Canine Atopic Dermatitis Extent And Severity Index Research Articles

Sphingomyelin-Rich Lipid Extract Collar for Canine Atopic Dermatitis.

The management of canine atopic dermatitis (CAD) is complex, and it needs to be multimodal, combining topical and systemic therapies. Given that the currently available options are not always totally effective and might have some associated adverse effects, novel alternatives are needed. For this reason, a new collar for CAD was developed with 2.5% of a sphingomyelin-rich lipid extract (LE) with proven benefits for skin health. The release of the active ingredient when incorporated into the collar was tested in vitro, showing an adequate kinetic profile. Then, the efficacy and safety of the collar were assessed in 12 client-owned dogs with CAD in a pilot study. After eight weeks, the dogs experienced significant clinical improvements on the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4, Pruritus Index for Canine Atopic Dermatitis (PCAD) and Pruritus Visual Analogue Scale (PVAS) scores, without any adverse effects. Additionally, further in vitro studies were performed, indicating that this LE collar should be compatible with antiparasitic collars (with deltamethrin or imidacloprid/flumethrin) if worn simultaneously. Given the observed benefits of this LE collar, combining it with other CAD therapies could potentially allow for drug sparing, reduction in adverse effects, enhanced owner compliance, and reduced treatment costs.

Pilot evaluation of a single oral fecal microbiota transplantation for canine atopic dermatitis

The gut microbiota has been suggested to be involved in the pathogenesis of canine atopic dermatitis (cAD). However, the gut microbiota has not been well characterized in dogs with atopic dermatitis (AD). In addition, the efficacy of fecal microbiota transplantation (FMT) in dogs with AD remains unclear. This research, therefore, aimed to characterize the gut microbiota of dogs with AD and conduct pilot evaluation of the efficacy of a single oral FMT on clinical signs and the gut microbiota of dogs with AD. For these purposes, we used 12 dogs with AD and 20 healthy dogs. The 16S rRNA analysis of the fecal microbiota revealed significant differences between 12 dogs with AD and 20 healthy dogs. Next, a single oral FMT was performed in 12 dogs with AD as a single-arm, open-label clinical trial for 56 days. A single oral FMT significantly decreased Canine Atopic Dermatitis Extent and Severity Index (CADESI)-04 scores from day 0 (median score, 16.5) to day 56 (8) and Pruritus Visual Analog Scale (PVAS) scores from days 0 (median score, 3) to day 56 (1). Furthermore, a single oral FMT changed the composition of the fecal microbiota of dogs with AD at the phylum and genus levels. The number of common amplicon sequence variants in the fecal microbiota between donor dogs and dogs with AD was positively correlated with CADESI-04 and PVAS reduction ratios 56 days after FMT. Our findings suggest that the gut microbiota plays a pivotal role in the pathogenesis of cAD, and that oral FMT could be a new therapeutic approach targeting the gut microbiota in cAD.

A randomised controlled trial testing the rebound-preventing benefit of four days of prednisolone during the induction of oclacitinib therapy in dogs with atopic dermatitis.

A rebound of pruritus occasionally occurs after oclacitinib dose reduction in dogs with atopic dermatitis (AD). To determine whether an initial 4-day course of prednisolone decreases the probability of a pruritus rebound after reducing the frequency of oclacitinib administration. Forty dogs with mild-to-moderate AD lesions and moderate-to-severe pruritus. Dogs were randomised to receive oclacitinib at 0.4-0.6mg/kg twice daily for 14 days then once daily, alone or with prednisolone at 0.5mg/kg, orally, twice daily for the first 4 days. Clinicians graded the Canine Atopic Dermatitis Extent and Severity Index (CADESI)4 and 2D-investigator global assessment (IGA) before and after 28 days; owners assessed the pruritis Visual Analog Scale (PVAS)10 and Owner Global Assessment of Treatment Efficacy (OGATE) on Day (D)0, D4, D14, D21 and D28. We considered a rebound any increase greater than one PVAS10 grade at D21 compared to D14. On D21, there were significantly fewer rebounds in the dogs receiving prednisolone (three of 20, 15%) compared to those given oclacitinib alone (nine of 20, 45%; Fisher's test, p=0.041). Compared to oclacitinib monotherapy, the concurrent administration of prednisolone for the first 4 days led to significantly lower PVAS10 on D4 and D28, CADESI4 and 2D-IGA on D28, and OGATE on D21 and D28 (Wilcoxon-Mann-Whitney U-tests). Adverse effects of therapy were minor, intermittent and self-resolving. The initial addition of 4 days of prednisolone significantly decreased the probability of a rebound of pruritus 1 week after oclacitinib dose reduction. This short concomitant glucocorticoid administration led to a higher skin lesion improvement and improved perception of treatment efficacy with minimal adverse effects.

