A randomized comparative clinical trial of recombinant canine interferon-gamma (KT-100) in atopic dogs using antihistamine as control

Modulation of MHC expression by interferon-gamma and its influence on PBMC-mediated cytotoxicity in canine mast cell tumour cells

Immunotherapy is a promising alternative treatment for canine mast cell tumour (MCT). However, evasion of immune recognition by downregulating major histocompatibility complex (MHC) molecules might decline treatment efficiency. Enhancing MHC expression through interferon-gamma (IFN-γ) is crucial for effective immunotherapy. In-house and reference canine MCT cell lines derived from different tissue origins were used. The impacts of IFN-γ treatment on cell viability, expression levels of MHC molecules, as well as cell apoptosis were evaluated through the MTT assay, RT-qPCR and flow cytometry. The results revealed that IFN-γ treatment significantly influenced the viability of canine MCT cell lines, with varying responses observed among different cell lines. Notably, IFN-γ treatment increased the expression of MHC I and MHC II, potentially enhancing immune recognition and MCT cell clearance. Flow cytometry analysis in PBMCs-mediated cytotoxicity assays showed no significant differences in overall apoptosis between IFN-γ treated and untreated canine MCT cell lines across various target-to-effector ratios. However, a trend towards higher percentages of late and total apoptotic cells was observed in the IFN-γ treated C18 and CMMC cell lines, but not in the VIMC and CoMS cell lines. These results indicate a variable response to IFN-γ treatment among different canine MCT cell lines. In summary, our study suggests IFN-γ's potential therapeutic role in enhancing immune recognition and clearance of MCT cells by upregulating MHC expression and possibly promoting apoptosis, despite variable responses across different cell lines. Further investigations are necessary to elucidate the underlying mechanisms and evaluate IFN-γ's efficacy in in vivo models.

Update on the role of cytokines and chemokines in canine atopic dermatitis

BACKGROUND

Cytokines and chemokines play central roles in the pathogenesis of canine atopic dermatitis (cAD). Numerous studies have been published and provide new insights into their roles in cAD.

OBJECTIVES

To summarise the research updates on the role of cytokines and chemokines in the pathogenesis of cAD since the last review by the International Committee on Allergic Diseases of Animals in 2015.

MATERIAL AND METHODS

Online citation databases, abstracts and proceedings from international meetings on cytokines and chemokines relevant to cAD that had been published between 2015 and 2022 were reviewed.

RESULTS

Advances in technologies have allowed the simultaneous analysis of a broader range of cytokines and chemokines, which revealed an upregulation of a multipolar immunological axis (Th1, Th2, Th17 and Th22) in cAD. Most studies focused on specific cytokines, which were proposed as potential novel biomarkers and/or therapeutic targets for cAD, such as interleukin-31. Most other cytokines and chemokines had inconsistent results, perhaps as a consequence of their varied involvement in the pathogenesis of different endotypes of cAD.

CONCLUSIONS AND CLINICAL RELEVANCE

Inconsistent results for many cytokines and chemokines illustrate the difficulty of studying the complex cytokine and chemokine networks in cAD, and highlight the need for more comprehensive and structured studies in the future.

Clinical efficacy of recombinant canine interferon-gamma therapy in dogs with cutaneous epitheliotropic T-cell lymphoma

BACKGROUND

The antitumour effects of interferon-gamma (IFN-γ) in humans with cutaneous epitheliotropic T-cell lymphoma (CETCL) have been described; however, the efficacy of IFN-γ in dogs has not been investigated.

HYPOTHESIS/OBJECTIVES

The aim of this study was to evaluate the efficacy of recombinant canine IFN-γ (rCaIFN-γ) therapy in dogs with CETCL.

ANIMALS

Twenty dogs with CETCL recruited from seven veterinary clinics were enrolled in the study.

MATERIALS AND METHODS

Fifteen dogs were treated with rCaIFN-γ, and five control dogs were treated with prednisolone. We evaluated survival time, skin lesions (erythema, nodules, ulcers and bleeding), pruritus and general condition (sleep, appetite and body weight). In the rCaIFN-γ group, a questionnaire regarding the therapy was administered to owners after the dogs died.

