1
|
Schuh L, Kietzmann M, Grote-Koska D, Brand K, Mischke R. Pharmacokinetics of a single orally administered therapeutic dosage of cyclosporine A in healthy cats. Res Vet Sci 2023; 161:77-79. [PMID: 37327691 DOI: 10.1016/j.rvsc.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/16/2023] [Accepted: 05/28/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to determine a pharmacokinetic profile for a single dosage of cyclosporine A (CsA) clinically used for immunosuppression in cats. Blood-CsA-concentrations were measured before and 1, 2, 4, 6, 8, 12 and 24 h after oral administration of 7 mg/kg body weight (BW) CsA (Atopica® oral solution) to 8 healthy adult cats using high-performance liquid chromatography coupled to mass spectrometry. Pharmacokinetic parameters were calculated using WinNonLin software based on a 1-compartment-model. The median maximum plasma-concentration of 1466 ng/ml (530-2235 ng/ml; minimum-maximum) was reached after 2.0 h (1.0-4.7 h). The area under the curve was 12,568 h x ng/ml (5732-20,820 h x ng/ml) and the apparent total clearance of the drug from plasma was 557 ml/h/kg (336-1221 ml/h/kg). Half-life of absorption into the central compartment was 0.6 h (0.4-2.6 h), half-life of elimination from the central compartment was 4.6 h (1.4-7.5 h).
Collapse
Affiliation(s)
- Lea Schuh
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany.
| | - Manfred Kietzmann
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, D-30559 Hannover, Germany.
| | - Denis Grote-Koska
- Institute of Clinical Chemistry, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, D-30625 Hannover, Germany.
| | - Korbinian Brand
- Institute of Clinical Chemistry, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, D-30625 Hannover, Germany.
| | - Reinhard Mischke
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany.
| |
Collapse
|
2
|
Kong J, Yang Y, Liu Y, Cao Y, Qiu J, Sun P, Cao X. The Pharmacokinetic and Absolute Bioavailability of Cyclosporine (Atopica for Cats ®) in Cats. Vet Sci 2023; 10:399. [PMID: 37368785 DOI: 10.3390/vetsci10060399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/04/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to evaluate the absolute bioavailability of cyclosporine in cats by investigating the pharmacokinetic profile after intravenous and oral administration, respectively. Twenty-four clinically healthy cats were enrolled in this study and randomly divided into four groups, namely the intravenous group (3 mg/kg), low oral group (3.5 mg/kg), medium oral group (7 mg/kg), and high oral group (14 mg/kg). Whole blood was obtained at the scheduled time points after a single dose administration and cyclosporine was determined using ultra-performance liquid chromatography-tandem mass spectrometry technology (UPLC-MS/MS). Pharmacokinetic parameters were calculated using the WinNonlin 8.3.4 software via compartmental and non-compartmental models. As a result, the bioavailability values for the low, medium, and high oral groups were 14.64%, 36.98%, and 13.53%, respectively. The nonlinear pharmacokinetic profile was observed in the range from 3.5 mg/kg to 14 mg/kg in cats following oral administration. Whole blood concentrations taken 4 h after oral administration were better correlated with the area under the blood concentration-time curve AUC0-24 with a high regression coefficient (R2 = 0.896). This concentration would be a greater predictor in the following therapeutic drug monitoring. No adverse effect was observed in the whole study process.
Collapse
Affiliation(s)
- Jingyuan Kong
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Yuxin Yang
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Yu Liu
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Yuying Cao
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Jicheng Qiu
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Pan Sun
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Xingyuan Cao
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
- Key Laboratory of Detection for Veterinary Drug Residues and Illegal Additives, Ministry of Agriculture and Rural Affairs of the People's Republic of China, Beijing 100193, China
| |
Collapse
|
3
|
Colombo S, Sartori R, Schievano C, Borio S. Development and validation of an owner-assessed Visual Analog Scale for feline pruritus severity scoring (VAScat). Vet Dermatol 2022; 33:407-413. [PMID: 35920060 DOI: 10.1111/vde.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/17/2022] [Accepted: 05/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Assessment of the severity of pruritus is difficult in cats, because they manifest discomfort by increased licking, increased scratching or both. HYPOTHESIS/OBJECTIVES Our objective was to develop and validate a feline-specific pruritus scale (VAScat). METHODS The scale was designed as a double Visual Analog Scale (VAS), one VAS for licking and one for scratching, with severity and behavioural descriptors. The highest score (VAS-max) on either VAS was taken as the pruritus score for each cat. Owners of 153 cats with skin diseases and of 108 healthy cats scored their pet's pruritus using the VAScat. Ninety-six of 153 cats with skin diseases also were re-evaluated after four to eight weeks of treatment. RESULTS Pearson's correlation value between VAS-licking and VAS-scratching scores was r = 0.26 (p < 0.01), and Cronbach's alpha was 0.41. Both indexes indicated that the two scales measure different manifestations of pruritus and supported the use of a dual assessing system. Comparison with a numerical pruritus severity scale (0, absent; 1, mild; 2, moderate; 3, severe) suggested that VAS-licking and VAS-scratching scales taken alone are unsuitable for measuring absent to mild pruritus (grades 0-1), while VAS-max is (p = 0.001). VAS-licking, VAS-scratching and VAS-max all were suitable to assess higher levels of pruritus (grades 2-3, p < 0.01). The VAScat was able to measure pruritus improvement following therapy, as post-treatment scores were significantly decreased compared to pre-treatment ones (p < 0.0001). CONCLUSIONS AND CLINICAL IMPORTANCE The VAScat proved to be a useful tool to assess pruritus in cats and for monitoring the response to treatment for pruritus.
