Requirement for additional treatment for dogs with atopic dermatitis undergoing allergen-specific immunotherapy

Allergen-specific immunotherapy (ASIT) is one of the main treatments for atopic dermatitis in dogs, but it often requires additional treatments such as antibacterial and antifungal therapy for secondary bacterial and yeast infections, or antipruritic drugs to control the clinical signs or treat the adverse effects of the immunotherapy. Twenty-seven dogs enrolled in a study of ASIT were clinically assessed four times over a period of nine months; their requirement for treatment for secondary bacterial and yeast infections, for the administration of glucocorticoids as additional antipruritic therapy, and for the treatment of any adverse effects of the ASIT were evaluated. Twenty (74 per cent) of the dogs were treated for superficial bacterial pyoderma, 18 (66.6 per cent) required treatment for Malassezia species dermatitis on one or more occasions, eight (29.6 per cent) required treatment for otitis externa due to Malassezia species or bacteria, and eight required glucocorticoids to control their clinical signs. Five (18.5 per cent) of the dogs experienced adverse effects due to the ASIT and two required treatment with antihistamines (H1 receptor antagonists) in order to continue with the ASIT.     

Prevalence and some clinical characteristics of equine cheek teeth diastemata in 471 horses examined in a UK first-opinion equine practice (2008 to 2009)

Cheek teeth (CT) diastemata are now recognised as a clinically significant equine disorder, but their prevalence in the general equine population is unknown. There is also limited information on the signalment of affected horses; the more commonly affected Triadan sites; and the shape and clinical characteristics of CT diastemata. During the 12-month study period (2008 to 2009), standardised records were obtained during routine dental examinations performed by five veterinarians in a first-opinion equine practice. Cheek teeth diastemata were identified in 49.9 per cent of all horses (n=471) of mean age 11 years (range one to 30 years), with 83.5 per cent of all diastemata affecting mandibular CT and 16.5 per cent affecting maxillary CT. The mean number of diastemata per case was 1.7 (range one to 20) and the mandibular 07 to 08 position was most commonly affected. Valve diastemata were more common (72.1 per cent prevalence) than open diastemata (27.9 per cent). Food trapping was present in 91.4 per cent of diastemata, with gingivitis and periodontal pockets adjacent to 34.2 per cent and 43.7 per cent, respectively. Halitosis was present in 45.5 per cent of affected horses. There was an age-related increase in both the prevalence of diastemata, and in the numbers of diastemata per affected horse, and horses over 15 years old had a significantly increased proportion of open diastemata.     

Feline immunotherapy

Feline allergen specific immunotherapy (ASIT) is considered to be a safe and effective treatment for feline atopy. ASIT is defined as the practice of administering gradually increasing quantities of an allergen extract to an allergic subject. The purpose of which is to reduce or eliminate the symptoms associated with subsequent exposures to the causative allergen. ASIT offers an effective and safe treatment option for cats. Reported success rates range for 60 to 78% in feline atopic patients. Additionally, the reported incidence of side effects in feline atopic patients undergoing ASIT is very low and mainly anecdotal.     

Survey of Feeding Practices, Supplement Use, and Knowledge of Equine Nutrition among a Subpopulation of Horse Owners in New England

Nutrition is a critical component of equine health. Horse owners' knowledge of nutrition is likely to affect their feeding practices. The aim of this study was to survey feeding practices, dietary supplement use, and knowledge about equine nutrition in New England by surveying a subpopulation of horse owners (67/337 or 19.8%) who brought their horses to the Large Animal Hospital at the Cummings School of Veterinary Medicine at Tufts University between July and September 2008. All owners reported feeding hay, with the majority feeding grass or timothy hay. Most owners (96%) reported feeding a concentrate in addition to hay. Approximately 84% of owners reported including at least one dietary supplement in their horse's daily feeding. The most commonly used supplements were chondroprotectives, electrolytes, and multivitamins. Survey questions designed to assess the owner's knowledge of nutrition suggested that many owners may not have a basic understanding of principles of equine nutrition; less than 50% knew the daily water and hay requirements for a horse, and 69% lacked knowledge about the proper use of concentrates in a diet. Most of the surveyed owners consulted multiple sources of information concerning equine nutrition, including veterinarians (n = 36), trainers (n = 27), feed stores (n = 10), and the internet (n = 7). Although the major source of information was the veterinarian, it appears that the communication between horse owners and their veterinarian about optimal feeding practices could be enhanced. This survey demonstrated areas in the veterinarian–client dialog that need to be addressed when evaluating the health and well-being of the horse.     