RESULTS

No significant differences existed in the median survival time between the rCaIFN-γ and control groups (log-rank test: p = 0.2761, Wilcoxon's rank sum test: p = 0.4444). However, there were significant differences in ulcer, bleeding, pruritus, sleep, appetite and body weight between the groups (Wilcoxon-Mann-Whitney U-test: p = 0.0023, p = 0.0058, p = 0.0005, p = 0.0191, p = 0.0306 and p = 0.0306, respectively). Two (40%) of five dogs were euthanised in the control group, compared with none in the rCaIFN-γ group. Fourteen questionnaires were collected, and owners reported that they were satisfied with the rCaIFN-γ treatment.

CONCLUSIONS AND CLINICAL RELEVANCE

Although the median survival time was not prolonged, rCaIFN-γ could be helpful in maintaining good quality of life for dogs with CETCL.

Recombinant human interferon-α14 for the treatment of canine allergic pruritic disease in eight dogs

BACKGROUND

Allergic pruritic diseases are increasingly common in dogs. This group of conditions hampers life quality as pruritus progressively interferes with normal behaviours. Therefore, new treatment modalities for canine allergic pruritic diseases are necessary. While novel drugs have recently reached the market, there is still the need for other therapeutic approaches. Some dogs are refractory even to the newer compounds, and cost is also an important issue for these. Older therapeutic modalities are only moderately successful or have considerable secondary effects, as is the case with glucocorticoids.

OBJECTIVES

Report on the use of recombinant human interferon-α14 (rhIFN-α14) for the treatment of canine allergic pruritus. Following the experience with a similar compound in the Japanese market, it was expected that rhIFN-α14 could alter the Th1/Th2 disbalance that drives these diseases.

METHODS

Here, we present an uncontrolled trial in which eight dogs with clinical diagnosis of allergic pruritus were treated with rhIFN-α14, either orally or via subcutaneous injections. Skin condition, microbiota and anti-interferon antibody levels were assessed.

RESULTS

The parenteral use of interferon induced hypersensitivity in two of the three dogs in which it was used. The oral administration was consistently safe and could reduce signs of the allergic condition in three of the five treated animals. Treatment also altered the skin microbiota, as verified by next-generation sequencing.

CONCLUSION

The present results indicate that rhIFN-α14 is a viable candidate for the treatment of canine allergic pruritus. Future controlled studies are needed, and the oral route is indicated for further trials.

Interferon therapies in small animals

Interferons (IFNs) are cytokines that play an important role in the immune response of animals and humans. A number of studies reviewed here have evaluated the use of human, canine and feline IFNs as treatments for infectious, inflammatory and neoplastic disease in dogs and cats. Recombinant canine IFN-γ is deemed an efficacious therapy for canine atopic dermatitis. Recombinant feline IFN-ω is effective against canine parvoviral enteritis and has also been recommended for canine atopic dermatitis. Based on limited evidence, recombinant canine IFN-α could be a topical treatment option for dogs with gingivitis and keratoconjunctivitis sicca. Conclusive evidence is lacking for other diseases and large randomised controlled trials are needed before IFNs can be recommended for other indications.

A proposed medication score for long-term trials of treatment of canine atopic dermatitis sensu lato

BACKGROUND

The use of concurrent medications is necessary in trials of treatment of canine atopic dermatitis. Our aim was to use the best available evidence to construct and then to validate a medication score (MS) formula that will estimate the impact of concurrent medications on trial outcomes.

METHODS

Trials of 15 interventions were scrutinized to find those that were consistent in terms of specific medication, administration route and dosage regimen. A MS was constructed in five steps, starting from assigning a score of 1 for each day on oral prednisone, prednisolone or methylprednisolone at 0.5-1.0 mg/kg. The MS score was validated using the clinical records of 35 dogs with atopic dermatitis that had been treated for a period of 12 ± 2 weeks with six of these medications and compared with a previously published non-validated MS.

