nd
32
ORGANIZED BY ESVD-ECVD-ISVD
ONLINE CONGRESS
16-18 SEPTEMBER 2021
PROCEEDINGS BOOK WWW.ESVD-ECVDCONGRESS.COM
32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
WELCOME
Dear Colleagues and Friends, On behalf of the Organizing Committee, I am very pleased to announce the 32nd European Veterinary Dermatology Congress. For the first time ever, this congress will be held virtually. Initially, it was planned to be held in the exciting city of Porto, Portugal. All of a sudden, the COVID-Pandemic that started at the beginning of 2020 made these plans obsolete. However, a crisis makes creative, and the members of the Scientific Organizing Committee put a lot of time and energy in planning a virtual European Veterinary Dermatology Congress. This year, as in recent ones, we have set up three concurrent sessions of increasing levels of complexity that, we hope, will satisfy attendees of all levels. I do hope that this virtual congress will be an excellent platform for discussing hot topics in the veterinary dermatology field. In the “Practical Programme”, we invited our speakers to provide general practitioners with the latest information on laboratory tests, dermatologic emergencies, feline and equine dermatology, exotics and antimicrobial stewardship. In the “Advanced” and “Cutting Edge” Programmes, we will offer “mini-symposium” sessions on the rapidly-evolving areas of autoimmune diseases, nutrition in dermatology and allergies and clinical immunology. In these, we have selected a comparative approach, having similar topics discussed by renowned academic medical and veterinary dermatologists. An identical format was chosen for autoimmune blistering skin diseases and pathophysiology and treatment of food allergies. In addition, we will have a debate between dermatologists and clinical nutritionists with a discussion on how to best utilize skin diets in atopic dermatitis and other skin diseases. We will also have sessions on a novel, exciting therapeutic modalities in regenerative medicine, focusing on stem cell therapy in the veterinary field. We are delighted that we have been fortunate enough to attract world-renowned speakers in their respective areas to bring you the benefits of their experience and knowledge. It is needless to say that we will also have the traditional short communications and posters as we have always had. In addition, this year’s program will feature the Annual Meeting Day of the International Society of Veterinary Dermatopathology, with topics on the dermatopathology advancements in the field of sebaceous glands and skin tumor markers. I am very excited to see how this virtual 32nd European Veterinary Dermatology Congress will work out, and I wish all of us good luck, exciting learning and motivation for our future meetings. We are very thankful for the support of all sponsors and exhibitors, especially the Gold Sponsors Ceva Santé Animale and Royal Canin. Please do not miss the opportunity to participate and please join us virtually in September 2021.
Dr. Frane Banovic Chair of the Scientific Organizing Committee
32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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COMMITTEES AND KEYNOTE SPEAKERS SPONSORS AND EXHIBITORS
SCIENTIFIC PROGRAMME THURSDAY 16 SEPTEMBER 2021 FRIDAY 17 SEPTEMBER 2021 SATURDAY 18 SEPTEMBER 2021 PROGRAMME INDEX THURSDAY 16 SEPTEMBER 2021 FRIDAY 17 SEPTEMBER 2021 SATURDAY 18 SEPTEMBER 2021
SHORT COMMUNICATIONS
SPONSOR ADVERTISEMENTS CONGRESS SECRETARIAT SAVE THE DATE CONGRESS PORTO PORTUGAL 2022
32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
COMMITTEES
KEYNOTE SPEAKERS
ESVD BOARD MEMBERS
Kerstin Bergvall University of Agriculture, Uppsala, Sweden Kirsten Beyer Charité Universitätsmedizin Berlin, Germany Petra Bizikova NC State University College of Veterinary Medicine, USA Patrick Bourdeau Ecole Vétérinaire de Nantes, ONIRIS, France Vincent Bruet Ecole Vétérinaire de Nantes, ONIRIS, France Patrick Brunner Medical University of Vienna, Austria Martina Dettwiler Vetscope Pathologie Dettwiler, Riehen, Switzerland Hilary Jackson Dermatology Referral Services, UK Annette van der Lee Evidensia-group, Netherlands Anette Loeffler Royal Veterinary College, UK Jaume Martorell Universitat Autònoma de Barcelona, Spain Ralf Mueller Ludwig-Maximilians-University Munich, Germany Georgios Nikolakis Städtisches Klinikum Dessau, Medizinische Hochschule Theodor Fontane, Dessau, Germany Thierry Olivry NC State University College of Veterinary Medicine, USA Laura Ordeix Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Spain Aimee S. Payne University of Pennsylvania, School of Medicine, USA Antonio Villatoro ImmuneStem. Inmunología y Terapia Celular, Málaga, Spain Cecilia Villaverde Expert Pet Nutrition, Ireland
Lucia Panakova (Slovakia), President Claudia Nett (Switzerland), Past-President Katarina Varjonen (Sweden), Secretary Luc Beco (Belgium), Congress Co-ordinator/Venue Finder Robert Cikota (Sweden), Treasurer Sandrine Herbelet (Belgium), Publications & ESVD Grants Peri Lau-Gillard (UK), Further Education & Meetings Secretary Jevgenija Kondratjeva (Latvia), Eastern European meeting coordinator
ECVD BOARD MEMBERS Chiara Noli (Italy), President Monika Linek (Germany), Past-President Marcel Kovalik (France), Vice-President, website Silvia Colombo (Italy), Secretary, Credentials, Member Nina Glos (Germany), Member Domenico Santoro (USA), Member at Large, Ombudsman of examination committee Manolis Saridomichelakis (Greece), Member at Large
ISVD BOARD MEMBERS Monika Welle (Switzerland), President Barbara McMahill (USA), Past-President Stefano Borio (Switzerland), Vice-President Chiara Brachelente (Italy), Secretary Jennifer Ward (USA), Treasurer Nadine Meertens (Netherlands), Board Member at Large Dominique Wiener (USA), Board Member at Large William Craft (USA), Board Member at Large
SCIENTIFIC ORGANIZING COMMITTEE Frane Banovic (Chair) Ana Oliveira Thierry Olivry Niksa Lemo Nina Fischer Ivan Ravera Elisa Maina Jacques Fontaine Ramon Almela Stefano Borio
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SPONSORS AND EXHIBITORS
The Organizing Committee of the 32nd European Veterinary Dermatology Congress, organized by ESVD-ECVD-ISVD gratefully acknowledges contributions:
GOLD SPONSORS
SILVER SPONSORS
BRONZE SPONSORS
DIGITAL BOOTH 6M2 Dermoscent®/LDCA Purina Institute
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME THURSDAY 16 SEPTEMBER 2021 Important note: All timings are Central European Summer Time (CEST) Practical Programme | Room: Auditorium 1 PRURITUS | Chair: Robert Cikota 09:00-09:45 Diagnostic approach to pruritus: comparative aspects between dogs and cats, L. Ordeix (ESP) 09:45-10:30 Therapeutic challenges on canine pruritus: case-based discussion, L. Ordeix (ESP) Advanced Programme | Room: Auditorium 2 HOST-MICROBIAL INTERACTION | Chair: Lucia Panakova 09:00-09:45 MRSP carriage - update and relevance, A. Loeffler (UK) 09:45-10:30 MRSP ‘Decolonisation’ - can it work?, A. Loeffler (UK) Cutting Edge Programme | Room: Auditorium 3
ON ALLERGY AND CLINICAL IMMUNOLOGY | MINI SYMPOSIUM, Chair: Nina Glos 09:00-09:45 Pathogenesis of pediatric food allergy, K. Beyer (DE) 09:45-10:30 Diagnostic approach in pediatric food allergy, K. Beyer (DE) 10:30-11:00 BREAK Practical Programme | Room: Auditorium 1
DERMATOLOGY CONSULTATION - VIRAL DISEASES | Chair: Jevgenija Kondratjeva 11:00-11:45 How to organize a consultation of Dermatology, V. Bruet (FR) 11:45-12:30 Virus of dermatologic interest: how do they affect the skin?, A. van der Lee (NL) Advanced Programme | Room: Auditorium 2 FOOD ALLERGY | Chair: Lucia Panakova 11:00-11:45 Food allergy - Pathogenesis and relevance, R. Mueller (DE) 11:45-12:30 Food allergy - Diagnosis and long-term management, R. Mueller (DE) Cutting Edge Programme | Room: Auditorium 3 ORAL COMMUNICATIONS | Chair: Nina Fischer 11:00-11:15 Transcriptome signatures in peripheral blood and skin cells of dogs with atopic dermatitis, A. Rostaher 11:15-11:30 Prospective, controlled, multicentric and double blinded study of the efficacy of combined treatment of allergen specific immunotherapy and lokivetmab for the treatment of canine atopic dermatitis: pilot study, L. Ramió-Lluch 11:30-11:45 The role of early life exposures to house dust mite allergens and endotoxins in the development of canine atopy: a birth cohort study from West Highland White Terriers, A. Rostaher 11:45-12:00 Dogs with moderate to severe leishmaniosis present an exaggerated allergen-specific IgE immune response, M. Cabré 12:00-12:15 Indirect Immunofluorescence reveals circulating anti-keratinocyte IgG autoantibodies in equine pemphigus foliaceus, M. Mosca 12:15-12:30 Pyoderma gangrenosum in dogs: a retrospective, single-center analysis of 13 cases, M. De Lucia 12:30-13:30 LUNCH Practical Programme | Room: Auditorium 1 EMERGENCY DERMATOLOGY | Chair: Katarina Varjonen 13:30-14:15 Dermatology emergencies: Patchy to diffuse erythroderma and maculo-papular eruptions in a dog (|), P. Bizikova (USA)
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME THURSDAY 16 SEPTEMBER 2021 14:15-15:00 Dermatology emergencies: Patchy to diffuse erythroderma and maculo-papular eruptions in a dog (||), P. Bizikova (USA) Advanced Programme | Room: Auditorium 2 AUTOIMMUNE DISEASES | Chair: Thierry Olivry 13:30-14:15 Update on human autoimmune blistering dermatoses: pemphigus, A. Payne (USA) 14:15-15:00 Update on human autoimmune blistering dermatoses: pemphigoid, A. Payne (USA) Cutting Edge Programme | Room: Auditorium 3
ALLERGY AND CLINICAL IMMUNOLOGY | MINI SYMPOSIUM, Chair: Nina Glos 13:30-14:15 Novel treatments for food allergies in children, K. Beyer (DE) 15:00-15:15 BREAK Practical Programme | Room: Auditorium 1 AUTOIMMUNE DISEASES | Chair: Diana Ferreira 15:15-16:00 Rare autoimmune diseases in dogs: four variants of cutaneous lupus erythematosus, T. Olivry (USA) Advanced Programme | Room: Auditorium 2 JOURNAL CLUB | Chair: Peri Lau-Gillard 15:15-16:00 Ectoparasites and skin: a complex relationship possibly mimicking “allergy”, P. Bourdeau (FR) This lecture is only available in the Download section. Short Communications | Room: Auditorium 3
ORAL COMMUNICATIONS | Chair: Luc Beco 15:15-15:30 Bedlington terriers diagnosed with familial footpad hyperkeratosis are carriers of an FAM83G missense variant, N. Makri 15:30-15:45 A case of environmental allergy and classical Ehlers-Danlos syndrome in a domestic shorthair cat caused by a heterozygous COL5A1 frameshift deletion, U. Mayer 15:45-16:00 Effect of a natural spot-on based on phyto-ceramides, plant-extracted essential fatty acids and essential oils on reconstructed canine epidermis, C. Darmon-Hadjaje 16:00-16:15 BREAK ECVD Annual General Meeting 16:15-18:00 Zoom meeting (only accessible via personal invitation)
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME FRIDAY 17 SEPTEMBER 2021 Practical Programme | Room: Auditorium 1
HOST-MICROBIAL INTERACTION | Chair: Ana Oliveira
This session is kindly sponsored by
09:00-09:45 Opportunities for good antimicrobial stewardship: managing pyoderma in dogs and cats, A. Loeffler (UK) 09:45-10:30 How to deal with recurrent pyoderma - any new magic?, A. Loeffler (UK) Advanced Programme | Room: Auditorium 2 NUTRITION IN DERMATOLOGY | Chair: Claudia Nett 09:00-09:45 Review of nutrition and its role in skin barrier function, C. Villaverde (IRL) 09:45-10:30 Guide to home cooked diets for elimination diet trials, pros, cons and what mistakes to avoid, C. Villaverde (IRL) Cutting Edge Programme | Room: Auditorium 3 ORAL COMMUNICATIONS | Chair: Tiago Carrapiço 09:00-09:15 Characterization of clinical phenotype (cutaneous lesion score and central sensitization) and comparison of serological allergen-specific IgE and intradermal testing in a colony of atopic-like cats, J. Lefrançois 09:15-09:30 Allermmune® immunotherapy in Feline Atopic Syndrome (FAS), F. Martini 09:30-09:45 Development and validation of an owner-assessed visual analogue scale (VAScat) for feline pruritus severity scoring, S. Borio 09:45-10:00 In healthy dogs, the middle ear microbiota is similar to that of the external ear canal, C. Leonard 10:00-10:15 Ear inflammation and hearing measurements: taking advantage of preclinical tools to assess the Tolerance of otic products, A. Marie 10:15-10:30 The efficacy of subcutaneous slow-release melatonin implants in the prevention of Canine Flank Alopecia recurrence: a double-blind, randomized, placebo-controlled study, M. Verschuuren 10:30-11:00 BREAK Practical Programme | Room: Auditorium 1 DIAGNOSTIC TESTING | Chair: Chiara Noli 11:00-11:45 Laboratory test as diagnostic tool in veterinary dermatology, V. Bruet (FR) 11:45-12:30 In house testing for general practitioners, V. Bruet (FR) Advanced Programme | Room: Auditorium 2 STEM CELL THERAPY | Chair: Carolina Mesquita 11:00-11:45 Regenerative medicine and cell therapy in veterinary field, A. Villatoro (ESP) 11:45-12:30 Stem cell therapy as strategy in immune-mediated diseases: indications and clinical cases, A. Villatoro (ESP) Cutting Edge Programme | Room: Auditorium 3 ORAL COMMUNICATIONS | Chair: Manolis Saridomichelaki 11:00-11:15 Epicutaneous immunotherapy as a novel route of allergen administration in dogs with atopic dermatitis: a proof of concept study, M. Pinto 11:15-11:30 Side effects in cats treated with subcutaneous allergen-specific immunotherapy: results of a worldwide survey of 116 veterinarians, A. Zuzzi-Krebitz 11:30-11:45 Oclacitinib alternative, off-label protocol for canine atopic dermatitis: can cost be reduced? A. Bizarro 11:45-12:00 Stability of the n-acetylcysteine (NAC) with Tris-EDTA solution and in combination with dexamethasone sodium phosphate in aqueous solution for 50 days, G. Ghibaudo 12:00-12:15 The comparative cerumenolytic activity of otic preparations, an in vitro study, G. Ghibaudo
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME FRIDAY 17 SEPTEMBER 2021 12:30-13:30 LUNCH Practical Programme | Room: Auditorium 1 DERMATOPHYTOSIS | Chair: Niksa Lemo 13:30-14:15 Dermatophytosis in dogs and cats: arriving where we started, A. van der Lee (NL) Advanced Programme | Room: Auditorium 2 SKIN BIOLOGY | Chair: Frane Banovic 13:30-14:15 Transcriptome applications in dermatology, P. Brunner (AT) Cutting Edge Programme | Room: Auditorium 3 ORAL COMMUNICATIONS | Chair: Diana Ferreira 13:30-13:45 Single myringotomy in the treatment of middle ear otitis in the cat : a retrospective study, P. Prelaud 13:45-14:00 Topical application of a combination of piperonyl butoxide with permethrin and prednisolone acetate for the treatment of Psoroptes cuniculi in naturally infected rabbits, R. Heredia 14:00-14:15 Comparison of scratching severity by owner completed PVAS to Whistle canine collar, A. Carson 14:15-14:45 BREAK Practical Programme | Room: Auditorium 1 EXOTIC DERMATOLOGY | Chair: Ivan Ravera 14:45-15:30 How to approach feather picking in psittacines, J. Martorell (ESP) Advanced Programme | Room: Auditorium 2 AUTOIMMUNE DISEASES | Chair: Thierry Olivry 14:45-15:30 Autoimmune subepidermal blistering skin diseases in animals: An update, P. Bizikova (USA) Cutting Edge Programme | Room: Auditorium 3 ORAL COMMUNICATIONS | Chair: Domenico Santoro 14:45-15:00 Transcriptome profiling of spontaneous canine atopic dermatitis lesional and non-lesional skin using deep RNA sequencing, A. Blubaugh 15:00-15:15 Development of a qPCR for the detection of Chorioptes spp in equine skin scrapings, K. Bergvall 15:15-15:30 Characterization of the pro-inflammatory and pruritogenic transcriptome in equine insect bite hypersensitivity, F. Banovic 15:30-15:45 BREAK Practical Programme | Room: Auditorium 1 WAVD | Chair: Susan Paterson 15:45-16:30 Equine Allergic Skin Diseases: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, R. Marsella 16:30-17:15 Canine Otitis Externa-Best Clinical Practices: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, J. Noxon ESVD Annual General Meeting 17:45-19:00 Zoom meeting (only accessible via personal invitation)
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME SATURDAY 18 SEPTEMBER 2021 Practical Programme | Room: Auditorium 1 FELINE DERMATOLOGY | Chair: Marcel Kovalik 09:00-09:45 Clinical manifestation of overgrooming: clinical implications on feline dermatology, L. Ordeix (ESP) 09:45-10:30 Diagnostic approach to symmetrical alopecia: comparative aspects between dogs and cats, L. Ordeix (ESP) Advanced Programme | Room: Auditorium 2
ALLERGY AND CLINICAL IMMUNOLOGY | Chair: Monika Linek 09:00-09:45 Pathogenesis, progression and treatments in early-onset pediatric atopic dermatitis, P. Brunner (AT) 09:45-10:30 Pathogenesis, progression and treatments in longstanding adult atopic dermatitis, P. Brunner (AT) ISVD Annual Meeting Day | Room: Auditorium 3 SKIN BIOLOGY | Chair: Stefano Borio 09:00-09:45 Sebaceous gland: biology and physiology, G. Nikolakis (DE) 09:45-10:30 Sebaceous gland pathology, G. Nikolakis (DE) 10:30-11:00 BREAK Practical Programme | Room: Auditorium 1 EXOTIC DERMATOLOGY | Chair: Silvia Colombo 11:00-11:45 Main skin disorders in rabbits, J. Martorell (ESP) 11:45-12:30 Dermatitis and dysecdysis in reptiles, J. Martorell (ESP) Advanced Programme | Room: Auditorium 2 AUTOIMMUNE DISEASES | Chair: Thierry Olivry 11:00-11:45 Canine and feline pemphigus (I), P. Bizikova (USA) 11:45-12:30 Canine and feline pemphigus (II), P. Bizikova (USA) ISVD Annual Meeting Day | Room: Auditorium 3 GENERAL | Chair: Monika Welle 11:00-12:00 Diagnostic dilemmas, C. Brachelente, M. Peleteiro 12:00-12:30 ISVD Grant 2019 Presentation, M. Dettwiler (SWI) 12:30-13:30 LUNCH Practical Programme | Room: Auditorium 1 EQUINE DERMATOLOGY | Chair: Sandrine Herbelet 13:30-14:15 Allergy testing in horses, K. Bergvall (SWE) 14:15-15:00 How to manage equine pruritus, K. Bergvall (SWE) Advanced Programme | Room: Auditorium 2 NUTRITION IN DERMATOLOGY | Chair: Elisa Maina 13:30-15:00 Skin diets: what makes them special for atopic dermatitis and beyond (audience participation), C. Villaverde (IRL), R. Mueller (DE), H. Jackson ISVD Annual Meeting Day | Room: Auditorium 3 SUPPORTING LECTURE | Chair: Barbara McMahill and William Craft 13:30-14:15 Skin tumour markers, what’s new?, M. Dettwiler (SWI) 14:15-15:00 Mystery Slides, B. McMahill, C. Ganta, D. Wiener
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SCIENTIFIC PROGRAMME SATURDAY 18 SEPTEMBER 2021
15:00-15:30 BREAK Practical Programme | Room: Auditorium 1 EAR INFECTIONS | Chair: Ramon Almela 15:30-16:15 Listen up! A step-by step approach to the diagnosis of ear infections in dogs, A. van der Lee (NL) 16:15-17:00 How to treat ear infections in dogs: where do we stand?, A. van der Lee (NL) ISVD Annual General Meeting 16:45-17:30 Zoom meeting (only accessible via personal invitation)
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PROGRAMME INDEX THURSDAY 16 SEPTEMBER 2021 PRACTICAL PROGRAMME ➔ Diagnostic approach to pruritus: comparative aspects between dogs and cats, L. Ordeix ➔ Therapeutic challenges on canine pruritus: case-based discussion, L. Ordeix ➔ How to organize a consultation of Dermatology, V. Bruet ➔ Virus of dermatologic interest: how do they affect the skin?, A. van der Lee ➔ Dermatology emergencies: Patchy to diffuse erythroderma and maculo-papular eruptions in a dog (I) and (II), P. Bizikova ➔ Rare autoimmune diseases in dogs: four variants of cutaneous lupus erythematosus, T. Olivry
ADVANCED PROGRAMME ➔ MRSP carriage - update and relevance, A. Loeffler ➔ MRSP ‘Decolonisation’ - can it work?, A. Loeffler ➔ Food allergy - Pathogenesis and relevance, R. Mueller ➔ Food allergy - Diagnosis and long-term management, R. Mueller ➔ Update on human autoimmune blistering dermatoses: pemphigus, A. Payne ➔ Update on human autoimmune blistering dermatoses: pemphigoid, A. Payne ➔ Ectoparasites and skin: a complex relationship possibly mimicking “allergy”, P. Bourdeau
CUTTING EDGE PROGRAMME ➔ Pathogenesis of pediatric food allergy, K. Beyer ➔ Diagnostic approach in pediatric food allergy, K. Beyer ➔ Novel treatments for food allergies in children, K. Beyer
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PROGRAMME INDEX FRIDAY 17 SEPTEMBER 2021 PRACTICAL PROGRAMME ➔ Opportunities for good antimicrobial stewardship: managing pyoderma in dogs and cats, A. Loeffler ➔ How to deal with recurrent pyoderma – any new magic? A. Loeffler ➔ Laboratory test as diagnostic tool in veterinary dermatology, V. Bruet ➔ In house testing for general practitioners, V. Bruet ➔ Dermatophytosis in dogs and cats: arriving where we started, A. van der Lee ➔ How to approach feather picking in psittacines, J. Martorell ➔ Equine Allergic Skin Diseases: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, R. Marsella ➔ Canine Otitis Externa-Best Clinical Practices: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, J. Noxon
ADVANCED PROGRAMME ➔ Review of nutrition and its role in skin barrier function, C. Villaverde ➔ Guide to home cooked diets for elimination diet trials, pros, cons and what mistakes to avoid, C. Villaverde ➔ Regenerative medicine and cell therapy in veterinary field, A. Villatoro ➔ Stem cell therapy as strategy in immune-mediated diseases: indications and clinical cases, A. Villatoro ➔ Transcriptome applications in dermatology, P. Brunner ➔ Autoimmune subepidermal blistering skin diseases in animals: An update, P. Bizikova
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PROGRAMME INDEX SATURDAY 18 SEPTEMBER 2021 PRACTICAL PROGRAMME ➔ Clinical manifestation of overgrooming: clinical implications on feline dermatology, L. Ordeix ➔ Diagnostic approach to symmetrical alopecia: comparative aspects between dogs and cats, L. Ordeix ➔ Main skin disorders in rabbits, J. Martorell ➔ Dermatitis and dysecdysis in reptiles, J. Martorell ➔ Allergy testing in horses, K. Bergvall ➔ How to manage equine pruritus, K. Bergvall ➔ Listen up! A step-by step approach to the diagnosis of ear infections in dogs, A. van der Lee ➔ How to treat ear infections in dogs: where do we stand?, A. van der Lee
ADVANCED PROGRAMME ➔ Pathogenesis, progression and treatments in early-onset pediatric atopic dermatitis, P. Brunner ➔ Pathogenesis, progression and treatments in longstanding adult atopic dermatitis, P. Brunner ➔ Canine and feline pemphigus (I) and (II), P. Bizikova ➔ Skin diets: what makes them special for atopic dermatitis and beyond (audience participation), C. Villaverde, R. Mueller, H. Jackson
ISVD ANNUAL MEETING DAY ➔ Sebaceous gland: biology and physiology, G. Nikolakis ➔ Sebaceous gland pathology, G. Nikolakis ➔ Diagnostic dilemmas, C. Brachelente, M. Peleteiro ➔ ISVD Grant 2019 Presentation, M. Dettwiler ➔ Skin tumour markers, what’s new?, M. Dettwiler ➔ Mystery Slides, B. McMahill, C. Ganta, D. Wiener
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 DIAGNOSTIC APPROACH TO PRURITUS: COMPARATIVE ASPECTS BETWEEN DOGS AND CATS L. ORDEIX Dermatology service, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain Departament de Medicina and Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain During the diagnostic process, diagnostic hypotheses are generated based on the knowledge of the diseases that manifest themselves in a certain clinical pattern or problem. Subsequently, a probability of occurrence is assigned to each of them based on other factors such as the prevalence of the disease and the clinical history data. This order of probability is adjusted until a single, ideally definitive diagnosis is reached based on the information obtained from the diagnostic tests. Some dermatologic problems defined both in cats and dogs share morphological characteristics, causes and the diagnostic protocol between species. Although causes of cutaneous pruritus and diagnostic protocol are similar between dogs and cats, clinical manifestations are different. Dogs generally display itch clinically by scratching anywhere they can reach. However, they may also manifest pruritus by biting and less frequently by licking, sucking, rubbing or rolling. On the other hand, cats use to lick, chew their hair, and less common to bit themselves, in addition of scratching. Therefore, due to these different behaviors, prevalence and type of cutaneous lesions secondary to pruritus are different among species. Dogs commonly present alopecia secondary to scratching while erosions and ulcers are seen after licking or biting (typically in pressure points). On the other hand, cats show deep and wide ulcers and/or linear excoriations after scratching, symmetric alopecia after hair-licking or chewing and multifocal alopecia after hair-pulling. Distribution of cutaneous lesions in pruritic cats overlap grooming. That is, cats manifest facial alopecia secondary to intense “face washing” and symmetric alopecia or multifocal alopecia in the trunk and extremities by licking, chewing or biting their pelage and skin surface. Moreover, ulcerative dermatitis of the neck and/or head is observed after scratching. Another difference among species is the high prevalence of liquenification, hyperpigmentation and scaling seen in dogs with chronic pruritus. The higher prevalence of secondary infections (bacterial and yeast) observed in dogs than in cats may account for that distinction. Feline dermatology is characterized by clinical polymorphism. In fact, many pruritic diseases present similarly in the cat. Therefore, contrary to what occurs in dogs, dermatological patterns observed in cats with pruritus are less suggestive of the underlying cause of pruritus. This is particularly true when itch is associated with primarily non-inflamed skin and clinical signs observed would be only those associated to behaviour-response evoked. For example, both allergic dermatitis and ectoparasitic diseases may cause symmetric auto-induced alopecia or head and/or neck auto induced ulcerative dermatitis. Moreover, noncutaneous induced pruritus (i.e. neuropathic origin) and overgrooming (i.e. behaviour origin) should be considered as eventual causes of auto-induced lesions as well. The diagnostic protocol for this skin problem is similar in dogs and cats. The first step is to rule out all non-allergic diseases being sarcoptic mange and dermatofitosis the main differentials in dogs and cats, respectively. The second objective is to identify and control any aggravating factor of allergic pruritus. Contrary to what occurs in the dog, skin infections seem to have an uncertain role in itching of allergic origin in the cat. Conflict of interest: The author has declared no conflict of interest for this lecture.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 THERAPEUTIC CHALLENGES ON CANINE PRURITUS: CASE-BASED DISCUSSION L. ORDEIX Dermatology service, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain Departament de Medicina and Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain Pruritus is an unpleasant skin sensation that triggers the dog’s desire to scratch, rub, lick or bite itself or shake its head. It is usually associated with an inflammatory skin disease commonly of allergic basis. However, pruritus in dogs can also have nondermatologic causes, such as neurologic or psychogenic. Therefore, the first challenge in the management of canine pruritus will be to correctly diagnose the disease that causes pruritus, in order to be treated by choosing drugs that act on the pathogenesis of such disease. The dermatologic diseases commonly associated with pruritus in the dog are inflammatory and less frequently neoplastic (in particular epitheliotropic cutaneous lymphoma). Sarcoptic mange and allergic dermatitis, especially atopic dermatitis, are the most frequent causes of dermatologic pruritus. Atopic dermatitis is a chronic inflammatory disease with a very complex pathogenesis involving different pruritic mechanisms. In fact, atopic itch is likely due to the combined action of multiple pruritogens in the skin originated from a complex interaction between keratinocytes, inflammatory cells, nerve endings and the skin microbiota. Due to the multifactorial nature of this disease, management frequently requires a multimodal approach to reduce skin inflammation and decrease pruritus below the threshold of clinical signs. Control of atopic itch will include the use of antipruritic drugs with a broader action (such as glucocorticoids and cyclosporine mainly) that suppress the cellular release of pruritus mediators or the use of drugs with a more restricted activity that block the action of some specific pruritus mediators (e.g., oclacitinib or lokivetmab). It is a therapeutic challenge to decide which therapeutic modality is the most appropriate on a case-by-case basis. In addition, colonization, overgrowth and subsequent infection by Staphylococcus pseudintermedius and Malassezia pachydermatis is also frequently observed in canine atopic dermatitis, where it contributes to the intensity of cutaneous inflammation and pruritus. Therefore, antimicrobial resistance in atopic dogs may be considered an additional therapeutic challenge in the management of atopic itch. Throughout this talk, cases of dogs showing scratching and/or licking behaviors associated with several dermatologic and nondermatologic itching diseases will be presented. Conflict of interest: The author has consulted for and/or received lecturing honorarium from the following companies marketing products mentioned in this lecture: Zoetis, Elanco, Ceva.