Ultrasonographic findings may be useful for differentiating interdigital abscesses secondary to migrating grass awns and interdigital furunculosis in dogs

Grass awn migration and furunculosis are common diseases in dogs that can lead to interdigital subcutaneous lesions with a similar clinical presentation, and occasionally similar ultrasonographic images, but different treatments are required. This retrospective, multicentric, analytical study aimed to determine whether epidemiological, clinical, and ultrasonographic features could be used to differentiate interdigital furunculosis and abscesses secondary to migrating grass awns. Fifty-nine dogs that underwent interdigital ultrasonography were included (interdigital furunculosis [IDF], n = 27; interdigital abscess secondary to a migrating grass awn [IAGA], n = 32). Ultrasonographic images were reviewed by two observers blinded to the diagnosis, who graded nine qualitative and four quantitative parameters for each patient. In both groups, pruritus/licking (IDF 74%, IAGA 70%), a discharging interdigital wound (63% for each group), and thoracic limb involvement (IDF 88%, IAGA 75%) were common features. On ultrasound, a subcutaneous multilinear hyperechoic main element was identified in most dogs (IDF 85%, IAGA 100%). The ability to display this element in a single plane (P < 0.01), the absence of additional hyperechoic linear elements in different planes (P < 0.01), and a surrounding hypoechoic halo (P < 0.05) were significantly more common in dogs with interdigital abscesses secondary to migrating grass awns. A cut-off value of 0.83 cm for the length of the main multilinear element provided a sensitivity of 91% and a specificity of 87% in the diagnosis of a migrating grass awn. Findings supported prioritizing a differential diagnosis of interdigital abscesses secondary to grass awns in dogs with these ultrasonographic characteristics.

Multifocal cutaneous phaeohyphomycosis caused by Exophiala spinifera with clinical resolution in an immunocompromised cat

Case summary

A 3-year-old neutered domestic shorthair cat with a long history of idiopathic immune-mediated haemolytic anaemia and thrombocytopenia treated with ciclosporin and prednisolone was referred 2 months after the appearance of nodular dermatitis. A single pigmented nodule was present in the lateral carpal region of the right foreleg. The lesion was 7 mm in diameter, non-exudative and cutaneous to subcutaneous. Fine-needle aspiration of the mass revealed the presence of pigmented fungal elements. Excisional surgery was planned; in the meantime, a plaque-like lesion developed in the interorbital region. Histopathological examination confirmed the presumptive diagnosis of phaeohyphomycosis, and Exophiala spinifera was identified as the aetiological agent. Itraconazole, given orally at a dose of 10 mg/kg for 8 weeks following surgery, enabled clinical resolution despite continued use of immunosuppressants. The follow-up was carried out over 14 weeks.

Relevance and novel information

This case report provides the first evidence of multifocal cutaneous phaeohyphomycosis caused by E spinifera with clinical resolution after combined surgical and itraconazole treatment in an immunocompromised cat.

Cutaneous epitheliotropic T-cell lymphoma in a donkey - a case report

Background

Cutaneous epitheliotropic T-cell lymphoma is a malignant tumour of the skin already reported in humans, dogs, cats, horses, and other species, but not previously in donkeys. The standard diagnosis is based on clinical, morphological and immunophenotypic data. Differentiation of malignant versus benign proliferation of lymphocytes is crucial; in ambiguous cases T-cell receptor gamma (TRG) molecular clonality should be tested. In the present paper, we report a case of mycosis fungoides diagnosed in a donkey whose diagnosis was based on clinical, histological and immunohistochemical aspects and a positive TRG clonality test.

Case presentation

A twenty-five-year-old donkey gelding was referred with a mildly pruritic, generalised and severe exfoliative dermatosis. Otherwise, the animal was clinically healthy, though mildly underweight. Dermatological examination revealed severe generalised alopecic and exfoliative dermatitis, occasionally eroded, with high number of large, thin, greyish scales. All mucocutaneous junctions except the hoofs were affected. Ectoparasites and dermatophytes were ruled out. The complete blood count and blood smear evaluation revealed mild normocytic normochromic anemia. The biochemistry panel showed mild hyperproteinemia with albumin within the normal range. Protein electrophoresis showed moderate polyclonal hypergammaglobulinemia. Histological findings were characterised by interface dermatitis with massive exocytosis in the epidermis of a homogenous population of lymphoid cells showing atypia. Clusters of neoplastic cells were present within the epidermis forming Pautrier “microabscesses”. These findings are consistent with cutaneous epitheliotropic lymphoma. Immunohistochemical staining revealed uniform labelling of the neoplastic cells for CD3, and lack of expression of CD20 (a B cell lineage associated marker). Molecular clonality PCR (PARR) was performed using equine TRG primers; this revealed a clonal rearrangement in a heavy polyclonal background. Transmission electronic microscopy showed multiple lymphocytes with convoluted or cerebriform nuclei.