RESULTS

A MS could be assigned to eight treatments, six of which had been administered to the 35 dogs. A positive correlation was seen with the previously published MS and a negative correlation with changes in lesional and pruritus scores.

CONCLUSION

This MS may be a useful tool in new studies evaluating the efficacy of treatments in canine atopic dermatitis.

Expression and characterization of albumin fusion protein canine IFNγ-CSA in baculovirus-insect cell expression system

In this study, canine IFNγ was fused by a flexible linker with canine serum albumin to construct the fusion protein IFNγ-CSA for the purpose to design a long-acting canine IFNγ. The fusion protein was successfully expressed in baculovirus-infected Sf9 insect cells and was purified by salting-out and ion exchange chromatography. The IFNγ-CSA fusion possessed potent anti-viral assay against vesicular stomatitis virus in cultured cells. IFNγ-CSA was also stable at 37 °C up to 72 h compared with 8 h for IFNγ alone. In vivo pharmacokinetics demonstrated a significantly longer half-life for IFNγ-CSA (15.42 h) than for canine reIFNγ (1.51 h) in KM mice. These results indicate that IFNγ-CSA expression in the baculovirus system was successful and provide a promising long-acting cytokine for veterinary clinical applications.

Therapies in Canine Atopic Dermatitis: An Update

Canine atopic dermatitis (AD) is one of the most common inflammatory skin diseases in dogs. The pathogenesis is complex and not completely understood. Many therapeutic options are available; however, because of cost, side effects, or a long lag phase, new compounds are constantly produced. This article provides a comprehensive review of the latest compounds for the treatment of canine AD. In addition, a brief review of new studies on conventional medications is provided. For a successful long-term therapeutic approach, it is important to considerate the status of the disease, as well as the patients' and their owners' needs.

Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA)

Background

In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document.

Results

The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD.

Conclusions

This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-015-0514-6) contains supplementary material, which is available to authorized users.

Vitamin E supplementation in canine atopic dermatitis: improvement of clinical signs and effects on oxidative stress markers

Low levels of plasma vitamin E concentrations were found in canine atopic dermatitis (CAD). The present study was aimed at determining the effect of an eight-week vitamin E supplementation on clinical response (Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) scores and pruritus intensity) in dogs with atopic dermatitis. Levels of oxidative stress markers (plasma malondialdehyde and total antioxidant capacity (TAC), blood glutathione peroxidase and erythrocyte superoxide dismutase, plasma and skin vitamin E concentrations) were also determined. Twenty-nine dogs with CAD were included in the study. Fourteen received vitamin E (8.1 IU/kg once daily, orally) and 15 received mineral oil as placebo (orally). All dogs were treated with antihistamine fexofenadine. Levels of oxidative stress markers (with the exception of skin vitamin E), CADESI-03 and pruritus intensity were determined at the beginning, then every two weeks. Skin vitamin E was determined at the beginning and at the end of the treatment. Significantly higher plasma levels of vitamin E and TAC were observed in the vitamin E group than in the placebo group. CADESI-03 scores determined throughout the treatment in the vitamin E group were significantly lower than in the placebo group. The findings of this study support the supplementation of vitamin E in dogs with atopic dermatitis.

Oral and subcutaneous therapy of canine atopic dermatitis with recombinant feline interferon omega

Canine atopic dermatitis (CAD) is a common allergic skin disease that has been treated with subcutaneously administered interferons (IFN). Recombinant feline IFN-ω (rFeIFN-ω) was reported to be efficacious for CAD. Whether dogs develop neutralizing antibodies against rFeIFN-ω during long-term treatment and whether orally administered IFNs are efficacious in CAD is unknown. The aim of this study was to evaluate the potential development of antibodies against rFeIFN-ω in atopic dogs and to compare subcutaneous and oral IFN therapy. Twenty-six atopic dogs were randomly assigned to two groups. The first group (n=15) received eight subcutaneous injections of rFeIFN-ω (Virbagen® omega, Virbac, Carros, France) over four months, the second group (n=11) received rFeIFN-ω daily orally. Concurrent medication was permitted, except systemically acting glucocorticoids and cyclosporin, which had to be withdrawn at least two weeks prior to the study. Serum samples for antibody detection were collected before and after the study. On days 0, 60 and 120 skin lesions and pruritus were evaluated using a validated lesion score (Canine Atopic Dermatitis Extent and Severity Index=CADESI) and a validated pruritus score. Concurrent medications were recorded. For every visit a total score, consisting of CADESI, pruritus score and medication score was created. For antibody detection an indirect ELISA, using Virbagen® omega as antigen, was performed. Comparison of pruritus scores, CADESI and total scores between days 0 and 120 showed improvement in both groups, however, significant improvement could only be detected in the oral group with CADESI and total scores (61%, P=0.04 and 36%, P=0.02 respectively). Serum antibodies against rFeIFN-ω could not be detected in any of the dogs. In this study antibody production could not be demonstrated. It suggests better efficacy with oral IFN administration, which should be further verified in larger, randomized, controlled studies.