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 HOW TO ORGANIZE A CONSULTATION OF DERMATOLOGY V. BRUET Ecole Vétérinaire de Nantes ONIRIS, France Skin problems are a frequent reason for owners to change veterinarians. So, to be good in Dermatology, you need to be organized, rigorous, even with simple cases. This approach should be applied to every animal you treat to calibrate your mind, to obtain a maximum amount of information and finally to obtain an accurate diagnosis and to treat the animal accurately. Have time to do all the steps of the consultation well: detailed history, physical examination, skin examination, diagnostic tests, explanation of the disease, the treatment and the follow-up. Thirty, sixty minutes is necessary to do that. Depending on your organization, we can carry out all of the procedures in one consultation or divide it up into different sections, using different formats (face-to-face, phone, internet), involving different professionals (veterinarian, nurse). You should acquire detailed history thanks to a set of closed questions about the signalment, date of onset, progression of the disease, first locations, past episodes, lifestyle, contagiousness (human being, animal), presence of other animals, past treatments (molecule, duration, dose, efficacy), travels, quantification of pruritus (with a scale) and qualification of pruritus (primary versus secondary pruritus), food, appetite, thirst, antiparasitic treatment (molecule, frequency of use, treatments of other animals, management of blankets), past diseases (including otitis). Primary pruritus is the observation of pruritus before the observation of lesions by the owner. Secondary pruritus is the contrary. With primary pruritus often the causes are ectoparasitic (except demodicosis), allergic and sometimes neoplastic, neurologic, behavioral skin diseases. With secondary pruritus, all the causes are possible. Take time carry out a good physical examination; some of the skin diseases are systemic diseases. Do a detailed examination of the entire skin surface and also of the ear canals for all your cases. All the lesions are noted and located. Papules, pustules are common lesions. Their presences are mainly due to infectious, parasitic diseases. So never use glucocorticoids in these cases without any definitive diagnosis. List the differential diagnosis. The differential diagnosis is the result of the confrontation between the theory (monography of the skin diseases) and the real case (all the clues obtained by history, examinations). Confirm or rule out hypothesis by diagnostic tests. The most important tests are carried out and read in your practice: Wood’s lamp, skin scrapings, ear curettage, trichoscopy, cytology. Never stop your diagnostic examination with a first positive result because often there are several associated diseases in the same animal (ex: bacterial pyoderma, demodicosis, hypothyroidism). When scientific work is over, the last step is to communicate with the owners. It is a fundamental step. Some of the most frequent skin and ear diseases are chronic. You need to explain the disease, the necessity of a follow-up, to explain the next step of the follow-up, to adapt the treatment to the animal’s behavior and to the owner’s life style. You have to explain, to show how to treat (shampoo, ear treatment, spot-on application…). Follow-up is crucial to cure a chronic skin disease. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 VIRUS OF DERMATOLOGIC INTEREST: HOW DO THEY AFFECT THE SKIN? A. VAN DER LEE Evidensia-group, Netherlands Cutaneous viral dermatoses are not so often diagnosed in cats and dogs. One explanation for this, is that they are considered to be rare. Another explanation is that they are difficult to identify. Hence, underdiagnosis may occur, although many of the recognized viral skin infections have a characteristic clinical appearance. The most commonly seen viral dermatoses in clinical practice are papillomavirus-associated dermatoses. Papillomaviruses belong to the Papovavirus family and are small doublestranded DNA viruses. They are predominantly species-specific and normally invade the damaged skin or mucous membrane after direct contact. They infect keratinocytes in the stratum basale, undergo genome replication in the spinous and granular layers and release new infectious virus in keratinized squames. The incubation time in general will vary between 4 to 8 weeks. Depending on the virus type and site of infection, the clinical appearance of papillomatosis may differ from exophytic, inverted, pigmented plaques, cutaneous horns or oral warts. The common histologic features are epidermal hyperplasia and koilocytosis with intranuclear basophilic inclusion bodies. A papillomavirus dermatosis may slowly undergo transmission into malignancy. The virus has been detected in squamous cell carcinomas (SCC) and feline Bowenoid in-situ carcinoma (intraepithelial neoplasia). The early genes (E genes) of the papilloma virus are involved in regulation of viral DNA replication, amongst which are the E6 and E7 oncogenes. These oncogenes are responsible for keeping host cells in an immortal state, inducing cell growth and promoting chromosomal instability in the host cell by degrading the tumor suppressor protein p53. In this way, intraepithelial neoplasia with full epidermal hyperplasia may gradually spread, also known as field cancerisation. From here, progression into SCC is characterized by acquisition of mutations and loss of papillomavirus replication. Other viruses capable of causing dermatitis are herpesvirus, calicivirus, poxvirus, distempervirus and feline leukemia virus. Existing therapies for cutaneous viral dermatoses include the use of the antiviral agents famciclovir, L-lysine, recombinant IFN-Ω and the topical formulation imiquimod. Lasertherapy or surgical excision may be indicated. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 DERMATOLOGY EMERGENCIES: PATCHY TO DIFFUSE ERYTHRODERMA AND MACULOPAPULAR ERUPTIONS IN A DOG P. BIZIKOVA Department of Clinical Sciences, College of Veterinary Medicine North Carolina State University, USA True dermatological emergencies are serious and often life-threatening conditions in which an early recognition and initiation of a proper treatment play an important role in the patient’s chance to survive. Additionally, many other skin diseases are considered emergencies by the owner because of the acute onset, nature of the skin lesions, their rapid progress and/or patient’s discomfort. These two lectures will discuss diseases presenting initially with patchy to diffuse erythroderma, and diseases in which erythroderma is accompanied by the formation of papules and/or plaques. 1. Stevens-Johnson syndrome (SJS), Toxic epidermal necrolysis (TEN) & overlap These conditions present a spectrum of life-threatening drug-reactions characterized by rapid onset of painful and erythematous skin progressing to epidermal necrosis and deep erosion formation. Mucosae and mucocutaneous junctions are frequently (but not always) involved. The degree of epidermal detachment dictates the final diagnosis. Systemic signs such as fever, lethargy and anorexia are common. Drug administration usually precedes the skin lesions by 1-3 weeks, and variety of drugs have been implicated in dogs (phenobarbital, carprofen, amoxicillin, sulfonamides, penicillin, cephalosporines, etc.). The pathomechanisms of the epithelial necrosis involve apoptosis via cytotoxic T cells and their products such as perforin, granzyme B and granulysin, keratinocyte upregulation of Fas and Fas-ligand, activation of necroptosis pathway via annexin A1, and others. Stevens-Johnson syndrome, the overlap and TEN are usually managed by the dermatologist as well as internist/ criticalist. Supportive measures include identification and removal of the offending drug, admission to an intensive care unit (or burn unit if available), proper fluid replacement, prevention of hypothermia, monitoring for sepsis and organ failure, etc. Supportive therapy is one of the most critical aspects of the treatment. Intravenous glucocorticoids and cyclosporine are often used as a first line treatment in veterinary medicine. The use of intravenous immunoglobulins has been reported in veterinary medicine but, like in people, their benefit, especially when considering the price, remains unconfirmed. 2. Necrotizing soft tissue infections Necrotizing soft tissue infections can rapidly progress into life-threatening conditions. Early identification is critical and can affect the patient’s chance to survive. Necrotizing soft tissue infections can be caused by a traumatic inoculation or hematogenous seeding of the bacteria. Initial skin lesions involve severe pain with focal or more diffuse erythema to purpura. Edema and, later pustules, hemorrhagic vesicles/bullae and necrosis follow the initial skin lesions. Systemic signs such as fever, lethargy and anorexia are common. Progression to sepsis may occur in untreated. Rapid identification of the condition and of the potential source of infection, cytology and bacterial culture are important steps in the diagnostic process. Surgical debridement of the necrotic tissue, early antibiotic treatment (empirical based on the patient’s history and cytology; consider following The Infectious Disease Society of America guidelines) and supportive therapy (if needed). 3. Canine acute eosinophilic dermatitis with edema (CAEDE; Wells-like syndrome) CAEDE is a rare skin disorder frequently associated with a history of moderate to severe gastrointestinal disease. Skin lesions may become apparent during or after the GI disease and drug reaction as the trigger has been suggested. Skin lesions include bright, erythematous macules, papules and plaques often affecting ventral body (axillae, groin, caudal abdomen, pinnae). Systemic signs, if present, are mild and often related to the GI disease. Pruritus is usually not reported. Diagnosis is based on the patient’s history, clinical signs and histopathology. Cytology from the papules can be attempted to demonstrate the
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PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 eosinophilic nature. Treatment involves discontinuation of drugs administered shortly before the disease development, oral glucocorticoids (antihistamines can be used concurrently). 4. Sterile neutrophilic dermatitis (Sweet’s-like syndrome; SLS) Sterile neutrophilic dermatitis is a rare skin disorder that overlaps clinically as well as histologically with CAEDE. In contrast to CAEDE, the maculo-papular erythroderma is often associated with pustules and erosions. Dogs with SLS often exhibit systemic signs such as fever, polyarthritis, pneumonia, etc.) and often require a hospitalization and intense care. Diagnosis is based on clinical signs and histopathology; both can overlap with CAEDE. Treatment involves discontinuation of drugs administered shortly before the disease development, oral glucocorticoids and supportive treatment (if needed). The etiology of SLS remains unknown, though drug-reaction has been suggested. It also remains unknown if SLS is its own entity or if SLS and CAEDE are a spectrum of the same disease. 5. Sterile pustular erythroderma of miniature schnauzers (SSND) SSND is a rare condition with clinical and histological features overlapping those of SLS. It has been described in miniature schnauzers shortly (within 48 hours) after a bath with various shampoos. The association with the shampoo was also shown by Murayama and colleagues via a patch test. Severe systemic signs requiring hospitalization are often present. Treatment includes oral glucocorticoids and supportive treatment. Hospitalization is often necessary. 6. Toxic shock syndrome (TSS) TSS is a rare disease similar to that seen in people. Cutaneous manifestations of TSS in dogs include maculo-papular erythroderma. With time pustule formation and erosions become apparent. Marked edema, especially distal limbs, has been described as well. In addition to the skin, dogs with TSS exhibit severe clinical signs associate with TSS (fever, hypotension, involvement of visceral organs such as liver, kidney, bone marrow, muscle and/or central nervous system, DIC). Intensive care is necessary to manage affected individuals together with a proper antibiotic treatment and identification of the source of infection. In addition to these true dermatological emergencies, other conditions in which the early lesions present as erythematous papules, and which often require an immediate attention of the veterinarian due to the patient’s discomfort will also be discussed in this lecture. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 RARE AUTOIMMUNE DISEASES IN DOGS: FOUR VARIANTS OF CUTANEOUS LUPUS ERYTHEMATOSUS T. OLIVRY Department of Clinical Sciences, College of Veterinary Medicine North Carolina State University, USA Autoimmune skin diseases (AISDs) are rare canine dermatoses, and they are broadly divided between diseases with autoantibodies against desmosomes (i.e., pemphigus) or basement membrane antigens (pemphigoids and similar diseases), and those with lymphocytes targeting epidermal keratinocytes (e.g., cutaneous lupus), melanocytes (vitiligo, uveodermatological syndrome) or adnexae (e.g., alopecia areata, sebaceous adenitis). In the 1980s, skin lesions of lupus erythematosus (LE) were thought to occur either alone (facial discoid LE, FDLE), or in the context of systemic lupus erythematosus (SLE). In the last two decades, we have expanded on the number of cutaneous lupus (CLE) variants, which now include five distinct entities sharing the common histopathologic pattern of a lymphocyte-rich interface dermatitis. In this lecture, starting with the presentation of a typical case, we will review the clinical, microscopic, immunologic, and treatment characteristics of vesicular CLE (VCLE), exfoliative CLE (ECLE), mucocutaneous LE (MCLE) and generalized DLE (GDLE).
Vesicular Cutaneous Lupus Erythematosus Rough collies, Shetland sheepdogs and border collies are so far the only three (related) breeds reported to be affected with VCLE. Females and males of adult age are equally affected. Signs are often worse during sunny times, as the skin lesions appear uniquely photosensitive. These consist of erythematous macules that expand centrifugally to form annular, polycyclic or serpiginous patterns. The lesions often erode or ulcerate, after the rupture of transient, non-tense, blistes. Lesions are seen predominantly in poorly-haired areas of the abdomen, medial thighs, axillae and concave pinnae, but erosions are also seen on the lips, periocularly and perianally. There are normally no systemic signs, and this form does not progress to SLE. Histologically, basal keratinocytes are killed by cytotoxic T cells, and the vacuolar degeneration of these cells becomes confluent to form transient intra-basal blisters. Immunologically, there are autoantibodies that target extractable nuclear antigens of the Ro/La family, which, in humans, are expressed by keratinocytes following sun exposure. At this time, the treatment of choice consists of high-dose oral glucocorticoids and calcineurin inhibitors like ciclosporin. The lesions often will recur, especially during the summer month. Canine VCLE is homologous to subacute cutaneous lupus erythematosus (SCLE) of humans. Exfoliative Cutaneous Lupus Erythematosus Canine ECLE affects predominantly German shorthaired pointers and some related breeds like Magyar Viszlas. The age of onset is in the very young adulthood, often after puberty. Females appear twice more often affected than males. Lesions consist of erythema, alopecia, follicular casts and scaly plaques that are present anywhere on the body. There are often systemic signs, such as lameness, lymphadenopathy, thrombopenia and infertility. Overt SLE can develop in older dogs. Histologically, in addition of the typical lymphocytic interface dermatitis, there is an interface folliculitis and a sebaceous adenitis that results in the disappearance of sebaceous glands. Immunologically, there are also autoantibodies targeting adnexae. This variant of CLE has a poor prognosis, and an aggressive immunosuppression with glucocorticoids and cytotoxics is warranted. Canine ECLE is a genetic disease with an autosomal recessive mode of transmission. A mutation in a gene hyperactivating the innate immune system (UNC93B1, a negative regulator of TLR7) has been discovered recently; there is yet no known human equivalent. Mucocutaneous Lupus Erythematosus Canine MCLE affects primarily German and Belgian shepherd dogs, with females outnumbering males; it is a disease of older adults. The first signs are pain when defecating and urinating, and this is associated with erosions on the anal, perianal and perigenital areas. Perioral, perinasal and periocular regions are also often affected. Lesions minimally affect mucosae.
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PRACTICAL PROGRAMME THURSDAY 16 SEPTEMBER 2021 The microscopic and immunologic findings are typical of a chronic CLE. The initial treatment of choice consists of oral ± topical glucocorticoid therapy. In case of mild lesions, treatment can be attempted with a doxycycline-nicotinamide/niacinamide combination. The prognosis is good, but lesions are chronically-relapsing. Canine MCLE does not appear to have a feline or human homologue.
Generalized Discoid Lupus Erythematosus Canine GDLE can affect any breed, but Chinese crested dogs appear over-represented, perhaps due to their poorly-haired skin. Females and males are equally seen; this is a disease of older dogs. The lesions affect predominantly the trunk, abdomen and limbs. They consist of round or polycyclic plaques with variable atrophic scarring, scaling and dyspigmentation. Erosions are much less common than in VCLE and MCLE. Lesions can be seen also on the face, but rarely. In most dogs, systemic signs are absent. The microscopic and immunologic findings are typical of a chronic CLE. Low levels of antinuclear antibodies can be seen, and the progression to SLE has been reported. The initial treatment of choice consists of oral ± topical glucocorticoid therapy with calcineurin inhibitors such as ciclosporin or tacrolimus. As in MCLE, treatment can be attempted with a doxycycline-nicotinamide/niacinamide combination, when lesions are mild. The prognosis is good, but lesions are chronicallyrelapsing. This GDLE variant has been reported in cats, horses, and humans. Conflict of interest: None relevant
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 MRSP CARRIAGE – UPDATE AND RELEVANCE A. LOEFFLER Royal Veterinary College United Kingdom Meticillin-resistant Staphylococcus pseudintermedius (MRSP), in line with the opportunistic nature of other staphylococci, also has the ability to colonise healthy mucosae and skin as part of a dog’s normal microflora. MRSP carriage has been reported in less than 10% of healthy dogs in various screening studies but is thought to be more common in dogs that have recovered from MRSP infection. While asymptomatic, such carriage poses three challenges: a) it contributes to the spread of MRSP to other dogs through direct or indirect transmission, b) carrier dogs may pose a risk to in-contact humans through zoonotic transmission if humans are immunocompromised or present with wounds or other breaks in skin barrier function and c) MRSP carrier dogs are themselves at increased risk of subsequent MRSP infection should the opportunity for invasive disease arise. In humans, S. aureus nasal carriage has long been recognised as a major risk factor for subsequent S. aureus infection and has become an area of extensive research in efforts to prevent infections due to methicillin-resistant S. aureus (MRSA). S. pseudintermedius carriage isolates have been shown to be identical to those from pustules found amongst pyoderma lesions on the same dog and MRSP carriage was identified as a risk factor for MRSP surgical site infections after tibial plateau levelling osteotomy (TPLO). Typical carriages sites are the nasal and oral mucosae, the conjunctivae, prepuce/vulva and perianal skin and sensitivities and best carriage screening methods have been identified for dogs. However, recommendations on usefulness and frequency of carriage screening remain less clear while management strategies for MRSP remain controversial. Available published data on MRSP carriage in dogs will be outlined alongside data from the widely studied area of MRSA carriage in humans in order to identify areas of relevance for extrapolation. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 MRSP ‘DECOLONISATION’ – CAN IT WORK? A. LOEFFLER Royal Veterinary College United Kingdom Decolonisation, which in the context of e.g. MRSA human carriage refers to the elimination of MRSA from healthy carriage sites, aims to reduce the spread of multidrug-resistant (MDR) bacteria in order to reduce infections due to MDR bacteria and their spread in healthcare facilities and in the community. Decolonisation can occur naturally where hosts lose their MDR carriage isolates over time and get re-colonised with more susceptible, fitter staphylococci, typically when selective pressure from antimicrobial therapy remains absent. Or decolonisation can be attempted with antibacterial drugs, mainly topically applied. Many clinical studies have shown efficacy for e.g. chlorhexidine and mupirocin amongst other agents in human MRSA carriers but many patients subsequently re-acquire MRSA and the effect is thought to be short lived. In addition, the use of antimicrobials in essentially healthy individuals raises ethical concerns that need to be weighed against the benefit in reduced spread and improved clinical outcomes from decolonisation. Strategies for decolonisation of MRSP carrier dogs could help to limit the spread of this veterinary nosocomial pathogen amongst dogs, their owners and in veterinary facilities and potentially improve the prognosis of some bacterial infections in dogs and thus improve welfare. Studies on MRSP decolonisation strategies have not been published to date but S. (pseud)intermedius could be eliminated from carriage sites of healthy beagles by twice daily application of a fusidic acid gel and the same gel combined with chlorhexidine washes eliminated MRSA carriage from some dogs. New data will be discussed that indicate a) that MRSP carriage in healthy dogs is most often intermittent and b) that medical decolonisation can be successful, but that efficacy is temporary in many cases. Practice infection control measures need to take into account potentially very long persistence of MRSP at carriage sites and intermittent carriage patterns. Interventions such as barrier nursing might be needed for prolonged periods for dogs that have recovered from MRSP infection. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 FOOD ALLERGY - PATHOGENESIS AND RELEVANCE R.S. MUELLER Centre for Clinical Veterinary Medicine, LMU Munich, Germany In the dog, food allergy is a differential diagnosis to environmentally induced atopic dermatitis. In cats, all reaction patterns associated with feline atopic skin syndrome may be due to food allergy amongst other causes, so food allergy is a frequent differential diagnosis in small animal practice. Depending on the studies, approximately a quarter of all dogs with atopic dermatitis are food-induced. In the cat, food allergy occurs in more than 15% of all animals presented with pruritus. In the past, adverse food reaction was the term of choice, as the exact pathogenesis is rarely elucidated in veterinary patients and toxic, metabolic and idiosyncratic reactions without any immunologic basis are also covered by this term. However, those non-immunologic food reactions have not been reported as a cause of food-induced skin disease. In contrast, many studies documented sensitisation to food allergens by identifying food-specific IgE antibodies, and a number of studies have shown increased lymphocyte proliferation with food allergens in dogs and cats compared to controls. Consequently, food allergy is probably the more appropriate term. Unfortunately, food-specific IgE testing has not correlated well with clinical findings in food allergic patients. In human medicine, clinical relevance is associated with specific allergens while other allergens of the same food source are clinically less relevant. A classic example is peanut, where reactivity to Ara h 2 is associated with severe clinical reactions, while Ara h 8, a labile birch pollen homologue causes little reaction. Although a positive peanut serum IgE result might suggest potential allergy, finding undetectable levels to Ara h 1, 2, 3, and 9 (stable proteins) and an isolated positive result to Ara h 8 would usually suggest general tolerance. Additionally, different threshold values for IgE testing have been suggested for different allergens in humans. No such studies have been published in veterinary medicine. In contrast to the unsatisfactory results of current food-specific IgE testing the dog and cat, lymphocyte proliferation tests have generally correlated better with clinical findings. However, those tests are currently not commercially available in Europe. Based on published data, it seems probable, that immediate hypersensitivity to specific allergens, cell-mediated hypersensitivity or a combination of the two are the underlying immunologic base of most cats and dogs with food allergy. Conflict of interest: None declared.
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ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 FOOD ALLERGY - DIAGNOSIS AND LONG-TERM MANAGEMENT R.S. MUELLER Centre for Clinical Veterinary Medicine, LMU Munich, Germany A large number of studies have evaluated food-specific serum IgE and IgG, salivary IgM and IgA, and hair testing for the diagnosis of food allergy in dogs and cats. Unfortunately, none of those tests correlated well with clinical findings and reliably differentiated normal or environmentally allergic from food allergic animals. Lymphocyte proliferation tests seem to perform better, but at this point are not commercially available in Europe. Patch testing with food allergens showed a high accuracy with negative results, particularly with protein sources. In contrast, false positive reactions were as common as positive reactions identifying clinically relevant food allergens. Consequently, patch testing can only be used to identify possible ingredients of an elimination diet. The gold standard for diagnosis of food allergy in dogs and cats is still an elimination diet with ingredients previously not fed. Home-cooked diets are one option, extensively hydrolysed diets another. Unfortunately, most of the tested commercial selected protein diets have been shown to be contaminated with proteins not mentioned on the label. Although it is unclear at this point, if this contamination is sufficient to elicit clinically relevant reactions, commercial selected protein diets are not recommended for the diagnostic elimination diet for this reason. Elimination diets should be fed for 8 weeks. If at that timepoint no improvement is seen, food allergy is very unlikely. If however improvement is noted, a provocation with the original food should lead to a recurrence of clinical signs within 2 weeks (and often within days), which - typically - quickly resolve upon reintroduction of the elimination diet. Based on this flare with provocation and remission with diet, the diagnosis food allergy is confirmed. The duration of the diet can be abbreviated in dogs initially concurrently treated with prednisolone or oclacitinib for the first 2 weeks of the diet. If clinical remission is achieved in those two weeks, and there is no recurrence of clinical signs in the following two weeks on the elimination diet, the dog can already be re-challenged after only four weeks of the diet. In the long-term, dogs with food allergy can be fed a suitable hydrolysed or commercial selected protein diet that maintains the patient in remission. Some owners prefer to continue with home-cooked food, in those cases the diet should be balanced to avoid dietary deficiencies and assure long-term health. In some animals a strict elimination diet is not possible, especially families with young children and cats which access outdoors, it may nevertheless be worthwhile pursuing an elimination diet to the best of the owners’ ability as with the allergen threshold, the animal may show partial response and require less ongoing symptomatic therapy. In some patients, where an elimination diet is not possible, symptomatic therapy may be the best option. Conflict of interest: None declared.
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ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 UPDATE ON HUMAN AUTOIMMUNE BLISTERING DERMATOSES: PEMPHIGUS A. PAYNE School of Medicine University of Pennsylvania, USA Pemphigus is a paradigm for understanding mechanisms of antibody-mediated autoimmune disease in humans. Current therapeutic options for pemphigus rely on immunosuppressive strategies that risk severe and potentially fatal complications. Thus, novel therapeutic approaches are needed to minimize treatment-related toxicity. Such strategies would ideally target only the autoreactive immune components to preserve beneficial immunity. We will review how decades of basic, translational, and clinical research in pemphigus have enabled the development of targeted therapeutic strategies. Conflict of interest: ASP possess equity, consult for, receive grants from, and have intellectual property (IP) with Cabaletta Bio, Tmunity, Novartis and Janssen.