Conclusions

This case report provides the first evidence of clinical, histopathological, immunophenotypic features, electron microscopy findings and molecular analysis of a cutaneous epitheliotropic T-cell lymphoma (mycosis fungoides) in a donkey. Our observations suggest that cutaneous T-cell lymphoma should be included in the differential diagnoses of exfoliative dermatitis, even those progressing in a chronic pattern and/or with few or no pruritus.

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

Simple Summary

Atopic 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.

Abstract

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.

Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog

Toxic epidermal necrolysis (TEN) is a rare and severe life-threatening syndrome characterized by apoptosis of keratinocytes resulting in devitalization of the epidermis affecting more than 30% of skin surface. In humans and animals, this condition is mostly triggered by drugs. Identification of the putative agent and its withdrawal are crucial to successful management of a patient with TEN. In this case study, we report the clinical features, histopathological findings and management of a dog with TEN. A 4-year-old intact male French bulldog presented with acute onset of severe lethargy and cutaneous ulcerations on the footpads, scrotum, and hind limbs associated with marked pain. A Stevens-Johnson syndrome/TEN was suspected and drugs, especially beta-lactams, were withdrawn. Histopathology confirmed the diagnosis of epidermal necrosis. Advanced supportive therapy, pain management and skin care led to rapid remission. Early identification and removal of the suspected medication was crucial to improving TEN prognosis in this dog. Antibiotics (penicillin, ampicillin, cephalexin, and sulfonamides) are frequently involved in adverse cutaneous reactions in dogs. Ideal treatment remains elusive is humans and dogs and this disease has a poor prognosis. Supportive care combined with pain management and treatment of the cutaneous ulcerations is essential.

Survey of cytokines on ocular surfaces of atopic dogs by multiplex analysis using two sampling methods - a pilot study

BACKGROUND

Conjunctivitis in atopic dogs has already been described yet is rarely observed, and likely underdiagnosed in practice.

OBJECTIVES

To assay various cytokines in tears and conjunctivae from atopic and normal dogs, and to compare canine atopic dermatitis-associated conjunctivitis with controls.

ANIMALS

Ten atopic and ten normal client-owned dogs.

METHODS AND MATERIALS

Ocular surfaces were sampled bilaterally in a prospective study, using two different methods. Tear samples were obtained with a sterile swab previously moistened with saline solution (method A). Conjunctival impressions were obtained with a conjunctival impression device (method B). For each sample, the concentrations of a panel of 13 cytokines were measured by multiplex analyses. CADESI-4, pruritus (PS) and conjunctival (CS) scores were determined.

RESULTS

Among the measured cytokines, only granulocyte-macrophage colony-stimulating factor (GM-CSF), keratinocyte-derived chemokine (KC)-like and interleukin (IL)-8 were above the limit of quantification in most samples. Absolute amounts of each cytokine were always higher in samples obtained with method A than with method B. GM-CSF amounts were lower in atopic dogs (method A, P=0.02; method B, P=0.0005). KC levels were higher in atopic dogs, yet the differences were not significant. IL-8 amounts were higher in atopic dogs (method A, P=0.0003; method B, P=0.006).

CONCLUSIONS AND CLINICAL RELEVANCE

Regardless of the method, these preliminary results suggest an overexpression of IL-8 in conjunctivae and tears of atopic dogs despite subtle conjunctival symptoms. As IL-8 is commonly found in many inflammatory conditions, further studies are needed to determine its specificity in atopic conjunctivitis.