Development and validation of the Canine Atopic Dermatitis Lesion Index, a scale for the rapid scoring of lesion severity in canine atopic dermatitis

BACKGROUND

The third iteration of the Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) is the only tool rigorously validated for canine atopic dermatitis (CAD) lesion scoring. The CADESI-03 requires 248 evaluations, limiting its widespread use.

HYPOTHESIS/OBJECTIVES

The goal of the study was to develop and validate a practical method of grading CAD lesions that requires scoring only the frequently affected body regions.

ANIMALS

Fifty-seven privately owned atopic dogs were used in the study.

METHODS

The Canine Atopic Dermatitis Lesion Index (CADLI) was evaluated in an open, multicentre reliability study. Validity was assessed with expert opinion (content validity) and comparison of CADLI with existing disease severity measures (construct and criterion validity). Reliability was evaluated by analysing repeated observations of each dog. Convenience was assessed in terms of the time required to complete the scale.

RESULTS

The CADLI scores correlated with overall assessment scores (r = 0.60, P < 0.001, linear mixed model) and pruritus severity scores (r = 0.53, P < 0.001, linear mixed model), establishing construct validity. The CADLI was strongly correlated with CADESI-03 (r = 0.84, P < 0.001, linear mixed model), establishing criterion validity. The CADLI values obtained by two observers correlated very strongly (r = 0.91, P < 0.001), as did the repeat values for the same observer (r = 0.98, P < 0.001). The mean time to complete the CADLI was less than that required for CADESI-03 (1.9 and 12.6 min, respectively), a highly significant difference (P < 0.001).

CONCLUSION AND CLINICAL IMPORTANCE

The CADLI was found to be an effective measure of CAD lesion severity, strongly correlating with CADESI-03. The convenience of CADLI makes it suitable for use in both clinical research and practice.

Nonsteroidal, nonimmunosuppressive therapies for pruritus

Pruritus, or itch, is defined as "a sensation that, if sufficiently strong, will provoke scratching or the desire to scratch." Pruritus is a symptom associated with a wide variety of causes and treatment options. Topical therapy is becoming the new target for the treatment of pruritus. The treatment of pruritus in the dog must be approached in a systematic manner and should include the search and resolution of the primary causes. Identifying and treating the primary cause of pruritus greatly increases the success rate of any therapy for pruritus.

Efficacy and safety of immunotherapy with interferon-gamma in the management of chronic sulfur mustard-induced cutaneous complications: comparison with topical betamethasone 1%

The present trial investigated the efficacy of immunotherapy with interferon-gamma (IFN-γ) in the treatment of sulfur mustard (SM)-induced chronic skin complications. Forty subjects who were suffering from chronic skin complications of SM and were diagnosed to have severe atopic dermatitis, were assigned to IFN-γ (50 μg/m(2)) subcutaneously three times per week (n = 20) or betamethasone valerate topical cream 0.1% (n = 20) every night for 30 days. Extent and intensity of cutaneous complications was evaluated using scoring atopic dermatitis (SCORAD) index, and quality of life using dermatology life quality index (DLQI) at baseline and at the end of trial. SCORAD-A and SCORAD-B scores were significantly decreased in both IFN-γ and betamethasone. However, SCORAD-C score was decreased only in the IFN-γ group. There were significant reductions in overall as well as objective SCORAD scores in both groups. As for the magnitude of changes, treatment with IFN-γ was associated with greater reductions in overall, objective and segmented SCORAD scores compared to betamethasone. DLQI reduction was found to be significantly greater in the IFN-γ group. Promising improvements in quality life and clinical symptoms that was observed in the present study suggest the application of IFN-γ as an effective therapy for the management of SM-induced chronic skin complications.