Factors influencing morbidity and outcome of equine ocular squamous cell carcinoma

A retrospective review of 41 cases of equine ocular squamous cell carcinoma with follow up information for 33 horses is presented. An apparent prevalence in heavy horse breeds was identified. Age and sex distribution were similar to those previously reported. High recurrence (42.4 per cent) and low metastasis (6 per cent) rates were seen. Initial tumour location, primary treatment used, or patient case history had no apparent influence on final outcome. The willingness of owners to pursue with continuous treatment correlated with a high degree of success.     

The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy.

Allergen-specific immunotherapy (ASIT) has been used for years to treat dogs with atopic dermatitis (AD) and humans with atopic diseases. The efficacy of ASIT has been well documented for humans with respiratory atopic diseases and stinging insect allergy, but its effectiveness seems more controversial for patients with AD. In spite of insufficient evidence derived from randomized controlled trials, multiple open studies and a large body of clinical observations suggest that ASIT is effective in controlling the clinical signs of dogs with AD. As a result of the scarcity of evidence from controlled trials, the true efficacy of ASIT, and the optimal protocols for allergen dose and frequency of injection are currently unknown. Allergen-specific immunotherapy nevertheless may be included in the treatment of canine AD because of its potential advantages and limited disadvantages compared to other forms of therapy. There is no evidence, however, for the preference of any specific treatment protocol. The predictive value of historical, clinical and immunologic features related to the efficacy of ASIT in dogs with AD are discussed in this paper. Adverse reactions, and the requirements for monitoring of patients receiving ASIT, then are reviewed and detailed. Finally, this review highlights aspects of ASIT where further research and controlled studies are needed.     

Sentinel practice-based survey of the management and health of horses in northern Britain.

Details of the management, feeding, level of activity and routine health care of horses in Scotland and the five northernmost counties in England were recorded through a stratified random sample of horse owners who had responded to a previous survey. Sixty-eight per cent of the horses were kept where their owners resided, and 32 per cent were kept away from the owner's home. More than 99 per cent were turned out to grazing for at least part of the year and 81 per cent were stabled for at least part of the time, most commonly bedded on straw (50 per cent) or shavings (34 per cent). Hay was fed to 87 per cent, sugar beet pulp to 64 per cent and commercially prepared concentrate mixes to 60 per cent of the horses. Hacking was the most popular activity (52 per cent of horses) followed by riding/pony club events (28 per cent) and showing (21 per cent). The majority of the horses were involved in more than one activity. There were an estimated 0.88 veterinary visits per horse per year and 29 per cent of the horses were reported to suffer from at least one permanent or recurrent health disorder. The median annual numbers of administrations of vaccines (influenza and tetanus) and anthelmintics were one and seven respectively per horse, and each horse was shod a median seven times. There were significant differences in the management of horses kept in different types of premises and in areas of different human population density.     

Demographic characteristics of the equine population of northern Britain.

The size, composition and distribution of the equine population of Scotland and the five northernmost counties in England were estimated through a series of mailed questionnaire surveys of sentinel veterinary practices and horse owners. An estimated 96,622 equine animals were kept by an estimated 26,114 owners. The mean (sd) age of the population was 11.0 (7.5) years (range one month to 37 years). Thoroughbred or thoroughbred-cross animals were the most numerous, constituting 30 per cent (95 per cent confidence interval 27 to 33 per cent) of the total population. The ratio of males:females was 1:1.     