Collapse
Affiliation(s)
| | | | | | - Stefano Borio
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| |
Collapse
|
4
|
Mueller RS, Nuttall T, Prost C, Schulz B, Bizikova P. Treatment of the feline atopic syndrome - a systematic review. Vet Dermatol 2021; 32:43-e8. [PMID: 33470011 DOI: 10.1111/vde.12933] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Feline allergic skin disease and asthma occur regularly in small animal practice. OBJECTIVES To provide evidence-based recommendations for small animal practitioners on the treatment of feline atopic syndrome (FAS). METHODS AND MATERIALS The authors reviewed the literature available before February 2020, prepared a detailed evidence-based literature review and made recommendations based on the evaluated evidence. RESULTS Sixty-six papers and abstracts were identified describing treatment interventions for FAS and evaluated to establish treatment recommendations. For many treatment options, the papers were retrospective, open studies or case reports. CONCLUSION AND CLINICAL RELEVANCE In this review, there was good evidence for the efficacy of systemic glucocorticoids and ciclosporin, and limited evidence for the efficacy of topical glucocorticoids, oclacitinib and allergen-specific immunotherapy in feline atopic skin syndrome. Evidence pointed to low-to-moderate efficacy for antihistamines, fatty acids and palmitoyl ethanolamide. In feline asthma, there was good evidence for the efficacy of oral and inhaled glucocorticoids, and limited evidence of moderate efficacy for allergen-specific immunotherapy. Evidence supported low-to-moderate efficacy of mesenchymal stem cells, inhaled lidocaine and oclacitinib as treatments for feline asthma. For almost all therapeutic options (with the exception of glucocorticoids and ciclosporin), more randomised controlled trials are needed.
Collapse
Affiliation(s)
- Ralf S Mueller
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Tim Nuttall
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | | | - Bianka Schulz
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Petra Bizikova
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
5
|
Rzeszutek U. Successful Treatment of a Multi-Drug-Resistant Severely Pruritic Hypersensitivity Dermatitis in a Cat. Case Rep Vet Med 2020; 2020:8897365. [PMID: 33123405 PMCID: PMC7582092 DOI: 10.1155/2020/8897365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/25/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022] Open
Abstract
A 3-year-old neutered female domestic shorthair cat was presented with a severely pruritic dermatitis. After exclusion of flea allergy dermatitis, ectoparasite infestation, retroviral infection, neoplasia, and cutaneous adverse food reaction, a diagnosis of nonflea, nonfood hypersensitivity dermatitis (NFNFHD) was made. The resolution of complicating bacterial infection and yeast overgrowth did not improve the animal's condition. Numerous antipruritic treatment modalities used during the investigation proved unsuccessful, including anti-inflammatory and immunosuppressive prednisolone doses, oclacitinib, antihistamines, ciclosporin A, and supplementation with essential fatty acids. Allergen-specific serology test results were negative. Treatment with oral dexamethasone allowed a complete resolution of clinical signs. The cat has been successfully maintained in remission for over 12 months. To the author's knowledge, this is the first case report of a cat with multi-drug-resistant NFNFHD treated successfully with dexamethasone.
Collapse
Affiliation(s)
- Urszula Rzeszutek
- Celia Hammond Animal Trust, 151-153 Barking Rd, Canning Town, London E16 4HQ, UK
| |
Collapse
|
6
|
Maina E, Fontaine J. Use of maropitant for the control of pruritus in non-flea, non-food-induced feline hypersensitivity dermatitis: an open-label, uncontrolled pilot study. J Feline Med Surg 2019; 21:967-972. [PMID: 30427273 PMCID: PMC11132245 DOI: 10.1177/1098612x18811372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES Non-flea, non-food-induced hypersensitivity dermatitis (NFNFIHD) is a common inflammatory and pruritic skin disease in cats. When avoidance and conventional systemic immunosuppressive treatments fail to control the clinical signs, there are limited treatment options. The aim of this study was to evaluate the efficacy and tolerability of maropitant in feline NFNFIHD. METHODS In an open-label, uncontrolled study, cats with proven non-seasonal NFNFIHD were treated with maropitant 2 mg/kg PO q24h for 4 weeks. Clinical lesions were evaluated with the Scoring Feline Allergic Dermatitis (SCORFAD) system and pruritus was evaluated with a 10 cm visual analogue scale (VAS) before and at the end of the study. Owners assessed global efficacy and tolerability with a 4-point scale at the end of the study. Adverse events and body weight changes were recorded. RESULTS Twelve cats were treated with a mean initial maropitant dose of 2.22 mg/kg PO q24h. The treatment decreased both SCORFAD and pruritus VAS (pVAS) scores in all cats except one, in which only pruritus was reduced. The efficacy and the tolerability of the treatment were judged as excellent or good by 83.3% of owners. Treatment did not cause any side effects other than, in a few cases, short-time, self-limiting sialorrhoea. CONCLUSIONS AND RELEVANCE Maropitant seems to be an effective, well-tolerated therapeutic option to control pruritus in cats. Caution is needed in interpreting the results as the pVAS score system has not yet been validated in cats and the trial was uncontrolled. A further, controlled study is required to confirm our findings.