Treatment of sarcoptic and chorioptic mange in an alpaca (Vicugna pacos) herd with a combination of topical amitraz and subcutaneous ivermectin

Clinical history: An outbreak of intense pruritus and weight loss in a herd of 40 alpacas (Vicugna pacos) in the south-west of France was investigated after the death of 14 adults. One alpaca was referred to a veterinary teaching hospital for diagnosis and treatment but died soon after and one of the dead alpacas was submitted for necropsy. Clinical findings: The remaining alpacas were intensely pruritic with variably severe and extensive alopecia, erythema, lichenification and crusting on the face, ventral abdomen and distal limbs. Superficial skin scrapes from five animals revealed large numbers of Sarcoptes scabiei mites, and less frequent and numerous Chorioptes bovis mites. Coproscopic examinations revealed a median of 1,350 (min 500, max 8800) strongyle epg. The alpaca admitted for treatment was anaemic and hypoalbuminaemic. Skin scrapes revealed copious S. scabiei and C. bovis mites. The two alpacas examined post-mortem had similar skin lesions to those examined on-farm and were cachexic. One had lung lesions attributed to protostrongylid infestation and its liver contained numerous Dicrocoelium spp. adults. Diagnosis: Sarcoptic and chorioptic mange with secondary superficial bacterial skin infection, associated with severe internal parasitism and underfeeding. Treatment and outcome: All 25 alpacas were treated topically with a 3% chlorhexidine shampoo followed by a 0.025% amitraz wash at the initial visit and then 1, 2, 3, 7 and 9 weeks later. A systemic treatment with S/C 500 µg/kg ivermectin was administered at the initial visit and then 2, 7 and 9 weeks later. The alpacas were treated orally with 50 mg/kg praziquantel to control dicrocoeliosis. Nutritional measures, including increased pasture area and supplemental feeding were simultaneously implemented. Pruritus was reduced 1 week after the start of treatment and had resolved after 2 weeks. After 9 weeks, skin lesions were markedly improved. Six months after the initial visit, skin lesions entirely resolved and superficial skin scrapes, taken from half of the animals, were negative for mites. Clinical relevance: This is the first report of the use of two acaricides combined with a chlorhexidine shampoo to successfully treat simultaneous sarcoptic and chorioptic mange in alpacas.

A prospective, randomized, double blind, placebo-controlled evaluation of the effects of an n-3 essential fatty acids supplement (Agepi® ω3) on clinical signs, and fatty acid concentrations in the erythrocyte membrane, hair shafts and skin surface of dogs with poor quality coats

Canine haircoat quality, the time course of incorporation of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) into the canine erythrocyte membrane, changes in total lipids content on hair shafts and of neutral lipids on the skin surface, were investigated after administrating an n-3 fatty acids supplement. Twenty-four dogs with poor haircoat received a placebo or n-3 oil capsules (110 mg EPA/68 mg DHA) daily for 90 days. Clinical assessments and tissue sampling were performed monthly from day (D)0 to D180. The clinical score in treated dogs was significantly reduced from D60, then attained a plateau and returned to baseline levels on D180. EPA and DHA contents in the erythrocyte membrane increased significantly from D30 and decreased rapidly after supplement withdrawal in treated dogs. Total lipids on the hair shaft increased progressively in the supplemented group. EPA/DHA supplements impact blood and hair fatty acids important for haircoat quality in dogs.

Control of fly strike dermatitis in dogs with a topically applied combination of imidacloprid and permethrin: a prospective open-label controlled clinical trial

Background

A prospective clinical study evaluated the tolerance and the efficacy of a combination of imidacloprid (10%) and permethrin (50%) (ADVANTIX^®: Bayer HC AH, France) applied topically as a spot-on, for the treatment of natural canine fly dermatitis due to Stomxys calcitrans. The study was an open-label controlled study and one-month follow-up.

Methods

Fifteen dogs, from the same animal kennel, with active pinnal lesions of fly dermatitis, received a single application of the solution on the cranium and the base of the ears on Day 0 (D0). Five dogs, from the same kennel, similarly affected, served as non-treated controls. No other therapeutical or hygienic measures were taken. Lesional score was based on extension, alopecia, crusts, scales, erosions/ulcers, loss of substance and lichenification, each assessed on a 0–4 scale. Evaluation was performed on D0, D14 and D30. Total lesion score reduction was calculated at each time point using the arithmetic mean of total lesion score according to Abbott’s formula. Scores obtained on D14 and D30 were compared with the baseline obtained on D0.

Results

No adverse event was recorded. The lesion score ranged between 4–13 at D0 in all dogs. In control dogs, D0 mean (± SD) lesion score was 7 ± 1.4. Lesion scores were maintained on D14 (6.6 ± 3.4) and D30 (8.6 ± 5.4). In treated dogs, D0 mean lesion score was 9.9 ± 2.5. Lesion scores of the treated dogs were reduced by 59% on D14 (4.1 ± 2.8) and 80% on D30 (1.9 ± 1.5) (P < 0.05).