Establishing an experimental model for canine atopic dermatitis through epicutaneous application of Dermatophagoides farinae.

There is no established protocol for the development of an experimental canine atopic dermatitis model in laboratory beagles. This study aimed to establish an experimental model that mimics spontaneous canine atopic dermatitis (CAD) clinically, immunologically, and microbiologically, by repeated epicutaneous applications of mite antigens and to describe the entire process including sensitization and provocation in detail for reproducibility. Six intact male laboratory beagle dogs aged 14 months were included in this study. During the sensitization and provocation phase, the house dust mite (HDM) paste consisted of Dermatophagoides farinae (Der f ) and mineral oil, which was applied focally to the 10 × 10 cm area of the right groin as evenly as possible. Further, 120 mg of Der f was applied to each dog twice a week for 12 weeks during the sensitization phase and 25 mg and 120 mg was applied to each dog for the first 2 weeks and subsequent 2 weeks, respectively, during the provocation phase. Thereafter, the applied area was covered with a dressing. Skin lesions including erythema, hyperpigmentation, excoriation, and lichenification were induced and exacerbated gradually through the experimental time course in all six dogs. The canine atopic dermatitis extent and severity index (CADESI) score and transepidermal water loss (TEWL) significantly increased after sensitization and provocation. IL-13 and IL-31 levels increased significantly after provocation as a result of the activation of the T helper-2 (Th2) response. On the contrary, the IL-10 levels decreased significantly after sensitization, which suggested a suppression of Tregs activity. After the completion of provocation, skin microbiome analysis showed that Firmicutes was the most abundant phylum, which indicated bacterial dysbiosis. This study demonstrated that epicutaneous application of HDM in beagle dogs resulted in the elevation of serum HDM-specific IgE levels and clinical atopic scores, a high TEWL, and microbiome dysbiosis resembling spontaneous CAD. These results suggest that this tailored protocol of epicutaneous exposure to Der f may provide support for the development of the experimental CAD model in laboratory beagles.

Multiplex Cytokine Analyses in Ear Canals of Dogs Suggest Involvement of IL-8 Chemokine in Atopic Otitis and Otodectic Mange-Preliminary Results.