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ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 UPDATE ON HUMAN AUTOIMMUNE BLISTERING DERMATOSES: PEMPHIGOID A. PAYNE School of Medicine University of Pennsylvania, USA Pemphigoid is a paradigm for understanding mechanisms of antibody-mediated autoimmune disease in humans. In pemphigoid, IgG1, IgG4, and IgE autoantibodies against basement membrane zone antigens directly interfere with hemidesmosomal adhesion, activating complement and Fc receptor-mediated effector pathways. Unraveling disease mechanisms in pemphigoid has identified numerous opportunities for clinical trials, which hold promise to identify safer and more effective therapies for this group of potentially life-threatening diseases. Conflict of interest: ASP possess equity, consult for, receive grants from, and have intellectual property (IP) with Cabaletta Bio, Tmunity, Novartis and Janssen.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME THURSDAY 16 SEPTEMBER 2021 ECTOPARASITES AND SKIN: A COMPLEX RELATIONSHIP POSSIBLY MIMICKING “ALLERGY” P.J. BOURDEAU Unit of Dermatology, Parasitology, Mycology Department of Clinical Sciences National Veterinary School (ONIRIS la chantrerie). Univ. Nantes, France Dermatoses due to ectoparasites and “allergies” represent the vast majority of primary pruritic skin diseases in canine and feline dermatology. They share many characteristics both in their mechanisms and clinical presentation making a complete diagnosis difficult. Parasites of skin are distributed in: 1) permanent (entire life cycle on the host). Cause typically pruritic (Sarcoptes, Notoedres, Otodectes), variably pruritic (lice, Cheyletiella, Lynxacarus) or generally non-pruritic (Demodex) dermatoses; 2) stationary or sessile (days to weeks, onto the same host). Elicit intensely pruritic (Straelensia), variably pruritic (fleas, chiggers) or non pruritic (ticks) dermatoses; 3) i ntermittent (multiple very short periods on different hosts and life cycle in environment). Induce a rapid inflammation however too slow to efficiently interfere with the feeding (mosquitoes, sand flies, midges, poultry mites). Allergies are traditionally classified according to their supposed origin (contact, food or inhalation), can be combined simultaneously or successively in the same individual and occur mostly in predisposed animals. Numerous studies (although limited number of models) revealed that immunological mechanisms have many similarities: an interaction between antibodies developed against antigens (named allergens in case of allergies) and effectors cells (mast cells, basophils, and eosinophils). In the case of parasites the pruritus is additionally due to mechanical and biological effects (bioactive components of saliva). The sequence (according to the model used) include a period of asymptomatic sensitization a clinical phase and possibly spontaneous desensitization. The severity of clinical allergy varies from one individual to another. The parasites have developed strategies to manipulate the host’s immune system (frequent asymptomatic carriage associated to co infection immunity) and dermatoses may reflect an host failure in the host-parasite relationship. The consequences on skin are comparable: keratinocyte activation with hyperplasia in chronic forms that can be even curative when the parasite is expelled (microvesicules and necrosis for ticks; pseudocarcinomatous proliferation pushing away the Straelensia cysts). Both conditions produce also a common pattern of superficial perivascular dermatitis with numerous eosinophils. Clinical presentation makes also the differential challenging even if, in typical cases, the pruritus (frequency, intensity…) and nature and distribution of lesions following sets of criteria help for the orientation. Diagnosis by exclusion is virtually always necessary. The results of diagnostic tools can be confusing. Most acari (except ticks, poultry mites) typically induce positive tests to house dust mites, said the most common allergens in canine atopic dermatitis. Whereas “allergens” are just commonplace antigens for normal individuals, ectoparasites produce harmful molecules and hypersensitivity response in all. The allergic reaction is disproportionate (allergic concept) whereas parasitic hypersensitivity is most often dose related. The confusion is aggravated by the fact that “allergic” individuals are highly predisposed to exhibit also severe parasitic dermatoses. Until recently the Flea bite dermatitis was associated to a postulate “one flea is enough” (allergy concept) and thus systemics insecticides not recommended because their “post-bite” action and topical products strongly promoted. Topical, although effective, do not prevent all the flea bites and systemics revealed to be as rapid and excellent for the control of Flea bite dermatitis. Conflict of interest: None for this lecture.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
CUTTING EDGE PROGRAMME THURSDAY 16 SEPTEMBER 2021 PATHOGENESIS OF PEDIATRIC FOOD ALLERGY K. BEYER Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany Food allergy is a common disease in humans. Genetic, environmental, and immunologic factors play an important role in its development. In the majority of cases food allergy is immunoglobulin (Ig)E-mediated. In early childhood primary food allergy predominates whereas in older children, teenagers and adults secondary, pollen-associated food allergy is more common. Primary food allergies arise primarily as a result of cutaneous or gastrointestinal sensitizations mainly against stable food allergens. The main risk factor for the development of primary food allergy is the presence of atopic eczema in infancy. Early development of eczema and severe inflammation of the skin promotes sensitization. Food allergens are everywhere present cannot only be found in house but also bed dust. Oral tolerance is normally gained in infancy through oral exposure. A lack of oral tolerance development will result finally in the development of food allergy. Food allergens of primary food allergy are often heat and digestion stable, e.g. the seed storage proteins in peanut or tree nuts. Despite the fact that primary food allergy often occurs in children with eczema immediate type reactions are more common than worsening of eczema. Reactions can occur at any organ system. Most common the skin is involved with urticaria and/or angioedema followed by gastrointestinal, respiratory and/or cardiovascular reactions. Reactions can be mild to life threatening. In childhood hen’s eggs, cow’s milk, peanut, tree nuts, wheat, soy and fish are the most common elicitors of food allergic reactions. Children with cow’s milk or hen’s egg allergy often outgrow their disease and become clinically tolerant whereas peanut and tree nut allergies tend to persist until adulthood. On the other hand secondary, pollen-associated food allergy is a result of cross-reactivity with aeroallergens (e.g. pollen allergens). It occurs e.g. often in patients with sensitization to birch pollen. The main allergen of birch Bet v 1, a PR-10 protein, can cross-react with other PR-10 proteins for example in apple (Mal d 1) or hazelnut (Cor a 1). Reactions are usually mild with oral allergy symptoms. In addition to the primary and pollen-associated IgE-mediated food allergy food-induced gastrointestinal reactions can occur that are typically not IgE mediated such as the food protein enterocolitis syndrome (FPIES). The pathomechanism of this disease is still not well understood. In patients with acute FPIES symptoms occur usually within 2-4 hours after food intake with profound vomiting, sometime followed by diarrhea after 24 h. Hypotension can occur. Finally, allergic eosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus characterized by eosinophilic infiltration into the esophageal mucosa and clinically by abdominal pain, reflux, failure to thrive, and in older patients food impaction. Atopy has been strongly linked with EoE. Food allergens have been demonstrated to be the most common trigger of mucosal inflammation. Conflict of interest: Kirsten Beyer has consulted for, received lecturing honorarium and/or research support from the following companies: Aimmune, Bencard, Danone/Nutricia/Milupa, DBV, Hipp, Hycor, Infectopharm, Jenapharma, Mylan/Meda, Nestle, Novartis, ThermoFisher.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
CUTTING EDGE PROGRAMME THURSDAY 16 SEPTEMBER 2021 DIAGNOSTIC APPROACH IN PEDIATRIC FOOD ALLERGY K. BEYER Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany For the diagnosis of a primary immediate-type food allergy objective symptoms after the intake of the causative food within minutes up to 2-3 hours in connection with IgE sensitization should be present. Objective reactions can occur at any organ and might involve the skin, the gastrointestinal, respiratory or cardiovascular system. Urticaria, angioedema, vomiting, coughing and/or wheezing are most common. Next to the patient history sensitization should be measured through the determination of food-specific serum IgE or a skin prick test. Component-resolved diagnostics is most helpful in peanut and tree nut allergy. Double-blind placebo controlled oral food challenges are the gold standard in food allergy diagnostics. This should be performed in infants and children with food-sensitization who have never eaten the food so far, in patients with food allergy to determine tolerance development and in all unclear cases. In oral food challenges the allergen of interest is given orally every 30 minutes in increasing amounts with half-logarithmic steps until objective reactions occur. After completion of all 7 titration steps without presenting any kind of objective allergic reaction, the patient received a subsequent cumulative dose on another day. In patients with atopic eczema food allergens can result in a worsening of eczema. If this is suspected, especially in sensitized patients, an elimination diet for 1-2 weeks without changing the treatment of the skin is recommended. In case of improvement a DBPCFC should be conducted to prove the causal relationship. In case of no improvement the consumption of food should be continued in order to avoid the switch to immediate reactions in sensitized patients. In patients with pollen-associated food allergy usually the combination of clear symptoms of a rhinoconjunctivitis in the pollen season and the determination of pollen-specific IgE in combination with oral allergy symptoms to cross-reacting foods is sufficient. Component-resolved diagnostics can be performed if needed. Food protein enterocolitis syndrome (FPIES) is mostly a clinical diagnosis based on the typical symptoms of profound vomiting 2-4 hours after food intake sometimes with severe hypotension and/or diarrhea after 24 h. Normally, food-specific IgE cannot be detected. Oral food challenges are also helpful to verify the diagnosis and are usually done in 3 provocation steps. Eosinophilic esophagitis (EoE) is diagnosed by typical symptoms and the presence of > 15 eosinophils per high-powerfield in the esophageal biopsy. In EoE measurement of food-specific IgE, skin prick or atopy patch test can be helpful in order to perform targeted diets. Most common foods associated with EoE are milk, egg, soy, and wheat. Alternatively empiric elimination diets have been studied. The most notable is the six-food-group elimination diet which eliminates milk, wheat, egg, soy, peanut, tree nuts, as well as fish and shellfish. After symptom improvement foods can be sequentially reintroduced into the diet with careful monitoring symptoms and biopsies after each dietary change. Conflict of interest: Kirsten Beyer has consulted for, received lecturing honorarium and/or research support from the following companies: Aimmune, Bencard, Danone/Nutricia/Milupa, DBV, Hipp, Hycor, Infectopharm, Jenapharma, Mylan/Meda, Nestle, Novartis, ThermoFisher.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
CUTTING EDGE PROGRAMME THURSDAY 16 SEPTEMBER 2021 NOVEL TREATMENTS FOR FOOD ALLERGIES IN CHILDREN K. BEYER Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany The treatment of food allergy relied so far on avoidance of the causative food(s), and the use of rescue medication in case of accidental allergic reactions in patients with immediate food allergic reactions. Patients’ education and training is essential for an effective elimination diet, and for the quick recognition and self first line treatment of an accidental reaction. In recent years a tremendous effort has been performed in order to develop an immunotherapy for food allergy. The routes of administration were subcutaneous, sublingual, oral and epicutaneous using modified or unmodified allergens. The main focus was on desensitization but studies on sustained unresponsiveness have been performed. Oral immunotherapy has also been performed under the umbrella of anti-IgE showing improved efficacy and a decrease in site effects. Most recently, oral immunotherapy has been studied in a phase III trial in 496 participants aged 4-17 years who had an allergic reaction with dose-limiting symptoms at ≤100-mg challenge dose of peanut protein (approximately one-third of a peanut kernel) during a screening double-blind, placebo-controlled food challenge (DBPCFC). The participants were randomized 3:1 to active treatment or placebo, and completed updosing, approximately six months of 300 mg/day maintenance treatment, and exit DBPCFC. 67.2% receiving active treatment tolerated ≥600 mg of peanut protein (approximately two peanut kernels) at exit DBPCFC, compared to 4% receiving placebo. Active treatment reduced symptom severity and rescue epinephrine use during the exit DBPCFC. With 307 patient-years of exposure, treatment-emergent adverse events (TEAEs) affected > 95% of participants, were mostly mild-tomoderate in severity, and were more frequent in the active group. TEAEs led to study withdrawal in 11.6% and 1.6% of active and placebo recipients; 2.2% and 0.8% had a serious AE, respectively. With these results oral immunotherapy has been approved by the Food and Drug Administration for the US and after a second European trial showing similar results by the European Medicines Agency for Europe as the first treatment for peanut allergy in children 4-17 years of age. Conflict of interest: Kirsten Beyer has consulted for, received lecturing honorarium and/or research support from the following companies: Aimmune, Bencard, Danone/Nutricia/Milupa, DBV, Hipp, Hycor, Infectopharm, Jenapharma, Mylan/Meda, Nestle, Novartis, ThermoFisher.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 OPPORTUNITIES FOR GOOD ANTIMICROBIAL STEWARDSHIP: MANAGING PYODERMA IN DOGS AND CATS A. LOEFFLER Royal Veterinary College United Kingdom The emergence and spread of multidrug resistant pathogens such as meticillin-resistant Staphylococcus pseudintermedius (MRSP) as a troublesome multidrug-resistant bacterial pathogen in dogs and the urgent need for reduced and refined antimicrobial prescribing, have prompted a few dogma changes in management recommendations for canine (and feline) pyoderma. In the context of increasing antimicrobial resistance, the skin as the infected organ provides both challenges and opportunities for responsible use of antimicrobials. The easy accessibility of the skin enables quick and non-invasive sampling for diagnosis and monitoring of treatment. In-house cytological examination of samples is an extremely valuable but still underused tool to confirm the presence of bacterial infection as the first step in responsible antimicrobial prescribing. Cytology will also help to guide treatment decisions for example in the rare instances of canine pyoderma where mixed infections or those due to Gram-negative (rod-shaped on cytology) and likely more resistant pathogens occur. Cytology will also help to optimise the duration of antimicrobial therapy needed for the management of pyoderma. With the skin always colonised by microflora bacteria, outcome measures for successful pyoderma therapy are not straightforward. Cytological resolution combined with absence of skin lesions may therefore help to avoid overlong courses of antimicrobial therapy. Another major opportunity for responsible prescribing in pyoderma cases is the availability of topical antibacterial therapy. Good in vitro and clinical evidence nowadays support the use of topical therapy for superficial pyoderma as the sole antibacterial treatment. Furthermore, data showed that topical therapy can be effective in MRSP pyoderma and that many different agents and formulations can be effective and used safely. Lastly, this session will outline some practice tips on how to interpret laboratory results in order to make responsible treatment decisions and provide an overview on current pyoderma treatment guidelines. More cytology, more frequent replacement of systemic antibiosis with topical treatment and a critical focus on identification and correction of primary triggers for pyoderma should be adopted as inherent parts of pyoderma management. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 HOW TO DEAL WITH RECURRENT PYODERMA – ANY NEW MAGIC? A. LOEFFLER Royal Veterinary College United Kingdom Recurrent pyoderma is one of the most frustrating dermatological presentations in small animal practice and frequently leads to animal suffering and repeated prescribing of systemic antimicrobials. Dogs are predisposed to bacterial folliculitis as they are lacking a sebum plug around the hair follicle opening. However, Staphylococcus pseudintermedius as the predominant pathogen is also a coloniser of healthy skin of most dogs and will only cause disease when opportunity arises (opportunistic pathogen). The focus of managing recurrent pyoderma or preventing pyoderma flares consequently is shifting from mere antibacterial therapy to addressing the primary underlying causes that lead to skin infection. While twenty years ago, repeated prescribing of antimicrobials may have been considered sensible, this is now no longer appropriate. Repeated antimicrobial therapy has been identified as one of the major risk factors for MRSP acquisition (and MRSA in human medicine) and avoidance of repeat prescribing has nowadays become critical. For dogs where pyoderma recurs secondary to underlying chronic inflammatory diseases (allergies), anti-inflammatory drugs such as glucocorticoids or ciclosporin might be recommended instead to prevent relapses. For other primary aetiologies, repeated diagnostic tests might be required before a final diagnosis can be made and corrective treatment be implemented to prevent flares. This session will review the supportive evidence for such recommendations, highlight where knowledge gaps exists and indicate where care is warranted when making treatment decisions. Lastly, alternatives to systemic antimicrobial therapy that can be considered in the management of dogs with recurrent pyoderma will be discussed. Alongside topical antibacterial therapy, good monitoring, control of other flare factors such as ectoparasites, alternative strategies to manage microbial imbalances such as staphylococcal “vaccines”, bacteriophage, antimicrobial peptides and microbiome manipulation will be mentioned. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 LABORATORY TEST AS DIAGNOSTIC TOOL IN VETERINARY DERMATOLOGY V. BRUET Ecole Vétérinaire de Nantes ONIRIS, France Even if the most frequent diagnostic tests are in-house tests, the use of laboratory tests is not rare in veterinary dermatology. They should be used in the case of specific hypothesis and not in the absence of hypothesis. In function of the hypothesis, the diversity and accessibility of the laboratory tests are variable. As for every diagnostic tool, the most important point is to know the sensitivity and the specificity of the test for the diagnosis. Confirmation or exclusion of a hypothesis based on a laboratory test is possible only in light of these two parameters. In the different fields of veterinary dermatology, there are specific laboratory tests in bacterial, fungal, parasitic, viral, allergic, endocrine, auto-immune, immune, genetic diseases. Moreover, histological examination is a key-point test in different clinical presentations as alopecic dermatosis, keratinization defects or neoplastic diseases. If sensitivity and specificity of a laboratory test is linked to the test it-self, it is also, for some of them, linked to the method of sampling (ex: cultures, PCR, histology), the period of sampling (ex: serology for sarcoptic mange) and to the laboratory it-self (technicity, knowledge). The method of sampling is crucial for bacterial culture (where to sample, how to sample, which technique to use), for histology. It is the same for dermatophytosis: where to sample for symptomatic or asymptomatic animals, which method of sampling to use. These are just some examples showing how methodology is directly associated with the sensitivity of the test. Finally, the choice of the laboratory is also important. Always favor a veterinary laboratory for bacterial and fungal cultures because veterinary agents have characteristics requiring specific knowledge. Dermatohistopathology is a specific field of veterinary histology and not all the histopathologists have the same expertise. Laboratory tests should to be used for specific hypotheses and not when you don’t have clear hypotheses. They should be carried out with particular attention in order to not decrease the sensitivity of the test. They should be processed and read in a laboratory chosen for its knowledge on the subject. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 IN HOUSE TESTING FOR GENERAL PRACTITIONERS V. BRUET Ecole Vétérinaire de Nantes ONIRIS, France The skin is an organ with limited patterns to respond to various stimuli. The result is that many skin diseases look the same. Moreover, there are often several diseases at the same time and the lesions of each disease overlap. And, to complicate the situation a little more, a specific skin disease can display very different clinical signs. It is for these reasons that even with a detailed history, a physical examination and a rigorous skin examination, it is extremely frequent to carry out diagnostic tests to confirm or exclude hypothesis. In-house diagnostic tests are used daily because they are quick, useful for frequent skin diseases (ex: infectious, parasitic dermatosis), not expensive, used without any particular material except a good microscope. Despite these qualities, each in-house diagnostic test is confined by their own sensitivity and their specificity. The higher they are, the better it is. So, the goal is to maintain the highest value of these two parameters and for that, the practitioner is in the center of the process. The choice of the material used, including the microscope, the choice of the location sampled, the choice of the site’s preparation, the choice of the number of slides needed, the method of microscopic lecture used, the capacity of recognition are all different steps interfering with the specificity and the sensitivity of the test. So, even if the majority of in-house tests are easy, you need to keep in mind that every step is important to obtain a final diagnosis. The main in-house diagnostic tests are coat brushing, flea combs, skin scraping, adhesive tape impression, ears’ curettage, trichoscopy (hairs’ observation), cytological techniques and Wood’s lamp. You have to know the indications, the techniques of sampling and the interpretations for all these diagnostic tests to keep the best sensitivity and the best specificity of your tests and to obtain a final diagnosis. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 DERMATOPHYTOSIS IN DOGS AND CATS: ARRIVING WHERE WE STARTED A. VAN DER LEE Evidensia-group, Netherlands In the year 2021, dermatophytosis can still be a frustrating disease to treat in veterinary practice. Dermatophytosis belongs to the infectious and zoonotic skin diseases and the primary pathogens in veterinary medicine are Microsporum canis, Microsporum gypseum and Trichophyton mentagrophytes. Different diagnostic methods have been developed in the last decades: From trichogram and the use of Woods’ lamp to culture and the most recent PCR-technique. However, there is no gold standard diagnostic test and diagnosis is best made by the performance of multiple tests. Extensive treatment protocols are being applied worldwide, which include the multimodal administration of systemic and topical antifungal therapy and environmental treatment. Systemic therapy is required to treat the fungal folliculitis. Topical treatment is needed to remove fungal spores from the hair coat. Environmental treatment is used to clear the surroundings and prevent the occurence of reinfection. The most common used systemic antifungals in Europe belong to the azole family of drugs as itraconazole and ketoconazole. They inhibit the growth of dermatophytes. The non-compounded itraconazole is found to be very effective and safe. It is licensed for cats and used as 5 mg/kg SID in a week on - week off schedule. Off-label use of itraconazole in small dogs is also safe and effective. Ketoconazole is registered and used in dogs at 10 mg/kg, however, this drug has more potential for gastrointestinal side effects, which may be less when 5 mg/kg BID is used. The most frequently used topical therapy includes 0,2% enilconazole solution or shampoo containing 2% miconazole-chlorhexidine every 3-5 days. Lime-sulfur dips can be used on a twice weekly basis and, although it stains and smells, is quite potent and safe. For environmental disinfection, 10% household bleach with a 10 minute contact-time is effective. Before disinfection takes place, it is important to first clean the environment with a detergent. To be able to cure the patient, all in-contact animals should be monitored, especially since asymptomatic carriers do occur. In general, in uncomplicated cases, treatment time to cure defined by 1 to 2 negative diagnostic tests, is 4 to 6 weeks. When concurrent illness is present in the patient with dermatophytosis, a prolonged duration of treatment and more diagnostic tests are often necessary. Nevertheless, dermatophytosis may still have challenges in both diagnostics and treatment. Understanding the characteristics of dermatophytes and the pathogenesis of dermatophytosis, will help to make a diagnosis in an early stage and make the right treatment decisions for the individual patient in it’s own specific environment. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 HOW TO APPROACH FEATHER PICKING IN PSITTACINE J. MARTORELL Departament de Medicina I Cirurgia Animals Fundació Hospital Clinic Veterinari Facultat de Veterinaria, Universitat Autònoma de Barcelona Barcelona. Spain Feather picking, feather plucking, self-mutilation refers to the avian feather self-mutilation syndrome. Unfortunately, this is one of the most common presentation in avian medicine. Sometimes, the process get worse and the patient ends doing a sever skin injury. Depending on the case, determining the cause of the feather picking can be frustrating by the veterinarian and by the owner. In fact, feather picking is just a clinical sign of an underlaying disease, or of a bad environmental aspect, diet or husbandry. There are many causes of this “syndrome”, such as skin disorders and systemic diseases. The diagnostic protocol include an complete anamnesis, complete physical examination and different analyses and tests, including imaging and histopathology. Anamnesis should include signalment (bird species, age, sex, sexual maturity) and all the detail abouts the history of the bird. A significant amount of time should be dedicated to acquiring a detailed and accurate history for the owner of the bird: when the animal was purchase, cage conditions, where is the cage placed into the house, does the bird live with other birds, other pets, diet and the feeding frequency, how many time does the owner dedicate to the bird, how is the relationship between them, and with the rest of the family, any smoker at home? All the question are needed to understand if the bird is well adapted to the environment. Clinical examination begin with the bird into the cage. The cage should be studied, the design, perches, toys, drink bowl, food bowl, the bottom of the cage (substrate, feces, rest of food). And then we can observe the bird, without restraining the animal. The behavior and the evident lesions should be seen at this moment: distribution of the feather picking and which feathers are affected, and how are they affected?. A complete physical examination should include an evaluation of the eyes, ears, nares, throat, oral cavity, content crop hyssop sample, content cloaca hyssop sample or feces, uropygial gland (species). Auscultation, whole body palpation and weigh should be included in the physical examination. The feathers can be examined by using a magnifying glass or microscope. The goal is to determine whether the feathers themselves are abnormal or if the bird is picking at a normal appearing feather. The minimum database should include initially a complete blood count, a complete biochemistry panel, fecal flotation and direct smear, and choanal and crop and cloacal gram stains, skin cytology, whole body radiographs. Other test include PCR, serologies, skin biopsy, coelomic endoscopy. Conflict of interest: I have no relevant financial interest, arrangement or affiliation with any company or organization.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 EQUINE ALLERGIC SKIN DISEASES: CLINICAL CONSENSUS GUIDELINES OF THE WORLD ASSOCIATION FOR VETERINARY DERMATOLOGY R. MARSELLA This page has been left blank for notes.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME FRIDAY 17 SEPTEMBER 2021 CANINE OTITIS EXTERNA-BEST CLINICAL PRACTICES: CLINICAL CONSENSUS GUIDELINES OF THE WORLD ASSOCIATION FOR VETERINARY DERMATOLOGY J. NOXON This page has been left blank for notes.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 REVIEW OF NUTRITION AND ITS ROLE IN SKIN BARRIER FUNCTION C. VILLAVERDE Expert Pet Nutrition Ireland The barrier function of the skin is required to prevent water loss (inside-outside barrier) and to protect the body from the environment (outside-inside barrier). The intercellular lipids from the stratum corneum (SC) are key for this function. Defects in the barrier are one of the factors associated with skin disease, such as atopic dermatitis (AD), in humans and rodent models1 and potentially in dogs as well, although data is still limited2,3. An adequate nutrition is important to maintain a healthy skin barrier4. The skin is a large organ, with a high turnover rate, for this reason several nutrient deficiencies manifest as skin problems5, including protein, some amino acids, vitamins, minerals, and essential fatty acids omega 6. There is some preliminary data suggesting that dietary management can also contribute to skin barrier improvement in dogs with AD, but there is still a lack of evidence in this area (particularly in cats). The nutrients most frequently used for skin barrier health are essential fatty acids, both from the omega 6 (linoleic acid) and the omega 3 families (eicosapentaenoic and docosahexaenoic acids, EPA and DHA). Linoleic acid (omega 6) is a critical component of ceramides from the SC, and, in dogs, its deficiency results in coarse, dry hair, desquamation, progressing to greasy, pruritic skin. Topical and oral supplementation with omega 6 fatty acids6,7 suggests improvement of ceramide synthesis in dogs, although more data is needed to confirm its effect and decide on an appropriate route, dose and composition of the treatment. This effect may also explain why sometimes a change to a higher fat diet (usually providing vegetable oils, rich in linoleic acid) or corn oil supplementation can result in a perceived improved hair coats in dogs. Omega 3 fatty acids are not as important to skin barrier function; however, their supplementation has been shown to have some benefits in dogs with AD8, potentially related to their anti-inflammatory properties. Other nutrients important for skin health include vitamins like niacin, pantothenic acid, and vitamin A. Deficiencies of these vitamins are extremely rare, but the question if added levels of them in the diet can help improve barrier function is still unknown. Vitamin E, a fat-soluble antioxidant, could help protect the lipids of the SC, and one study9 found that its supplementation improved the subjective CADESI score in dogs with AD, but it is unknown if it has a role specifically on skin barrier function. There are some studies in dogs, healhty10 and with AD11,12 with diets using proprietary combinations of several nutrients like essential fatty acids, antioxidants (like polyphenols), B vitamins, and vitamin like substances, showing some benefit. Although they have important limitations, and their role in the actual barrier function is unclear, these studies are supportive of the role of some nutrients as part of the multimodal treatment of AD. Conflict of interest: CV has done consulting for several food companies. References 1. Kezic S, Novak N, Jakasa I, et al. Skin barrier in atopic dermatitis. Front Biosci 2014;19:542-56. 2. Santoro, D.; Marsella, R.; Pucheu-Haston, C.M.; Eisenschenk, M.N.; Nuttall, T.; Bizikova, P. Review:Pathogenesis of canine atopic dermatitis: Skin barrier and host-micro-organism interaction. Vet. Dermatol.2015, 26 3. Marsella R, De Benedetto A. Atopic Dermatitis in Animals and People: An Update and Comparative Review. Vet Sci. 2017 Jul 26;4(3):37. 4. Hensel P. Nutrition and skin diseases in veterinary medicine. Clin Dermatol 2010;28:686-93. 5. National Research Council. Nutrient requirements of dogs and cats. Washington DC: The National Academies Press; 2006. 6. Blaskovic M, Rosenkrantz W, Neuber A, et al. The effect of a spot-on formulation containing polyunsaturated fatty acids and essential oils on dogs with atopic dermatitis. Vet J 2014;199:39-43.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 7. Popa I, Pin D, Remoué N, et al. Analysis of epidermal lipids in normal and atopic dogs, before and after administration of an oral omega-6/omega-3 fatty acid feed supplement. A pilot study. Vet Res Commun 2011;35:501-9. 8. Bauer JE. Therapeutic use of fish oils in companion animals. J Am Vet Med Assoc 2011;239:1441-51. 9. Plevnik Kapun A, Salobir J, Levart A, et al. Vitamin E supplementation in canine atopic dermatitis: improvement of clinical signs and effects on oxidative stress markers. Vet Rec 2014;175:560. 10. Watson AL, Fray TR, Bailey J, et al. Dietary constituents are able to play a beneficial role in canine epidermal barrier function. Exp Dermatol 2006;15:74-81. 11. van Beeck FL, Watson A, Bos M, Biourge V, Willemse T. The effect of long-term feeding of skin barrier-fortified diets on the owner-assessed incidence of atopic dermatitis symptoms in Labrador retrievers. J Nutr Sci. 2015 Feb 12;4:e5. 12. Witzel-Rollins A, Murphy M, Becvarova I, Werre SR, Cadiergues MC, Meyer H. Non-controlled, open-label clinical trial to assess the effectiveness of a dietetic food on pruritus and dermatologic scoring in atopic dogs. BMC Vet Res. 2019 Jun 28;15(1):220
