cent), as good in 26 (53 per cent), as fair in four (8 per cent) and poor in one (2 per cent). After frame removal, one fracture was stabilised with a plate, and eight patients were lost to follow‐up. Functional and cosmetic outcome at follow‐up was judged as excellent in 32 cases (80 per cent), good in seven (18 per cent) and fair in one (2 per cent). Clinical Significance : Circular external fixation can effectively treat antebrachial and crural fractures in dogs, even geometrically complex fractures. Minor complications are frequent but easily managed in most instances. Healing time is comparable to that of other external fixation methods.     

Mitotane (o, p''-DDD) Treatment of 200 Dogs with Pituitary-Dependent Hyperadrenocorticism

Two hundred dogs with pituitary dependent hyperadrenocorticism (PDH) were treated with mitotane at an initial daily dosage of 21 to 69 mg/kg (mean = 45.2 mg/kg) for 5 to 14 days. During the induction period, 194 of the dogs also were given daily maintenance dosages of a glucocorticoid. Fifty of the dogs exhibited one or more adverse effects during initial induction, including weakness, vomiting, anorexia, diarrhea, and ataxia. After completion of the induction period, repeat ACTH stimulation testing revealed significant decreases in mean serum cortisol concentrations when compared with initial values. Twenty-five dogs, however, still responded to exogenous ACTH with serum cortisol concentrations above normal resting range, necessitating daily treatment for an additional 5 to 55 days. In contrast, 70 of the 200 dogs had low post-ACTH serum cortisol concentrations after the induction period. These subnormal serum cortisol concentrations generally increased spontaneously to within normal resting range 2 to 6 weeks after cessation of mitotane. In 184 dogs, mitotane was continued at an initial mean maintenance dosage of 49 mg/kg administered weekly in two to three divided doses. Of these dogs, 107 had one or more relapses of hyperadrenocorticism during treatment. In the 75 dogs that had one relapse, the median maintenance dosage was increased by approximately 35%, whereas the median maintenance dosage in the 32 dogs having two or more relapses was eventually increased by 225% over the initial dosage. After a mean maintenance treatment time of 2.0 years, the final maintenance dosage required in the 184 dogs ranged from 26.8 to 330 mg/kg/week.(ABSTRACT TRUNCATED AT 250 WORDS)     

Orthovoltage radiation and weekly low dose of doxorubicin for the treatment of incompletely excised soft-tissue sarcomas in 39 dogs

The efficacy and toxicity of orthovoltage radiation therapy and concurrent low doses of doxorubicin for the treatment of incompletely excised soft-tissue sarcomas in 39 dogs was investigated retrospectively. The 39 dogs had 40 soft-tissue sarcomas and received 51 Gy orthovoltage radiation in 17 daily 3 Gy fractions; they also received 10 mg/m(2) doxorubicin once a week administered intravenously one hour before the dose of radiation. The median follow-up time was 910 days. The tumours recurred locally in seven of the dogs, in five of them within the radiation field; the median time to their recurrence was 213 days (range 63 to 555 days). Six of the dogs developed a distant metastasis after a median time of 276 days (range eight to 826 days). The one-year and two- to four-year tumour control rates were 84 per cent and 81 per cent, respectively, and the one-, two- and three- to four-year survival rates were 85 per cent, 79 per cent and 72 per cent, respectively. Tumours with a mitotic rate of more than 9 per 10 high-power fields were significantly more likely to recur, and the dogs with such tumours survived for significantly shorter periods.     

