Patrick Hensel

Masitinib decreases signs of canine atopic dermatitis: a multicentre, randomized, double‐blind, placebo‐controlled phase 3 trial

This study investigated the efficacy and safety of masitinib, a selective tyrosine kinase inhibitor capable of downregulating mast cell functions, for treatment of canine atopic dermatitis (CAD). Dogs with confirmed CAD received masitinib at 12.5 mg/kg/day (n = 202) or control (n = 104) for 12 weeks. A reduction in CAD Extent and Severity Index (CADESI-02) score of ≥ 50% at week 12 was observed in 61% of masitinib-treated dogs versus 35% of control dogs (P < 0.001), according to the modified intent-to-treat population. For dogs resistant to ciclosporin and/or corticosteroids (60% of the study population), CADESI-02 response rates were 60 versus 31%, respectively (P = 0.004). The mean reduction in pruritus score of severely pruritic dogs was 46 versus 29%, respectively (P = 0.045). Furthermore, 65% of owners with severely pruritic dogs assessed masitinib efficacy as good/excellent versus 35% control (P = 0.05). Overall, 63% of investigators assessed masitinib efficacy as good/excellent versus 35% control (P < 0.001). Premature discontinuations from the modified intent-to-treat population (28.2% masitinib versus 26.0% control) were mainly due to adverse events (13.4 versus 4.8%, respectively) or lack of efficacy (12.4 versus 18.3%, respectively). In total, 13.2% dogs presented with severe adverse events (16.0% masitinib versus 7.7% control). Masitinib showed a risk of reversible protein loss, although regular surveillance of blood albumin and proteinuria allowed for discontinuation of treatment while the dog was still clinically asymptomatic. Masitinib proved to be an effective and mostly well-tolerated treatment of CAD, including severe and refractory cases, with medically manageable adverse effects.

In vitro and in vivo evaluation of a potentiated miconazole aural solution in chronic Malassezia otitis externa in dogs.

This study assessed the in vitro and in vivo activity of an ear solution containing a third-generation chelating agent (Tricide) as an antimicrobial potentiator for miconazole in chronic Malassezia otitis. Thirty-one ears from 20 dogs were enrolled in the study. Fungal culture, minimum inhibitory concentration (MIC), and minimum fungicidal concentration (MFC) testing of miconazole with and without Tricide were performed on all ears. In a randomized, controlled, and blinded treatment trial the ears were treated either with 0.9% saline solution containing 0.01% miconazole, 0.03% dexamethasone and 540 microg/mL Tricide or the same solution without Tricide. Cytologic and auroscopic examinations were conducted on day 0, 14 and 28 and evaluated for number of yeast organisms, degree of erythema, hyperplasia and amount of discharge. The in vitro data was compared with Wilcoxon signed-rank test. The cytologic and auroscopic scores were compared between the visits and treatment groups at day 0, 14 and 28 using a Wilcoxon-Mann-Whitney test and repeated measures analysis. MIC and MFC were significantly (P < 0.0001) reduced when miconazole was combined with the chelating agent versus miconazole alone. The cytologic scores were significantly lower on days 14 (P = 0.0156) and 28 (P = 0.0280) for the group treated with Tricide. The auroscopic scores decreased significantly by the end of the trial compared to day 0, but the difference between the two groups was not significant. This study suggests that Tricide enhances in vitro activity and in vivo efficacy against Malassezia sp. in dogs with yeast otitis.

Nutrition and skin diseases in veterinary medicine

Veterinarians are confronted with a variety of food and nutrition-related skin diseases, with cutaneous food adverse reaction the most common in small animal dermatology. In addition to canine atopic dermatitis, cutaneous food adverse reaction has been an area of interest for extensive research for the last decade. Nutritional deficiencies and toxicoses are rare these days due to commercially available high-quality diets; however, poorly stored diets, inadequate husbandry of exotic pets, or problems in a farm animal environment may result in zinc, vitamin A, vitamin C, and fatty acid, or copper deficiency. Inherited deficiencies due to abnormal zinc absorption through the gastrointestinal tract must be considered in Nordic breed dogs and goats.