Collapse
Affiliation(s)
- Elisa Maina
- Laboratory of Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
- Medi-vet SA, Lausanne, Switzerland
| | - Jacques Fontaine
- University of Liège Veterinary Faculty, Small Animal Internal Medicine Service – Dermatology, Liège, Belgium
| |
Collapse
|
7
|
Lopes NL, Campos DR, Machado MA, Alves MSR, de Souza MSG, da Veiga CCP, Merlo A, Scott FB, Fernandes JI. A blinded, randomized, placebo-controlled trial of the safety of oclacitinib in cats. BMC Vet Res 2019; 15:137. [PMID: 31068210 PMCID: PMC6506962 DOI: 10.1186/s12917-019-1893-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background Oclacitinib is a Janus kinase (JAK) 1 enzyme inhibitor and blocks JAK1-dependent cytokines and is used to control pruritus. Studies available in cats are very limited and as there is a potential role for oclacitinib in the control of pruritus in this specie, the aim of this study was to evaluate the safety and clinical effects of oral oclacitinib maleate in healthy cats. Results Thirty mixed-breed cats weighing from 2.1 to 5.3 kg each were randomly allocated to three treatment groups of 10 animals each. Cats in two groups received oclacitinib at 1 mg/kg or 2 mg/kg q 12 h orally for 28 days. Cats in the third group were given placebo tablets (cornstarch) q 12 h orally for 28 days. Oclacitinib maleate was well tolerated during the study and few adverse events were observed in treated cats. Clinical signs of toxicity were not observed in any animals treated at 1 mg/kg. Gastrointestinal clinical signs observed in the 2 mg/kg group included vomiting in two of the 10 cats and soft stools in two cats. One cat treated with placebo also exhibited soft stools. No significant differences were observed between the groups for hematologic analyses performed during the study. There was a slight increase in neutrophils and monocytes and a decrease in eosinophil mean counts in treated cats. Mean renal and liver enzymes remained normal throughout the entire study. A small, but significant increase in fructosamine levels was observed for both treated groups compared with placebo; however, values remained within the normal reference range. There were no significant difference between treated groups and the placebo group for urine specific gravity, pH, or urine protein to creatinine ratio mean values. Conclusions Oclacitinib maleate was well tolerated by cats at 1 mg/kg and 2 mg/kg and appeared to be safe for this species when administered orally twice daily for 28 days. More studies would be needed to demonstrate if oclacitinib maleate may be a suitable alternative to treat pruritic cats.
Collapse
Affiliation(s)
- Natália Lôres Lopes
- Veterinary Medicine, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropédica, Brazil.
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Colombo S, Sartori R. Ciclosporin and the cat: Current understanding and review of clinical use. J Feline Med Surg 2018; 20:244-255. [PMID: 29478396 PMCID: PMC10816290 DOI: 10.1177/1098612x17748718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Ciclosporin (CsA) is a systemic immuno-modulatory drug widely used to treat immune-mediated diseases in humans and veterinary species. CsA was registered for use in cats in the USA and Europe in 2011, and is indicated for the treatment of chronic allergic dermatitis at a recommended daily dose of 7 mg/kg PO. AUDIENCE This review will be of interest to all veterinarians working with cats, given the wide range of potential applications of CsA and its safety profile. Although the drug is currently only licensed to treat chronic allergic dermatitis in cats, a small number of reports describe its use in non-dermatological conditions. Evidence base: This article reviews the mechanism of action, pharmacokinetics, drug interactions, adverse effects and clinical use of CsA, both for the licensed indication and for off-label use in the feline patient. Information presented has been summarised from the existing literature on CsA, with specific interest in studies carried out in cats. For its licensed indication, chronic allergic dermatitis, evidence provided includes randomised, placebo or prednisolone-controlled studies (EBM grade I) and prospective or retrospective open trials.
Collapse
Affiliation(s)
- Silvia Colombo
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| | - Roberta Sartori
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| |
Collapse
|
9
|
Koch SN, Torres SMF, Diaz S, Gilbert S, Rendahl A. Subcutaneous administration of ciclosporin in 11 allergic cats - a pilot open-label uncontrolled clinical trial. Vet Dermatol 2017; 29:107-e43. [DOI: 10.1111/vde.12505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra N. Koch
- Department of Veterinary Clinical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
| | - Sheila M. F. Torres
- Department of Veterinary Clinical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
| | - Sandra Diaz
- Department of Veterinary Clinical Sciences; The Ohio State University; 601 Vernon Tharp Street Columbus OH 43210 USA
| | - Sophie Gilbert
- Centre Vétérinaire Laval; 4530 Highway 440 Laval Quebec Canada H7T 2P7
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences; University of Minnesota; 1365 Gortner Avenue Saint Paul MN 55018 USA
| |
Collapse
|
10
|
|
11
|
Roberts ES, Speranza C, Friberg C, Griffin C, Steffan J, Roycroft L, King S. Confirmatory field study for the evaluation of ciclosporin at a target dose of 7.0 mg/kg (3.2 mg/lb) in the control of feline hypersensitivity dermatitis. J Feline Med Surg 2016; 18:889-897. [PMID: 26965676 PMCID: PMC11132215 DOI: 10.1177/1098612x16636660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives This study was designed to confirm the efficacy and tolerability of a daily dose of 7.0 mg/kg (3.2 mg/lb) ciclosporin (CsA) in the treatment of feline hypersensitivity dermatitis (HD), as this includes some of the most frequently suspected skin diseases in cats and recent publications have reported the successful use of CsA in the treatment of feline HD. Methods In total, 217 cats with feline HD were treated daily for 42 days with a target dose of 7 mg/kg CsA (n = 144) or a placebo control (n = 73) administered either in the food or directly in the mouth following feeding. Clinical and dermatological evaluations were conducted on days 0, 21 and 42, or study exit. Safety was evaluated through physical examinations, clinical pathology and the monitoring of adverse events (AEs). Results Administration of CsA at 7.0 mg/kg produced a significant improvement in the total lesion score ( P <0.0001). The average reduction from visit 1 to visit 3 was 65.1% in the CsA group (9.2% for the placebo). In addition, owners assessed 78.3% of the cases in the CsA group as a success. Statistically significant recoveries were also seen in extent of lesions, investigator assessment of overall improvement, and mean improvement in both the investigators' and owners' assessment of pruritus. Mild gastrointestinal disorders were the most common AEs but did not require cessation of therapy. Conclusions and relevance Results confirm that 7.0 mg/kg CsA dosed daily in food or orally for up to 6 weeks is effective and well tolerated by cats with feline HD.