The use of recombinant omega interferon therapy in canine atopic dermatitis: a double-blind controlled study

This double-blind controlled study assessed whether reduced doses of omega interferon (rFeIFN-omega) (Virbagen Omega) could improve the clinical signs of canine atopic dermatitis (CAD) over a 6-month period, in comparison with cyclosporin. Thirty-one dogs diagnosed with CAD were entered in the study. Complicating infections were treated prior to entry. Dogs received 10 injections of rFeIFN-omega (1-5 million units according to bodyweight) or placebo over 6 months, and placebo capsules or cyclosporin (5 mg/kg) once daily for 2 months and then twice weekly for 4 months in groups 1 and 2 respectively. Flea control, non-medicated shampooing and ear cleansing were performed regularly. If a bacterial infection or Malassezia overgrowth developed, it was treated with oral cephalexin or with 3% chlorhexidine shampoo respectively. Oral prednisolone was used before day 90 to relieve pruritus when required for humane reasons (1 mg/kg once daily for 7 days). The CADESI-03 and a pruritus index were evaluated on day (D) 0, D14, D35, D56, D90, D120 and D180. No significant difference was detected between the groups for the time courses of lesions or pruritus over 6 months. On D90, the proportions of dogs with > or =50% improvement of pruritus and lesion scores were 56% and 72% respectively with interferon, 75% and 75% respectively with cyclosporin. Five dogs from group 1 and two dogs from group 2 were withdrawn from the study for treatment failure. Both products were well tolerated. Treatment with rfeIFN-omega at low doses may help for the long-term management of CAD.

Low-dose recombinant canine interferon-gamma for treatment of canine atopic dermatitis: an open randomized comparative trial of two doses

The purpose of this study was to investigate the minimum effective dose of recombinant canine interferon-gamma (rCaIFN-gamma) for the treatment of dogs with atopic dermatitis (AD). Thirty-four dogs with AD from 17 animal hospitals in Japan were administered half or one-fifth of the approved rCaIFN-gamma dose of 10 000 units/kg, three times a week for 4 weeks, followed by once weekly for an additional 4 weeks. Pruritus, excoriation, erythema and alopecia were evaluated and scored by the investigators on weeks 2, 4, 6, 8 and 12. The efficacy rate (number of excellent cases + number of good cases/total number of cases) at week 8 in the 2000 units/kg group was 36.4% for pruritus, 36.4% for excoriation, 45.5% for erythema and 36.4% for alopecia. In contrast, in the 5000 units/kg group, the efficacy rate was 64.3% for pruritus, 57.1% for excoriation, 78.6% for erythema and 78.6% for alopecia. The efficacy rate of the 5000 units/kg group was high for all signs evaluated and comparable to that of the 10 000 units/kg group reported in a previous study. The results of this study showed that 2000 units/kg of rCaIFN-gamma is less effective than 5000 units/kg to treat dogs with AD, and the efficacy of the 5000 units/kg dose is comparable to that of 10 000 units/kg at week 8.

Equine recurrent airway obstruction and insect bite hypersensitivity: understanding the diseases and uncovering possible new therapeutic approaches

Recurrent airway obstruction (RAO) and insect bite hypersensitivity (IBH) are allergic conditions that are commonly encountered in the horse. Whilst complete allergen avoidance is an effective management strategy for both diseases, this may not be achievable in all cases and treatment options are therefore required. The inflammatory response is the main therapeutic target for glucocorticoids given to horses with RAO and severe cases of IBH, whilst the bronchodilators used in RAO primarily target airway smooth muscle. Such drugs are effective in most but not all individuals and there may be unwanted adverse effects. This article will review how knowledge of drug action and the pathogenesis of RAO and IBH can be utilised to identify potential targets for novel therapeutic agents that, in the longer term, may be safer and/or more effective in managing the allergic horse.