Determination of irritant threshold concentrations to weeds, trees and grasses through serial dilutions in intradermal testing on healthy clinically nonallergic dogs

Irritant threshold concentration (ITC) for intradermal testing (IDT) was determined in 31 healthy, clinically nonallergic dogs. Twenty-three allergens were tested at five variable concentrations ranging from 1000 to 8000 PNU/mL. To distinguish irritant reactions from subclinical IgE-mediated hypersensitivities, serum allergy testing was performed. ITCs were determined by evaluating the lowest concentration to which no dogs (0% cut-off) and to which at least 10% of dogs (> or = 10% cut-off) reacted. ITCs at the 0% cut-off were: 1000 PNU/mL (Johnson grass), 2000 PNU/mL (Ash, Lambs Quarter and Bermuda), 3000 PNU/mL (Bahia, Rye, Pig Weed and Virginia Oak), 4000 PNU/mL (Marsh Elder and Maple), 5000 PNU/mL (Sorrel sheep) and 7000 PNU/mL (Cocklebur and Black Willow). ITC for Dog Fennel, Box Elder and Red Cedar was <1000 PNU/mL. ITCs at the > or = 10% cut-off were: 2500 PNU/mL (Johnson), 3000 PNU/mL (Box Elder), 5000 PNU/mL (Bahia), 6000 PNU/mL (Pigweed and Marsh Elder) and 8000 PNU/mL (Virginia Oak and Black Willow). For all other allergens, the ITC was >8000 PNU/mL and could not be determined. No significant agreement between positive values was found for the same allergen on IDT and serum allergy testing for each dog suggesting reactions caused by the determined ITCs are less likely subclinical IgE-mediated reactions. These results suggest that ITCs may vary, also they may be very high for the allergens tested and that higher test concentrations may be used for IDT for the tested allergens without inducing an irritant reaction. Further studies are needed to evaluate the benefit of higher IDT concentrations in atopic dogs.

Prior antibacterial drug exposure in dogs with meticillin‐resistant Staphylococcus pseudintermedius (MRSP) pyoderma

BACKGROUND The emergence of meticillin-resistant Staphylococcus pseudintermedius (MRSP) has become a significant animal health problem. Recent studies have indicated that previous antibacterial drug exposure is a factor in acquisition of meticillin-resistant strains of staphylococci. HYPOTHESIS/OBJECTIVES The purpose of this study was to identify factors associated with prior antimicrobial drug use and MRSP pyoderma in dogs presented to a veterinary teaching hospital. ANIMALS Dogs diagnosed with pyoderma associated with MRSP (n = 53) or meticillin-sensitive S. pseudintermedius (MSSP; n = 45). METHODS The medical records of dogs diagnosed with pyoderma associated with isolation of S. pseudintermedius between January 2006 and November 2012 were reviewed. All cases with a complete twelve month to 3 yr drug history prior to the diagnosis were included. RESULTS Fifty two of 53 (98%) MRSP cases and 42 of 45 (93%) MSSP cases had received at least one course of antibacterial drug prior to diagnosis. The total number of antibacterial drug prescriptions provided to pet owners and the variety of antibacterial drug classes represented were higher for cases with MRSP than for cases with MSSP (P < 0.0001 and P = 0.009, respectively). More cases with MRSP (98%) received beta-lactam drugs than those with MSSP (82%; P = 0.007) and the proportion of MRSP cases that had received concurrent immunomodulatory therapy was higher (62% versus 42%; P = 0.048). CONCLUSIONS AND CLINICAL IMPORTANCE These results suggest that the total number of antibacterial drug prescriptions, exposure to multiple drug classes (beta-lactams in particular) and concurrent immunomodulatory therapy may be associated with increased risk for acquisition of MRSP.

DEBILITATION AND MORTALITY ASSOCIATED WITH BESNOITIOSIS IN FOUR VIRGINIA OPOSSUMS (DIDELPHIS VIRGINIANA)

Abstract:  Besnoitia spp. are coccidian parasites that infect a variety of wild and domestic mammals as well as some reptiles. Although infection with Besnoitia is common in Virginia opossums (Didelphis virginiana), clinical signs or death due to Besnoitia is rare. This manuscript describes four Virginia opossums that had severe clinical disease and inflammation associated with besnoitiosis. Clinical signs included trembling, incoordination, circling, blindness, poor body condition, and sudden death. Gross lesions included parasitic cysts in eyes, skin, and visceral organs. Histologically, cysts were often degenerate and associated with mild to marked inflammation, and amyloidosis was noted in one animal. Polymerase chain reaction and sequencing confirmed Besnoitia darlingi in three of the four opossums.