Simple SummaryAtopic dermatitis is a form of allergy of genetic origin accompanied by itching, during which the animal more easily develops allergies to environmental factors, usually pollen and dust mites. Among the symptoms, otitis is common. The mechanisms of this disease are still not fully understood. In this study, we aimed to demonstrate the detection ability of inflammatory markers (cytokines and chemokines) in the ear canals of atopic dogs suffering from otitis externa compared to healthy dogs and to dogs with parasitic otitis (inflammatory but not allergic otitis). Therefore, we non-invasively sampled the surface of the ear canals of atopic dogs and compared the amounts of certain cytokines and chemokines with those in similar samples taken from ears of healthy dogs and ears with spontaneous ear mite infestation. It appears that concentrations of IL-8 are significantly higher in atopic ears than in healthy ears. Nevertheless, this difference does not appear to be atopic-specific, since the amount of interleukin-8 (IL-8) also increased in ears infested with mites. Further investigations with a larger number of dogs are now required to confirm these results and possibly to find other biomarkers involved in the pathogenesis of canine atopic otitis.Cutaneous cytokines and chemokines are involved in the pathogenesis of human and canine atopic dermatitis. The aim of the present study was to discriminate cytokine expression in the ear canals of atopic dogs with otitis, dogs with non-allergic inflammatory otitis (otodectic mange) and healthy non-atopic dogs. The ear canals of nine atopic dogs suffering from non-infected otitis externa (n = 14 ears), 10 healthy dogs suffering from otodectic mange (n = 20 ears) and 21 healthy controls (39 ears) were swabbed. The concentrations of a panel of 13 cytokines and chemokines on the aural surface were measured by multiplex analyses (Milliplex Canine Cytokine Panel). In addition, Canine Atopic Dermatitis Extent and Severity Index (CADESI)-04 and Otitis Index Score (OTIS3) scores were used to evaluate the overall status of the dogs. The concentration of IL-8 was significantly higher in the ears of atopic dogs and dogs with otodectic mange compared to those of healthy dogs. Significant increases in the levels of IL-10 were also overexpressed in atopic otitis but at lower rates. The concentrations of interleukin(IL)-8 were positively correlated with the OTIS3 hyperplasia score in atopic dogs. Taken together, these results suggest that IL-8 is overexpressed in atopic otitis and otodectic mange and that levels correlate with the otitis severity in atopic dogs.

Canine memory T-cell subsets in health and disease

A more complete understanding of canine T-lymphocyte immunity is necessary for improving diagnostic and therapeutic approaches to canine diseases, developing cell-based canine immunotherapeutics, and evaluating dogs as large mammal models for comparative immunology research. The aim of this study was to utilize CD45RA (indicating antigen inexperience) and CD62L (indicating lymph node homing capability), to quantify canine memory T-cell subsets in healthy dogs and dogs with various diseases.Peripheral blood mononuclear cells (PBMCs) were prospectively collected from dogs belonging to one of four groups:dermatologic inflammation (n = 9), solid tumors (n = 9), lymphoma (n = 9), and age-/weight-matched healthy control dogs (n = 15). Dogs receiving prednisone or any other immunomodulating medication within two weeks were excluded. Flow cytometry was performed and T-cell subsets were defined as CD4+ or CD8+, and naïve (TN), central memory (CM), effector memory (EM), or terminal effector memory re-expressing CD45RA (TEMRA). T-cell subset proportions were compared between each disease group and their healthy age-/weight-matched controls using a Mann-Whitney test.Significantly increased %CD8+ TN (P = 0.036) and decreased %CD8+ TEMRA (P = 0.045) were detected in dogs with dermatologic inflammation compared to healthy controls. Furthermore, %CD4+ TN positively correlated with Canine Atopic Dermatitis Extent and Severity Index (CADESI) score within the inflammation group (ρ = 0.817, P = 0.011). No significant differences between either cancer group and their healthy controls were detected.Taken together, these data indicate that dermatologic inflammation can alter proportions of peripheral blood T-cell subsets, possibly due to the migration of antigen-specific T-cells into tissues. Furthermore, these findings support the utility of CD45RA and CD62L in characterizing clinical canine immune responses.

Evaluation of Plasma C-Reactive Protein as a Biomarker in Dogs with Atopic -Dermatitis Receiving Allergen-Specific Immunotherapy: A Pilot Study.

In this pilot study, we wished to determine if C-reactive protein (CRP) levels could be a useful severity or treatment biomarker for canine atopic dermatitis (AD). Nine atopic dogs received allergen immunotherapy for 1 year. Blood was collected before and at four re-evaluation visits. At each time point, the skin lesions were graded with the Canine Atopic Dermatitis Extent and Severity Index (CADESI) 4, and the plasma CRP levels were measured by Enzyme-linked Immunosorbent Assay (ELISA). We found a significant yet minimal correlation between the CRP levels and the CADESI4 scores. The CRP levels were not significantly different between dogs with AD of increasing severity. Finally, there was no correlation between the percentage change in CADESI4 and CRP values during immunotherapy. In conclusion, the lack of significant difference in CRP levels between dogs of increasing AD severity and lack of correlation between percentage changes in skin lesion and CRP values suggest that this protein would not be a clinically-useful biomarker in atopic dogs.