Willingness of a Convenience Sample of Horse Owners to Use Stem Cell Therapy for the Treatment of Equine Tendon Injury and Factors that Influence This Decision

Stem cell therapies offer huge potential for the treatment of tendon injury in horses. However, the factors influencing clients' willingness to use these therapies have not yet been investigated. This study examines the willingness of a population of horse owners to choose stem cell therapy for the treatment of equine tendon injuries and the factors that may influence this choice including treatment cost and efficacy, veterinarian advice, client knowledge, and success stories. A short, anonymous questionnaire was delivered to a convenience sample of equine owners. Questions related to (1) respondent background; (2) prior experience with tendon injuries and their treatment; (3) willingness to use equine stem cell therapy; and (4) the importance of factors that may affect their decision to use the therapy. Responses were summarized using graphical methods and compared using Fisher exact test where appropriate. Fifty-four percent of our cohort (n = 113) reported they would be willing to use equine stem cell therapy, 6% were not willing, and 40% were unsure. When asked to rank factors that would influence their decision, scientific proof that the therapy works was ranked highest followed by veterinarian advice. This result may have been influenced by the high proportion of tertiary-educated respondents recruited in this study. This is the first reported study to investigate the willingness of a population of horse owners to use stem cell therapy for their horses. Results suggest that the majority of these equine owners may consider using stem cell therapies for their horses given a larger positive evidence base was provided for the therapy.     

Equine perioperative fatalities associated with general anaesthesia at a private practice--a retrospective case series

OBJECTIVE: To determine the fatality rate of horses undergoing general anaesthesia at a private equine referral practice using a limited number of anaesthetic protocols. METHODS: A retrospective analysis of records (n = 17 961) from all horses undergoing general anaesthesia for surgical procedures from 1997 to 2001 at Rood and Riddle Equine Hospital, Lexington, Kentucky, USA. Results were reported as percentage of the population, and as crude mortality rates for each procedure (deaths per 1000). RESULTS: The prevalence of equine fatalities directly related to anaesthesia was 0.12% (n = 21) and this rose to 0.24% (n = 42) with the inclusion of horses killed or dying within 7 days post general anaesthesia. Causes of death directly related to anaesthesia were cardiac arrest (n = 10), fracture in recovery stall (n = 8), neuropathy and myopathy necessitating euthanasia (n = 3). Crude mortality rates per procedure were < or =7 deaths per 1000 cases, except arthrodesis/osteotomy cases were 66.7 deaths per 1000 cases. CONCLUSIONS: The anaesthetic fatality rate at this practice is lower than has been reported previously. CLINICAL RELEVANCE: Familiarity with an anaesthetic protocol in combination with reduced anaesthetic time, emergencies of shorter duration between diagnosis and surgery, and adequate preoperative examination appear to minimize the risks associated with general anaesthesia in horses.     

Survey of the provision of prophylactic dental care for horses in Great Britain and Ireland between 1999 and 2002

A survey of 854 horse owners, trainers and equestrian managers in 10 regions of Great Britain and Ireland showed that 83 per cent provided their horses with routine prophylactic dental care at fixed intervals, including 49 per cent at intervals of 12 months and 30 per cent at intervals of six months; a further 10 per cent provided it only when they felt it was required and 7 per cent did not provide it at all. Overall, 44 per cent of the owners had their horse's wolf teeth (first premolar) extracted routinely; when prophylactic dentistry was provided, it was carried out solely by equine dental technicians (EDTS) for 53 per cent of owners, solely by veterinarians for 35 per cent, by both EDTS or veterinarians for 10 per cent of owners and by other than veterinarians or EDTS for 1 per cent. There was confusion among some horse owners concerning the qualifications of the EDTS, because no recognised British qualification was available until towards the end of this survey in 2001. Several reasons were cited by owners for choosing between veterinarians and EDTS including their perceived qualifications, personal recommendations, costs, the availability of a wide range of dental equipment and sedation, and the time and effort devoted to the procedures.     

Serological surveillance of equine viral arteritis in the United Kingdom since the outbreak in 1993

Serological analysis of blood samples submitted to the Animal Health Trust showed that during 1995, 185 of 9203 unvaccinated horses (2.0 per cent) tested positive for antibodies to equine arteritis virus (EAV), and that during 1996, 46 of 8851 unvaccinated horses (0.52 per cent) tested positive. During both years thoroughbreds were the predominant breed tested and only a small proportion of these (<0.3 per cent), consisting predominantly of imported mares, were seropositive. In contrast, among standardbred horses, from which samples were actively solicited in 1995, 84 of 454 (18.5 per cent) were seropositive. Among standardbreds there was a difference in prevalence between types of horses, with 3.7 per cent of racing horses, 25 per cent of non-racing horses and 41 per cent of stallions testing seropositive. Investigations of seropositive stallions identified during 1994 and 1995 demonstrated that clinically inapparent equine viral arteritis (EVA) had occurred previously in the UK. Of 50 seropositive stallions, nearly half were standardbreds and nearly all had been imported from either North America or the European Union. Whether 34 seropositive stallions were shedding virus in their semen was established either by test mating, by the serology of the covered mares, or by investigation by MAFF following the introduction of the Equine Viral Arteritis Order 1995. Nine of the stallions (26.5 per cent) were identified as presumptive shedders of EAV in semen and among specific breeds, viral shedding was identified in six of 15 (40 per cent) standardbreds and three of nine (33 per cent) warmbloods. In contrast with the outbreak of EVA in the UK in 1993, no signs of disease typical of EAV infection were reported during these investigations, even in mares test mated to stallions shedding the virus.     