Conclusions

The combination imidacloprid-permethrin proved safe and helpful in the management of natural canine fly dermatitis. It could also be suggested as a preventive measure with a monthly application during the fly exposition phase.

Control of canine idiopathic nasal hyperkeratosis with a natural skin restorative balm: a randomized double-blind placebo-controlled study

BACKGROUND

Nasal hyperkeratosis may cause discomfort in dogs by predisposing them to fissures and secondary bacterial infection. Approaches to treatment have been described anecdotally; the effectiveness of such therapies remains unproven.

HYPOTHESIS/OBJECTIVES

To investigate the efficacy of a balm containing essential oils and essential fatty acids in dogs with idiopathic nasal hyperkeratosis.

ANIMALS

Client-owned dogs with noncomplicated nasal hyperkeratosis.

METHODS

The study was conducted as a randomized, double-blind, placebo-controlled clinical trial with parallel group design and two month follow-up period. Dogs received daily topical application of a commercial balm product (group DBB) or placebo (aqueous gelling agent with preservatives, group PB). The main outcome variables were lichenification, dryness, suppleness and extent of lesions. Subjective owner satisfaction index score was a secondary variable. Evaluation was performed on days (D)0, 30 and 60. Response to treatment was assessed as the change from baseline to each examination day for each criterion.

RESULTS

Forty eight dogs, principally French (26 of 48) and English (seven of 48) bulldogs, were included and 39 completed the study. No major adverse events were reported. On D60, changes from baseline for lichenification, lesion extent, suppleness and total score were -31.2%, -18.3%, -72.8% and -36.8% in group DBB (23 dogs) and -11.9%, 2.3%, -42.1% and -14% in group PB (16 dogs), respectively. The total score was significantly improved on D60 in group DBB compared to PB (Wilcoxon-Mann-Whitney U-test, P = 0.0016).

CONCLUSIONS AND CLINICAL IMPORTANCE

The balm proved safe and helpful in managing canine idiopathic noncomplicated nasal hyperkeratosis.

Treatment of Neotrombicula species infestation in cats using a 10% (w/v) fipronil topical spot-on formulation: a pilot study

Objectives

Few data are available concerning therapeutic aspects of feline trombiculiasis. This study evaluated the efficacy of a 10% w/v fipronil-based spot-on solution in 15 cats with natural Neotrombicula species infestation.

Methods

Ten cats received 1 drop per affected site on day (D)0 and D14, with the rest of the 0.5 ml pipette applied on the skin between the shoulders. Five cats served as non-treated controls. Parasite score (0 = absent; 3 = severe, >10 parasites/zone) was assessed on D0, D14 and D28 on all animals. Skin lesions (SCORing Feline Allergic Dermatitis lesion severity scale [SCORFAD]) and investigator pruritus scale (IPS; 0 = cat comfortable, grooming like any normal cat; 4 = cat uncomfortable, pruritic all the time) were assessed on treated cats on the same days. Global assessment of efficacy, tolerance and ease of use (GAS; 1 = very poor; 5 = excellent) was assessed on D28.

Results

All the cats completed the study. Parasite scores of the control cats were maintained throughout the trial (mean ± SD: D0 4 ± 0.7, D14 3.2 ± 1.1 and D28 3.2 ± 0.4). In treated cats, SCORFAD (D0 3.2 ± 5.4, D14 1.1 ± 2.1 [P <0.002] and D28 0.5 ± 1.3 [P <0.002]), parasite (D0 3.9 ± 1.3, D14 1.2 ± 0.8 [P <0.005] and D28 0.4 ± 0.5 [P <0.005]) and IPS (D0 1 ± 1.2, D14 0.5 ± 1.1 [P <0.05] and D28 0.3 ± 0.7 [P <0.05]) scores significantly decreased throughout the trial. On D28, the GAS was 4.2 ± 0.9. There were no adverse effects from treatment.

Conclusions and relevance

The 10% w/v fipronil preparation appeared to be effective, safe and practical in the treatment of localised Neotrombicula species infestation in these cats.