A comparative study of subcutaneous, intralymphatic and sublingual immunotherapy for the long-term control of dogs with nonseasonal atopic dermatitis.

Allergen-specific immunotherapy (ASIT) is the only causative treatment of canine atopic dermatitis (cAD). Different routes for administration of ASIT have been used; however, comparative studies are lacking. The present study compared the efficacy and safety of subcutaneous (SCIT), intralymphatic (ILIT) and sublingual (SLIT) immunotherapy. 30 atopic dogs were included and allocation to three groups (SCIT, n=8; ILIT, n=12; SLIT, n=10) was determined by the owners. ASIT was administered using routine protocols. The pruritus Visual Analog Scale (PVAS), canine atopic dermatitis extent and severity index (CADESI), concurrent medications and adverse events were recorded initially and one, three, six and 12 months later. The main outcome measure was return to a normal status, which included CADESI <12, PVAS <2.5 and medication score <10. Drop-outs were distributed evenly and 23 dogs finished the study (SCIT, n=6; ILIT, n=10; SLIT, n=7). Adverse reactions to treatment were rare. At the start of the study, the three groups were homogeneous with respect to clinical signs and concurrent medications. After 12 months of ASIT, the CADESI and PVAS had decreased with a stable medication score in the ILIT and SCIT groups (P < 0.05), while all three scores had increased in the SLIT group. Return to normal state was achieved in one of six (17%) dogs receiving SCIT, in six of 10 (60%) dogs receiving ILIT and in one of seven (14%) dogs receiving SLIT. These findings suggest that SCIT and ILIT improved clinical signs of cAD, whereas ILIT had a much higher return to normal rate.

The influence of treatment with lokivetmab on transepidermal water loss (TEWL) in dogs with spontaneously occurring atopic dermatitis.

Atopic dermatitis (AD) is one of the most common skin diseases in dogs. Monitoring the progress of treatment may include assessment of lesion severity by use of Canine Atopic Dermatitis Extent and Severity Index (CADESI), assessment of pruritus and measurement of biophysical parameters of the skin. This study aimed to assess changes in transepidermal water loss (TEWL) during 12weeks of treatment with lokivetmab and its correlation with the CADESI-04 and the severity of pruritus. Ten client-owned dogs with canine AD. The animals were administered lokivetmab three times at four week intervals. Pruritus and CADESI-04 were assessed, and TEWL was measured at six body regions, on Day 0 and repeated at weeks 4, 8 and 12. There was a significant decrease in the CADESI-04 score, the severity of pruritus and the mean TEWL between baseline and each of the time points. TEWL also decreased in the majority of body sites examined. Significant correlations between the CADESI-04 and mean TEWL (r=0.519, P=0.0003), and between pruritus severity and mean TEWL (r=0.517, P=0.0003), were found. Overall TEWL decreased during lokivetmab treatment but not at all body sites. If TEWL is used to assess the effectiveness of a treatment, a mean TEWL score should be calculated from several areas of the body.

In-home assessment of flea control and dermatologic lesions in dogs provided by lotilaner (Credelio®) and spinosad (Comfortis®) in west central Florida