Collapse
|
12
|
Roberts ES, Tapp T, Trimmer A, Roycroft L, King S. Clinical efficacy and safety following dose tapering of ciclosporin in cats with hypersensitivity dermatitis. J Feline Med Surg 2016; 18:898-905. [PMID: 26316515 PMCID: PMC11132228 DOI: 10.1177/1098612x15602523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives This study was designed to evaluate the efficacy and safety of reducing ciclosporin (CsA) dosing frequency from daily to every other day (EOD) or twice a week (TW) according to clinical response in cats with hypersensitivity dermatitis (HD) and treated with CsA. Methods One hundred and ninety-one cats with HD were given 7 mg/kg CsA daily for at least 4 weeks. Depending on clinical response, the dosing frequency was tapered from daily to EOD over the next 4 weeks and further to TW for an additional 4 weeks. Safety was evaluated through physical examinations, clinical pathology and the monitoring of adverse events (AEs). Results The majority of cats were able to have their dose of CsA tapered to either EOD (15.5%) or TW (62.9%) according to the clinical response. Observed AEs were most frequently mild and self-limiting vomiting and diarrhea. A higher percentage of AEs occurred with daily administration (73%) compared with other dosing regimens (27%). Conclusions and relevance Following 4 weeks of daily dosing at 7 mg/kg, CsA may be tapered to EOD or TW while maintaining the desired therapeutic response in cats with HD. Additionally, CsA appears to be well tolerated with fewer AEs at EOD or TW dosing. Establishing the lowest effective dosing frequency of CsA improves the drug's safety profile.
Collapse
Affiliation(s)
| | - Tiffany Tapp
- Veterinary Healing Arts, East Greenwich, RI, USA
| | - Ann Trimmer
- Animal Allergy and Dermatology Specialists, Las Vegas, NV, USA
| | | | | |
Collapse
|
13
|
Nafe LA, Leach SB. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. J Feline Med Surg 2015; 17:1073-6. [PMID: 25527351 PMCID: PMC10816346 DOI: 10.1177/1098612x14563342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy.
Collapse
Affiliation(s)
- Laura A Nafe
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| |
Collapse
|
14
|
DIAGNOSIS AND PALLIATIVE MANAGEMENT OF ATOPIC DERMATITIS IN A MALAYAN FLYING FOX (PTEROPUS VAMPYRUS). J Zoo Wildl Med 2015; 46:386-92. [PMID: 26056901 DOI: 10.1638/2014-0141r.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 7-yr-old male Malayan flying fox (Pteropus vampyrus) presented with chronic, recurrent bilateral conjunctivitis and palpebral chemosis. Variable, temporary response to topical ocular antibiotic-corticosteroid therapy occurred. Histopathology of a conjunctival biopsy was consistent with allergic conjunctivitis. The bat was treated systemically with antihistamines and topically with an ocular antibiotic-corticosteroid combination for acute episodes of conjunctivitis. Pruritus, severe alopecia of the head and neck, and moist dermatitis later developed in conjunction with bilateral conjunctivitis. Cytology and histopathology of affected skin supported a diagnosis of atopic dermatitis. Although the assay was not validated for P. vampyrus, serum immunoglobulin E levels against multiple possible antigens were measured. Acceptable resolution of clinical signs was achieved for 20 mo following systemic cyclosporine administration. Cyclosporine levels were measured in whole blood for additional therapeutic monitoring. This is the first reported case of histopathologic support for atopic dermatitis, novel diagnostics, and palliative management of atopy using cyclosporine in a flying fox.
Collapse
|
15
|
Ortalda C, Noli C, Colombo S, Borio S. Oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis: results of a small prospective pilot study of client-owned cats. Vet Dermatol 2015; 26:235-e52. [DOI: 10.1111/vde.12218] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Christian Ortalda
- Servizi Dermatologici Veterinari; Strada Revigliasco 11 Moncalieri 10024 Italy
| | - Chiara Noli
- Servizi Dermatologici Veterinari; Strada Bedale della Ressia 2 Peveragno 12016 Italy
| | - Silvia Colombo
- Servizi Dermatologici Veterinari; via Felice Musazzi 24 Legnano 20025 Italy
| | - Stefano Borio
- Servizi Dermatologici Veterinari; via Italia 12 San Mauro Torinese 10099 Italy
| |
Collapse
|
16
|
Jensen-Jarolim E, Einhorn L, Herrmann I, Thalhammer JG, Panakova L. Pollen Allergies in Humans and their Dogs, Cats and Horses: Differences and Similarities. Clin Transl Allergy 2015; 5:15. [PMID: 25852853 PMCID: PMC4387677 DOI: 10.1186/s13601-015-0059-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/16/2015] [Indexed: 11/17/2022] Open
Abstract
Both humans and their most important domestic animals harbor IgE and a similar IgE receptor repertoire and expression pattern. The same cell types are also involved in the triggering or regulation of allergies, such as mast cells, eosinophils or T-regulatory cells. Translational clinical studies in domestic animals could therefore help cure animal allergies and at the same time gather knowledge relevant to human patients. Dogs, cats and horses may spontaneously and to different extents develop immediate type symptoms to pollen allergens. The skin, nasal and bronchial reactions, as well as chronic skin lesions due to pollen are in principle comparable to human patients. Pollen of various species most often causes allergic rhinitis in human patients, whereas in dogs it elicits predominantly eczematous lesions (canine atopic dermatitis), in horses recurrent airway obstruction or hives as well as pruritic dermatitis, and in cats bronchial asthma and so-called cutaneous reactive patterns (eosinophilic granuloma complex, head and neck pruritus, symmetric self-induced alopecia). In human allergy-specific IgE detection, skin tests or other allergen provocation tests should be completed. In contrast, in animals IgE and dermal tests are regarded as equally important and may even replace each other. However, for practical and economic reasons intradermal tests are most commonly performed in a specialized practice. As in humans, in dogs, cats and horses allergen immunotherapy leads to significant improvement of the clinical symptoms. The collected evidence suggests that canines, felines and equines, with their spontaneous allergies, are attractive model patients for translational studies.