Feline familial pedal eosinophilic dermatosis in two littermates

In cats, the most common eosinophilic dermatoses are feline miliary dermatitis and eosinophilic granuloma complex. The most commonly identified underlying cause is a hypersensitivity reaction. Few cases of familial forms of eosinophilic dermatoses are reported in the literature. Two young adult cats from the same litter presented 2 years apart with a severe and chronic fluid or tissue infiltration of the distal part of several limbs. Lesions started on the forelegs and developed on the other limbs. Cytological and histopathological examinations showed lesions consistent with an atypical form of feline eosinophilic dermatosis associated with secondary bacterial infection. In both cats, antibiotics combined with immunosuppressive treatment partially improved the lesions, which continued to progress on a waxing and waning course, even in the absence of treatment. Allergy work-up did not permit the identification of an underlying allergic triggering factor. The severity of the lesions, the unusual presentation and the unsatisfactory response to immunosuppressive therapy in two feline littermates suggested a genetic form of eosinophilic dermatosis.

Comparative study of aural microflora in healthy cats, allergic cats and cats with systemic disease

Twenty healthy cats (group 1) with clinically normal ears, 15 cats with systemic disease (group 2) and 15 allergic cats (group 3) were included in a prospective study. The experimental unit was the ear. A clinical score was established for each ear canal after otoscopic examination. Microbial population was assessed on cytological examination of smears performed with the cotton-tipped applicator smear technique. Fungal population was significantly more prominent in allergic cats ( P <0.001) and in diseased cats compared with healthy cats ( P <0.02). Bacterial population was significantly higher in allergic cats than in healthy cats ( P <0.001) and cats suffering from systemic disease ( P <0.001). Bacterial overgrowth was also higher in cats with systemic disease than healthy cats. In cats from group 2, only fungal overgrowth was associated with otitis severity. In group 3, only bacterial overgrowth was associated with otitis severity.

Efficacy of spinosad tablets administered to a colony of 15 indoor cats naturally infested with fleas

The aims of the study were (i) to describe adult fleas distribution in a strictly indoor cat colony composed of cats with flea allergy dermatitis (FAD) and non-FAD cats and (ii) to evaluate the efficacy of spinosad used alone. Skin lesions were scored according to the SCORing Feline Allergic Dermatitis lesion severity scale (SCORFAD) on days 0, 15, 30, 45, 60, and 90. Cats were combed prior to the treatment (days 0, 30, and 60) and on days 15, 45, and 90; collected fleas were replaced on the animals. All cats received flavored spinosad tablets (Comfortis) at a dosage of 50-75 mg/kg on days 0, 30, and 60. Cats were fed immediately afterwards. On day 0, a total of 60 fleas were collected (mean: 4 ± 4). Cats with FAD had a SCORFAD of 6, 8, 12, and 13 and harbored 0, 2, 1, and 0 fleas, respectively. Tablets were taken voluntarily by 8, 11, and 12 cats on days 0, 30, and 60, respectively. No adverse event was recorded. From day 15 to day 90, no fleas could be collected. SCORFAD was reduced by 40%, 71%, 80%, 89%, and 98% on days 15, 30, 45, 60, and 90, respectively.

A case of Trichophyton mentagrophytes infection in a fennec fox (Vulpes zerda)

A 2-year-old male fennec fox presented with a 4 month history of nonpruritic, crusty skin lesions on the forehead, the pinnae and the tail tip. Initial investigations, including routine haematology, biochemistry profile, multiple skin scrapings, trichoscopic examination, Wood's lamp examination and fungal culture, failed to reveal any abnormalities. Histopathological examination of a first set of skin biopsies showed an interface dermatitis pattern, with lymphocyte infiltration in the basal layer, a significant lymphocytic exocytosis and occasional apoptotic basal epidermal keratinocytes; periodic acid Schiff stain did not reveal any fungal elements. On further biopsies, there was a pustular neutrophilic dermatitis, with numerous crusts containing high numbers of arthrospores and fungal hyphae. Trichophyton mentagrophytes infection was confirmed on fungal culture and PCR. The fennec fox received oral itraconazole (5 mg/kg once daily for 6 weeks) combined with a miconazole and chlorhexidine shampoo applied on affected areas once weekly, followed with an enilconazole dip. The fox improved dramatically, and a fungal culture performed at 6 weeks was negative. Unfortunately, a few days later the fennec fox developed anorexia, icterus and died. To the authors' knowledge, this is the first report of Trichophyton infection in a fennec fox and, although a postmortem examination was not performed, this is possibly the first report of fatal acute liver failure associated with itraconazole in a canid.