Post-launch field investigations of recently-approved flea control products establish an efficacy baseline and in subsequent years can detect any efficacy decline suggestive of emerging resistance. As part of a continuing program of yearly assessment of flea control products in west central Florida, this study, using client-owned dogs, investigated the efficacy of lotilaner and spinosad in controlling fleas and in alleviating dermatologic signs likely associated with flea infestations. Forty-four qualifying households were randomized to either a lotilaner (Credelio®) (minimum dose rate 20 mg/kg) or a spinosad (Comfortis®) (30 mg/kg) group, with 33 and 36 dogs in each group, respectively. On Days 0 and 28 (±2) all dogs in each household were treated with the allocated product according to label directions, and all household cats received spinetoram (Cheristin®). On Day 0 and at weekly intervals through Day 56 (±2), on-animal and premises flea burdens were enumerated, a veterinary dermatologist scored integumental changes using canine atopic dermatitis extent and severity index (CADESI)-4 and flea allergy dermatitis (FAD) scales, and owners scored pruritus using the validated canine pruritus severity scale (CPSS).At study entry geometric mean flea counts were 33.2 and 29.9 in the lotilaner and spinosad groups, respectively. For both groups, reductions in flea counts were > 99% at the first post-treatment assessment (Week 1), and 100% from Week 6 through the final assessment (Week 8) when all study dogs were flea-free. For both groups, at each timepoint, flea counts on dogs and in traps were significantly reduced compared to the initial assessment (p < 0.001), as were improvements in median CADESI-4, FAD and CPSS scores (p ≤ 0.001). At Week 4, the geometric mean flea count on dogs in the lotilaner group (0.1) was significantly lower than that of dogs in the spinosad group (0.6) (p = 0.027), significantly fewer dogs in the lotilaner group were found to have fleas (p = 0.034), and mean owner-rated pruritus scores were significantly lower (p = 0.025).Under field conditions favoring heavy flea challenge, two consecutive monthly treatments of dogs with either lotilaner or spinosad produced a 100% reduction in canine flea infestations and dramatic improvements in dermatologic lesions and pruritus, based on scoring by a veterinary dermatologist and by dog owners. Household flea burdens were driven to extinction in all but one home in each treatment group.

Long-term effects of intralymphatic immunotherapy (ILIT) on canine atopic dermatitis.

Subcutaneous allergen immunotherapy (SCIT) is an established and efficacious therapy for canine atopic dermatitis (AD). In humans, intralymphatic immunotherapy (ILIT) was reported to be associated with fewer and less severe adverse effects than subcutaneous allergen immunotherapy and to be efficacious for several years after three intralymphatic injections. To evaluate safety and effects of ILIT in a case series of dogs with (AD). Fifty one privately owned dogs with AD. Dogs received injections of 0.2 mL alum-precipitated allergen extract into the popliteal lymph nodes at monthly intervals for 3-5 months. Lesion scores, pruritus and medication scores were determined before and at three and 12 months after beginning immunotherapy, and compared in a per protocol analysis (PP) and an intention-to-treat analysis (ITT). Twenty two dogs completed the study and 29 dogs did not fulfil study completion criteria due to lack of a final study visit (21 of 29) or due to insufficient improvement (14 of 29). All scores improved during the study with both analyses. For pruritus and Quality of Life scores this improvement was significant with both analyses; for Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 values and medication scores only with PP. The only rare adverse effects observed included mild swelling of the lymph node post-injection and increased pruritus. ILIT is safe and feasible, and provides long-lasting relief in some atopic dogs with a limited number of injections.

Randomized, double-blinded, placebo-controlled pilot study on the effects of topical blackcurrant emulsion enriched in essential fatty acids, ceramides and 18-beta glycyrrhetinic acid on clinical signs and skin barrier function in dogs with atopic dermatitis.

Lipid-based emulsions can be useful for the management of canine atopic dermatitis (cAD). 18-beta glycyrrhetinic acid (GRA), a component of liquorice root, has anti-inflammatory and anti-pruritic effects. To evaluate the effects of a topical lipid emulsion containing ceramides, fatty acids and GRA on clinical signs of cAD and skin barrier in a randomized, double-blinded, placebo-controlled trial. Client owned (n = 45) dogs with nonseasonal, mild/moderate AD, received either treatment or placebo for three months. Skin lesions, pruritus, transepidermal water loss (TEWL) and global assessment (GA) were evaluated. Fourteen dogs receiving treatment and 14 receiving the placebo completed the study. After one month ≥50% reduction in pruritus was seen in seven of 14 dogs (50%) in the Treatment group, and in two of 14 dogs (14.3%) in the Control group (P = 0.047). After two and three months, significant reduction in pruritus was not seen. For Canine Atopic Dermatitis Extent and Severity Index (CADESI), TEWL and GA, there were no significant findings over time or between groups. The emulsion had some transient beneficial clinical effects. However, it was not effective in controlling pruritus as a monotherapy. Further studies should examine whether owner compliance was a factor in the steady decline of effect on pruritus scores. Further studies evaluating its role as an adjunctive therapy are indicated.