Efficacy of licofelone in dogs with clinical osteoarthritis

To evaluate the effect of licofelone, an arachidonic acid substrate with combined inhibitory activity against 5-lipoxygenase and cyclooxygenases 1 and 2, a double-blind, randomised and placebo-controlled study was conducted in 33 client-owned dogs that were lame owing to hindlimb osteoarthritis. Seventeen of the dogs received a placebo and 16 were treated with 2.5 mg/kg licofelone twice a day for 28 days. The dogs' lameness was assessed on a visual analogue scale (vas), and by force plate analyses at baseline and 14 and 28 days after starting the treatment. After 14 days the mean (se) change in peak vertical force in the licofelone-treated dogs (1.7 [0.8] per cent bodyweight) was significantly greater (P<0.05) than in the placebo-treated dogs (-0.3 [0.6] per cent bodyweight), and after 28 days the difference had increased. In contrast, the dogs' lameness, as assessed by the vas values, had decreased significantly over baseline in both the treated and control groups.     

Clinical efficacy and safety of cefovecin in the treatment of canine pyoderma and wound infections

OBJECTIVES: To determine the efficacy and safety of cefovecin in the treatment of bacterial skin infections in dogs. METHOD: Dogs with superficial or deep pyoderma or wounds/abscesses were enrolled in three separate studies. Dogs (354) were randomised to treatment and received either cefovecin administered by subcutaneous injection at 14 day intervals, as clinically necessary, or amoxicillin/clavulanic acid as oral tablets twice daily for 14 days. Courses of treatment were repeated at 14 day intervals up to a total of four courses. Clinicians responsible for assessing lesions were masked to treatment allocation. Only animals where the presence of a pretreatment bacterial pathogen was confirmed were included in the analysis of efficacy. Cases were evaluated for clinical efficacy at 28 days after initiation of the final course of treatment. Clinical efficacy was assessed by scoring the clinical signs typical of skin infections. RESULTS: Cefovecin demonstrated statistical non-inferiority compared with amoxicillin/clavulanic acid for all three clinical diagnoses; for cefovecin, up to 96.9 per cent efficacy was observed versus 92.5 per cent for amoxicillin/clavulanic acid. CLINICAL SIGNIFICANCE: Cefovecin was shown to be as effective as amoxicillin/clavulanic acid administered orally in the treatment of bacterial skin infections in dogs. Cefovecin offers the additional benefit of eliminating owner non-compliance.     

Monthly application of 10 per cent moxidectin and 2{middle dot}5 per cent imidacloprid spot-on to prevent relapses in generalised demodicosis: a pilot study

Canine generalised demodicosis (GD) can be difficult to cure, with some dogs requiring life-long treatment. The aim of this pilot study was to evaluate the effectiveness of monthly 10 per cent moxidectin/2·5 per cent imidacloprid spot-on in maintaining long-term (12 months) clinical and parasitological remission in dogs with relapsing GD. Fourteen dogs were included: 10 with juvenile-onset GD (JOGD) and four with adult-onset GD (AOGD). All?dogs had been treated previously and relapsed (1-4 times). Each dog was treated again with either milbemycin oxime 2 mg/kg or ivermectin 400 μg/kg orally once daily, until two consecutive negative skin scrapings at one-month intervals (total 4-7 months of treatment). After treatment discontinuation, 10 per cent moxidectin/2·5 per cent imidacloprid spot-on was applied monthly for 12 months. Dogs were rechecked after 1, 2, 3, 6 and 12 months, and multiple skin scrapings were taken. Twelve dogs completed the study and were clinically normal and parasitologically negative at each recheck (four dogs with AOGD and eight with JOGD). One dog died suddenly for unrelated reasons, and one dog relapsed. Results of this pilot study suggest that monthly application of 10 per cent moxidectin/2·5 per cent imidacloprid spot-on may be effective as maintenance therapy in relapsing cases of GD.     