Canine inflammatory bowel disease: retrospective analysis of diagnosis and outcome in 80 cases (1995-2002)

The case records of 80 dogs in which idiopathic inflammatory bowel disease (IBD) had been diagnosed were reviewed, and owners were contacted for follow-up information using a telephone questionnaire. The types of IBD encountered were lymphocytic (n=6), lymphocytic-plasmacytic (n=38), eosinophilic (n=6) and mixed inflammation (n=30). Prednisolone, sulphasalazine, metronidazole and tylosin were the most frequently prescribed medications. At follow-up, 21 dogs (26 per cent) were classified as being in remission (for a median of 14 months), 40 dogs (50 per cent) had intermittent clinical signs (for a median of 17 months) and three dogs (4 per cent) had uncontrolled disease (for a median of 19 months). Ten dogs (13 per cent) had been euthanased due to refractory IBD and four of these had entered remission for a median of 21 months prior to developing severe relapse and refractoriness to further treatment. Six dogs (8 per cent) had been euthanased or had died for reasons unrelated to IBD. Hypoalbuminaemia at the time of diagnosis was significantly associated with a negative outcome (P=0.0007). No association was found between the site (P=0.75), type (P=0.44) and severity (P=0.75) of disease. Dietary change to single protein and carbohydrate commercial diets had no association with outcome (P=0.12). Owner assessment of quality of life at follow-up was significantly associated with outcome (P=0.006).     

Current joint therapy usage in equine practice: a survey of veterinarians 2009

Reasons for performing study: Medications are frequently employed to treat intra‐articular (IA) problems in the performance horse. Actual usage of the different IA medications in horses is not available. Objectives: To determine the most common usage of these medications, members of the American Association of Equine Practitioners (AAEP) were surveyed. Methods: An email link to an online survey was electronically sent to 6305 AAEP members and the responses tabulated and analysed with a logistic regression model. Results: A total of 831 survey responses were submitted and tabulated. Eighty per cent of the respondents indicated that they see 100% equine cases in their practice. The majority of respondents (77%) use triamcinolone acetonide (TA) to treat high motion joints and 73% use methylprednisolone acetate (MPA) to treat low motion joints. Veterinarians treating the Western performance and Sport horse were significantly more likely to use TA in high motion joints compared to MPA (P = 0.0201 and P<0.0001, respectively). Triamcinolone acetonide use compared to MPA in high motion joints by racehorse veterinarians was significantly lower compared to other veterinarians (P<0.0001). Polysulphated glycosaminoglycan (Adequan) and hyaluronate sodium (Legend) were the most commonly used disease modifying products (63 and 57% of respondents, respectively). Sport horse practitioners were significantly more likely than race or show horse veterinarians to utilise IRAP products (P = 0.0035 and P = 0.04, respectively). Respondents who had been in practice for more than 10 years were significantly less likely to use antimicrobials in their joint injections compared to those in practice for less than 10 years (P<0.0001). Conclusions: Significant differences existed in usage of medications related to primary discipline treated and years practicing. Potential relevance: The results of this study aid in defining the current usage of different joint therapy medications within equine practice. This knowledge can guide further research as well as education.     