Collapse
Affiliation(s)
- Erika Jensen-Jarolim
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, c/o Institute of Pathophysiology and Allergy Research, Währinger G. 18-20, Vienna, 1090 Austria
| | - Lukas Einhorn
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, c/o Institute of Pathophysiology and Allergy Research, Währinger G. 18-20, Vienna, 1090 Austria
| | - Ina Herrmann
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Johann G Thalhammer
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Lucia Panakova
- Dermatology Unit, Clinics of Small Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
17
|
Lappin MR, Roycroft LM. Effect of ciclosporin and methylprednisolone acetate on cats previously infected with feline herpesvirus 1. J Feline Med Surg 2015; 17:353-8. [PMID: 25204453 PMCID: PMC11104156 DOI: 10.1177/1098612x14548865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Feline herpesvirus 1 (FHV-1) is a common ocular and respiratory pathogen of cats that can be associated with recurrent clinical signs of disease. Ciclosporin (cyclosporine) is commonly administered per os (PO) for the treatment of a number of inflammatory diseases in cats. A number of client-owned cats administered ciclosporin (cyclosporine) A (CsA) PO to block renal transplant rejection have developed clinical signs of upper respiratory tract disease that may have been from activated FHV-1. In this study, cats experimentally inoculated with FHV-1 several months previously were administered methylprednisolone acetate intramuscularly, CsA PO or a placebo PO. While clinical signs of activated FHV-1 occurred in some cats, disease was mild and self-limited in most cats. There was no vomiting, diarrhea, inappetence, weight loss, polydipsia, polyuria or polyphagia recognized.
Collapse
Affiliation(s)
- Michael R Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, USA
| | | |
Collapse
|
18
|
Whitehouse W, Viviano K. Update in feline therapeutics: clinical use of 10 emerging therapies. J Feline Med Surg 2015; 17:220-34. [PMID: 25701861 PMCID: PMC11148892 DOI: 10.1177/1098612x15571879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE The field of veterinary medicine is constantly evolving. New medications are being introduced into clinical practice, and novel uses for established medications are frequently being discovered as new information comes to light. CLINICAL CHALLENGES Therapeutic options for our feline patients can be restricted based on inadequate clinical evidence, adverse effects and patient compliance concerns. Additionally, with the reduced availability of commonly used medications in some regions, clinicians are forced to utilize alternatives with which they may have limited experience. AUDIENCE This review article is directed towards primary care veterinarians working with feline patients. The selection of medications discussed is based on many of the clinical challenges commonly encountered in practice. EVIDENCE BASE The evidence for use of some of these medications is limited due to their novelty. Known mechanisms of action, pharmacokinetic and pharmacodynamics data, adverse effects and clinical uses are reviewed where possible, with clinical recommendations made based on the evidence of data available.
Collapse
Affiliation(s)
- William Whitehouse
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| | - Katrina Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| |
Collapse
|
19
|
Roberts ES, VanLare KA, Roycroft LM, King S. Effect of high-dose ciclosporin on the immune response to primary and booster vaccination in immunocompetent cats. J Feline Med Surg 2015; 17:101-9. [PMID: 24820998 PMCID: PMC10816412 DOI: 10.1177/1098612x14533550] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Ciclosporin (Atopica oral solution for cats 100 mg/ml; Novartis Animal Health) was recently approved for use in cats with feline hypersensitivity dermatitis. The immunosuppressant effect of ciclosporin on the ability of cats to mount an immune response following vaccination was determined. Thirty-two healthy, immunocompetent adult cats (16 cats/group) were treated with either ciclosporin for 56 days at a dose of 24 mg/kg once daily or sham dosed. Prior to treatment, cats had an adequate antibody response to primary vaccination against feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), feline panleukopenia virus (FPV), feline leukemia virus (FeLV) and rabies. Booster vaccination or novel vaccination with feline immunodeficiency virus (FIV) was administered 28 days after initiation of treatment with ciclosporin. There were no differences between the ciclosporin-treated and control cats for FCV and FPV antibody titers following booster vaccination. There were delays/reductions in antibody response to FHV-1, FeLV and rabies in treated cats; however, adequate protection was achieved in response to all booster vaccinations. Following primary vaccination with FIV, control cats showed a response, but treated cats showed no antibody production. Adverse events commonly associated with ciclosporin treatment, including diarrhea/loose stool, vomiting, salivation and regurgitation, were reported. In adult cats treated with 24 mg/kg/day of ciclosporin (more than three times the therapeutic dose), vaccine titer levels were adequate for protection following booster vaccination. In contrast, treated cats failed to mount a humoral response to a novel (FIV) vaccination, suggesting that memory B-cell immune responses remain intact during repeated high-dose ciclosporin administration in cats, but that primary immune responses are impaired.