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 GUIDE TO HOME COOKED DIETS FOR ELIMINATION DIET TRIALS, PROS, CONS AND WHAT MISTAKES TO AVOID C. VILLAVERDE BVSc, Dip ECVCN (EBVS® European Specialist in Veterinary and Comparative Nutrition); Dip ACVN (Board Certified Veterinary Nutritionist ™) Dietary elimination and challenge trial is the gold standard to diagnose cutaneous adverse food reactions (CAFR)1. Although there are a variety of commercial options available, home prepared diets (HPD) can also be used. The HPD used for elimination trials can be complete or not, with the former providing all essential nutrients (around 402). Non complete HPD consist usually of two ingredients (a protein and a starch source) and should meet at least energy and protein needs during the trial. Complete HPD usually include one or more fat sources and supplements on top to provide the micronutrients not provided by the main ingredients. The use of commercial elimination diets (based on uncommon ingredients or hydrolysed protein) is preferred, because it is convenient and, in most cases, cost-effective. They have some challenges, and a HPD can be preferred in some cases. The diets made by commercial manufacturers have sometimes been on backorder, which can be very problematic, especially in animals already diagnosed that are doing well on the elimination diet long term. The uncommon ingredient diets are not always novel to the patient; therefore, these patients will require hydrolysed diets or HPD. In some cases, it is potentially possible that a patient does not improve with a commercial uncommon ingredient diet but there is improvement when using a HPD with the same main ingredients. Regarding hydrolysed protein diets, there are some animals that react to the native protein that will also react to the hydrolysate, which might be related to the size of the hydrolysed particle3. Likely the biggest benefit of HPD is their customization, they can be formulated with ingredients that the client can source, that are novel to the patient, and can accommodate other needs or diseases when formulated by a specialist. Another problem of commercial diets is the possibility of uncontrolled antigens due to cross contamination4, especially if the manufacturer does not have quality control measures to prevent it, but HPD can also have this problem (this can happen in the slaughterhouse, point of sale, and at home). However, HPD can also have serious problems, including cost5, effort, and nutritional imbalances due to lack of compliance or “diet drift”6 or due to the diet being unbalanced. Generic recipes from the internet and books are frequently nutritionally inadequate7,8, and so are some of the diets used for diagnostic of AFR (with the idea that their short-term use will not be too problematic for the patient). If these unbalanced diets are fed long term, they can result in issues, but short-term use can also be a problem depending on the nutritional status and needs of the patient. An added problem of HPD, as opposed to commercial diets from reputable manufacturers, is that they cannot be tested, neither for nutritional adequacy and safety nor for clinical efficacy. Conflict of interest: CV has done consulting for several food companies. References 1. Olivry T, Mueller RS. Critically appraised topic on adverse food reactions of companion animals (3): prevalence of cutaneous adverse food reactions in dogs and cats. BMC Vet Res. 2017 Feb 15;13(1):51. 2. National Research Council. Nutrient requirements of dogs and cats. Washington DC: The National Academies Press; 2006. 3. Cave NJ. Hydrolyzed protein diets for dogs and cats. Vet Clin North Am Small Anim Pract. 2006 Nov;36(6):1251-68, vi. 4. Fossati LA, Larsen JA, Villaverde C, Fascetti AJ. Determination of mammalian DNA in commercial canine diets with uncommon and limited ingredients. Vet Med Sci. 2019 Feb;5(1):30-38. 5. Vendramini THA, Pedrinelli V, Macedo HT, Zafalon RVA, Risolia LW, Rentas MF, Macegoza MV, Gameiro AH, Brunetto MA. Homemade versus extruded and wet commercial diets for dogs: Cost comparison. PLoS One. 2020 Jul 24;15(7):e0236672. 6. Johnson LN, Linder DE, Heinze CR, Kehs RL, Freeman LM. Evaluation of owner experiences and adherence to home-cooked diet recipes for dogs. J Small Anim Pract. 2016 Jan;57(1):23-7. 7. Stockman J, Fascetti AJ, Kass PH et al. Evaluation of recipes of home-prepared maintenance diets for dogs. J Am Vet Med Assoc 2013;242:1500-5. 8. Wilson SA, Villaverde C, Fascetti AJ, Larsen JA. Evaluation of the nutritional adequacy of recipes for home-prepared maintenance diets for cats. J Am Vet Med Assoc. 2019 May 15;254(10):1172-1179.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 REGENERATIVE MEDICINE AND CELL THERAPY IN VETERINARY FIELD A.J. VILLATORO ImmuneStem. Inmunología y Terapia Celular. Málaga, Spain Regenerative medicine is the specialty that uses different types of strategies to enhance the body’s own restorative and regenerative mechanisms. Among these strategies, to highlight cell therapy or the use of cells as a therapeutic agent, as an alternative in diseases whose current treatment is not effective or simply does not exist, providing the elements to regenerate or repair damaged organs or tissues. Stem cells have raised the highest expectations among the scientific community thanks to their promising results. Specifically, the so-called mesenchymal stem cells (MSC), also known as mesenchymal stromal stem cells, stand out among all stem cells due to their enormous immunomodulatory and repairing capacities. MSC are undifferentiated, multipotential cells, of nonhematopoietic origin, which come from the embryonic layer of the mesoderm, with the capacity for self-renewal and located in various adult or extra-embryonic tissues. In veterinary medicine, MSC isolated from bone marrow, adipose tissue, peripheral blood and extra-embryonic tissues are the main sources of use in cell therapy, due to the ease of obtaining them from the tissues where they are located. According to their origin, they show differences regarding quantity, proliferation, differentiation capacity, phenotyping, immunomodulatory properties, secretory profile, etc. There is an agreement that the main mechanism of action of MSC is paracrine. It is carried out through the release of a great variety of bioactive substances whose objective is a multitude of biological targets (pleiotropic effect), encompassed under the concept of secretome. In the secretome we find different soluble factors such as cytokines and growth factors, and extracellular vesicles (exosomes and microvesicles) that play a very important role in the intercellular communication. Its composition varies according to the species, age, origin and microenvironment where the MSC themselves develop; they are responsible for different actions, such as production of extracellular matrix, antiapoptotic, antifibrotic, chemoattraction, neuroprotective, angiogenic, antimicrobial and immunomodulatory activity, etc., which give them an interesting therapeutic potential in the field of regenerative medicine and cell therapy. Conflict of interest: The author has no conflict of interest.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 STEM CELL THERAPY AS STRATEGY IN IMMUNE-MEDIATED DISEASES: INDICATIONS AND CLINICAL CASES A.J. VILLATORO ImmuneStem. Inmunología y Terapia Celular. Málaga, Spain As a continuation of our previous conference, and once we have understood what a mesenchymal stem cell (MSC) is, its capabilities and mechanisms of action, we will delve into its use as a therapeutic element in veterinary medicine. The clinical relevance that immune-mediated pathologies have reached in both veterinary and human medicine is forcing the development of new, safer and more effective therapeutic strategies. In recent years, cell therapy has provided new and promising alternatives that are greatly helping the therapeutic management of pathologies of immune origin. Among all of them stands out, without any doubt, the use of MSC as an immunotherapeutic agent due to its powerful immunoregulatory and restorative capacity.This immunomodulatory effect is exerted on both the innate and adaptive immune responses, through different mechanisms such as direct cell-to-cell contact and the components of its secretome, and will allow modulating the polarized responses that occur in many immune-mediated pathologies. In this presentation, I want to teach you in a practical and applicative way, the latest therapeutic strategies with MSC, which I am currently using in the treatment of various pathologies in veterinary medicine, and which are at the forefront of biomedical research.I will focus on the different protocols of clinical application with this cell type, explaining its mechanism of action and the results obtained in each pathology, mainly in those immune-mediated pathologies with a high prevalence in veterinary medicine, where today it is a real alternative for these diseases that are difficult to handle. On the other hand, under the concept “One health, one medicine”, which unites animal and human health, the results with veterinary patients in this specialty are representing an ideal alternative to translate them as a preclinical model to different studies in human medicine, where life conditions , longevity, etiopathogenesis and treatment protocols are more similar to humans compared to laboratory animals. Therefore, human and veterinary medicine can mutually benefit from research that applies an unique health approach. Finally, we will comment on future strategies with cells or their derivatives that are currently being developed and that will be a very interesting reality in the coming years. Conflict of interest: The author has no conflict of interest.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 TRANSCRIPTOME APPLICATIONS IN DERMATOLOGY P. BRUNNER Medical University of Vienna Austria Skin harbors many different cell types, with often nuanced transcriptomic regulation within similar cell pools, likely reflecting a complex cell-cell interplay that is still only insufficiently understood. Single-cell RNA sequencing is a novel technique that can characterize these cells at unprecedented depth, and has tremendously increased our capabilities to profile tissues, thereby rapidly increasing our understanding of both healthy skin and dermatological diseases, and accelerating novel treatment developments. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME FRIDAY 17 SEPTEMBER 2021 AUTOIMMUNE SUBEPIDERMAL BLISTERING SKIN DISEASES IN ANIMALS: AN UPDATE P. BIZIKOVA Department of Clinical Sciences, College of Veterinary Medicine North Carolina State University, USA Autoimmune subepidermal blistering diseases (AISBDs) are rare skin disorders recognized in dogs and, even more rarely, in other domestic animals. The first description of an AISBD in animals was made in a dog more than 40 years ago. Initially, most cases with histological evidence of a subepidermal blister formation were given the diagnosis of bullous pemphigoid; a diagnosis that would not be always supported by today’s criteria. The emergence of more advanced molecular techniques in veterinary medicine and the growing knowledge about human AISBDs allowed us to identify other AISBD variants also in animals. The common pathomechanism shared by these diseases is the autoimmune response against structural proteins of the dermoepidermal junction. Multiple pathomechanisms have been proposed to cause the dermo-epidermal blister formation. Humoral immune response, in conjunction with complement activation, neutrophil and/or eosinophil recruitment and Fc-receptor mediated inflammation, has been shown to have damaging effects to BMZ structures in the majority of human AISBDs. Furthermore, support for the independent effects of autoantibodies on blister formation has been shown in some disease models. Because of the similarities, the pathomechanism(s) of blister formation in veterinary species are presumed to share features of their human counterparts, though detailed investigations have not been performed yet. Nonetheless, the knowledge about the similarities and differences between the most common human and animal AISBDs could help us in selecting relevant treatment strategies and assist in the diagnostic process. Indeed, the diagnosis of a specific AISBD is made by combining clinical features with histological and, depending on the disease, immunopathological data (e.g., direct immunofluorescence (IF), indirect IF on saltsplit mucosa, antigen-specific ELISA). Unfortunately, commercial laboratories do not offer routine immunotesting for veterinary species and, therefore, the diagnostic ability of veterinarians to properly classify these cases is limited. To deal with these limitations, veterinarians are often left with a periodic acid-Schiff stain (PAS) or anti-collagen IV immunohistochemistry (IHC) to demonstrate the level of the dermo-epidermal split to narrow down the list of possible AISBD variants. Regrettably, because of their frequently negative staining, these techniques have been shown unreliable for distinguishing individual AISBDs in people. The main AISBDs in animals, the diagnostic process and its limitations and treatment strategies will be discussed in this lecture. Conflict of interest: None declared. Suggested reading: 1. Egami S, Yamagami J, Amagai M. Autoimmune bullous skin diseases, pemphigus and pemphigoid. J Allergy Clin Immunol. 2020 Apr;145(4):1031-1047. DOI: 10.1016/j.jaci.2020.02.013. PMID: 32272980. 2. Daniel BS, Murrell DF. Review of autoimmune blistering diseases: the pemphigoid diseases. J Eur Acad Dermatol Venereol. 2019 33(9): 1685-1694 3. Olivry T, Chan LS. Autoimmune blistering dermatoses in domestic animals. Clin Dermatol 2001; 19: 750-760. 4. Olivry T. An autoimmune subepidermal blistering skin disease in a dog? the odds are that it is not bullous pemphigoid. Vet Dermatol 2014; 25: 316-318. 5. Tham HL, Olivry T, Linder KE, et al. Mucous membrane pemphigoid in dogs: A retrospective study of 16 new cases. Vet Dermatol 2016; 27: 376-e94. 6. Bizikova P, Linder KE, Wofford JA, et al. Canine epidermolysis bullosa acquisita: A retrospective study of 20 cases. Vet Dermatol 2015; 26: 441-50, e102-3. 7. Olivry T, Bizikova P, Dunston SM, et al. Clinical and immunological heterogeneity of canine subepidermal blistering dermatoses with anti-laminin-332 (laminin-5) auto-antibodies. Vet Dermatol 2010; 21: 345-357.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 CLINICAL MANIFESTATION OF OVERGROOMING: CLINICAL IMPLICATIONS ON FELINE DERMATOLOGY L. ORDEIX Dermatology service, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain Departament de Medicina and Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain Grooming is a frequently performed, centrally controlled, behavioral pattern of cats. Some cats have been observed to spend up to one-third of their time awake grooming. One of the important functions of grooming in nature is the removal of ectoparasites. In fact, one study has revealed that flea exposure can increase grooming rate in cats and that grooming is effective in removing fleas. Other functions attributed to grooming are removal of dirt and stale oil, maintaining the insulating capacity of the pelage and temperature control. There are two grooming patterns in cats. Oral grooming is cephalocaudallydirected and multiple-region oriented (around the head in the form of face washing, licking of the hindlimb, sides/back, neck/ chest, anogenital region, abdomen and tail). A second, less frequently performed pattern, is scratch grooming directed to a single region, most often to the chin, followed by the ear and neck. Interestingly, there is no significant difference in behavioral time budget for grooming and grooming patterns between longhair and shorthair cats. Excessive self-grooming is considered a behavioral alteration, an aberrant form that may be clinically associated with secondary cutaneous lesions. This overgrooming meets the criteria as formulated for stereotyped behaviors and preceding stress is associated with its occurrence and considered an indicator of poor welfare. Excessive oral grooming (self-licking and hair-pulling) usually results in symmetric alopecia with stubbed hairs on those areas submitted. This disorder is known as psychogenic alopecia. Behavioral ulcerative dermatitis is a recently described behavioral problem resulted from excessive scratch grooming. It is clinically characterized by a crusted, non-healing, self-induced ulcer occurring most commonly on the dorsal or lateral neck or between the scapula. These grooming repetitive behaviors may be considered differential diagnoses of dermatologic diseases associated with pruritus. Clinical features useful to orientate the diagnosis are the pattern of oral grooming and the presence of primary cutaneous lesions. In the case of self-induced symmetric alopecia, one would expect differences in the oral grooming pattern depending on the cause, if it is a consequence of an itching or peripheral stimulus or is a centrally programmed behavioral pattern. If grooming was the response to peripheral stimuli, one would not expect grooming bouts to sequence from one area to another in a cephalocaudal trend. Moreover, the presence of cutaneous lesions that the cat was unable to induce itself such as papules, plaques, nodules, would suggest a primary inflammatory skin condition. Conflict of interest: The author has declared no conflict of interest for this lecture.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 DIAGNOSTIC APPROACH TO SYMMETRIC ALOPECIA: COMPARATIVE ASPECTS BETWEEN DOGS AND CATS L. ORDEIX Dermatology service, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain Departament de Medicina and Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain During the diagnostic process, diagnostic hypotheses are generated based on the knowledge of the diseases that manifest themselves in a certain clinical pattern or problem. Subsequently, a probability of occurrence is assigned to each of them based on other factors such as the prevalence of the disease and the clinical history data. This order of probability is adjusted until a single, ideally definitive diagnosis is reached based on the information obtained from the diagnostic tests. Some dermatologic problems defined both in cats and dogs share morphological characteristics, causes and the diagnostic protocol between species. Others, such as symmetric alopecia does not. In dogs, non-inflammatory symmetric alopecia is defined if the patient presents a complete or partial loss of the coat in the absence of clinical alterations suggestive of dermatitis and with a symmetric distribution. The distribution of alopecia in dogs can vary depending on its origin, however, most of the diseases associated with this problem generally respect the head and distal half of the extremities. On the other hand, in most cats, there is no true alopecia but, after a dermatologic examination, we observe the presence of broken hairs probably as a consequence of excessive licking. If so, the clinical problem is defined as selfinduced symmetric alopecia. On rare occasions, the cat may manifest symmetric alopecia with spontaneous complete hair loss. Non-inflammatory symmetric alopecia in dogs can result from an alteration in the follicular cycle or the morphology of the hair and/or hair follicle (dysplastic disorders). The main causes for an alteration of the follicular cycle are hormonal in origin (hypothyroidism, hypercortisolism and hyperestrogenism). Typically, affected dogs are adult-old dogs with an endocrine pattern of alopecia (neck, trunk, back of thighs, perineum, tail). Dysplastic follicular disorders are typical of young dogs and in certain predisposed breeds. Alopecia X and canine recurrent alopecia are idiopathic diseases in between these two causes of symmetric alopecia. Alopecia X is presented as endocrine pattern alopecia, while the last one is commonly presented affecting only the flanks and/or the dorsal part of the nose. Self-induced symmetric alopecia in cats is typically associated to cutaneous hypersensitivities and distribution rarely suggests the cause. Less commonly a behavior disorder (overgrooming) or a hyperthyroidism may be at the origin of an excessive selflicking or hair-pulling. In rare cases of spontaneous symmetric alopecia, a paraneoplastic disease should be considered. The diagnostic hypotheses for a canine case will be refined and verified initially based on the results of blood workup, urinalysis and thyroid function evaluation. If there are clinic-pathological alterations suggestive of hyperestrogenism or hypercortisolism, abdominal +/- testicular ultrasound and specific adrenal function evaluation will be performed. Skin biopsies are useful for the final diagnosis of dysplastic and idiopathic alopecies. Diagnostic protocol for self-induced symmetric alopecia in cats should include diagnostic tests to rule out non-allergic causes of pruritus before performing the diagnostic protocol for allergic dermatitis. Blood and urinary workup, dermatopathologic examination and referral to an ethologist will be performed case by case. Conflict of interest: The author has declared no conflict of interest for this lecture.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 MAIN SKIN DISORDERS IN RABBITS J. MARTORELL Departament de Medicina I Cirurgia Animals Fundació Hospital Clinic Veterinari Facultat de Veterinaria. Universitat Autònoma de Barcelona. 08193 Bellaterra, Barcelona, Spain Many skin diseases are seen in pet rabbit practice. Although many rabbits are kept indoor, infectious diseases of domestic rabbits are being reported. Clinical history is very important, especially as bad diet, environment, behaviour and management can contribute to develop many problems. All of these factors should be addressed to the owner in order to resolve and avoid the recurrences of the skin diseases. Bacterial, fungal and parasites are the most common causes of infectious dermatitis, however some virus, such as myxoma virus can cause a sever dermatitis in this specie. The predominant clinical signs are alopecia, pruritus, scaling and nodules. Because of a high number of skin diseases may present with variable clinical signs, if we know the differential diagnosis, the approach to skin disease in the rabbit will be easier. Alopecia. In rabbits. there are some body areas with low fur density, dorsal neck, especially in belier rabbits, and the scrotum in bucks. Barber¬ing causes alopecia without other signs of dermatitis; females pull her hair to do the nest. However, alopecia should be considered as a clinical sign in the neck when it happens secondary to injection or vaccination. Barbering, hair pulling and In those cases, alopecia is preceded by a crusty lesion. Alopecia, crusty, erythematous, or pruritic lesión is seen in young animals, parasite and fungal dermatitis are seen very often in clinical practice. Psoroptes cuniculi and Trichophyton mentagrophytes are the most common causes, respectively. In adult and obese rabbits with improper grooming, Cheyletiella can cause subclinical disease; it causes a scaly, dry, sometimes pruritic dermatitis with patchy alopecia or broken hairs over the dorsal neck, trunk, hind end, and abdomen. Other affecting rabbits mites are Leporacarus gibbus, Sarcoptes scabiei, Notoedres cati, Demodex and Ornithonyssus bacoti. Moist dermatitis is another cause of alopecia. Ventral neck moist dermatitis can result from exces¬sive drooling secondary to dental disease or from a constantly wet dewlap in rabbits that drink of bowls. Perianal or inguinal moist dermatitis occurs in rabbits with polyuria due to renal disease, cystitis, urolithiasis, or microurinary calculi. Pododermatitis is a chronic dermatitis of the plantar metatarsal that starts as erythematous alopecia area, following as an bacterial ulcer; this infection can cause osteomyelitis and sepsis. Subcutaneous abscesses commonly occur in rabbits from trau¬matic wounds or bacteremia secondary to tooth root infection, oral foreign bodies, or upper respiratory tract or urinary tract infections. Rabbit skin tumors include squamous cell car-cinoma, basal cell tumor, trichoepithelioma, trichoblastoma, sebaceous cell carcinoma, nonviral squamous papilloma, apo¬crine carcinoma, meibomian adenoma, sebaceous carcinoma, lipoma, liposarcoma, myxosarcoma, nerve sheath tumor, fibrosarcoma, leiomyosarcoma, leiomyoma, rhabdomyosar-coma, anaplastic sarcoma, and malignant melanoma. Conflict of interest: I have no relevant financial interest, arrangement or affiliation with any company or organization.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 DERMATITIS AND DYSECDYSIS IN REPTILES J. MARTORELL Departament de Medicina I Cirurgia Animals Fundació Hospital Clinic Veterinari Facultat de Veterinaria. Universitat Autònoma de Barcelona. 08193 Bellaterra, Barcelona, Spain Reptile skin is dry, and the scales are arranged in regular geometric patterns. Scales may vary in size, shape, and texture from species to species, and they are frequently used to assist with the taxonomic classification of a species. Ecdysis is a normal physiologic occurrence in reptiles that is characterized by a renewal stage, and resting phase. Because reptiles are ectotherm animals, they depend on the environmental temperature to regulate their core body temperature. And this temperature is needed to develop a normal metabolic rate and a good immune response. Abnormal shedding is the most common presentation of skin disease in reptiles. This phenomenon is called dysecdysis. Reptile dermatitis are due to infectious or non-infectious causes, such as environmental, nutritional deficiencies, trauma, although the most cases use to occur due to a combination of both causes. Specific environmental questions should include the environmental temperature gradient (lower and upper values, refresh areas), humidity, type and size of enclosure, substrate, lighting, photoperiod, contents of the enclosure, such as plants, rocks, and the number of reptiles housed in the enclosure. Among the infectious causes, fungi have been described in all orders and suborders of reptiles, but in tuatara. The most fungal infections are due to yeasts and filamentous fungi. The species most often described are Aspergillus, Fusarium, Geotrichum, Microsporum, Mucor, Penicillium, Trichophyton, Trichosporn and Candida. They have not always been associated to primary diseases, but they use to act as opportunist agents. But Fusarium semitectum and Chrysosporium anamorph of Nannizziopsis vriesii species have been isolated from primary agents of skin diseases in tortoises and chameleons, respectively. Conflict of interest: I have no relevant financial interest, arrangement or affiliation with any company or organization.