A Survey of Horse Owner's Compliance with the Finnish Vaccination Program

Finnish Trotting and Breeding Association's electronic database (IT register) in Finland does not include vaccination entries of all horses. Especially, vaccination status of horses outside sport arenas is unclear. Objectives were to investigate vaccination practices of horse owners in Finland, to look for reasons associated with nonvaccination, and to evaluate the accuracy of the other statistics in Finland. The questionnaire study was executed. Horse owners (n = 1,198) told their vaccination practices, vaccinations used, and reasons for nonvaccination. Horses were mainly (85%–95%) vaccinated depending on the number of horses per horse owner. Equine influenza vaccine was mainly favored (94%). One reason for nonvaccination is that the horse is inactive in equine sport arenas (43%). Other reasons (53%) were age, horse does not take part in competitions but stay at home, and the owner decides that the horse does not need vaccination. Differences between age groups (young and old), competition types, and regions were not found by one-variable analysis, but vaccination status of horses outside equine sport arenas differed from horses active in competitions. By logistic regression analysis, it was indicated that purpose of use had influence on vaccination status. Reasons for nonvaccination surveyed in UK were confirmed. The control of the competition rules and possible sanctions exercised in competition venue are better explanatory factors than age, type of competition, and geographic home area. However, the risk to meet a nonvaccinated horse increases when going to the northern part of Finland.     

Indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses: 82 cases (1995-2005)

OBJECTIVE: To identify indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses. DESIGN: Retrospective case series. ANIMALS: 82 horses undergoing permanent tracheostomy. PROCEDURES: Data obtained from medical records included signalment, diagnosis, surgical technique, complications, use of the horse before and after surgery, and owner satisfaction. Follow-up information was obtained through a telephone questionnaire administered to owners. RESULTS: Indications for permanent tracheostomy included nasopharyngeal cicatrix (n = 59), arytenoid chondropathy (55), and laryngeal hemiplegia (20); 54 horses had multiple indications for tracheostomy. Complications identified prior to discharge included partial dehiscence (n = 8), transient fever (10), and excessive swelling (13). Complications identified after discharge included partial dehiscence (n = 3), inversion of skin (2), and stenosis of the tracheostomy requiring repair (1). Long-term follow-up information was available for 64 horses. Fifty-seven of the 64 (89%) horses returned to their previous use, and owners of 63 (98%) horses reported being very satisfied with the results. The owner of 1 (2%) horse was unsatisfied with the results. The 1-year survival rate was 97% (95% confidence interval, 95% to 100%). Mean estimated truncated survival time (ie, failure-free period) was 9.7 years (95% confidence interval, 9.3 to 10.1 years). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that permanent tracheostomy can be safely performed in standing horses and was a viable treatment for horses with obstructive disease of the upper respiratory tract that was unresponsive to medical treatment or other surgical treatments.     

Management of horses showing stereotypic behaviour, owner perception and the implications for welfare

A telephone survey was conducted of 100 racing stables, 100 riding schools and 100 competition establishments (8,427 horses in total) to determine what management practices were being applied to horses showing stereotypic behaviour, and to determine the underlying reasons for them by assessing the perceptions and opinions of the people working with the horses. The results indicated that horse owners are concerned about stereotypic behaviour, first, because it reduces the performance of the animal (31, 30 and 27 per cent of the owners of racing stables, riding schools and competition establishments respectively), secondly, because it has adverse clinical effects on the horse (52, 55 and 56 per cent), and thirdly, because it reduces the monetary value of the animal (45, 59 and 31 per cent). The belief that these behaviours are learnt or copied also affects the management of affected horses: they are not allowed on to the premises by 4, 32 and 17 per cent of owners of racing stables, riding schools and competition establishments, respectively; attempts are made to remove the causal factors of the stereotypy by 35, 43 and 36 per cent; the behaviours are physically prevented by 77, 67 and 79 per cent, and the affected horses are kept separate from other horses by 39, 30 and 48 per cent.     

Examination of serum total IgG1 concentration in atopic and non-atopic dogs

In this study, serum immunoglobulin G1 (IgG1) concentrations were examined in atopic and non-atopic dogs receiving different levels of parasite control. Significantly lower serum total IgG1 concentrations were found in non-atopic dogs receiving stringent parasite control than in atopic dogs or non-atopic dogs receiving less stringent parasite control. Examination of serum total IgG1 concentrations of atopic dogs after six months of allergen specific immunotherapy (ASIT) showed a significant increase in serum total IgG1 concentrations. It is proposed that serum total IgG1 concentrations are affected by parasitism, atopic dermatitis and ASIT.