Increased numbers of peripheral blood CD34+ cells in dogs with canine atopic dermatitis.

The bone marrow may be involved in human atopic diseases, as shown by the release of CD34+ cells into the peripheral blood. The aim was to determine the numbers of CD34+ cells in atopic dogs. The following three groups of dogs were studied: 27 dogs with nonfood-induced atopic dermatitis (NFICAD); 16 dogs with nonallergic inflammatory diseases; and 13 healthy control dogs. Dogs with NFICAD were selected after fulfilment of Favrot's criteria and exclusion of other pruritic dermatoses, including flea infestation and adverse reaction to foods. The Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 and a Visual Analog Scale (VAS) score for pruritus were used to quantify clinical signs. A phycoerythrin-conjugated anticanine CD34 antibody was used to stain peripheral blood CD34+ cells, and these were enumerated using a flow cytometer. The CD34+ cell counts were compared between groups and tested (in the NFICAD group) for correlation with the severity of clinical signs. The numbers of peripheral CD34+ cells in dogs with NFICAD (median 1.7) were statistically higher than in dogs with other nonallergic inflammatory diseases (median 1.0; P=0.01) and healthy control dogs (median 0.9; P=0.009). In dogs with NFICAD, there was no correlation between CD34+ cell numbers and CADESI-03 scores or owner-assessed pruritus (VAS score). The results of this study suggest the possible involvement of CD34+ cells in dogs with NFICAD. The role of CD34+ cells in the aetiopathogenesis of canine atopic dermatitis remains to be determined.

Assessment of the relationship between transepidermal water loss (TEWL) and severity of clinical signs (CADESI‐03) in atopic dogs

Atopic dermatitis (AD) is a common allergic skin disease of dogs. Objective documentation of disease severity is important for the assessment of responses to therapeutic interventions. One common means of assessing the severity of clinical signs is the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03. In addition, studies of the biophysical parameters of the skin suggest that assessment of transepidermal water loss (TEWL) may also have value for estimation of disease severity. The aim of the present study was to verify the correlation between TEWL and CADESI-03 measured at 10 different body sites. Twenty-six dogs with AD (age range 1-7years, median age 3years). The assessment was performed at the following 10 body sites: the lumbar, inguinal, ventral abdominal, interdigital regions, axillary fossa, lateral thorax, lateral aspect of the antebrachium, concave surface of the auricle, cheek and bridge of the nose. Positive correlations were found between TEWL and the total CADESI-03 for the auricle (r=0.59), bridge of nose (r=0.62) and interdigital skin (r=0.47). Positive correlations were also observed between TEWL and local CADESI-03 scores for the axillary fossa (r=0.73), inguinal region (r=0.55) and interdigital skin (r=0.77). The results indicate that it may be possible to use measurement of TEWL to assess the severity of skin lesions, but a positive correlation was found in only five of 10 body regions examined.

Validation of the Canine Atopic Dermatitis Extent and Severity Index (CADESI)‐4, a simplified severity scale for assessing skin lesions of atopic dermatitis in dogs

