The ACVD task force on canine atopic dermatitis (XXI): antihistamine pharmacotherapy.

Antihistamines frequently are recommended by veterinary dermatologists for symptomatic treatment of pruritus associated with canine atopic dermatitis (AD), perhaps because of their moderate success in some human patients with AD. A critical review of the literature describing antihistamine use in canine AD reveals that the majority of published, peer-reviewed studies are open, uncontrolled or partially-controlled trials. Such studies vary widely in reported efficacy, from perhaps 0 to 75% of patients, even using the same drug. The few blinded placebo-controlled trials available have failed to confirm efficacy of these drugs to relieve the pruritus of canine AD. Some studies indicate that synergistic effects could occur with concurrent use of essential fatty acid supplements. Consequently, at the time of this writing, there is insufficient evidence to conclude for or against the efficacy of antihistamines for treatment of canine AD. Additional blinded, randomized and controlled trials with larger numbers of patients are necessary to establish which of the antihistamine drugs currently available, if any, are truly efficacious for canine AD. Nevertheless, present clinician consensus suggests that several different antihistamine drugs should be evaluated in sequence, for 7-14 days each, in canine patients with AD.     

Strategies for management of recurrent pyoderma in dogs

Staphylococcal skin infection (pyoderma) is a common clinical problem in dogs. The infection can be either superficial or deep. Most cases of staphylococcal pyoderma occur secondary to a definable underlying cause. Treatment consists of finding the underlying cause and correcting it, if possible, and treating the pyoderma with antibiotics. Antibacterial shampoos may be used as adjunct treatment, but corticosteroid drugs should not be used. When canine pyoderma recurs in the absence of an identifiable underlying cause, several treatment strategies can be effective in eliminating recurrence or limiting its severity. Frequent antibacterial shampoos are an easy and sometimes effective method. Immunomodulatory drugs are variably effective. Some commercially available bacterins are clearly helpful in treating recurrent pyoderma. As a last resort, the clinician may opt to keep the patient on long-term antibiotic therapy. Such therapy may promote development and dissemination of resistant strains of Staphylococcus and should be used only if absolutely necessary.     

The ACVD task force on canine atopic dermatitis (XII): the relationship of cutaneous infections to the pathogenesis and clinical course of canine atopic dermatitis.

Dogs and human beings with atopic dermatitis (AD) frequently exhibit concurrent skin infections with Staphylococcus sp. bacteria or Malassezia yeast, and treatment of such infections is an important facet of managing these patients. Staphylococci appear to colonize atopic skin readily, and bacterial products on the skin could augment cutaneous inflammation via immediate hypersensitivity responses to the bacteria, by superantigen-mediated lymphocyte activation, or other non-specific mechanisms. Similarly, skin colonization by Malassezia yeast could contribute to clinical signs of AD; yeast components could induce inflammation via non-specific mechanisms, such as alteration in mediator release, or via antigen-specific hypersensitivity reactions. Clinical and experimental evidence exists that secondary microbial infections can both initiate and perpetuate episodes of AD in dogs and humans, and could even participate in promotion of pro-allergic immunologic responses. Mechanistic details of these complex interactions are under extensive investigation in human beings; only a few observations have been extended to include dog with AD.     

Clinicopathologic characterization of canine juvenile cellulitis

The syndrome of canine juvenile cellulitis was observed and characterized throughout its clinical course when it occurred spontaneously in a litter of dogs. Histologically, pyogranulomatous inflammation was seen in facial skin and mandibular and superficial cervical lymph nodes of affected dogs. The predominant inflammatory cell characterized by light and electron microscopy and by immunohistochemical staining was an epithelioid macrophage. The same pyogranulomatous inflammatory process was seen in a lymph node anatomically distant from the site of apparent disease. Interestingly, a littermate with neither clinically evident dermal lesions nor lymphadenopathy had histologic evidence of a milder, but similar inflammatory process in a mandibular lymph node. The observation of canine juvenile cellulitis in clusters of dogs between 1 and 4 months of age and its apparent systemic nature suggest an infectious etiology. Bacterial, fungal, or viral agents were not isolated from affected lymph nodes. Attempts to transfer the disease by inoculation of neonatal puppies with tissue from affected dogs were also unsuccessful.     