Repeatability and reproducibility of numerical rating scales and visual analogue scales for canine pruritus severity scoring

Although they are used frequently in veterinary dermatology, the reliability of canine pruritus severity scales has not been reported. The objective of this study was to evaluate the reliability of pruritus severity numerical rating scales (NRS) and pruritus severity visual analogue scales (VAS). Videos of 16 dogs were evaluated for pruritus severity by 24 observers utilizing three NRS and three VAS. Intraobserver repeatability and interobserver reproducibility were evaluated with Cohen's kappa and Kendall's rank correlation statistics, respectively. The repeatability of pruritus severity NRS was fair, with mean Cohen's weighted kappa (kappa(w)) values ranging from 0.49 to 0.60. The mean Kendall's rank correlation coefficient (t) for the three VAS ranged from 0.62 to 0.73. The reproducibility of mid-range pruritus severity ranks was poor with both scale types. Scales describing overall pruritus severity were found to be reliable most consistently. Neither NRS nor VAS displayed the degree of reliability desired in a health measurement scale. Interpretation of research results evaluating canine pruritus severity with NRS and VAS scales should account for suboptimal reliability.

Development of an owner-assessed scale to measure the severity of pruritus in dogs

Assessment of pruritus is critical in dermatological history taking, both for initial diagnosis and for monitoring treatment. Various methods of assessing pruritus in the dog have been described but none have been validated. In this study, four different pruritus scales were initially assessed: a 0-5 numerical scale; a scale containing six categories of pruritic behaviours; a scale with six basic descriptors of severity; and a visual analogue scale with severity descriptions at either end. One hundred and sixteen owners were asked to grade their dog's pruritus with each of the four scales given to them in a randomized order, and asked which they thought was easiest to use, which was most accurate in assessing their dog's pruritus level, and which two scales they would combine to make a superior scale. Pruritus scores from different scales were highly correlated with each other, but scores were significantly higher with the severity and numerical scales compared to the behaviour scale. Based on the clients' responses, a new scale was developed that combined features of the behaviour and severity-based scales with the visual analogue scale. When tested on 166 different owners, 98% thought it was easy to use and accurate in assessing their dog's pruritus level. In 44 dogs, independent scores obtained by two owners were highly correlated (R = 0.8; P < 0.0001), confirming the scale's repeatability. The new scale proved to be an easy and repeatable method for owners to determine the severity of pruritus in their dog.

Frequency of appropriate and inappropriate presentation and analysis methods of ordered categorical data in the veterinary dermatology literature from January 2003 to June 2006

Clinical outcomes that are difficult to measure directly are often graded with ordinal scales in the veterinary dermatology literature to approximate objective evaluation. Ordered categorical scales require statistical presentation and analysis methods consistent with the structure of the data. The objective of this study was to determine the frequency of inappropriate presentation and analysis methods of ordered categorical data in the recent veterinary dermatology literature. A total of 62 articles published between 1 January 2003 and 30 June 2006 in 16 journals reported categorical scales and were included in the study. The presentation and analysis methods of ordered categorical data were classified as appropriate or inappropriate based on published recommendations. Forty articles (64.5%) utilized a median of four ordinal scales (range 1-13). Inappropriate presentation methods of ordered categorical data were identified in 23 of 40 articles (57.5%). These included reporting inappropriate summary statistics (n = 17) and summation of ad hoc numerical rating scales (n = 15). Inappropriate analytical methods were used in nine of 40 articles (22.5%). These included inappropriate use of t-tests (n = 3) and analysis of variance (anova, n = 6). The frequency of inappropriate presentation and analysis methods of ordered categorical data in the veterinary dermatology literature is similar to that reported for several fields in the human medical literature. In order to reduce the likelihood of making unwarranted implications or conclusions regarding ordinal data, authors should follow established guidelines for methods of presentation and analysis of ordered categorical scales.