Severity scales are used to grade skin lesions in clinical trials for treatment of dogs with atopic dermatitis (AD). At this time, only two scales have been validated, namely the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-3 and the Canine Atopic Dermatitis Lesion Index (CADLI). However, the high number of assessed sites makes the CADESI-3 impractical. The aim of this study was to develop and validate a fourth version of the CADESI that is simpler and quicker to administer. Body sites, lesions and severity grades were revised by members of the International Committee on Allergic Diseases of Animals (ICADA). The newly designed CADESI-4 was tested for its validity (i.e. content, construct and criterion), reliability (i.e. inter- and intra-observer reliability and internal consistency), responsiveness (i.e. sensitivity to change) and time to administer. Disease severity benchmarks were chosen using receiver operating characteristic methodology. The CADESI-4 was simplified in comparison to its previous version to comprise 20 body sites typically affected in atopic dogs. Three lesions (erythema, lichenification and alopecia/excoriation) were scored from 0 to 3 at each site. The CADESI-4 had satisfactory validity, reliability and sensitivity to change. On average, the time to administer a CADESI-4 was one-third that of a CADESI-3. Proposed benchmarks for mild, moderate and severe AD skin lesions are 10, 35 and 60, respectively. The CADESI-4 is simpler to use and quicker to administer than its previous version. The ICADA recommends the CADESI-4 instead of the CADESI-3 to score skin lesions of AD in dogs enrolled in clinical trials.

Efficacy of dimetinden and hydroxyzine/chlorpheniramine in atopic dogs: a randomised, controlled, double-blinded trial

Antihistaminic drugs are commonly used as symptomatic therapy of atopic dermatitis in dogs. Unfortunately, their clinical benefit is largely unsubstantiated. In a double-blinded, placebo-controlled, cross-over trial, the influence of dimetinden...

The efficacy of cetirizine hydrochloride on the pruritus of cats with atopic dermatitis: a randomized, double‐blind, placebo‐controlled, crossover study

Various antihistamines have been used in the management of feline atopic dermatitis, with variable reported benefit. To date, there have been no randomized, double-blind, placebo-controlled, crossover clinical trials on the use of this drug class in cats. To evaluate the clinical efficacy of cetirizine hydrochloride for the control of pruritus and dermatitis in cats diagnosed with atopic dermatitis. In this randomized, double-blind, placebo-controlled crossover clinical trial, 21 client-owned cats diagnosed with mild to moderate nonseasonal atopic dermatitis were randomly assigned to two groups. Cats in each group received either 1 mg/kg cetirizine hydrochloride or placebo once daily per os for 28 days followed by a 14 day wash-out period. Treatments were then crossed over, and cats received placebo or cetirizine hydrochloride for another 28 days. Owners marked a pruritus severity scale before inclusion in the study and weekly throughout the entire study period. Lesions were scored by the clinician using a Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 modified for the cat before enrolment and at day 28 of each treatment. Nineteen cats completed the study. There were no statistically significant differences between treatment with cetirizine hydrochloride and placebo for modified CADESI-03 or pruritus scores. This study suggests that cetirizine hydrochloride cannot be recommended for the management of feline atopic dermatitis.

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.

Ciclosporin therapy is associated with minimal changes in calcium metabolism in dogs with atopic dermatitis

Ciclosporin is widely used in the management of canine atopic dermatitis. In humans, ciclosporin therapy has been linked to disturbances in calcium metabolism and resultant skeletal disorders. The objective of this study was to assess calcium homeostasis in dogs before and after a 6 week course of once daily oral ciclosporin at the licensed dose (5 mg/kg). Sixteen client-owned dogs with spontaneous atopic dermatitis. Serum concentrations of calcium, phosphate, creatinine, 25-hydroxyvitamin D, 1,25-dihyroxyvitamin D and plasma concentrations of ionized calcium and parathyroid hormone (PTH) were measured, together with the urinary fractional excretion of calcium and phosphate. The extent of skin lesions was scored using the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 and the degree of pruritus by the Edinburgh Pruritus Scale prior to and at the end of the study. The CADESI-03 and the Edinburgh Pruritus Scale scores decreased satisfactorily in all dogs by the end of the study. Plasma PTH concentrations were significantly increased (P = 0.02) following ciclosporin treatment, whereas all other biochemical parameters were not significantly different from their starting values. The increase in PTH was mild in most cases and the proportion of dogs that had a PTH concentration above the reference range was not significantly different following treatment. This study indicates that ciclosporin has minimal impact on calcium metabolism in dogs with atopic dermatitis when used at the licensed and clinically effective dosage for 6 weeks.

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

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. 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. 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. 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. It is concluded that TEWL does not correlate with disease severity.