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 ALLERGY TESTING IN HORSES K. BERGVALL Department of Clinical Sciences University of Agriculture, Uppsala, Sweden In horses, a spectrum of conditions can be associated with allergic hypersensitivity reactions including pruritus, urticaria, eosinophilic granulomas and inflammatory airway disease. All of these clinical entities can though have other, nonallergic, pathogenesis. In allergy, IgE needs to be functional, bound to effector cells and be able to degranulate these cells. Demonstration of elevated total IgE or allergen specific IgE alone does unfortunately not discriminate between atopic and non-atopic horses and allergy remain a diagnosis based on exclusion of differential diagnoses. In humans, allergic patients have a significantly elevated total serum IgE, whereas healthy dogs, cats and horses have a total IgE that is extremely high, with no statistical difference between healthy and atopic individuals. Nevertheless, allergy testing can aid in the work to identify offending allergens in an atopic patient in which treatment with allergen specific immunotherapy (ASIT) is desired. In vivo testing via intradermal test or in vitro testing via IgE serology can both be used for this purpose, with different benefits and draw backs. Serology testing is easy to perform and less sensitive to previous medication. IgE half-time in serum (humans) is 2-3d and test results mirror what happened during last days. For this type of test pre-determined panels of allergens for testing are provided via test manufacturer. In horses testing with monoclonal ab to equine IgE is likely to improve reliability of the test. Furthermore, presence of plant allergen sugars (cross-reactive carbohydrate determinants, CCDs) can lead to reactions falsely interpreted as pollen reactions if not blocked by CCD-inhibition. Intradermal testing (IDT) on the other hand do not only indirectly demonstrate presence of allergen specific IgE, but also the ability of the IgE to degranulate mast cells (MC) in tissue upon challenge with a specific allergen. IgE half-life on MC is 1620d and positive reactions represent a more sustained IgE-production or what happened weeks earlier. Interpretation of IDT needs a trained clinician and drug withdrawal time of 7-14d for antihistamines and 2-4w for glucocorticoids. Sedation with detomidine, butorphanol and xylazin do not affect test results, but phenothiazine inhibits test reactions. For IDT, the clinician can decide what individual allergens to test for. For both test methods, the lack of standardization of allergens (i.e. recombinant allergens) is problematic. For insect hypersensitivity IgE testing with today commercially available allergens are not helpful for diagnosis or ASIT. Testing with local variant of insect species improve results, and especially the work to identify and produce recombinant major insect allergens can in the future give us better possibilities for both diagnosis and treatment in IBH horses. Only few studies on eq ASIT efficacy have been published. In summary ASIT in atopic horses was reported effective in 60-80%, with approximately 1/3 relapsing after discontinuation of immunotherapy after 9m-2y treatment. In one study an increased efficacy rate could be seen in horses that continued therapy for 2 years. No difference in response rate has been reported whether ASIT was based on IgE serology or IDT. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 HOW TO MANAGE EQUINE PRURITUS K. BERGVALL Department of Clinical Sciences University of Agriculture, Uppsala, Sweden Pruritus in horses is not uncommon and can constitute a severe animal welfare problem. For a clinician, dealing with equine pruritus can be a challenge, both to identify underlying condition and pharmacologically address the pruritus. With help of signalment, history and distribution of pruritus and skin lesions, the list of differential diagnosis can be narrowed. For example horses with heavy leg feathering are more prone to Chorioptes infestation and Icelandic, Shire, Friesian, Arabian, Quarter horses, Thoroughbreds, Shetland and Welsh ponies, Connemaras and PRE horses have been reported overrepresented with insect bite hypersensitivity (IBH). Horses with a longer hair coat (winter time, PPID or poor condition) are more likely to have lice infestation and Chorioptes infestation elicit more clinical signs during autumn, winter and early spring. On the other hand, Trombiculosis is seen during late summer months/early autumn and IBH reflects the insect season. Looking at the body distribution of pruritus, IBH affects the base of the mane and tail, ears, under the fore lock, intermandibular space, ventral midline and axillae and groin. Leg pruritus make Chorioptic infestation, trombiculosis, contact reaction, poultry mites and nematode dermatitis more likely. For pruritus mainly affecting the rear end IBH, Oxyuriasis, yeast overgrowth, Chorioptes infestation should be considered, but also atopy and food hypersensitivity should be kept in mind. For the latter two, a more generalized distribution of pruritus is often present, and seasonal distribution reflects exposure to offending allergen. Treatment protocols focus on addressing underlying condition, but may also include various symptomatic treatments. For IBH avoidance of biting insects is important. The use of protecting blankets and repellants are helpful. Topical use of antipruritic shampoos, essential oils, corticosteroids are helpful to reduce pruritus and inflammation. Systemic antipruritic treatment include antihistamines (Cetirizine 0,2-0,4mg/kg BID, Hydroxyzine 200-400mg/500kg BID) and corticosteroids (prednisolone 0,5-1mg/ kg SID). Dexamethasone and triamcinolone are more potent corticosteroids, but carries increased risk of inducing the severe side effect of laminitis. I one study antihistamine was effectively controlled pruritus in 61% of atopic horses and corticosteroids in 94%. In case antihistamine should be tried in a horse with an already ongoing allergic inflammation, addressing lymphocyte and eosinophilic infiltration with corticosteroids for 1-2 weeks improve the chance of efficacy. Anecdotally also tricyclic antidepressants (Doxepin 300-600mg/500kg BID), calcineurin inhibitor (cyclosporine 5mg/kg SID) and oclacitinib have been used (0,25mg/kg BID 14d, then 0,125mg/kg EOD). Very promising future symptomatic treatments consist of cytokine vaccination. IL-5 is a very strong chemotactic factor for eosinophils. With a vaccine consisting of equine IL-5 (eIL-5) linked to a cucumber mosaic virus-like particle (VLP) aab to IL-5 was induced and effectively reduced pruritus in a majority of vaccinated IBH horses. In another study the VLP vaccine was designed to induce aab to eqIL-31, an important mediator of equine pruritus. The vaccine was effective in controlling pruritus in allergic horses. Both these vaccines are promising for future treatment. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 LISTEN UP! A STEP-BY STEP APPROACH TO THE DIAGNOSIS OF EAR INFECTIONS IN DOGS A. VAN DER LEE Evidensia-group, Netherlands Otitis externa (OE) in dogs is a very common disorder in both first line and referral practice. It may occur as unilateral or bilateral. Episodes of recurrent otitis have the greatest risk of progression into chronic disease. Especially these chronic cases are frequently painful and difficult to manage, and are therefore most often referred to a dermatologist. Otitis externa is not a stand-alone disease. When one understands the ear anatomy and the factors underlying the disorder, targeted treatment can be performed leading to an improved prognosis. This lecture aims at making the diagnosis of canine OE easier and thereby minimizing the occurence of chronic OE by means of the use of a systematic approach, the so-called PPSP-system. PPSP stands for predisposing, primary, secondary and perpetuating factors, all contributing to the development and maintenance of the OE. Predisposing factors are factors not causing OE by themselves, however, they can increase the likelihood of the development of OE. Frequently swimming and excessive ear canal hair growth are examples. Primary factors are factors actually causing the OE. Allergy, in particular atopic dermatitis (food-induced and non-food induced), is a well-known underlying disease. Other frequently occurring examples of underlying diseases which may cause OE are hypothyroidism and sebaceous adenitis. Ectoparasites causing OE are Otodectes cynotis and less common Demodex canis can be found. Secondary factors are skin infections, which proliferate when the environment of the external ear canal becomes favourable. Infections with bacteria as Staphylococci spp. and Streptococci spp. and the transient bacteria Pseudomonas aeruginosa, Proteus spp. and E. coli are frequently seen. The yeast Malassezia pachydermatis is often found, especially in allergic dogs. Perpetuating factors are factors as a result of the development of OE. They will lead to ongoing OE and are therefore present in chronic cases. Examples are epithelial hyperplasia, stenosis and calcification of the external ear canal, and otitis media. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
PRACTICAL PROGRAMME SATURDAY 18 SEPTEMBER 2021 HOW TO TREAT EAR INFECTIONS IN DOGS: WHERE DO WE STAND? A. VAN DER LEE Evidensia-group, Netherlands Canine otitis externa (OE) is a very common disorder and treatment may have some challenges. Often the focus of treatment is erroneously only based on the secondary microbial ear infection, leading then often to recurrent OE, while easily inducing bacterial resistance. Therefore, treatment of otitis externa should always address the predisposing, primary and perpetuating factors in addition to the secondary infections. Manual ear cleaning is necessary in cases with large amounts of debris. The presence of an abundance amount of cerumen can obscure a corpus alienum, will provide a favourable environment for microbial infections, will block the sight of the tympanic membrane and will lower the effect of otological treatment formulations. The use of commercial ear cleaners is recommended for this matter, especially when recurrent OE ceruminosa is the case due to overproduction and/or a lower epithelial migration. Various ear cleaners can be used, however, one should choose the best fitting cleaner for the patient at that particular time, based on its ingredients and the composition of the cerumen (e.g. dry or waxy) present. Various ear cleaners also have proven antimicrobial activity. Especially chlorhexidine and Tris-EDTA will help in effectively manage bacterial infections, regardless of their antibiotic resistance. An ear flush with tap-water or saline is safe and effective to perform in clinic. A thorough cleaningup of the external ear canal and middle ear by video-otoscopy under general anaesthesia is mandatory in many chronic cases. Ear canal erythema, seborrhea, pruritus, pain and malodour are frequently seen as the result of ear infections. The infection may be either bacterial, fungal (yeast) or a mixed infection, which needs to be diagnosed by cytologic examination. Culture and sensitivity data are less useful for topical drugs because concentrations in the ear canal are much higher than those used with in vitro tests. Antimicrobial sensitivity data can be used to predict the efficacy of systemic drugs, although the concentration in the ear tissues is often too low and very high doses are needed. Hence, treating canine OE with systemic antibiotics is commonly not recommended. To prevent development of bacterial resistance, alternative antimicrobial compounds have been studied. Silver sulfadiazine, medicated honey and anti-microbial peptides have predominantly shown their activity in vitro. Acetic acid or salicylic acid drops combined with triamcinolone are good options to pro-actively prevent OE flare-ups in the atopic dog. Furthermore, almost all topical ear formulations include a glucocorticosteroid to manage the inflammation. Acute and milder cases will be well managed with the lower potent hydrocortisone and triamcinolone, while the more severely proliferative and hyperplastic cases will need the more potent steroids as mometasone furoate, betamethasone, dexamethasone and hydrocortisone aceponate. In summary, the choice for a particular topical ear formulation should be based on the infection and the severity of the existing inflammation present. Best results are achieved when the ear is cleaned prior to treatment. For recurrent or chronic cases, the perpetuating factors need to be reversed or controlled whenever possible. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME SATURDAY 18 SEPTEMBER 2021 PATHOGENESIS, PROGRESSION AND TREATMENTS IN EARLY-ONSET PEDIATRIC ATOPIC DERMATITIS P. BRUNNER Medical University of Vienna Austria Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in humans. The disease typically starts very early during life. Fortunately, the majority of patients show spontaneous clearance of this disease when growing up, while a subset suffers from life-long disease. The reason for this phenomenon is not yet fully understood. However, we now know that early-onset AD in children shows some important differences from adult AD, which might be relevant for future therapeutic approaches in this yet understudied patient population. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME SATURDAY 18 SEPTEMBER 2021 PATHOGENESIS, PROGRESSION AND TREATMENTS IN LONGSTANDING ADULT ATOPIC DERMATITIS P. BRUNNER Medical University of Vienna Austria During the last few years, our pathophysiological understanding of atopic dermatitis (AD) has tremendously increased. Better insights into disease mechanisms have directly led to the development and approval of various novel treatment approaches, which are highly effective, at an excellent safety profile. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME SATURDAY 18 SEPTEMBER 2021 CANINE AND FELINE PEMPHIGUS: PART 1 & 2 P. BIZIKOVA Department of Clinical Sciences, College of Veterinary Medicine North Carolina State University, USA Veterinarians have been aware of the existence of a naturally occurring pemphigus in domestic animals for decades. Canine and feline pemphigus, like in people, encompasses four variants: pemphigus foliaceus (PF), pemphigus vulgaris (PV), pemphigus vegetans (PVeg; not described in cats) and paraneoplastic pemphigus (PNP). Pemphigus erythematosus is considered to be a facial-restricted variant of pemphigus foliaceus. Pemphigus foliaceus is the most common pemphigus variant in dogs and cats, while PV, the most common variant in people, is seen only rarely in our companion animals. In this lecture, selected topics on canine and feline pemphigus will be reviewed. These will include: - our current knowledge about the pathomechanism of pemphigus and its comparison with its human counterpart - antibodies and autoantigens - neutrophils and PF - clinical features of canine and feline pemphigus foliaceus - diagnostic approach and diagnostic dilemmas - canine trunk-dominant PF and generalized impetigo - polyautoimmunity - treatment strategies and novel treatment options Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ADVANCED PROGRAMME SATURDAY 18 SEPTEMBER 2021 SKIN DIETS: WHAT MAKES THEM SPECIAL FOR ATOPIC DERMATITIS AND BEYOND C. VILLAVERDE, R. MUELLER, H. JACKSON This page has been left blank for notes.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 SEBACEOUS GLAND: BIOLOGY AND PHYSIOLOGY (I) G. NIKOLAKIS*† and C. C. ZOUBOULIS*† * Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane † Faculty of Health Sciences Brandenburg, Dessau, Germany The human sebaceous gland (SG) is a small, branched type multiacinar gland, which can be found in all areas of the human skin except of palms, soles and dorsum of the feet. The SG is an integral part of the pilosebaceous unit (also including the hair follicle and the arrector pili muscle) and consists of secretory lobules formed from its epithelial cells, called sebocytes, and a short tubular infundibulum, composed of sebaceous duct cells. Although their number appears to remain relatively constant, their size tends to increase with age. Culture of primary sebocytes in vitro or of sebaceous glands in full-thickness skin is problematic, mainly because of the function of these cells, namely to undergo a type of programmed cell death called holocrine secretion. During this process, sebocytes gradually accumulate lipid droplets until they burst and release their content to the supernatant. Primary sebocytes can be subcultured for a maximum of three to six passages. To address this problem cell lines of immortalized sebocytes were created using various methods, which would retain the properties of primary cells but would be able to be sufficiently subcultured, with the human SZ95 sebaceous gland cell line being the first one. More sophisticated sebaceous gland models, including co-culture models and three-dimensional culture in matrigel lattices were subsequently developed to better mimic the in-vivo situation. Cardinal role of the gland is the production and secretion of sebum, which is species-specific and has antimicrobial, photoprotective and antioxidant capacities. Moreover, it is involved in inflammatory processes through specific lipids. Its components include free fatty acids, triglycerides, wax esters, squalene, cholesterol esters and cholesterol. Moreover, it possesses all the necessary enzymatic machinery to produce steroid hormones including sex hormones de novo from cholesterol, and catalyze more potent ones from their precursors, having a role of hormonal finetuning of steroidogenesis in situ. Receptors for insulin growth factor, corticotropin-releasing hormone, melanocortin-1 and melanocortin-5, progesterone, retinoic acid, vitamin D were also found to be expressed in sebocytes. Moreover, peroxisome proliferator-activated receptors α, γ and δ, crucial molecules for the follicular homeostasis, were detected in sebocytes and were demonstrated to orchestrate lipid accumulation, sebaceous differentiation and inflammation. Major physiologic processes mediated by the sebaceous gland and its mediators will be presented in this lecture, providing fundamental knowledge for the understanding of the most sebaceous gland-related diseases, such as acne, rosacea, seborrhea and sebaceous hyperplasia. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 SEBACEOUS GLAND PATHOLOGY G. NIKOLAKIS*† and C. C. ZOUBOULIS*† * Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane † Faculty of Health Sciences Brandenburg, Dessau, Germany This presentation is an overview of the major disorders of the pilosebaceous unit, where the sebaceous gland plays a key role in their pathogenesis, namely: acne, rosacea, sebostasis and seborrhea. Acne vulgaris is an inflammatory disease of the pilosebaceous unit, which usually manifests with puberty and is localized in the face, chest and back of the patients. Its complex pathophysiology includes follicular plugging through keratinocyte hyperproliferation, an aberrant innate immune response to bacteria (Cutibacterium acnes, formerly known as Propionibacterium acnes), an in situ hyperresponsiveness to normal levels of circulating androgens, environmental factors (nutrition and smoking). Human sebocytes, keratinocytes and skin macrophages express CD14 and Toll-like receptors (TLR2 and TLR4). Interestingly, C. acnes can directly activate the NLRP3 inflammasome, resulting to production of IL-1β in human sebocytes and can form biofilm-like clusters inside the sebaceous follicle. C. acnes thus promotes sebaceous lipogenesis and inflammation, through production of the IL-6 and IL-8. An upregulation of antimicrobial peptides in acne was also observed in lesional skin. The central role of the sebaceous gland in the homoeostasis of the skin is indirectly underlined by the fact that inflammatory cutaneous diseases with a predominat TH1 response – such as psoriasis and hidradenitis suppurativa/acne inversa – are characterized by a reduced volume or number of sebaceous glands. Peroxisome prolifetor receptors regulate sebaceous lipogenesis and agonists of such drugs – such as the antidiabetic drugs thiazolidinediones – increase sebum production. Rozacea is an inflammatory disorder affecting mostly middle aged women and men (3:1) with telangiectasias in the centrofacial area with progress to acne-like papules and pustules or even granulomatous lesions. Dermatoendocrinologic factors and an aberrant immune response or hypercolonization with Demodex folliculorum, as well as environmental factors (stress, alcohol, sun exposure) contribute to the manifestation of the disease. Knowledge from the pathophysiology of human cutaneous disorders of the sebaceous gland might provide useful insights in animal sebaceous gland pathologies and facilitate the development of new treatment strategies in veterinary medicine. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 DIAGNOSTIC DILEMMAS C. BRACHELENTE, M. PELETEIRO This page has been left blank for notes.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 ISVD GRANT 2019 PRESENTATION M. DETTWILER*, G. WANG†, A. C. DURHAM‡ * University of Bern Vetsuisse Faculty, Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Bern, Switzerland, and Vetscope Pathologie Dettwiler, Riehen, Switzerland †University of Pennsylvania, Perelman School of Medicine, Department of Pathology & Laboratory Medicine, Philadelphia, PA, USA ‡ University of Pennsylvania, School of Veterinary Medicine, Department of Pathobiology, Philadelphia, PA, USA Genetic mutation profiling of canine cutaneous epitheliotropic T-cell lymphoma – the key to predict prognosis and therapy response of this poorly predictable disease? Canine cutaneous epitheliotropic T-cell lymphoma (CETCL) is a heterogenous neoplastic skin disease with an incompletely understood pathogenesis. Many dogs diagnosed with CETCL show poor response to chemotherapy and rapid progression to generalized skin involvement and lymph node metastasis. A proportion of dogs exhibit slower disease progression and better response to therapy; however, these cases cannot be identified by currently available diagnostic methods. Skin biopsies from CETCL-afflicted dogs display variable histomorphological features, but the underlying cause and impact on prognosis of these features is unclear. Data from human pathology suggest that along with immunophenotyping, the mutational profile is a major prognostic determinant. We hypothesized that genetic alterations are also present in canine CETCL and may explain the differences in histomorphology and clinical behavior. In a retrospective study, a systematic histopathological evaluation of canine CETCL was performed, and the mutational profile of a subset of cases was investigated with targeted next generation sequencing (NGS). Data on clinical history and survival were collected from 176 canine CETCL cases retrieved from the biopsy archives of the University of Pennsylvania, USA, and the University of Bern, Switzerland (2012-2018). Histopathological evaluation was performed using digitized HE slides and open access QuPath software. Parameters assessed included degree and distribution of the neoplastic infiltrate, cellular morphology and size, mitotic count, and additional findings (e.g. keratinocyte apoptosis, mucinosis, etc.). From this cohort, 32 cases representing a wide spectrum of histomorphological features, survival times, and treatment modalities were selected for NGS. Genomic DNA was extracted from formalin-fixed, paraffin-embedded neoplastic tissues, and non-neoplastic tissue from 5 cases using standard protocols. DNA of 31 dogs was able to be sequenced utilizing a previously designed NGS hybrid-capture targeted panel (The Canine Oncopanel) to screen for a wide-spectrum alterations in 283 cancer genes that are commonly mutated in human and canine cancers. Results were compared with survival data. The NGS cohort included 17 dog breeds and the median survival time was 65 days (2 – 728 days). NGS sequencing identified 748 non-synonymous mutations affecting 223 genes in 31 tumors, with an average mutation count of 24 per sample (range 3-95). Most frequently mutated genes were CIC (n= 11), LRP1B, PCLO, FAT1, KMT2A, TP53 and WRN (n= 10 each). Mutations in STK11 and SMARCA4 were associated with shorter overall survival (HR 5.870 and 3.552, respectively, p<0.05), while mutations in PLCG1 were associated with longer overall survival (HR 0.128, p=0.05). Potential associations between specific mutations and clinical and histopathological parameters need additional exploration. In conclusion, our study revealed a considerable number of mutations in cancer-related genes in CETCL, of which some are potential prognostic markers. Their influence on pathogenesis, histomorphology, treatment response and outcome require further investigation. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 SKIN TUMOUR MARKERS, WHAT’S NEW? M. DETTWILER*† * Vetscope Pathologie Dettwiler, Riehen, Switzerland †Institute of Animal Pathology, University of Bern, Bern, Switzerland In the last two decades, the development, availability, and affordability of high-throughput screening methods, large datasets and complex computational analyses have leveraged biomedical research, and have opened new possibilities to search for novel biomarkers in cancer and non-neoplastic diseases. For example, next generation sequencing (NGS) methods like whole exome or transcriptome sequencing performed on blood and tissue samples provide a comprehensive and unbiased approach to search for genetic variants and transcriptional differences between cancer subtypes. Resulting genes and their proteins may help to understand pathogenesis, may prove as diagnostic or prognostic markers or may even emerge as drug targets. Publicly available datasets comprising histopathological specimens, molecular profiles and clinical history of thousands of cancer patients offer an additional huge playground to confirm NGS study results, and to search for novel biomarkers in silico. Within the last few years, human skin cancer researchers generated several hundreds of publications by employing the new techniques, mainly focusing on melanoma and squamous cell carcinoma, and revealed a handful of novel diagnostic or prognostic markers. The advanced research techniques have also become available and affordable for veterinary researchers in recent years. So, what about skin cancer research in veterinary medicine? Is there a success story to report for canine, feline and equine skin cancer tumor markers as well? This talk will focus on the most common malignant or potentially malignant skin tumors in dogs, cats and horses, namely mast cell tumors, melanocytic tumors, epidermal tumors, sarcoids, soft tissue and vascular sarcomas, hair follicle tumors and cutaneous lymphoma, and will give an overview over the current state of knowledge in veterinary pathology considering diagnostic and prognostic markers. Moreover, it will give an outlook on research techniques and tumor marker discoveries from human medicine of potential interest and relevance for animals. Conflict of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
ISVD ANNUAL MEETING DAY SATURDAY 18 SEPTEMBER 2021 MYSTERY SLIDES B. MCMAHILL, C. GANTA, D. WIENER This page has been left blank for notes.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS INDEX ➔ Transcriptome signatures in peripheral blood and skin cells of dogs with atopic dermatitis, C. Altunbulakli ➔ Topical application of a combination of piperonyl butoxide with permethrin and prednisolone acetate for the treatment of Psoroptes cuniculi in naturally infected rabbits, E. Alvarez ➔ A case of environmental allergy and classical Ehlers-Danlos syndrome in a domestic shorthair cat caused by a heterozygous COL5A1 frameshift deletion, N. Apostolopoulos ➔ Characterization of the pro-inflammatory and pruritogenic transcriptome in equine insect bite hypersensitivity, F. Banovic ➔ Transcriptome profiling of spontaneous canine atopic dermatitis lesional and non-lesional skin using deep RNA sequencing, A. Blubaugh ➔ Concerns about human contact allergens in skin-and-coat veterinary products, A. Belloni Fortina ➔ Oclacitinib alternative, off-label protocol for canine atopic dermatitis: can cost be reduced?, A. Bizarro ➔ Dogs with moderate to severe leishmaniosis present an exaggerated allergen-specific immunologlobulin E immune response, M. Cabré ➔ Comparison of scratching severity by owner completed PVAS to Whistle canine collar, A. Carson ➔ Development and validation of an owner-assessed visual analogue scale (VAScat) for feline pruritus severity scoring, S. Colombo ➔ Effect of a natural spot-on based on phyto-ceramides, plant-extracted essential fatty acids and essential oils on reconstructed canine epidermis, C. Darmon-Hadjaje ➔ Compliance and side effects of oral ciclosporin A administration in cats: a 4-year retrospective survey of long-term administration in referral practice, S. Deleporte ➔ Single myringotomy for the treatment of otitis media in cats : a retrospective study, S. Deleporte ➔ Human skin tolerance to dog hygiene products: evaluation of two hypoallergenic, irritant-free formulations, M. De Lucia ➔ Pyoderma gangrenosum in dogs: a retrospective, single-center analysis of 13 cases, M. De Lucia ➔ Are images worth a thousand words? Testing a video for owners’ education in canine atopic dermatitis, B. Fernandes ➔ Alopecia areata concurrent with atopic dermatitis in three dogs, G.A. Grapí ➔ First description of a Toxic Shock-like Syndrome (TSLS) in a cat, E. Guaguere ➔ Urticarial vasculitis in dogs: a report of 4 cases, E. Guaguere ➔ Skin barrier reinforcement effect of a spot-on based on natural ingredients in a dog model of tape stripping, A. Idee ➔ Development of a qPCR for the detection of Chorioptes spp in equine skin scrapings, M. Isaksson
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