Collapse
|
20
|
Abstract
Ciclosporin is a lipophilic cyclic polypeptide with powerful immunosuppressive and immunomodulatory properties that has been used in veterinary medicine for two decades. It is a calcineurin inhibitor whose principal mode of action is to inhibit T cell activation. The drug is principally absorbed from the small intestine and is metabolised in the intestine and liver by the cytochrome P450 enzyme system. Ciclosporin is known to interact with a wide range of pharmacological agents. Numerous studies have demonstrated good efficacy for the management of canine atopic dermatitis and this has been a licensed indication since 2003. In addition to the treatment of atopic dermatitis, it has been used as an aid in the management of numerous other dermatological conditions in animals including perianal fistulation, sebaceous adenitis, pododermatitis, chronic otitis externa and pemphigus foliaceus. This article reviews the mode of action, pharmacokinetics, indications for use and efficacy of ciclosporin in veterinary dermatology.
Collapse
Affiliation(s)
- Peter Forsythe
- The Dermatology Referral Service, 528 Paisley Road West, Glasgow G51 1RN, UK
| | | |
Collapse
|
21
|
Miller R, Schick AE, Boothe DM, Lewis TP. Absorption of Transdermal and Oral Cyclosporine in Six Healthy Cats. J Am Anim Hosp Assoc 2014; 50:36-41. [DOI: 10.5326/jaaha-ms-5970] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cyclosporine is commonly used orally to treat feline dermatoses. Due to difficulties administering oral medications, veterinarians sometimes prescribe compounded transdermal cyclosporine, despite studies showing limited absorption. The study objective was to compare cyclosporine blood concentrations after oral administration to concentrations after transdermal application of cyclosporine (prepared in pluronic lecithin organogel [PLO]) in six cats using a controlled, cross-over design with a 2 wk washout period. Cats were dosed at 5.1–7.4 mg/kg of cyclosporine q 24 hr either per os for 7 days or transdermally for 21 days. Cyclosporine blood concentrations were measured q 7 days and after the washout period. A monoclonal-based immunoassay (lower limit of quantitation was 25 ng/mL) was used. Median concentrations on the seventh day were 2,208 ng/mL (range, 1,357–3,419 ng/mL) 2 hr after orally administered cyclosporine and 37 ng/mL (range, 25–290 ng/mL) 2 hr after transdermally applied cyclosporine. Median concentration on day 21 was 58 ng/mL (range, 51–878 ng/mL) 2 hr after transdermally applied cyclosporine. Concentrations were quantifiable for transdermally applied cyclosporine, but considered therapeutic in only one of six cats. Based on those results, transdermally applied cyclosporine was not recommended in cats because of inconsistent absorption.
Collapse
Affiliation(s)
- Rose Miller
- Dermatology for Animals, Salt Lake City, UT, (R.M.); Dermatology for Animals, West Juniper, AZ (A.S., T.L.); and Clinical Pharmacology Laboratory (D.B.), College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Anthea E. Schick
- Dermatology for Animals, Salt Lake City, UT, (R.M.); Dermatology for Animals, West Juniper, AZ (A.S., T.L.); and Clinical Pharmacology Laboratory (D.B.), College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Dawn M. Boothe
- Dermatology for Animals, Salt Lake City, UT, (R.M.); Dermatology for Animals, West Juniper, AZ (A.S., T.L.); and Clinical Pharmacology Laboratory (D.B.), College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Thomas P. Lewis
- Dermatology for Animals, Salt Lake City, UT, (R.M.); Dermatology for Animals, West Juniper, AZ (A.S., T.L.); and Clinical Pharmacology Laboratory (D.B.), College of Veterinary Medicine, Auburn University, Auburn, AL
| |
Collapse
|
22
|
Roberts ES, Vanlare KA, Strehlau G, Peyrou M, Roycroft LM, King S. Safety, tolerability, and pharmacokinetics of 6-month daily dosing of an oral formulation of cyclosporine (ATOPICA for cats®) in cats. J Vet Pharmacol Ther 2013; 37:161-8. [PMID: 24134659 PMCID: PMC4282489 DOI: 10.1111/jvp.12081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/23/2013] [Indexed: 11/28/2022]
Abstract
Cyclosporine was proven efficacious in the treatment of feline hypersensitivity dermatitis. This target animal study was conducted to evaluate the safety, tolerability, and pharmacokinetics of ATOPICA for Cats® (cyclosporine oral solution, USP) MODIFIED following 6-month daily dosing in cats. Forty healthy cats (four cats/sex/group) received 0, 8 (1×), 16 (2×), 24 (3×), or 40 (5×) mg/kg cyclosporine once daily for 6 months (183 days). Body weight, food consumption, ophthalmoscopic, physical examinations including neurological assessments, blood pressure, electrocardiography, clinical pathology (hematology, coagulation, clinical chemistry, urinalysis), organ weights, and macroscopic and microscopic examinations were performed and assessed. In addition, blood concentrations of cyclosporine were measured at the pretreatment trough on Days 1, 2, 7, 14, 31, 91, 154, and 182, and post-treatment on Days 1, 31, and 182. Adverse effects possibly related to treatment included prolonged APTT and one report each of bone marrow hypocellularity and lymphoma; all occurred in cats treated with doses more than 16 mg/kg. There was no significant accumulation of cyclosporine beyond the first week of treatment. Results confirm that ATOPICA for Cats is safe and well tolerated in cats without unexpected accumulation beyond the first week of treatment when administered as directed.