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

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

IgE-reactivity to major Japanese cedar (Cryptomeria japonica) pollen allergens (Cry j 1 and Cry j 2) by ELISA in dogs with atopic dermatitis

The present study investigated IgE-reactivity to two major Japanese cedar (Cryptomeria japonica, C. japonica) pollen allergens (Cry j 1 and Cry j 2) in dogs with atopic dermatitis by use of a fluorometric ELISA. The serum samples from 27 dogs that showed IgE-sensitivity to crude C. japonica pollen allergen by ELISA were tested for specific IgE to the two major allergens. All 27 dogs had anti-Cry j 1 IgE, and 10 (37%) had anti-Cry j 2 IgE. Inhibition of binding of dog specific IgE to crude C. japonica pollen allergen was carried out by addition of Cry j 1. When serum samples containing anti-Cry j 1 IgE but no anti-Cry j 2 IgE were incubated with Cry j 1, specific IgE binding to crude C. japonica pollen allergen was almost abolished. These findings suggest that Cry j 1 is a major allergen in dogs.     

Survey of intradermal skin testing practices in North America

Allergic skin diseases are commonly diagnosed by veterinarians. Inhalant-related allergic diseases are especially prevalent in companion animal species. Intradermal skin testing (IDST) is the usual method for diagnosis of these syndromes, and is often followed by hyposensitization treatment if an animal reacts to substances during testing. A mail survey of veterinarians in the United States and Canada was conducted to determine current procedures in use for IDST and opinions on results of IDST and hyposensitization. Results of the survey indicate that IDST procedures are not currently standardized and that there is wide variation in the methods used. Opinion regarding results of skin testing and hyposensitization was largely in agreement with previously published patient studies.     

Analysis of the canine IgE-binding epitope on the major allergen (Cry j 1) of Japanese cedar pollen with anti-Cry j 1 monoclonal antibodies

In our previous study [Immunology 91 (1997) 161] using monoclonal antibodies (mAbs) specific to Cry j 1, a major allergen in Japanese cedar (Cryptomeria japonica) pollen, we identified five independent epitopes (EP-1-EP-5) on the molecule and found that EP-1 and EP-5 are the predominant allergic epitopes for humans and monkeys, respectively. In this study, we analyzed the epitopes recognized by IgE in the sera of 10 dogs sensitive to C. japonica pollen allergen using an IgE-ELISA inhibition method with these mAbs. The IgE reaction patterns varied among dogs. In eight of the 10 dogs, IgE recognized EP-5 which is a predominant allergic epitope for monkeys with the pollenosis. In four dogs, IgE recognized EP-1 which is a predominant allergic epitope for human patients with the pollenosis. In three dogs, IgE recognized EP-4 which is a heat-stable epitope. EP-5 is a predominant allergic epitope for dogs and some, but not all, dogs have IgE reaction patterns to the epitopes similar to those of humans.     

Commercial dry dog food in the north central United States is not contaminated by Dermatophagoides house dust mites

Contamination of home-stored cereal grain food products with Dermatophagoides spp. house dust mites (HDM) was reported recently, along with anaphylaxis after consumption of these foods by dust mite-allergic people. We hypothesized that commercial dry dog food could become similarly contaminated, particularly if stored improperly, and could eventually contribute to allergic signs in dogs. Newly purchased bags of dry dog food (n = 30), from a variety of sources and manufacturers, and client samples of dry dog food (n = 50), stored under a variety of conditions, were obtained. Food samples were extracted in aqueous buffer, and extracts were assayed using ELISA for Dermatophagoides group II (Der II) allergen, as a marker for the presence of HDM. Der II allergen was not detected in any of the 30 newly purchased or 50 stored samples tested. Positive control samples consisting of house dust or dog food mixed with house dust, similarly extracted, and Dermatophagoides commercial allergen extract were positive for Der II in the same assay. We could find no evidence of HDM contamination in newly purchased or stored commercial dry dog food in the north central United States.