➔ Characterization of clinical phenotype (cutaneous lesion score and central sensitization) and comparison of serological allergen-specific IgE and intradermal testing in a colony of atopic-like cats, J. Lefrançois ➔ The middle ear microbiota in healthy dogs is similar to that of the external ear canal, C. Leonard ➔ In vitro antibacterial effect and cytotoxicity on canine keratinocytes of PurO3 Ozonated Olive Oil, N. Maheas ➔ Bedlington terriers diagnosed with familial footpad hyperkeratosis are carriers of an FAM83G missense variant, N. Makri ➔ Ear inflammation and hearing measurements: taking advantage of preclinical tools to assess the Tolerance of otic products, A. Marie ➔ Allermmune immunotherapy in feline atopic syndrome, F. Martini ➔ Stability of the N-acetylcysteine (NAC) with Tris-EDTA solution and in combination with dexamethasone sodium phosphate in aqueous solution for 50 days, N. Milanesi ➔ The comparative cerumenolytic activity of otic preparations, an in vitro study, N. Milanesi ➔ Tris-NAC (Tris-EDTA + N-acetylcysteine) activity against biofilm production, an in vitro study, N. Milanesi ➔ Indirect Immunofluorescence reveals circulating anti-keratinocyte IgG autoantibodies in equine pemphigus foliaceus, M. Mosca ➔ Does a disease resembling human psoriasis exist in dogs?, L. Ordeix ➔ Epicutaneous immunotherapy as a novel route of allergen administration in dogs with atopic dermatitis: a proof of concept study, M. Pinto ➔ A prospective, controlled, multicentric and double-blinded study of the efficacy of combined treatment of allergen specific immunotherapy and lokivetmab for the treatment of canine atopic dermatitis: a pilot study, L. Ramió-Lluch ➔ Effect of using textiles containing copper and zinc in dogs with superficial pyoderma, C. Romero ➔ The role of early life exposures to house dust mite allergens and endotoxins in the development of canine atopy: a birth cohort study from West Highland White Terriers, A. Rostaher ➔ Effectiveness of fluralaner against ticks infesting horses (equus caballus), G. Sheinberg ➔ Evaluation of in vitro antimicrobial activity of Cannabidiol oil solution against staphylococcal isolates from pyoderma and otitis, A. Statelli ➔ The efficacy of subcutaneous slow-release melatonin implants in the prevention of canine flank alopecia recurrence: a double-blind, randomized, placebo-controlled study, M. Verschuuren ➔ Side effects in cats treated with subcutaneous allergen-specific immunotherapy: results of a worldwide survey of 116 veterinarians, A. Zuzzi-Krebitz
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
TRANSCRIPTOME SIGNATURES IN PERIPHERAL BLOOD AND SKIN CELLS OF DOGS WITH ATOPIC DERMATITIS C. ALTUNBULAKLI*, N. FISCHER†, C. AKDIS‡, C. FAVROT† and A. ROSTAHER† * Lund University, Department of Immunotechnology, Lund, Sweden † Clinic for Small Animal Internal Medicine, Vetsuisse Faculty Zurich, Zurich, Switzerland ‡ Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland Canine atopic dermatitis is a multifactorial disease characterized by skin barrier and immune cell dysfunction. We aim to study the state of circulating immune cells in atopic dogs, a relatively understudied area of AD. RNA was isolated from peripheral blood mononuclear cells (PBMCs) and non-lesional skin tissue collected from 7 client-owned atopic dogs with active disease and 11 healthy dogs. RNA-sequencing was performed using Illumina Hi-Seq 2500 platform. Gene Ontology term enrichment and pathway analysis were performed with the GOseq R package and Enricher platform, respectively. The comparison of PBMC RNA-seq data from atopic and healthy dogs revealed a distinct transcriptome expression in AD, with 1604 significantly regulated genes (P < 0.01). The GO Analysis indicated an increased expression of genes belonging to the regulation of MAP kinase pathways, immunoglobulin production, and general inflammatory response. Among the most differentially expressed genes were CD80, CD83, ICAM1, PD-L1 and IRF1, suggesting a breaking of inflammatory homeostasis in the peripheral blood. When comparing skin tissue RNA-seq between atopic and healthy dogs, we identified 804 significantly regulated genes (P < 0.01). Upregulated genes in AD skin includes antimicrobial peptides S100A8 and S100A9, genes belonging to production of matrix metalloproteinases (TIMP3, MMP1), as well as enzymes and transcription factors regulating tissue inflammatory response. We herein show the dysregulation of immune cells in the peripheral blood and in the skin inflammation in AD. A closer analysis of RNA-seq is a step toward unravelling the complete disease pathogenesis and identifying possible biomarkers. Source of funding: Swiss National Fund. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
TOPICAL APPLICATION OF A COMBINATION OF PIPERONYL BUTOXIDE WITH PERMETHRIN AND PREDNISOLONE ACETATE FOR THE TREATMENT OF PSOROPTES CUNICULI IN NATURALLY INFECTED RABBITS E. ALVAREZ*†, R. HEREDIA* †, M. GUILLOT†and M. ROJAS *† * Centro Universitario UAEM Amecameca, Estado de Mexico, Mexico † Centro Integral Veterinario CIVET, Estado de Mexico, Mexico The Psoroptes cuniculi mite is the most common ear ectoparasite of rabbits. Parasitized rabbits show skin lesions on the pinna and ear canal and are susceptible to secondary infections. A seventeen rabbits naturally infested with Psoroptes cuniculi a consecutive number was assigned and using the index/random formulas in a spreadsheet, was forming 5 groups completely random. Otic swabs from both ears were collected in all animals, placing a drop of mineral oil on a sterile cotton swab to facilitate adherence of mites and crusts, to evaluate the acaricidal effect of a single application of 0.25 ml of piperonyl butoxide with permethrin and topical prednisolone acetate (Scabisin Suspension® CHINOIN Veterinaria, Mexico City, Mexico). Samples were collected on days 1, 2, 3, 4, 5, 10 and 20 post-applications. The presence or absence of mites in both ears was evaluated, as well as the quantity, viability, and stage of the mites, and severity of lesions. The number of positive rabbits decreased to 52% at day 4, 82% at day 5, 94.1% at day 10 and 100% at day 20. On day 3, 1 live adult mite was found and from day 4 there were no live adult mites found in the ears of the rabbits, from day 2 no live nymphs were found in the samples. From day 5 no severe lesions were observed in the ears of the treated rabbits, and from day 10 until 20 all rabbits were free of lesions. A single topical application was able to eliminate P. cuniculi mites in the ears of all rabbits and reduced the lesions, without concurrent topical or systemic treatments. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
A CASE OF ENVIRONMENTAL ALLERGY AND CLASSICAL EHLERS-DANLOS SYNDROME IN A DOMESTIC SHORTHAIR CAT CAUSED BY A HETEROZYGOUS COL5A1 FRAMESHIFT DELETION N. APOSTOLOPOULOS*, S. KIENER†, V. JAGANNATHAN†, M. WELLE‡, S. SOTO‡, T. LEEB† and U. MAYER § * Dermatology Service, Anicura Kleintierspezialisten Augsburg GmbH, Augsburg, Germany † Vetsuisse Faculty, Institute of Genetics, Bern, Switzerland ‡ Vetsuisse Faculty, Institute of Animal Pathology, Bern, Switzerland § Dermatology Service, Anicura Kleintierspezialisten Augsburg GmbH, Augsburg, Germany Ehlers-Danlos syndromes are rare in domestic animals and poorly described. In many cases, they cannot be unequivocally confirmed examining skin biopsies. Concomitant pruritic skin disease makes diagnosis and clinical management challenging. A two-year-old male castrated domestic shorthaired cat, living only indoors and with another cat, was referred for repeated laceration wounds on the neck and shoulder, observed by the owner since adoption at 10 months of age. Hematology and biochemistry including basal cortisol were within reference ranges when tested back then. At the time of referral, the owner reported moderate head and neck pruritus. The skin extensibility index was 22%. Neither ecto- and endoparasite treatment of both cats, nor an eight week elimination diet improved pruritus – which was observed all year-round with exacerbation in June and August. In skin biopsies thin, wispy and irregularly arranged collagen fibers in two biopsies were observed, whereas collagen appeared normal in the other biopsies (four biopsies were taken in total). In addition, a mild to moderate superficial perivascular to interstitial mastocytic and lymphocytic infiltrate and a focally extensive subepidermal fibrosis consistent with a recently healed ulcer was present. Genetic analysis of the cat revealed a heterozygous de novo frameshift variant in the COL5A1 gene encoding the collagen α1(V) chain. The variant is a single base deletion (c.3066del). The genetic analysis enabled the precise diagnosis of classical Ehlers-Danlos syndrome. Self-trauma due to allergic pruritus, fighting with the other cat and crawling under a bed were identified as sources for lacerations, and accordingly managed to prevent further skin wounding. Source of funding: Swiss National Science Foundation no. 310030_200354. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
CHARACTERIZATION OF THE PRO-INFLAMMATORY AND PRURITOGENIC TRANSCRIPTOME IN EQUINE INSECT BITE HYPERSENSITIVITY F. BANOVIC*, A. BLUBAUGH*, T. DENLEY* and A. GONZALES† * University Of Georgia College Of Veterinary Medicine, Athens, USA † Global Therapeutics Research, Zoetis Inc., Kalamazoo, MI, USA A recent RNA-sequencing skin transcriptome of equine insect bite hypersensitivity revealed only a significant mild upregulation of interleukin (IL)-13 among the T helper 2 (Th2) cytokines; no changes in itch-related mediators were observed. The objectives of this large-scale study of IBH were to characterize the skin inflammatory and pruritogenic transcriptome using deep sequencing with long, 150 paired-end reads. Biopsies collected from IBH lesional skin in 13 horses (n=21 samples) and healthy site-matched skin in seven horses (n=13 samples) were subjected to RNA-sequencing. Lesional IBH skin displayed substantial transcriptomic difference compared to healthy controls with 2,744 upregulated and 2,417 downregulated genes (+/-1.5-fold change, P-adjusted value &lt;0.05). Lesional IBH skin showed a significant upregulation of pro-inflammatory (e.g. IL-1B, PTX3, CCL2, IL-8) and Th2 (e.g. IL-4, IL-5, IL-13, IL-33, TSLP, POSTN) genes, as well as Th2 chemokines (CCL17) and eotaxins (CCL11, CCL24, CCL26). IL-13 was the most distinct Th2 marker with a 310-fold change upregulation. There were no changes in the expression of IL-17A and IL-22 cytokines. The Th1 signal (e.g. STAT-1, OASL, MX-1, CXCL10, IL-12A) as well as the T-cell trafficking chemokine (CCR7) and its ligand (CCL19) were upregulated. Among the itch-related mediators and receptors, a significant upregulation of known pruritogenic genes (e.g. chymase 1, cathepsin S (CTSS), CTSC, histamine-synthesis enzyme HDC, HNMT, histamine receptors HRH1, HRH4) was observed. Gene NTRK1, encoding a receptor for NGF, was the highest upregulated itch receptor. The lesional IBH signature exhibits upregulation of itch signaling, innate, and adaptive immune genes with a dominance of IL-13 pathways. Source of funding: Zoetis Inc. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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TRANSCRIPTOME PROFILING OF SPONTANEOUS CANINE ATOPIC DERMATITIS LESIONAL AND NON-LESIONAL SKIN USING DEEP RNA SEQUENCING A. BLUBAUGH, T. DENLEY and F. BANOVIC University of Georgia College of Veterinary Medicine, Athens, USA Large-scale transcriptomic studies evaluating global patterns of gene expression and inflammatory pathways in lesional and non-lesional canine atopic dermatitis (AD) skin have not been reported. Our objectives were to characterize the skin atopic lesional (AL, 62 samples) and non-lesional (ANL, 29 samples) transcriptome in 33 AD dogs (13 breeds); 20 site-matching healthy skin samples from 12 dogs (9 breeds) served as controls. We extracted total RNA from skin biopsies and analyzed the transcriptome using 150 paired-end RNA sequencing. The comparison of the mRNA expression of spontaneous canine AL and ANL skin with that of healthy skin identified 5,259 and 1,711 differentially expressed genes (DEGs) at +/-1.5-fold change (P-adjusted value <0.05). The top upregulated DEGs in AL and ANL skin were antimicrobial calcium-binding proteins S100A12 and S100A9, keratinocyte gene KRT2, matrix metalloprotease MMP12, chemokines (CCL5, CCL17, CCL22, CXCL10) and interleukins (IL)-8, IL-13, IL-26 and IL-36G; these genes expressed higher fold changes in AL skin in addition to significantly upregulated IL-9, IL-17A, IL-17C, IL-22 and IL-24. There was also significant upregulation of genes encoding known pruritogenic proteins and pathways, such as cathepsin S (CTSS) and CTSC, mast cell chymase (CMA1), nerve growth factor (NGF), neuromedin B (NMB), periostin (POSTN) and substance P (TAC1). Gene Set Variation Analysis for phenotypically unbiased analysis of T-helper (Th) gene sets (Th1, Th2, Th17, Th22) revealed significant upregulation of all multipolar immunological axes in AL skin. In conclusion, spontaneous canine AD skin exhibits a multipolar immunological axis upregulation resembling changes in spontaneous human AD. Source of funding: This study was partially funded by AKC Health Foundation. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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CONCERNS ABOUT HUMAN CONTACT ALLERGENS IN SKIN-AND-COAT VETERINARY PRODUCTS A. BELLONI FORTINA*, M. DE LUCIA†, G. BARATTO‡, P. BARATTO‡, M. MORETTI§, E. PESERICO¶ and A. PESERICO† * Dermatology Unit, Department of Medicine (DIMED) - University of Padua, Padova, Italy † San Marco Veterinary Clinic and Laboratory, Dermatology Unit, Veggiano, Italy ‡ Mundavet s.r.l., Padova, Italy § Unifarco s.p.a., Santa Giustina, Italy ¶ Department of Information Engineering (DEI) - University of Padua, Padova, Italy Ideally, one should be able to rule out the presence of allergens in a veterinary skin-and-coat-care product by inspecting its label. This is particularly true since most owners wash their pets without gloves (89% according to a preliminary survey). Unfortunately, veterinary products do not always provide on the label the complete ingredient list, as is instead compulsory for human skin-care products. We examined the ingredients reported on the labels of the 30 top-selling products in the “dog shampoos & conditioners” category of amazon.com. Only 1 of the 30 products provided the full ingredient list, and only 20 more provided a somewhat comprehensive list. Even if the full ingredient list was mostly unavailable, all the products reported the presence of at least one human allergen (and in some cases ten or more) including fragrances, betaine, lanolin, chlorhexidine, oat proteins, cocamide DEA, vitamin E, alkyl glucosides, acrylates, preservatives, menthol, plant and leaf extracts. We stress that the allergens above are only those reported on the label. We believe that for greater safety of both pets and caregivers, and to improve the accuracy of dermatologic diagnostics, the full ingredient list in veterinary skin-and-coat-care products should always be provided according to the International Nomenclature of Cosmetic Ingredients (INCI) rules. Source of funding: Self-funded. Conflicts of interest: ABF, MDL, GB, PB, EP and AP share ownership of Mundavet s.r.l. MM is an employee of Unifarco s.p.a.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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OCLACITINIB ALTERNATIVE, OFF-LABEL PROTOCOL FOR CANINE ATOPIC DERMATITIS: CAN COST BE REDUCED? A. BIZARRO*, B. FERNANDES*, H. PEREIRA*, M. PINTO*, V. SCHMIDT†, A. MARTINS†, B. BRAZ† and A. LOURENÇO† * Centre for Interdisciplinary Research in Animal Health (CIISA), Lisbon, Portugal † School of Veterinary Science, The University of Liverpool, Leahurst, Cheshire, UK Despite the high level of owners’ satisfaction with the oclacitinib treatment, the drug’s cost represents a concern for 75% of them, with 42,5% mentioning that they even had to limit other expenses to afford their dog’s treatment. This study aims to evaluate the possibility of using an alternative therapeutic protocol with oclacitinib on alternate days and whether there is an advantage in administering oral glucocorticoids at the beginning. In this prospective, randomised, double-blinded clinical trial, atopic dogs were randomly assigned to either the Placebo (P) or the Glucocorticoid group (G). Dogs were evaluated for skin lesions (CADESI-04) and pruritus (PVAS) at D-30 (beginning of oclacitinib standard protocol), D0 (beginning of the alternate days’ protocol), and endpoint (whether disease’s relapse or D30). This study comprised two distinct and successive phases. In the first phase, oclacitinib was given orally to both groups, following its standard protocol for 30 days. In the first 7 days, group G was given oral prednisolone (1 mg/kg SID), and group P was given a placebo following the same regimen. In the second phase, all animals underwent the same protocol with oclacitinib administered every other day until the endpoint. It was possible to use the alternate days’ protocol for at least 30 days in 71,43% (10/14) of the dogs, with 4/14 maintaining the treatment for 5 months. Prednisolone had no impact on CADESI-04, PVAS and treatment length. The alternate days’ treatment protocol can allow monthly costs to be reduced by half, giving greater access to this therapeutic tool. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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DOGS WITH MODERATE TO SEVERE LEISHMANIOSIS PRESENT AN EXAGGERATED ALLERGENSPECIFIC IMMUNOLOGLOBULIN E IMMUNE RESPONSE M. CABRÉ1, L. SOLANO-GALLEGO2 and L. ORDEIX1 * Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain † Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, Spain Dogs with moderate to severe canine leishmaniosis develop a strong non-protective humoral response which is mainly associated to a massive production of immunoglobulin (Ig) G, but IgE are also produced. The aim of this study was to determine the allergen-specific IgE response in dogs with moderate to severe leishmaniosis and to compare it with that observed in clinically healthy dogs. Serum samples from dogs with leishmaniosis (n=26) without atopic dermatitis and with high L. infantum-specific antibody levels were studied by means of a commercially available allergen-specific IgE assay kit (Polycheck Canis 20, Biocheck GmbH, Germany); serums from clinically healthy dogs (n=21) negative (<35 ELISA units) to the same L. infantum in house ELISA served as controls. The median age of dogs with leishmaniosis and clinically healthy dogs was 4 (range 1-10) and 6 years (range 1-13), respectively (Mann-Whitney test, P=0.129). IgE anti-cross-reactive carbohydrates determinants (CCD) were detected in 4/26 (15.4%) dogs with leishmaniosis and 3/21 (14.3%) clinically healthy dogs (Fisher’s exact test, P=0.916). Therefore, only dogs without anti-CCD IgE were analyzed. Total allergen-specific IgE concentration was higher in dogs with leishmaniosis (mean 27.28 kU/l) compared to healthy dogs (mean 14.06 kU/l) (Mann-Whitney test, P=0.015). Specific-IgE positive results against at least one allergen were detected in 21/22 (95.5%) of dogs with leishmaniosis and in 12/18 (66.7%) of clinically healthy dogs (Chi-Squared, P=0.017). This preliminary study indicates that dogs with moderate to severe leishmaniosis present an exaggerated allergen-specific IgE immune response that does not appear to be of clinical relevance. Source of funding: 2019 ESVD Minor Grant. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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COMPARISON OF SCRATCHING SEVERITY BY OWNER COMPLETED PVAS TO WHISTLE CANINE COLLAR A. CARSON*, A. WRIGHT†, R. HOLLAND‡, N. CERNICCHIARO§, C. KRESNYE¶ and S. LYLE¶ * Kinship Partners, Inc, Portland OR, USA † Zoetis, Inc, Parsippany NJ, USA ‡ Holland Management Services Inc., Lexington, KY, USA § Center for Outcomes Research and Epidemiology, College of Veterinary Medicine, Manhattan, KS 66506, USA ¶ Kinship Partners, Inc, San Francisco, CA 94103, USA Monitoring severity of pruritus is a challenge for dog owners but important in communicating with veterinarians and evaluating response to therapy. Pruritus visual analogue scoring (PVAS) is effective but requires pet owner recording. This study compares scratching severity recorded using Whistle canine activity monitors (Mars Petcare, McLean, VA); measured in a 24-hour period preceding the owner recorded PVAS scores. Out of 1,000 canine owners (with dogs previously classified as presenting low and high levels of scratching) invited to participate, 358 filled in an online questionnaire including a digital PVAS and confirmation that the dog owner was in contact to monitor the dog in the past 24 hours. Any dog owner that logged into the app to see the scores was eliminated. The association between Whistle scratching categories with PVAS scores was modelled using a logistic regression model with a beta distribution and logit link. As scratching severity increased as measured by the Whistle canine collar, PVAS scores significantly (P &lt; 0.01) increased. On average, dogs experiencing infrequent scratching (0 to 52 sec) were described as having mild itching based on PVAS (mean score = 30.4, 95% CI = 26.1-35.1), whereas dogs experiencing occasional (53 to 119 sec), elevated (120 to 299 sec) or severe (&gt;300 sec) scratching as per Whistle measurements, were assigned a moderate PVAS itching score (mean scores = 42.2 (95% CI = 38.3-46.3), 48.9 (44.5-53.3), and 52.8 (43.4-62.0), respectively) by pet owners. Whistle provides a practical tool to objectively evaluate pruritus severity. Source of funding: Zoetis, Inc., Kinship Partners, Inc. Conflicts of interest: Authors employed or funded by Zoetis, Inc. or Kinship Partners, Inc.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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DEVELOPMENT AND VALIDATION OF AN OWNER-ASSESSED VISUAL ANALOGUE SCALE (VASCAT) FOR FELINE PRURITUS SEVERITY SCORING S. COLOMBO*, S. BORIO†, R. SARTORI‡ and C. SCHIEVANO§ * Servizi Dermatologici Veterinari, Legnano, Italy † Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA ‡ Servizi Dermatologici Veterinari, Milano, Italy § University of Padova, Padova, Italy Assessment of the severity of pruritus is difficult in cats, because they manifest discomfort by overgrooming, which includes increased licking, increased scratching or both. Our objective was to develop and evaluate the effectiveness of a feline-specific pruritus scale (VAScat). The scale was designed using the combination of a double visual analogue scale (VAS), one 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 108 healthy cats scored their pet’s pruritus using the VAScat. Ninety-six/153 cats with skin diseases were re-evaluated after 4-8 weeks of treatment. Pearson’s correlation value between VAS-licking and VAS-scratching scores was r=0.26, 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 clinical pruritus severity scale (0=absent, 1=mild, 2=moderate, 3=severe) suggested that VAS-licking and VAS-scratching scales taken alone are not suitable for measuring absent to mild pruritus (grades 0-1), while VAS-max is (p=0.001). VAS-licking, VAS-scratching and VAS-max were all 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 pretreatment ones (p<0.0001). The VAScat proved to be a useful tool to assess pruritus in cats and for monitoring the response to treatment. Source of funding: SIDEV Research Grant. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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EFFECT OF A NATURAL SPOT-ON BASED ON PHYTO-CERAMIDES, PLANT-EXTRACTED ESSENTIAL FATTY ACIDS AND ESSENTIAL OILS ON RECONSTRUCTED CANINE EPIDERMIS C. DARMON-HADJAJE*, J. DELLACASAGRANDE† and N. AMALRIC† * CHV Frégis, Arcueil, France † Synelvia, Labège, France Atopic dermatitis (AD) involves cutaneous barrier impairment linked to inflammation. Reconstructed canine epidermis (RCE) from healthy dog keratinocytes cultured with Th1 and Th2 cytokines for fours days (RCE-AD) mimicks changes observed in canine AD. This study evaluated the effect of a natural complex designed specifically for allergy-prone skin contained in a spot-on (ATOP 7 spot-on: Dermoscent, France) in RCE-AD model. Three RCE-ADs were treated with 0.02% of ATOP 7® spot-on complex for four days, three RCE-AD and three normal RCEs treated with a placebo served as controls. Qualitative histological analysis evaluated RCE morphology whereas profilaggrin and filaggrin expressions were quantified through immunofluorescence staining using Image J software. Inflammation was assessed by measuring the secreted canine cytokine IL-8 by ELISA. Results are expressed as mean ± SD. After having confirmed the good tolerance of the natural complex on normal RCEs, the efficacy of the natural complex was then tested on RCE-AD. Morphological disorganisation was observed on control RCE-AD, while improvement with less spongiosis was noted after treatment. Immunofluorescence staining revealed a 52% improvement in profilaggrin and filaggrin expressions comparing the treated RCE-AD quantified at 32.58%±6.3 and the control RCE-AD at 21.47%±7.79, both compared to normal RCEs as baseline (100%). RCE-AD treated with the natural complex showed 25% reduction in IL-8 release (30423 pg/mL±6597) compared to the control RCE-AD at 40471 pg/mL±4110. ATOP 7® spot-on could be of interest in the multimodal management of canine AD thanks to its natural complex demonstrated to decrease IL-8 and improve skin barrier of RCE-AD models. Source of funding: LDCA. Conflicts of interest: C. Darmon is a consultant for LDCA.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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COMPLIANCE AND SIDE EFFECTS OF ORAL CICLOSPORIN A ADMINISTRATION IN CATS: A 4-YEAR RETROSPECTIVE SURVEY OF LONG-TERM ADMINISTRATION IN REFERRAL PRACTICE S. DELEPORTE§, A. BRIAND¶ and P. PRELAUD¶ * AniCura LorraineVet, Ludres, France † ADVETIA CHV, Velizy Villacoublay, France The aim of the study was to assess the compliance of ciclosporin treatment in cats. To assess this matter, we performed a survey for 42 owners that had used ciclosporin for their cats. The cat population was composed of 30 DSH, 5 Maine Coon, 2 Birman and 5 other breeds; 20 males and 22 females; the median age was 5,5 years. Ciclosporin oral suspension was administered directly in the mouth in 75% and with the food in 25% of cases. The administration was considered easy, difficult, and impossible in 43%, 55% and 2% of cases respectively. The treatment was disrupted in 50% of cases. The causes were: difficulty of administration (9/42), failure (4/42), price (2/42) and other causes (2 deaths, 2 tumours, 1 secondary effect and 1 lack of compliance). Adverse events were reported in 59% of cases: vomiting-diarrhoea (8/42), ptyalism (8/42), dysorexia-anorexia (6/42), gingival hyperplasia (1/42), and combination of vomiting, diarrhoea and ptyalism (2/42). Behavioural problems were reported in 64% of cases: hiding (7/42), scared of owner (10/42), modification of sleeping or playing activity (6/42), urine/faeces out of the litter (2/42), aggressivity toward the owner (2/42) and all the above (1/42). In total, 57% presented both physical adverse events and behavioural problems, and only 7% presented either physical adverse events or behavioural problems. Interestingly this study shows that behavioural problems is underestimated in the cats; that could be a cause of therapeutic failure due to lack of compliance. Larger scale studies are needed to confirm these preliminary results. Source of funding: Self-funded Conflicts of interest: None declared
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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SINGLE MYRINGOTOMY FOR THE TREATMENT OF OTITIS MEDIA IN CATS : A RETROSPECTIVE STUDY S. DELEPORTE* and P. PRÉLAUD† * LORRAINEVET, Ludres, France † CHV ADVETIA, Velizy-Villacoublay, France Otitis media (OM) is common in cats, but, outside of polyp-associated OM, data on medical treatment are lacking. We retrospectively studied 24 cats with MRI- or CT-confirmed OM without polyps or neoplasia. Most cats (58%) presented with a bilateral OM. Both parts of the bulla were involved in 97% of cases. Clinical signs included a head tilt in 11/24 cats (54%), Horner syndrome in 7 (29%), ataxia or otalgia in 2 (9%), otitis externa in 5 (21), and nystagmus and facial paralysis in 1 (4%). Cytologic examination of the middle ear effusion was dominated by neutrophils. Cocci were identified on cytology in 20/38 samples (53%) and rods in 2/38 samples (5%). The bacterial culture was positive in half of samples, and Pseudomonas sp, Pasteurella multocida, Staphylococcus felis, S. schleiferi, S. pseudintermedius and Serratia marcescens were isolated. All cats were treated with a single myringotomy, soft bulla flushing (0.5 to 2 mL of saline), oral prednisolone (1 mg/kg/d for 7-10 days) and one month of systemic antibiotics chosen according to the susceptibility testing. Seventeen cats (71%) were clinically cured 60 to 240 days after starting treatment, while one cat was healthy except for a mild head tilt. One cat was euthanized because of failure to control a Pseudomonas infection; another died because of complications of anesthesia. The four remaining cats were cured after ventral bulla osteotomy. This simple technique with only one myringotomy and mild ear flushing offers a very practical, safe and efficient method to treat suppurative OM in cats. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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HUMAN SKIN TOLERANCE TO DOG HYGIENE PRODUCTS: EVALUATION OF TWO HYPOALLERGENIC, IRRITANT-FREE FORMULATIONS M. DE LUCIA*, A. BELLONI FORTINA†, G. BARATTO‡, P. BARATTO‡, M. MORETTI§, E. PESERICO¶ and A. PESERICO† * San Marco Veterinary Clinic and Laboratory,Dermatology Unit, Veggiano, Italy † Dermatology Unit, Department of Medicine (DIMED) - University of Padua, Padova, Italy ‡ Mundavet s.r.l., Padova, Italy § Unifarco s.p.a., Santa Giustina, Italy ¶ Department of Information Engineering (DEI) - University of Padua, Padova, Italy Contact dermatitis caused by skin-cleaning agents is common in humans. We investigated human skin tolerance to a dog shampoo (Mundavet Skerma 23® shampoo) and a dog cleanser (Mundavet Skerma 23® cleanser), both lipid-enriched, hypoallergenic and irritant-free. First, the products were patch-tested to rule out irritancy or allergenicity, as usually done for human cosmetics, in 20 adult human volunteers. Then, 49 other volunteers were asked to wash their hands at least twice daily for five consecutive days; 27 with the shampoo and 22 with the cleanser. Shampoo volunteers were 6 males, 21 females (mean age 38); 21 had no pre-existing conditions, 3 seborrheic dermatitis, 3 contact dermatitis. Cleanser volunteers were 9 males, 13 females (mean age 39); 14 had no pre-existing conditions, 4 contact dermatitis, 2 skin dryness, 1 pityriasis rosea, 1 seborrheic dermatitis. No restrictions regarding regular cleaning or topicals were imposed. At the end, each participant completed a questionnaire reporting presence or absence of skin softness, dryness, pruritus, burning, erythema. 45 out of 49 volunteers (92%) reported soft clean skin and no adverse effects; 1 participant in the shampoo group and 3 (1 with pre-existing seborrheic dermatitis) in the cleanser group reported dryness. High-quality formulation of pet-cleaning products and patch-tested absence of human irritancy/allergenicity would then appear predictive of human skin tolerability after repeated use. We believe our approach should become standard in the pet-care industry, given how often pets are hand-washed without gloves (89% of owners in a preliminary survey). Source of funding: Self-funded. Conflicts of interest: ABF, MDL, GB, PB, EP and AP share ownership of Mundavet s.r.l. MM is an employee of Unifarco s.p.a..