Collapse
Affiliation(s)
- E S Roberts
- Novartis Animal Health US, Inc, Greensboro, NC, USA
| | | | | | | | | | | |
Collapse
|
23
|
Wildermuth K, Zabel S, Rosychuk RAW. The efficacy of cetirizine hydrochloride on the pruritus of cats with atopic dermatitis: a randomized, double-blind, placebo-controlled, crossover study. Vet Dermatol 2013; 24:576-81, e137-8. [DOI: 10.1111/vde.12067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Kerstin Wildermuth
- Department of Clinical Sciences; Colorado State University College of Veterinary Medicine and Biomedical Sciences; 300 West Drake Fort Collins CO 80523 USA
- Tierdermatologie Dr. Wildermuth; Borsigstraße 7a 65205 Wiesbaden Germany
| | - Sonja Zabel
- Department of Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; 501 DW Brooks Drive Athens GA 30602 USA
| | - Rod A. W. Rosychuk
- Department of Clinical Sciences; Colorado State University College of Veterinary Medicine and Biomedical Sciences; 300 West Drake Fort Collins CO 80523 USA
| |
Collapse
|
24
|
Favrot C. Feline non-flea induced hypersensitivity dermatitis: clinical features, diagnosis and treatment. J Feline Med Surg 2013; 15:778-84. [PMID: 23966004 PMCID: PMC11110976 DOI: 10.1177/1098612x13500427] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Hypersensitivity dermatitis (HD) is often suspected in cats and is mostly caused by insect bites, food or environmental allergens. Cats with non-flea induced HD are reported to present frequently with one or more of the following cutaneous reaction patterns: miliary dermatitis, eosinophilic dermatitis, self-induced symmetrical alopecia or head and neck excoriations/pruritus. CLINICAL CHALLENGES None of the above patterns are, however, pathognomonic for non-flea induced HD and the diagnosis of this condition is based on exclusion of diseases presenting similarly and an adequate response to treatment. Therapeutic approaches to affected cats include use of immunomodulatory drugs (ciclosporin, glucocorticoids, antihistamines), hypoallergenic diets and allergen-specific immunotherapy. EVIDENCE BASE This review provides an update on the clinical signs, diagnosis and treatment of feline non-flea induced HD. It draws on the findings of a recent large-scale study that described the clinical signs of numerous cats with non-flea HD and has proposed criteria to facilitate the diagnosis of the condition.
Collapse
Affiliation(s)
- Claude Favrot
- Dermatology Department, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
| |
Collapse
|
25
|
Steffan J, Roberts E, Cannon A, Prélaud P, Forsythe P, Fontaine J, King S, Seewald W. Dose tapering for ciclosporin in cats with nonflea-induced hypersensitivity dermatitis. Vet Dermatol 2013; 24:315-22, e70. [PMID: 23530522 PMCID: PMC7169265 DOI: 10.1111/vde.12018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little information is available on the ciclosporin dose-tapering regimen and clinical response in the treatment of feline hypersensitivity dermatitis. HYPOTHESIS/OBJECTIVES To test a dose-tapering regimen and assess efficacy and clinical safety for up to 18 weeks. ANIMALS Eighty-eight client-owned cats with feline hypersensitivity dermatitis. METHODS Cats that received either a placebo or ciclosporin at 2.5 mg/kg or 7 mg/kg daily for 6 weeks were given 7 mg/kg ciclosporin daily for 4 weeks. Depending on the clinical response, the dose was tapered from daily to every other day over the next 4 weeks and further to twice a week for an additional 4 weeks. RESULTS After all cats received 7 mg/kg for 4 weeks, the dose could be tapered to every other day for the next 4 weeks in 70% of cats remaining in the study. During the next 4 weeks, 57, 15 and 22% of cats remaining in the study could be treated at twice a week, every other day or daily, respectively. After the first 4 weeks, the mean lesion score and owner-assessed pruritus improved over baseline by 69 and 61%, respectively, and remained stable during the following 8 weeks. Approximately 65% of the cats in the study were reported to have an adverse event (AE), very often mild and resolving spontaneously. The most frequent AEs were gastrointestinal and included primarily vomiting and diarrhoea. Eighty per cent of AEs occurred when cats were on daily treatment. CONCLUSIONS AND CLINICAL IMPORTANCE Results suggest that the induction dose of 7 mg/kg ciclosporin can be tapered as soon as 4 weeks without deterioration of the clinical response. Establishment of the lowest effective dosing regimen of ciclosporin reduced the frequency of AEs.
Collapse
Affiliation(s)
- Jean Steffan
- Novartis Animal Health, Schwarzwaldallee 214, Basel, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed.