Value of the pinnal-pedal reflex in the diagnosis of canine scabies

The potential value of the pinnal-pedal scratch reflex as an aid to diagnosing canine scabies was assessed in 588 dogs with skin disease. The reflex was assessed by vigorously rubbing the tip of one earflap on to the base of the ear for five seconds, and it was considered positive if the ipsilateral hind leg made a scratching movement. A diagnosis of scabies was based on the dog's history, a physical examination and either positive skin scrapings or the complete resolution of pruritus and dermatitis after treatment with ivermectin or milbemycin, with no relapse for at least 12 months. Scabies was diagnosed in 55 of the dogs, allergic skin disease in 463, and 70 had other miscellaneous skin diseases. There was a positive pinnal-pedal scratch reflex in 45 (82 per cent) of the 55 dogs with scabies. Forty (73 per cent) of the dogs with scabies had pinnal dermatitis, and 36 (90 per cent) of these had a positive pinnal-pedal scratch reflex. There was a positive pinnal-pedal scratch reflex in 33 (6.2 per cent) of the other 533 dogs. On the basis of these results, the specificity of testing for scabies by the pinnal-pedal scratch reflex was 93.8 per cent, and the sensitivity was 81.8 per cent The test's positive predictive value was 0.57 and its negative predictive value was 0.98.     

Long-term treatment with carprofen of 805 dogs with osteoarthritis

The pain-relieving effect of carprofen and tolerance to the drug were investigated in 805 dogs that were lame as a result of osteoarthritis. The dogs were of different breeds, ages and bodyweights and of both sexes, and were selected from 51 veterinary clinics. Each dog was treated orally by its owner with 4 mg/kg carprofen for 84 consecutive days. Twenty-four dogs were removed from the study because of side effects, and 55 left the study for reasons unrelated to the treatment. The condition of the dogs and the benefit of the treatment were evaluated by the veterinary surgeons and the owners after 14 days, and at the end of the period of treatment, when 194 of the dogs (26.7 per cent) were no longer lame, and 357 (49.2 per cent) had improved. The period for which the dogs had been lame before entering the study significantly (P<0.01) affected the results and the rate of improvement. Too much exercise during the 84 days of treatment caused some dogs to relapse.     

Pharyngeal stick penetration injuries in the dog

Sixty-five dogs were examined and treated for stick penetration wounds of the pharynx. Dysphagia, pain, pyrexia and local cellulitis were common presenting signs amongst recently injured dogs. Injuries involving the oesophagus resulted in subcutaneous emphysema and dyspnoea associated with pneumomediastinum. Longstanding wounds presented with discharging sinuses of the head, neck or cranial thoracic region. Wooden foreign bodies were recovered from 37 dogs (57 per cent) with subsequent resolution of their clinical signs. No foreign body was retrieved from a further 18 dogs (28 per cent) but their clinical signs resolved after appropriate wound management. Four dogs (6 per cent) died shortly after the injury from major oesophageal tears which allowed mediastinal contamination. Six dogs (9 per cent) had no foreign body recovered at surgery and the discharging sinuses persisthed. The need for vigorous management of the fresh injury in order to preclude the development of chronic complications is emphasised.     

Adrenal gland function in dogs given methylprednisolone

Serum cortisol (hydrocortisone) was measured by radioimmunoassay in dogs given methylprednisolone (MP) orally or methylprednisolone acetate (MPA) IM. The MP was given on a daily and on an alternate-day basis to different treatment groups and the MPA was administered weekly. Samples of blood were obtained twice a week over a 9-week treatment period for serum cortisol determination, and the adrenal gland response to ACTH was assessed on posttreatment days 1, 3, 5, and 7. Administration of MP on an alternate or daily basis caused a slight but significant (P < 0.05) depression in mean resting cortisol values over time. The MPA administration caused a severe depression of resting serum cortisol values. In response to ACTH, cortisol values invariably increased sharply in nontreated control dogs and in those dogs given MP on an alternate-day basis. Dogs given MP daily had a depressed response to ACTH. The MPA treatment resulted in adrenal cortices that were unresponsive to ACTH. Dogs given MPA, but not challenge exposed with ACTH, had markedly lowered cortisol values for at least 2 weeks after cessation of treatment. Consequently, a difference between daily- and alternate-day MP administration was detected after ACTH challenge exposure; MPA administration inhibited adrenal cortisol secretion for at least the duration of the experiment.