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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PYODERMA GANGRENOSUM IN DOGS: A RETROSPECTIVE, SINGLE-CENTER ANALYSIS OF 13 CASES M. DE LUCIA *†, P. ORLANDINI*, D. DENTI*, A. BELLONI FORTINA‡, A. PESERICO‡ and G. MEZZALIRA† * San Marco Veterinary Clinic and Laboratory, Dermatology Unit, Veggiano, Italy † San Marco Veterinary Clinic and Laboratory, Dermatopathology Unit, Veggiano, Italy ‡ Dermatology Unit, Department of Medicine (DIMED) - University of Padua, Padova, Italy Pyoderma gangrenosum in dogs is a poorly described condition. Thirteen cases of pyoderma gangrenosum were diagnosed between 2017 and 2021. Various breeds were included –mixed-breed dogs (4) and American Staffordshire terriers (3) were overrepresented. There were six females and seven males, ranging from 24 to 174 months of age (median 92 months). At the time of the visit, the median duration of disease was 4.5 months. Painful undermined ulcers (13/13) were the most common lesions, followed by pustules, hemorrhagic bullae, sinus tracts, erythematous papules, edema and alopecia. Pathergy was observed in three cases. Lesions were almost always multiple (12/13) involving dorsal and ventral trunk (7/13), limbs (5/13), paws (5/13), eyelids (2/13), perioral (2/13) and perianal areas (1/13). Lameness (7/13), gastrointestinal signs (5/13), inflammatory arthropathy (4/13) and fever (4/13) were additional clinical features. Mild to severe anemia, neutrophilia, increased C-reactive protein and hypoalbuminemia were the most relevant laboratory abnormalities. In all the cases, histopathology showed diffuse, dermal to subcutaneous, neutrophilic to pyogranulomatous inflammation with hemorrhages. Luminal neutrophilic folliculitis, furunculosis, fistulation, vasculitis, hair follicle atrophy and ulcers were variably present. Antibiotic treatment based on susceptibility test led to no (11/13) or partial (2/13) improvement. Complete (11/13) or partial (2/13) remission of the skin lesions was achieved with ciclosporin (5 mg/kg twice daily) (7/13), glucocorticoids (3/13) or a combination of both (3/13). The study provides additional information to better characterize this uncommon disease in dogs. Source of funding: Funded by San Marco Clinic & Lab. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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ARE IMAGES WORTH A THOUSAND WORDS? TESTING A VIDEO FOR OWNERS’ EDUCATION IN CANINE ATOPIC DERMATITIS B. FERNANDES*, A. CAVACO†, H. PEREIRA*, M. PINTO*, A. BIZARRO* and A. LOURENÇO* * CIISA, Faculty of Veterinary Medicine, University of Lisbon, Lisboa, Portugal † IMed. ULisboa, Pharmacy Faculty, University of Lisbon, Lisboa, Portugal Successful management of canine atopic dermatitis (cAD) requires effective pet owner education considering its challenging and complex nature. Given the lack of proven effective owner education strategies, we wanted to create an effective and appealing cAD owner education tool of feasible application in the clinical context. An 8-week prospective randomised controlled study was conducted. Our study hypothesis was that the video-based educational intervention would be noninferior or equivalent to the control group (standard verbal educational intervention). Participants were randomly assigned (1:1) to either the control (CG) or the intervention group (IG). In both groups, cAD knowledge scores and clinical outcomes were measured at the beginning and end of the study. Additionally, owners’ adherence and perceived utility and appeal ratings were measured at the end of the study. The educational intervention’s outcome was defined by a cAD knowledge score’s improvement, provided that the end score was superior to the positive scale’s central value. It was found a significant association (p<0,01) between educational intervention outcome and group, with a higher percentage of success in the IG (CG= 6/13 (46,15%); IG: 15/16 (93,75%)). The differences found in the clinical outcomes, utility and appeal ratings and owners’ adherence were not statistically significant. This novel study establishes a positive impact of video-based education on therapeutic owner education regarding cAD, confirming its great potential as an effective way to deliver pet owner’s education. It also provides general veterinarians with the opportunity to achieve a good quality cAD’s owner education in a time-efficient way. Source of funding: CEVA Saúde Animal. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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ALOPECIA AREATA CONCURRENT WITH ATOPIC DERMATITIS IN THREE DOGS G.A. GRAPÍ*, E.R. RIERA*, C. YOTTI†, J. DECLERCQ‡ and L. FERRER§ * Citopat Veterinaria and Letipharma, Barcelona, Spain † Centro Dermatológico Skinpet, Madrid, Spain ‡ Small Animal Practice, Kortrijk, Belgium § Universitat Autònoma de Barcelona, Barcelona, Spain Alopecia areata is an uncommon autoimmune skin disease of the dog characterized clinically by noninflammatory alopecia and histologically by a lymphocytic bulbitis. Atopic dermatitis is a common, genetically predisposed inflammatory and pruritic skin disease associated with well-defined clinical signs and immunoglobulin (Ig)E directed against environmental allergens. We present three dogs, two Chow Chows and one Shih Tzu, with a clinical history of atopic dermatitis that developed alopecia areata. All three dogs had a clinical history of non-seasonal pruritus and after ruling out other pruritic diseases by appropriate diagnostic tests, a diagnosis of atopic dermatitis was made. The dogs responded totally or partially to oclacitinib and/or ciclosporin. Concurrently, the animals developed atypical areas of non-inflammatory alopecia that were not self-induced. Histologically, the lesions were characteristic of alopecia areata and consisted of lymphocytic inflammation of the hair bulbs of anagen follicles and surrounding adjacent tissue, with scant macrophages. Additional findings were infundibular keratosis, follicular atrophy and marked vacuolization along the follicle walls (vacuolar degeneration) confirming the diagnosis of alopecia areata. Lymphocytic infiltrates were positive to CD3, with no positivity for S100. Comorbidity between immune-mediated diseases is a well-known phenomenon in humans and dogs. We describe for the first time, the association between atopic dermatitis and alopecia areata, with additional new findings not previously described such as intense vacuolar degeneration of follicular walls. All three dogs had a plush hair coat (Chow Chow, Shih Tzu). One of the dogs showed recurrence of hair loss during the following two years, suggesting a seasonal course. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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FIRST DESCRIPTION OF A TOXIC SHOCK-LIKE SYNDROME (TSLS) IN A CAT E. GUAGUERE†, F. DEGORCE-RUBIALES‡ and A. MULLER† * Clinique vétérinaire Saint Bernard, Lomme, France † LAPVSO, Toulouse, France Toxic Shock-like Syndrome (TSLS) is a rare dermatological condition in veterinary medicine. A 3-year-old, 5-week pregnant Sphynx cat was presented for a sudden onset of painful skin lesions. General signs revealed depression, hypothermia and dehydration. Cutaneous signs included generalised erythematous rash and superficial epidermal detachment. Abdominal ultrasound showed three dead kittens in the uterine lumen. Hematology and biochemistry tests showed neutrophilia, hypoalbuminemia, hypernatremia, hyperuremia and hypercreatininemia. Histopathological features consistent with TSLS included superficial dermatitis with superficial epidermal splitting, neutrophilic exocytosis and apoptotic keratinocytes. Bacteriological culture (from skin biopsies and dead fetus) revealed colonies of a coagulase-positive staphylococcus, Staphylococcus pseudintermedius. Despite treatments to fight pain and the risk of sepsis, the cat died 24 hours later. The tentative diagnosis of TSLS was based on history, clinical presentation and histopathological findings. Human Toxic Shock Syndrome (TSS) is a rare but life-threatening condition caused by bacteria getting into the body and releasing harmful toxins. TSS results from toxins produced by Staphylococcus aureus or group A Streptococcus bacteria. This syndrome can affect anyone, including men, children and postmenopausal women. Risk factors include skin wounds, surgery and the use of tampons or other devices. In dogs, one case was reported in a bitch with a closed-cervix pyometra. To our knowledge, this present case is the first description of TSLS in cats and seems to be associated with a genital cause as it has been described in humans and dogs. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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URTICARIAL VASCULITIS IN DOGS : A REPORT OF 4 CASES E. GUAGUERE*, A. MULLER*, C. MULLER*, F. DEGORCE-RUBIALES† and CATHY MEGE‡ * Clinique vétérinaire Saint Bernard, Lomme, France † LAPVSO, Toulouse, France ‡ Clinique vétérinaire des Ducs de Bourgogne, Chenove, France Urticarial vasculitis (UV) is a subtype of vasculitis, clinically defined by urticarial and purpuric lesions and histopathologically characterized by leukocytoclastic vasculitis. Four cases of UV were observed: 10-year-old spayed female Labrador retriever, 5-year-old spayed female American Staffordshire terrier, 4-year-old female Whippet, 6-year-old male Boxer. Dogs were referred with a 1 to 4 days history of acute onset of pruritic and/or painful skin lesions. General signs were constant (fever, depression, pain), but more severe in 3 cases. Dermatological signs were generalized in 3 cases and localized (ventrum) in one case. They included multifocal (up to 30 foci) sudden persistent well-delimited purpuric wheals or purpuric annular and arciform coalescent lesions. Facial and pedal oedema was noted in 2 cases. Histopathological features demonstrated neutrophilic leukocytoclastic vasculitis with severe oedema and haemorrhage in the surrounding dermis. In one case, a perivascular infiltrate rich in eosinophils and mast cells was observed. Abdominal ultrasound was performed revealed severe abnormalities (bowel, kidney, liver) in one case. One dog was treated with oclacitinib (0,6 mg/kg BID for 3 weeks, then SID for 3 weeks) with a progressive clinical improvement within 3 weeks. A spontaneous resolution was observed in one case within 5 days. Two dogs died after 4 days of medical resuscitation. In one case, post-mortem examination revealed hepatic, renal and intestinal leukocytoclastic vasculitis. The cause of the disease was identified in 2 cases out of 4 (cold urticarial vasculitis / drug (amoxicillin/clavulanic acid)). No infectious cause has been identified in these cases. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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SKIN BARRIER REINFORCEMENT EFFECT OF A SPOT-ON BASED ON NATURAL INGREDIENTS IN A DOG MODEL OF TAPE STRIPPING A. IDEE, M. MOSCA and D. PIN Vetagrosup, Marcy l’étoile, France Canine atopic dermatitis being linked to skin inflammation and barrier alterations, cutaneous barrier reinforcement is therefore essential in a multimodal approach. This study aims to evaluate the barrier reinforcement effect of a spot-on (ATOP 7® spoton: Dermoscent®, LDCA, France), with a non-invasive method of acute barrier disruption by stratum corneum delamination with repeated tape stripping. Five healthy adult Beagle dogs were enrolled in this study. A fixed number of adhesive tapes was applied on each of 4 predesignated clipped zones (Z1-4) on the back, at one zone per week. The spot-on was applied weekly for 3 weeks on the same spot, at the medium point of the 4 zones. Its effect on transepidermal water loss (TEWL) was measured (AF200Aquaflux®) weekly following delamination on Z2, Z3, Z4, 4 days after each spot-on application. Z1 (before first application of the spot-on) and a non-delaminated zone on the abdomen were used as controls. Tape stripping induced a significant increase in TEWL on Z1 (before first spot-on application) compared to non-delaminated abdomen zone (77.62±17.68 vs 20.46±10.24 g/m2/h, p&lt;0.001, ANOVA2 test). Spot-on applications progressively limited the TEWL after delamination, with a TEWL close to that of the abdomen area after the 3rd application (40.56±17.51 vs 21.64±10.51 g/m2/h, no significant difference, ANOVA2 test). Moreover, the spot-on demonstrated its diffusion efficacy at distance from the application point. No deleterious effect was noted. Weekly application of this spot-on at one point during 3 weeks protects and strengthens the skin by limiting TEWL in case of barrier alteration. Source of funding: The study was funded by LDCA. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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DEVELOPMENT OF A QPCR FOR THE DETECTION OF CHORIOPTES SPP IN EQUINE SKIN SCRAPINGS M. ISAKSSON*, K. BERGVALL† and G. GRANDI* * Swedish Veterinary Institute, Uppsala, Sweden † Swedish University of Agriculture, Uppsala, Sweden Equine leg mange caused by Chorioptes (C.) bovis, often associated to pruritic pastern dermatitis, is a recognized welfare problem in horses. Diagnosis by direct microscopy can be a challenge in field practice. Our aim was to develop a reliable, molecular tool for detection of C. bovis DNA in skin scrapings. A new set of primers and Taqman probe were designed within the mitochondrial COI-gene sequence of C. bovis. DNA was extracted from four C. bovis positive and eight C. bovis-negative at microscopy sampled with different techniques. PCR analysis was run using 400 nM of each primer and 133 nM of the hydrolysis probe labelled with FAM-MGBNFQ (two min of initial denaturating at 95°C followed by 45 cycles of 95°C for five sec and 60°C for 30 sec). Samples were considered positive if the reaction curve exhibited characteristic exponential shape and reached above the selected threshold based on the baselines for samples and controls. To test the specificity of the assay, nine species of environmental mites were tested, all with negative results. The results from the microscopy of the samples used for optimization of sampling were in general congruent with the PCR results, except in one case, when after acaricidal treatment a horse was still positive at PCR but negative at microscopy. While our PCR method showed a good specificity and sensitivity, it still needs to be tested at larger sample batches and the timing for post-treatment follow up has to be set up. Source of funding: Swedish-Norwegian Foundation for Equine Research. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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CHARACTERIZATION OF CLINICAL PHENOTYPE (CUTANEOUS LESION SCORE AND CENTRAL SENSITIZATION) AND COMPARISON OF SEROLOGICAL ALLERGEN-SPECIFIC IGE AND INTRADERMAL TESTING IN A COLONY OF ATOPIC-LIKE CATS J. LEFRANÇOIS*, E. TRONCY†, A. GONZALES‡, M. VISSER‡, C. OTIS†, M. MOREAU§, J.P. PELLETIER§, J. MARTELPELLETIER§ and F. SAUVÉ* * Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, Canada † Groupe de recherche en pharmacologie animale du Québec (GREPAQ), St-Hyacinthe, Canada ‡ Zoetis, Kamalazoo, United States § Osteoarthritis Research Unit, University of Montreal Hospital Research Centre, Montreal, Canada Intradermal testing (IDT) and allergy serology testing (AST) are used in feline atopic syndrome (FAS) patients and the relationship between these two tests is unknown. Central neural sensitization has been demonstrated in humans with chronic pruritus and cats with chronic osteoarthritis pain. We wished to evaluate the relationship between IDT and AST’s results in a colony of cats with FAS, with or without skin lesions and 2) to characterize their somatosensory profile. Twenty-four cats were divided into three groups: i) FAS with skin lesions (16), ii) FAS without skin lesions (4), and iii) control (4). With group blinding the following were evaluated: a complete physical examination, SCORFAD calculation, IDT (Stallergenes Greer, Canada), AST (Heska, USA), somatosensory profile determined by punctate tactile withdrawal threshold test (using von Frey esthesiometer on paw plantar surface) and response to mechanical temporal summation (RMTS). All statistical analyses were performed with an alpha value set at 0.05. For the allergy testing results, the allergens were grouped into seven categories. In the first group, the median SCORFAD was 4. Results showed a significant relationship between the IDT and AST only for the ‘mites’ category (χ2 (1)=10.9, P=0.003). The RMTS was significantly (P<0.049) lower in both FAS groups [10.9(3.6), 8.9(1.4)] compared to control [13.6(2.3)]. These results reinforce the lack of relationship between IDT and AST. This is the first report investigating a possible role of central sensitization in FAS, which could help better understand the pruritus pathways and open new horizons for treatment. Source of funding: Zoetis, Kalamazoo, Michigan, USA. Conflicts of interest: AG and MV are employees of Zoetis.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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THE MIDDLE EAR MICROBIOTA IN HEALTHY DOGS IS SIMILAR TO THAT OF THE EXTERNAL EAR CANAL C. LEONARD*, S. CLAEYS*, P. PICAVET*, B. TAMINIAU†, G. DAUBE† and J. FONTAINE* * Faculty of Veterinary Medicine, University of Liège, Liege, BE † Fundamental and Applied Research for Animal & Health (FARAH), University of Liege, Liege, BE Otitis media can be a consequence of chronic otitis externa and could represent a perpetuating factor. Only sparse information is available concerning the normal microbiota of the middle ear. The objective of the study is to characterize the microbiota of the tympanic bullae (TB) and to compare it with that of the external ear canal (EEC) in healthy dogs. Six healthy Beagle dogs euthanized for reasons unrelated to the study were selected based on the absence of signs of ear canal inflammation and negative direct cytology and bacterial aerobic culture from the TB. Swab samples were collected bilaterally within six to 12 hours after death in the EEC and the TB, using an aseptic surgical technique (total ear canal ablation and lateral bulla osteotomy). For each sample, the hypervariable segment V1-V3 of the 16S rDNA was amplified and sequenced with a MiSeq Illumina sequence carried out by the Mothur software using the SILVA database. A significant difference (P = 0.009) was noted (Kruskall-Wallis Test) for Chao1 richness index between the right and the left EEC. No significant differences were observed between the EEC and TB microbiota (Kruskal-Wallis test) for the Chao1 richness index (P = 0.6544), Simpson evenness index (P = 0.4328) and the reciprocal Simpson alpha diversity index (P = 0.4313). The most abundant genera in the EEC and TB were Lactobacillus and Turicibacter. Based on these results, it appears that the middle ear microbiota is similar to that of the external ear canal in healthy dogs. Source of funding: Self-funded thorugh “Clinique Vétérinaire Universitaire”, University of Liège, Belgium. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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IN VITRO ANTIBACTERIAL EFFECT AND CYTOTOXICITY ON CANINE KERATINOCYTES OF PURO3 OZONATED OLIVE OIL N. MAHEAS, B. CHATAIGNER, N. MILHAU, D. PIN and M. MOSCA VetAgro Sup, Marcy l’étoile, France In the current antibacterial resistance context, alternative therapies to decrease the use of antibiotics are necessary. PurO3 Ozonated Olive Oil (O3-Oil) is a skin ointment with antiseptic, healing and anti-inflammatory properties that could be useful in treating canine pyoderma. This in vitro study aims to prove the antibacterial effect of O3-Oil on Staphylococcus (S.) pseudintermedius and its lack of toxicity on canine keratinocytes. The antibacterial effect of O3-Oil at different concentrations (2.5, 5, 7.5 and 10% incorporated into TSA agar plates) was tested on nine S. pseudintermedius strains obtained from dogs with pyoderma (three sensitive to all antibiotics tested, three resistant to 1 or 2 antibiotics, three multiresistant). Canine progenitor epidermal keratinocytes (CPEK) were incubated with O3-Oil at different concentrations (0, 25, 50, 75 and 100% diluted with virgin olive oil) for 2, 4 and 6 hours and cell viability were determined by a colorimetric CCK8 assay to evaluate toxicity. Results showed a minimal inhibitory concentration varying between 5 and 10% depending on the strain tested. All bacterial strains of S. pseudintermedius were completely inhibited at 10% of O3-Oil within the culture medium. The toxicity assay showed no significant difference of cell viability between virgin olive oil and the different concentrations of O3-Oil tested, even pure (p&gt;0.05 at each time and each concentration, student test). PurO3 Ozonated Olive Oil is a non-cytotoxic to keratinocytes product with a strong in vitro antibacterial effect. Further research is needed to demonstrate in vivo efficacy of the product for topical treatment of canine pyoderma. Source of funding: Self-funded Conflicts of interest: None declared
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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BEDLINGTON TERRIERS DIAGNOSED WITH FAMILIAL FOOTPAD HYPERKERATOSIS ARE CARRIERS OF AN FAM83G MISSENSE VARIANT N. MAKRI*, K. VARJONEN†, C. WALKER‡, D. OZDEMIR§, J. SCHOENEBECK§ and D. GOW§ * R(D)SVS and The Roslin Institute, Edinburgh, United Kingdom † Anicura, Stockholm, Sweden ‡ TheSkinVet, Essex, United Kingdom § R(D)SVS and The Roslin Institute, The University of Edinburgh, Edinburgh, United Kingdom Hereditary footpad hyperkeratosis (HFH) is a genetically heterogenous group of diseases described in various breeds, notably Irish terriers and the Kromfohrländer. Genetic mutations in these breeds are published and pre-breeding screening tests available. Affected dogs develop hyperkeratotic pads that become deeply fissured and secondarily infected, thus leading to significant pain and discomfort. Since HFH is a hereditary disease treatment is symptomatic (e.g., the use of softening agents). Bedlington terriers have also been noted to develop HFH. Lesions in these dogs have been seen at an early age indicating a genetic predisposition. The aim of this study was to assess the genetic profile of Bedlington terriers with FH to identify an underlying genetic defect responsible for the hyperkeratosis. Three Bedlington terriers were clinically diagnosed with FH. Saliva swabs were collected from each dog and genomic DNA extracted according to manufacturer’s protocol. Each sample was genotyped for the FAM83G:c.155G>C variant by Sanger sequencing. All three of the affected dogs were homozygous for the FAM83G risk allele, while two control Bedlington terriers were negative for this mutation. All affected dogs were diagnosed with HFH between the ages of 6-9 months, with the first signs of disease noted by the owner as paw licking and lameness. Affected dogs responded to the use of regular hydrating agents applied to the paws. The finding of a FAM83G mutation as a cause for HFH in the Bedlington terrier may allow for genetic screening to be offered in this breed to subsequently reduce the frequency of occurrence. Source of funding: Fiona and Ian Russell Clinical Seed Corn grant, R(D)SVS. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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EAR INFLAMMATION AND HEARING MEASUREMENTS: TAKING ADVANTAGE OF PRECLINICAL TOOLS TO ASSESS THE TOLERANCE OF OTIC PRODUCTS A. MARIE*, C. VINCENT*, M. DOLON†, P. SCHREIBER†, P. GRUET†, JB. RASCLE† and G. NAERT* * CILcare SAS, Montpellier, France † Virbac, Carros, France Ear infections are a relatively common disease in pets and one of the leading causes of veterinary appointments for dogs. Therapies developed to prevent and treat otitis should be safe and well tolerated when administered by otic route. As some molecular agents may possess ototoxic properties and cause profound hearing impairments, their impact on ear inflammation and hearing should be assessed. The standard otoscopes and hearing tests used in veterinary clinics do not provide enough sensitivity to detect slight changes in hearing and the appearance of the eardrum. In pre-clinical research, specific oto-endoscopes and electrophysiological measures, the Brainstem Auditory-Evoked Responses (BAER), are valuable tools to evaluate auditory changes with high precision. The BAER consists in the detection of electrical activity of the brainstem in response to a range of frequencies sent at specific intensities. We transposed the method widely used in rodents to species such as dogs or mini swine, using a portable BAER device and an oto-endoscope equipped with a camera. The protocol was developed to detect BAER waves at different frequencies, according to the hearing range of the tested species. Oto-endoscopes specifically adapted to the anatomy of each species were used to observe the auditory canal down to the eardrum. Otoscopic and BAER evaluations were successfully developed in both species. In conclusion, a dedicated BAER device coupled to an oto-endoscope is a flexible and sensitive diagnostic tool for pets. It can easily be used to monitor ear integrity and hearing and detect ototoxic effects of otic products. Source of funding: Self-funded Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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ALLERMMUNE IMMUNOTHERAPY IN FELINE ATOPIC SYNDROME F. MARTINI, C. FAVROT, A. ROSTAHER and N. FISCHER Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, Zurich University, Zurich, Switzerland Allermmune (Zenoaq, Japan) is a recombinant Dermatophagoides farinae 2 (Der f 2) pullulan-based immunotherapy vaccine whose efficacy on house dust mite allergic dogs has been demonstrated in several studies. The goal of the present pilot study was to evaluate the efficacy of this intervention in Der f sensitized cats. Ten affected cats diagnosed with feline atopic syndrome received Allermmune® weekly for 6 weeks and then every month for 3 months. On week 0, 6 and 17 clinical lesions were assessed by means of the Feline Dermatitis Extent and Severity Index (FeDESI), while owners assessed pruritus with a 10cm visual analogue scale (pVAS). Concurrent medications were recorded, using a previously published scoring (MS). Data were normally distributed, and a one-tailed paired t-test was used for statistical analysis. FeDESI, pVAS and MS means improved greatly from 37 to 12 (p=0.003), 7.2 to 3.2 (p=0.001) and 32 to 10 (p=0.005), respectively. Only 2 out of 10 cats were considered non responders. Interestingly, the improvement was already obvious (> 50% improvement) after 6 weeks in 58%, 71% and 60%, for pVAS, FeDESI and MS respectively. Two cats with concurrent asthma and relapsing angioedema also responded adequately. The results of this study are very similar to those seen in dogs and suggest that Allermmune® may be effective in alleviating symptoms in cats with skin- or respiratory signs of mite-hypersensitivity. Further large-scale and controlled studies are needed to confirm these findings. Source of funding: Allermmune® was provided by Zenoaq. Conflicts of interest: CF is scientific consultant for Zenoaq.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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STABILITY OF THE N-ACETYLCYSTEINE (NAC) WITH TRIS-EDTA SOLUTION AND IN COMBINATION WITH DEXAMETHASONE SODIUM PHOSPHATE IN AQUEOUS SOLUTION FOR 50 DAYS N. MILANESI*, G. GHIBAUDO* and T. DELLA MURA† * Clinica Veterinaria Malpensa, Samarate (Varese), Italy † ICF SRL, Palazzo Pignano, Italy The objective of this study was to evaluate the stability of a formulation containing N-acetylcysteine (NAC) + Tris-EDTA (Tris-NAC, ICF SRL, Palazzo Pignano, Italy) and the compatibility between the dexamethasone sodium phosphate in aqueous solution, 2 mg/ml injectable formulation (Dexadreson, MSD Italia SRL) and Tris-NAC for 50 days. To evaluate the compatibility between dexamethasone and Tris-NAC, redox titrations were performed to evaluate the NAC content in the formulations. Two tests were performed: (1) stability assessment of Tris-NAC mixing 100 ml of the formulation with 5ml of a solution of dexamethasone sodium phosphate (2mg/ml); and (2) stability assessment of the Tris-NAC formulation without any additions. The two formulations were stored for 50 days at 25 °C and 5 °C and titrations were performed every 10 days to evaluate the NAC content in the formulation. The data obtained experimentally regarding the NAC titre in the two formulations were found to be comparable. In conclusion, after 50 days at 25 °C and 5 °C, both formulations maintain the NAC titration almost unchanged compared to time zero. Source of funding: ICF SRL. Conflicts of interest: NM is a ICF employee, TDM is ICF Scientific Manager and GG have received consultancy and speaker fees from ICF.