Collapse
|
27
|
King S, Favrot C, Messinger L, Nuttall T, Steffan J, Forster S, Seewald W. A randomized double-blinded placebo-controlled study to evaluate an effective ciclosporin dose for the treatment of feline hypersensitivity dermatitis. Vet Dermatol 2012; 23:440-e84. [DOI: 10.1111/j.1365-3164.2012.01086.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
28
|
Steffan J, Olivry T, Forster SL, Seewald W. Responsiveness and validity of the SCORFAD, an extent and severity scale for feline hypersensitivity dermatitis. Vet Dermatol 2012; 23:410-e77. [DOI: 10.1111/j.1365-3164.2012.01071.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Buckley L, Nuttall T. Feline eosinophilic granuloma complex(ities): some clinical clarification. J Feline Med Surg 2012; 14:471-81. [PMID: 22736681 PMCID: PMC10822386 DOI: 10.1177/1098612x12451549] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE The feline eosinophilic granuloma complex (EGC) comprises a group of clinically well recognised but poorly understood dermatoses that are common in cats. In many cases, lesions are severe and can be accompanied by varying degrees of (and sometimes considerable) pruritus and/or pain. In addition, lesions can be chronic and recurrent. It is, therefore, important to achieve a prompt and accurate diagnosis in order to provide optimal, often life-long, treatment for affected cats. PATIENT GROUP There is no age predisposition or well documented breed predilection for the development of EGC lesions in cats. Some studies have reported a possible female predisposition, but this has not been consistently documented. CLINICAL CHALLENGES The clinical diagnosis of EGC lesions is usually straightforward, but investigation of the potential underlying aetiology can pose a challenge for the clinician. Information on the indication for various diagnostic tests and their interpretation is lacking, and the tendency for these cases to be managed with chronic medical intervention prior to achieving a definitive diagnosis can further complicate the interpretation of any diagnostic investigation. In addition, successful therapeutic management of these cases can be challenging. Some cats suffer only a single episode of disease that resolves with treatment, while others have recurrent lesions and some of these can be refractory to treatment. The individual variation in both the clinical nature of the disease and the response to therapy could be related to disease severity, but could also be explained by differences in the underlying aetiopathogenesis. EVIDENCE BASE This article reviews the published literature to discuss the complex aetiology of the EGC and present an overview of the different clinical presentations and diagnosis. A further and particular aim has been to provide some evidence-based recommendations for the management of this unusual group of dermatoses.
Collapse
Affiliation(s)
- Laura Buckley
- Small Animal Teaching Hospital, University of Liverpool, Leahurst, Chester High Road, Neston CH64 7TE, UK
| | - Tim Nuttall
- Small Animal Teaching Hospital, University of Liverpool, Leahurst, Chester High Road, Neston CH64 7TE, UK
| |
Collapse
|
30
|
Irwin KE, Beale KM, Fadok VA. Use of modified ciclosporin in the management of feline pemphigus foliaceus: a retrospective analysis. Vet Dermatol 2012; 23:403-e76. [DOI: 10.1111/j.1365-3164.2012.01069.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
31
|
Ganz EC, Griffin CE, Keys DA, Flatgard TA. Evaluation of methylprednisolone and triamcinolone for the induction and maintenance treatment of pruritus in allergic cats: a double-blinded, randomized, prospective study. Vet Dermatol 2012; 23:387-e72. [DOI: 10.1111/j.1365-3164.2012.01058.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Kovalik M, Thoday KL, van den Broek AHM. The use of ciclosporin A in veterinary dermatology. Vet J 2012; 193:317-25. [PMID: 22609151 DOI: 10.1016/j.tvjl.2012.03.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 03/14/2012] [Accepted: 03/29/2012] [Indexed: 11/18/2022]
Abstract
Ciclosporin A (CsA) has potent immunosuppressive and immunomodulatory activity that has been exploited in human medicine to prevent the rejection of transplanted organs and to manage atopic dermatitis and psoriasis. Over the past decade, CsA has been employed more frequently in veterinary dermatology and its value in the management of several canine and feline dermatoses is now well established. CsA inhibits calcineurin phosphatase, suppressing T cell activation and the synthesis of T cell cytokines consequently impairing the activity of B cells, antigen-presenting cells, mast cells, basophils and eosinophils. The pharmacokinetics of CsA are similar in humans, dogs and cats and the drug has a wide safety margin in dogs, cats and rabbits. Adverse effects, principally transient vomiting and soft faeces/diarrhoea, may be seen shortly after instituting treatment but often resolve despite continuing treatment. Gingival hyperplasia and cutaneous effects such as hirsutism may occur after prolonged treatment.
Collapse
Affiliation(s)
- Marcel Kovalik
- The University of Edinburgh, Division of Veterinary Clinical Sciences, Dermatology Unit, The Royal (Dick) School of Veterinary Studies, The Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
| | | | | |
Collapse
|
33
|
Schmidt V, Buckley LM, McEwan NA, Rème CA, Nuttall TJ. Efficacy of a 0.0584% hydrocortisone aceponate spray in presumed feline allergic dermatitis: an open label pilot study. Vet Dermatol 2011; 23:11-6, e3-4. [DOI: 10.1111/j.1365-3164.2011.00993.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
34
|
Heinrich NA, McKeever PJ, Eisenschenk MC. Adverse events in 50 cats with allergic dermatitis receiving ciclosporin. Vet Dermatol 2011; 22:511-20. [DOI: 10.1111/j.1365-3164.2011.00983.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
Thacker EL. Immunomodulators, immunostimulants, and immunotherapies in small animal veterinary medicine. Vet Clin North Am Small Anim Pract 2010; 40:473-83. [PMID: 20471530 DOI: 10.1016/j.cvsm.2010.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Immunomodulators, immunostimulants, and immunotherapies are important tools used by veterinary practitioners and researchers to control and direct the immune system of small animals. This article is an overview and summary of some of the most common immunomodulatory agents used in companion animals emphasizing steroidal and nonsteroidal agents, T-cell inhibitors, cytotoxic drugs, immunostimulators and biologic response modifying agents, and neoplasia chemotherapeutic agents.
Collapse
Affiliation(s)
- Eileen L Thacker
- United States Department of Agriculture-Agricultural Research Service, 5601 Sunnyside Avenue, Beltsville, MD 20705-5148, USA.
| |
Collapse
|
36
|
Inhibitory Effect of Luteolin Liposome Solution by Animal Model for Atopic Dermatitis in NC/Nga Mice. Lab Anim Res 2010. [DOI: 10.5625/lar.2010.26.1.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|