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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THE COMPARATIVE CERUMENOLYTIC ACTIVITY OF OTIC PREPARATIONS, AN IN VITRO STUDY N. MILANESI*, G. GHIBAUDO * and T. DELLA MURA† * Clinica Veterinaria Malpensa, Samarate (Varese), Italy † ICF SRL, Palazzo Pignano, Italy The canine ear canal has an abundant presence of sebaceous and ceruminous glands. Ceruminous otitis is a very common pathology in dogs. The cerumenolytic activity of some otic preparations represents a valuable aid for the management of this condition. The study aimed to evaluate the in vitro wax removal efficacy of various veterinary otic preparations used in Europe. To evaluate the effectiveness of the otic preparations (Otoprof ®, Otoact ®, Epiotic ®, Diclorex oto ®, Otifree ®, Aurinet ®, Malacetic ®, Otodog ®, Otolane ®) an analytical and experienced protocol was used. Standardized synthetic cerumen (SCC) was prepared, weighed in test tubes, and left to solidify. An aliquot of the otological product equal to 2 milliliters (ml) was added. The tubes were shaken moderately at a temperature of 35 °C for five minutes, and subsequently, were inverted. After 24 hours each test tube was weighed, and another 2 ml of the product were added. Five washes per tube were repeated and the test was performed in triplicate. A total of 99.4% of removed cerumen was obtained only with the product containing carbamide peroxide and dioctyl sodium sulfosuccinate (Otoprof ®: ICF Srl, Palazzo Pignano, Italy). A good cerumenolytic property, 65%, was obtained from the product containing squalene (Otoact ®: ICF Srl, Palazzo Pignano, Italy). Other products containing disodium EDTA, PCMX, diethylhexyl sodium sulfosuccinate like Epiotic ® (Virbac SRL, Milano, Italy) showed less cerumenolytic activity with 7% and the remaining ones with a range from 5 to 1% of activity. Source of funding: ICF SRL. Conflicts of interest: NM is a ICF SRL employee, TDM is ICF SRL Scientific Manager and GG have received consultancy and speaker fees from ICF SRL.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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TRIS-NAC (TRIS-EDTA + N-ACETYLCYSTEINE) ACTIVITY AGAINST BIOFILM PRODUCTION, AN IN VITRO STUDY N. MILANESI‡, G. GHIBAUDO† AND T. DELLA MURA‡ * Clinica Veterinaria Malpensa, Samarate (Varese), Italy † ICF Srl, Palazzo Pignano, Italy The aim of the study was to assess the efficacy of product containing N-acetylcysteine + Tris-EDTA (Tris-NAC: ICF Srl, Palazzo Pignano, Italy) in preventing the formation of biofilm and aiding its disintegration. The study of biofilm growth inhibition, conducted by the Clever Bioscience Srl laboratory in Pavia (Italy), was evaluated using the microplate biofilm formation test against three microorganism strains: Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923), Malassezia pachydermatis (DSM 6172). The same three microorganisms were used to study the action of the formulation on the biofilm breakdown: for this study, the microorganisms were grown in microtiter plates and the method for to evaluate the growth of the biofilm is called Microtiter Dish Biofilm Formation Assay. Biofilm growth and production were assessed at two different times (8 hours and 24 hours) for bacteria and at three different times for yeasts (8 hours, 24 hours, and 48 hours). Subsequently, the Tris-NAC formulation, at different dilutions, was added to the same plates to evaluate the ability to desegregate the biomass during the 24 hours. To obtain reliable results, the test was carried out in triplicate. The data show that Tris-NAC (a formulation containing Disodium-EDTA) can disaggregate Pseudomonas aeruginosa biofilm both at 8 hours and at 24 hours, Staphylococcus aureus biofilm at 24 hours (in this case at 8 hours the biofilm was still absent), and it was not able to completely disaggregate the Malassezia pachydermatis biofilm at 48 hours (at 8 hours and 24 hours the biofilm was absent). Furthermore, the formulation can inhibit the biofilm formation of all three microorganisms. Source of funding: ICF Srl. Conflicts of interest: NM is a ICF employee, TDM is ICF Scientific Manager, GG have received consultancy and speaker fees from ICF.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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INDIRECT IMMUNOFLUORESCENCE REVEALS CIRCULATING ANTI-KERATINOCYTE IGG AUTOANTIBODIES IN EQUINE PEMPHIGUS FOLIACEUS M. MOSCA, N. MILHAU, A. IDEE and D. PIN VetAgro Sup, Marcy l’étoile, France Pemphigus foliaceus (PF) is the most common auto-immune disease in horses with unknown pathogenesis. The aim of this study was to reveal the presence of circulating anti-keratinocyte autoantibodies with indirect immunofluorescence (IIF). PF was diagnosed by history, clinical signs, cytological and histopathological examinations and direct immunofluorescence (DIF). DIF was performed with a rabbit anti-horse IgG antibody (Rabbit anti-horse IgG H&L, ab6700, Abcam; Paris, France) and compared to that of two healthy horses and three horses with a non-autoimmune inflammatory dermatosis. IIF was performed on rat bladder with the same antibody and compared with two heathy horses. IgG dosage was recorded and clinical severity (extension score from (0 to 3) and absence (0) or presence (1) of general signs) was scored. Nine horses were included, four males and five females with a mean age of 4.5 years (range: 2 months - 23 years). Several breeds were included: French Trotter (n=3), Shetland ponies (n=2), Thoroughbred (n=1), Breton (n=1), Appaloosa (n=1), Camargue (n=1). Clinical severity scores varied between two and four. Circulating anti-keratinocyte IgG were observed in all PF cases with a granular inter-keratinocyte staining. IIF with sera of healthy horses was negative. There was no significant difference between total IgG blood levels in affected compared to healthy horses (t-test, p=0.1963). No correlation between clinical severity scores and total IgG blood levels (Pearson test, p=0.2149, r2=0.3515) was seen. IIF reveals the presence of circulating IgG anti-keratinocyte autoantibodies in equine PF. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
DOES A DISEASE RESEMBLING HUMAN PSORIASIS EXIST IN DOGS? L. ORDEIX*, A. FONDATI†, F. SCARAMPELLA‡ and C. MARIA§ * Fundació Hospital Clínic Veterinari, Barcelona, Spain † Veterinaria Trastevere and Veterinaria Cetego, Rome, Italy ‡ Studio Dermatologico Veterinario, Milan, Italy § Servei de Dermatologia, Fundació Hospital Clínic Veterinari, Barcelona, Spain Human psoriasis is an immune-mediated disease resulting from gene-environmental triggers interaction, characterized clinically by chronic, symmetric, well-demarcated scaling erythematous plaques and histologically by acanthosis, parakeratosis and lymphocytic infiltrate. We report four dogs with clinical-pathological findings resembling human psoriasis. Two spayed female Belgian shepherd and two male Jack Russell terrier dogs with a median age of 7 years (range 2-8) were presented with a chronic (9-month history; 6-30) and intensely pruritic dermatitis. Predominant lesions were symmetric erythematous plaques covered by whitish adherent scales on the extremities and bony prominences (n=4), periocular (n=4) and perioral (n=3) regions, inner pinnae (n=3), footpads (n=3) and scrotum (n=1). Histopathologic lesions were regular acanthosis with parakeratosis, spongiosis, lymphocytic exocytosis, lymphocytic perivascular dermatitis (n=4) and intraepidermal neutrophilic micropustules (n=2). Three dogs exhibited lack of remission following elimination diet and allergen-specific serology resulted negative (n=1) and positive for salivary flea (n=1) and Ambrosia (n=1). Oral glucocorticoids led to partial improvement in three dogs, although relapses following treatment tapering were observed. Pruritus, but not lesions, partially responded to 6 months course of oclacitinib in one dog. Complete clinical response (n=4) was achieved with 5 mg/kg of ciclosporin (41 days; range 10-70). Median follow-up was 8.5 months. One dog showed a mild relapse when cyclosporin was administered once weekly and another dog did not show any relapse one year after ciclosporin discontinuation. Chronic erythematous-scaling dermatitis associated with hyperplastic and parakeratotic lymphocytic dermatitis may represent a psoriasis-like distinctive clinical-histopathological reaction pattern related to an immune-mediated response whose triggers remain currently unknown. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
EPICUTANEOUS IMMUNOTHERAPY AS A NOVEL ROUTE OF ALLERGEN ADMINISTRATION IN DOGS WITH ATOPIC DERMATITIS: A PROOF OF CONCEPT STUDY M. PINTO †, J. MARTO ‡, L. RAMINO-LLUCH §, B. FERNANDES †, A. BIZARRO †, H. PEREIRA †, V. SCHMIDT ¶, M. MORAIS-ALMEIDA Ç, B. BRAZ † and A. MAFALDA LOURENCO † † Centre for Interdisciplinary Research in Animal Health (CIISA), Lisbon, Portugal ‡ Research Institute for Medicines (iMed.ULisboa), Lisbon, Portugal § LETI Pharma S.L.U., Barcelona, Spain ¶ School of Veterinary Science, The University of Liverpool, Liverpool, United Kingdom Ç Allergy Centre, CUF Descobertas Hospital, Lisbon, Portugal Allergen immunotherapy is a well-established treatment for canine atopic dermatitis (CAD), but new non-invasive, safe, effective, painless and at-home easy-to-use vaccine-delivery routes that promote compliance are needed. Epicutaneous immunotherapy (EPIT) is a promising alternative that takes advantage of the skin’s unique immunological features and high accessibility. Our goal was to assess the feasibility, efficacy and safety of EPIT in CAD. Sixteen dogs, French bulldogs (FB, n=9) and Labrador retrievers (LR, n=7), with spontaneous nonseasonal CAD were enrolled for a three-month, weekly 12h patch application. A 3D-printed delivery system was developed to incorporate a 150HEP allergen-based formulation. Primary outcomes included the owner-assessed pruritus manifestations (PVAS10), veterinarian-assessed skin lesions (2D-IGA), and owner’s perceived treatment efficacy (OGATE). Secondary outcomes were the quality-of-life (QoL), allergen-specific (s)IgE, IL-10, and adverse side effects. Efficacy was defined by the primary outcome measures’ success, according to the ICADA’s COSCAD’18 recommendations. EPIT was deemed safe if no severe local/systemic side-effects occurred. One LR dog dropped out of follow-up. All dogs improved their pruritus score and 13/15 dogs (86.67%) achieved success [FB=8/9 (88.89%); LR=5/6 (83.33%)]. Lesions’ score successfully improved in 8/12 dogs [66.67%; FB=5/8 (62.5%); LR=3/4 (75%)]. A good-to-excellent response to therapy and improved QoL, with a percentage mean improvement of 54.58%, were reported by 13/15 owners (86.67%). No severe adverse events were recorded. sIgE overall decreased in 10/15 dogs (66.67%), but non-conclusive IL-10 results were obtained. This pilot study emphasizes the EPIT’s great potential as an effective, well-tolerated and safe CAD treatment, supporting further investigation on this novel therapy. Source of funding: Centre for Interdisciplinary Research in Animal Health (CIISA) – project CIISA MSC SET 20 – 14. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
A PROSPECTIVE, CONTROLLED, MULTICENTRIC AND DOUBLE-BLINDED STUDY OF THE EFFICACY OF COMBINED TREATMENT OF ALLERGEN SPECIFIC IMMUNOTHERAPY AND LOKIVETMAB FOR THE TREATMENT OF CANINE ATOPIC DERMATITIS: A PILOT STUDY. L. RAMIÓ-LLUCH* and A. PUIGDEMONT† * LETI Pharma, Barcelona, Spain † Universitat Autonoma de Barcelona, Barcelona, Spain The objective of this pilot, prospective, double-blinded, controlled, multicentric study was to evaluate the efficacy of ASIT given concomitantly with lokivetmab in dogs with atopic dermatitis (AD) during one year. Sixteen privately- owned, miteallergic dogs were enrolled in this study. Dogs were treated with subcutaneous ASIT (treatment group; n = 7) or placebo (control group, n = 9) for 12 months concomitantly with lokivetmab before, and after 1 and 2 months of starting ASIT. CADESI and PVAS scores were obtained at 0, 2, 5, 8 and 12 months. Lokivetmab was the rescue medication after these 2 months period. Significant differences between groups were observed in the CADESI values (p = 0.019). In the lokivetmab-treated group, values significantly decreased from 33.4 ± 13.2 to 2.9 ± 2.6 (mean ± SD) with a mean improvement of 91%. In the control groups, they decreased from 32.7 ± 8.3 to 12.9 ± 10.4 (an improvement of 58%). PVAS values also decreased during the treatment in both groups ranging from 6.7 ± 2.0 to 2.6 ± 2.5 in the control group (an improvement of 47%) and from 7.1 ± 1.5 to 1.3 ± 1.5 in the treated group (an improvement of 82%). Significant differences were not observed. This pilot study revealed that combined treatment with lokivetmab given at the beginning of ASIT leads to a faster improvement of AD and improves owner’s compliance. Further evaluation of a larger population of dogs treated with the combined regimen should be conducted to verify these observations. Source of funding: LETI Pharma. Conflicts of interest: LR is an employee of LETI Pharma; AP has received unrelated funding from LETI Pharma.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
EFFECT OF USING TEXTILES CONTAINING COPPER AND ZINC IN DOGS WITH SUPERFICIAL PYODERMA C. ROMERO*, I. ASTEINZA†, R. HEREDIA‡ and L. REYES† * DERMAVET Veterinary Hospital, Mexico † Veterinary Hospital Animal Home, Mexico ‡ Integral Veterinary Center, Animal Health and Welfare CIVET, Mexico The use of metallic particles is one of the promising therapies to avoid the use of antimicrobials and it is a new therapeutic alternative for the control of cutaneous infections in dogs. Copper and zinc, which have been shown antimicrobial activity against several strains of fungi and bacteria, inhibition of protein synthesis, altering the cell membrane, inducing oxidative damage and the lysis of nucleic acids, and eliminating the microbes in contact with the particles. The aim was to evaluate the effect of using textiles containing particles of copper and zinc in dogs with superficial pyoderma. Dogs were included in the study if they had a diagnosis of superficial pyoderma and no ongoing treatments. 15 dogs were enrolled and made wear a petsuit containing copper and zinc for 15 days, according to the manufacturer’s instructions. No topical nor systemic treatment were administered. Cytology was performed on days 1, 3, 5, 10, and 15 to evaluate the presence of polymorphonuclear leukocytes, bacteria, and yeast. The polymorphonuclear and extracellular cocci showed a statistically significant constant decrease (p≤ 0.001) among days 1, 3, 5, 10, and 15, the number of yeasts gradually decreased during the study. The use of textiles containing copper and zinc particles resulted in a decrease in polymorphonuclear cells, cocci, and yeast present in dogs with superficial pyoderma. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
THE ROLE OF EARLY LIFE EXPOSURES TO HOUSE DUST MITE ALLERGENS AND ENDOTOXINS IN THE DEVELOPMENT OF CANINE ATOPY: A BIRTH COHORT STUDY FROM WEST HIGHLAND WHITE TERRIERS A. ROSTAHER*, L. ZWICKL*, C. AKDIS†, E. WEST§, S. AUDERGON*, N. FISCHER* and C. FAVROT* * Clinic for Small Animal Internal Medicine, Vetsuisse Faculty Zurich, Zurich, Switzerland † Swiss Institute of Allergy and Asthma Research, Davos Wolfgang, Switzerland § Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland Early life exposures to bacterial endotoxins and house dust mite (HDM) allergens appear to be critical for developing atopy in humans, however, not much is known in veterinary allergology. The objective of this study was to determine the relationship of endotoxin and HDM allergen exposure in early life and their influence on the development of atopy in a high-risk dog breed West Highland White Terriers (atopic n=48; healthy=44) followed up to the age of three years. Bacterial endotoxin and HDM Der p1 and Der f1 allergen levels in the beddings were measured at 3 months of age and environmental factors recorded. Serum allergen-specific and total IgE levels were evaluated using commercial ELISAs. Bivariate odds ratios (OR) and Pearson correlation coefficients (r) were calculated. Endotoxin and HDM allergen levels correlated positively (r=0.36, P=0.0005). HDM allergen levels were negatively correlated with serum IgE levels to any environmental allergen (r=-0.22, P=0.031). Environmental endotoxin levels of ≥16.6 IU/m2 were associated with a significant risk reduction to be sensitized to any allergen and to the development of AD in dogs (for both OR 0.12, CI 0.01-0.098). The endotoxin or HDM allergen levels were negatively associated with disinfectant use (r=-0.46, P=0.00001) or altitude (r=-0.30, P=0.0035), and positively with time spent outside (r=0.35, P=0.0006) or air humidifier usage (r=0.24, P=0.021), respectively. The negative influence of early life HDM and bacterial endotoxin levels in the beddings of dogs with the development of atopy may shed some light on the pathogenesis of canine atopic dermatitis. Source of funding: Swiss National Funding. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
EFFECTIVENESS OF FLURALANER AGAINST TICKS INFESTING HORSES (EQUUS CABALLUS) G. SHEINBERG*, C. ROMERO*, A. CORDERO†, L. BAUTISTA‡ and R. HEREDIA§ * Dermatologia Especializada CVM, Mexico City, Mexico † VETDERM, Guadalajara, Mexico ‡ Centro Universitario UAEM, AMECAMECA EDOMEX, Mexico § DERMAVET, EDOMEX, Mexico Tick control in horses is usually achieved through the application of different acaricides but there is no report of using isoxazolines. Objective of the study was to evaluate the efficacy of fluralaner (Bravecto®, MSD, USA) against ticks in horses. Five females and five males were used in the trial, with an average age of 12 (± 5) years, and weight of 432 (±12) kilos. Selected animals were evaluated for the presence of ticks and they did not receive any acaricides 30 days before the trial. All horses were treated with fluralaner 25 mg per kilogram. Ticks were counted and identified by morphology on days one, seven, 14, 30, 45, 60, and 90. No other treatment was administered during the study. Data were analysed using the Wilcoxon Matched Pairs test with an alpha of 0.05 for comparison between post-treatment measurements. Two tick genera were identified: Amblyomma cajennense and Rhipicephalus microplus. The most significant number of ticks were found in the ears (55.63%), followed by the head (23.23%) and the rest of the body (21.12%). On day seven, tick numbers were significantly reduced by 78.67% (P=0.0001). On day 14, there was a continued decrease in tick numbers compared to initial counts; tick numbers were reduced by 94% (P=0.0001). By day 30, tick numbers were reduced by 99.33% (P=0.006). From day 30 to 90, no ticks were found showing the sustained activity of fluralaner over time. No adverse effects were observed during clinical trial. Based on these data, fluralaner appears to provide effective control of ticks A. cajennense and R. microplus for at least 90 days. Source of funding: Self-funded Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
EVALUATION OF IN VITRO ANTIMICROBIAL ACTIVITY OF CANNABIDIOL OIL SOLUTION AGAINST STAPHYLOCOCCAL ISOLATES FROM PYODERMA AND OTITIS A. STATELLI*, A. TROTTA†, M. BECCATI‡, F. SOGARI† and M. CORRENTE† * Centro Veterinario Ragusa, Ragusa, Italy † Department of Veterinary Medicine, University of Bari, Bari, Italy ‡ Centro Medico Veterinario Adda, Capriate San Gervasio Bergamo , Italy Antimicrobial resistance is an emerging problem in therapy of bacterial infections and there is a urgent need of new antimicrobials or alternative treatments. The aim of this study is to evaluate the in vitro antimicrobial activity of Cannabidiol oils (CBD) against bacterial isolated from otitis and pyoderma in dogs and cats. A collection of 33 staphylococcal isolates were tested. Previously, the isolates were identified by means of biochemical and biomolecular tests. Staphylocococcus aureus and S. pseudintermedius isolates were tested with PCR for the detection of methicillin resistance, for antimicrobial susceptibility to oxacillin, erythromycin, tetracycline, clindamycin, cefoxitin, cephalexin, cefovecin, amoxicillin/clavulanic acid, enrofloxacin, gentamycin, rifampicin, vancomycin and linezolid by means of disk diffusion test. Three different CBD oil solutions were analysed: 2 oil solutions of pure commercial CBD oil (99.99%) and a galenic preparation of CBD based oil 30% extracted from Cannabis sativa. Antimicrobial activities of the extracts were evaluated by using the agar well diffusion method evaluating the diameter of inhibition zone. All the isolates were not inhibited at 5% and 10% of CBD oil concentrations. Thirty % CBD oil solution showed in vitro an antimicrobial activity on all the isolates, methicillin resistant S. aureus included. Our preliminary results highlight the importance of alternative substances such as CBD as an alternative topic treatment for pyoderma and otitis in dogs and cats. Source of funding: Self-funded. Conflicts of interest: None declared.
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
SHORT COMMUNICATIONS
THE EFFICACY OF SUBCUTANEOUS SLOW-RELEASE MELATONIN IMPLANTS IN THE PREVENTION OF CANINE FLANK ALOPECIA RECURRENCE: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED STUDY M.U.M.Y. VERSCHUUREN*, Y.M. SCHLOTTER†, I.M. VAN GEIJLSWIJK‡, R. GEHRING‡ and J.J. van der LUGT† * Dierenartsen Combinatie ZuidOost, Beek en Donk, the Netherlands † IDEXX Europe BV, Hoofddorp, the Netherlands ‡ Department Population Health Sciences - Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, the Netherlands Canine flank alopecia (CFA) is characterized by seasonally recurring (November to April) non-inflammatory alopecia, predominantly in the thoracolumbar area. Previous research suggests that melatonin plays a role in CFA pathogenesis, but placebo-controlled studies on the efficacy of melatonin treatment are lacking. We evaluated the efficacy of subcutaneous slowrelease melatonin implants (Melovine: CEVA Santé Animale, France) in the prevention of CFA recurrence in 21 client-owned dogs who suffered ≥2 consecutive CFA episodes. A general physical and dermatological examination, a histological evaluation of two skin biopsies, and a serum biochemistry analysis, to exclude comorbidities, was performed at baseline. Four dogs (19%) developed permanent CFA before timepoint (T)1 (10 months after baseline), and were excluded. At T1, 17 dogs were randomly assigned to receive placebo (n=9) or 18 mg subcutaneously injected melatonin (n=8). The investigator scored CFA recurrence (one- or two-sided) qualitatively as complete, 50%-or-less, or no recurrence at 5 (T2) and 7 (T3) months after intervention. The percentages for complete recurrence, 50%-or-less recurrence, and no recurrence in placebo-treated dogs at T3 were 44% (4/9 dogs), 0% (0/9 dogs), and 56% (5/9 dogs), respectively. In dogs treated with melatonin, these percentages were 25% (2/8 dogs), 50% (4/8 dogs), and 25% (2/8 dogs), respectively. In 3/8 melatonin-treated dogs, we observed mild transient swelling at the injection site. There was no statistically significant difference in the scores between melatonin-treated dogs and placebotreated dogs (Pearson’s chi-squared test, p=0.4). In conclusion, this study did not provide evidence that melatonin implant treatment is efficacious in preventing CFA recurrence. Source of funding: ESVD Practitioners Grant Conflicts of interest: None declared
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32ND EUROPEAN VETERINARY DERMATOLOGY CONGRESS | 16 - 18 SEPTEMBER 2021 | ONLINE CONGRESS
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SIDE EFFECTS IN CATS TREATED WITH SUBCUTANEOUS ALLERGEN-SPECIFIC IMMUNOTHERAPY: RESULTS OF A WORLDWIDE SURVEY OF 116 VETERINARIANS A-M ZUZZI-KREBITZ*, I HERRMANN†, N. SKALOVA*, A.TICHY* and L. PANAKOVA* * University of Veterinary Medicine Vienna, Vienna, Austria † NC State University, College of Veterinary Medicine, Raleigh, North Carolina, USA The use of allergen-specific immunotherapy (AIT) in cats is reported for over 30 years, but data on side effects (SE) of subcutaneous AIT (SCIT) is limited. The aim of this study was to survey veterinarians on their use of SCIT in cats and to summarize specific SE of SCIT. A link for an online questionnaire was sent to veterinarians specialized and/or interested in veterinary dermatology. The questionnaire was completed anonymously by 116 veterinarians (78 (67,2%) specialists and 38 (32,8%) general practitioners) from 22 countries/ five continents. Seventy-eight (67,2%) participants used SCIT only in Feline Allergic Skin Syndrome (FASS), and 38 (32,8%) in FASS and/or feline asthma. Aluminium hydroxide (25%), distilled water (25%), glycerol (6,9%) were used as adjuvants; (43%) remained unknown. Forty-three (37%) of the participants reported SE related to SCIT. No feline injection-site sarcoma (FISS) was confirmed histopathologically, although one veterinarian suspected FISS. Mild reported SE were: increase in pruritus by 33, vomiting/diarrhea by 12 and local injection reaction by ten survey participants. Interestingly, following severe SE were observed; sudden death was seen in three, collapse in four, dyspnoe in two and anaphylaxis in four cats. Appearance of the acute SE after SCIT was within 24 hours in 38,8%, within 48 hours in 38,8%, between one day, one week in 16,3%, and in 2 weeks – 2 months in 6,1% of questionnaires. In conclusion, although confirmed FISS after SCIT was not reported, veterinarians reported severe SE like anaphylaxis, sudden collapse and even death of cats after the administration of AIT. Source of funding: Self-funded. Conflicts of interest: None declared.
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* Amongst isoxazoline-based cat parasiticides NexGard Combo spot-on solution for cats < 2.5 kg and cats 2.5 7.5 kg Active Substance: Cats 0,8-<2,5 kg (volume of unit dose 0,3 mL): Esafoxolaner 3,60 mg, Eprinomectin 1,20 mg, Praziquantel 24,90 mg. Cats 2,5–<7,5 kg (volume of unit dose 0,9 mL): Esafoxolaner 10,80 mg, Eprinomectin 3,60 mg, Praziquantel 74,70 mg. Indications: For cats with, or at risk from mixed infections by cestodes, nematodes and ectoparasites. The veterinary medicinal product is exclusively indicated when all three groups are targeted at the same time. Treatment of infestations by fleas (Ctenocephalides felis). One treatment provides immediate and persistent flea killing activity for one month. The product can be used as part of a treatment strategy for the control of flea allergy dermatitis (FAD). Treatment of infestations by ticks. One treatment provides immediate and persistent tick killing activity against Ixodes scapularis for one month and against Ixodes ricinus for five weeks. Treatment of infestations by ear mites (Otodectes cynotis). Treatment of infections with tapeworms (Dipylidium caninum, Taenia taeniaeformis, Echinococcus multilocularis, Joyeuxiella pasqualei and Joyeuxiella fuhrmanni). Treatment of infections with gastrointestinal nematodes (L3, L4 larvae and adults of Toxocara cati, L4 larvae and adults of Ancylostoma tubaeforme and Ancylostoma ceylanicum, and adult forms of Toxascaris leonina and Ancylostoma braziliense). Prevention of heartworm disease (Dirofilaria immitis) for one month. Treatment of infections with feline lungworms (L4 larvae and adults of Troglostrongylus brevior). Treatment of infections with vesical worms (Capillaria plica). Contraindications: Do not use in cases of hypersensitivity to the active substances or to any of the excipients. Special warnings for each target species: special attention should be paid to long hair breeds in order to ensure that the product is applied directly to the skin and not on the hair, as this could lead to a lower bioavailability of the active substance. Ticks and fleas need to start feeding on the cat to become exposed to esafoxolaner; therefore, the risk of transmission of arthropod borne diseases cannot be excluded. Adverse reactions (frequency and seriousness): Hypersalivation, diarrhoea, transient skin reactions at the application site (alopecia, pruritus), anorexia, lethargy and emesis were uncommonly observed in clinical trials shortly after administration. They are mostly mild reactions, of short duration and self-limiting. Use during pregnancy, lactation or lay: The safety of the veterinary medicinal product has not been established during pregnancy and lactation. Since foetotoxic and teratogenic effects are described in laboratory animals after significant daily exposure to glycerol formal, use only according to the benefit-risk assessment by the prescribing veterinarian. Administration: For the treatment of infestations with fleas and/or ticks and/or ear mites, and the concurrent treatment of gastrointestinal and/or pulmonary, and/or vesical nematodes, and cestodes, a single dose of the product should be applied. The need for and frequency of re-treatment(s) should be in accordance with the advice of the prescribing veterinarian and should take into account the local epidemiological situation and the animal’s lifestyle (e.g. outdoors access). To be supplied only on veterinary prescription. Updated: 02/04/2021
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Neptra POM-V (UK) and POM (IE) contains 16.7 mg florfenicol, 16.7 mg terbinafine hydrochloride, equivalent to terbinafine base: 14.9 mg, and 2.2 mg mometasone furoate. Further information is available from the SPC. Advice should be sought from the Medicine Prescriber. Refer to the product packaging and leaflets for information about side effects, precautions, warnings and contra-indications. Contact Elanco Animal Health for further information on 01256 353131 or email elancovets@elanco.com, or write to: Elanco Animal Health, Form 2, Bartley Way, Bartley Wood Business Park, Hook, RG27 9XA. Neptra, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates. © 2021 Elanco or its affiliates. PM-IE-21-0128. Date of preparation: 04/21. Use medicines responsibly www.noah.co.uk/responsible, www.apha.ie.
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References: 1. CYTOPOINT Summary of Product Characteristics. 2. Zoetis Study Report No C866C-XC-19-255. 3. Zoetis Market Research: Global Apoquel Cytopoint Brand Health Tracker: Veterinarians: Wave 2 (2020). 4. Zoetis Study - Kynetec Market Research: Cytopoint AD Claim Research (2020). CYTOPOINT is a lokivetmab POM-V. For further information please see the product’s SPC or contact Zoetis UK Ltd, Birchwood Building, Springfield Dr, Leatherhead, KT22 7LP • www.zoetis.co.uk • 0845 300 8034 or customersupportUK@zoetis.com Use medicines responsibly (www.noah.co.uk/responsible) • Date of preparation: August 2021. MM-15896
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