UK-based multicentre cross-sectional study assessing advice requests veterinary dermatologists received from general practitioners.

BACKGROUND: There is little currently little information available regarding the nature of the advice requests veterinary dermatologists receive from general practitioners. Collation of such data could direct continuing veterinary development in the future. METHODS: Dermatologists completed hand-written recording sheets during or after enquiries. Information recorded included the route of enquiry, nature of advice, material provided, practice type and location, animal signalment, presenting signs, diagnosis/differential diagnosis, treatment and referral recommendations, time taken and if charges were made. RESULTS: Twelve dermatology services recorded 768 advice requests over a 6-month period. Most requests were submitted via email and related to canine dermatology (81%). An average of 9.5 minutes was spent replying to requests. Charges were made in 2% of cases. Advice regarding otitis was most commonly sought, followed by pruritus, alopecia and crusting. The most frequently discussed diagnoses included allergy, otitis, pyoderma, demodicosis, dermatophytosis and neoplasia. Antibiotics, anti-pruritics and topical otic medications were the most commonly discussed therapeutics. LIMITATIONS: This is an initial study and therefore there are limitations involving the depth of the data. Additional studies should be completed which identify why advice is sought, decision-making regarding referral, and if advice should be charged similarly to other disciplines. CONCLUSIONS: These findings highlight that veterinarians mostly frequently seek advice on management of common dermatological problems, including allergy, otitis and pyoderma.

Long-term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions.

BACKGROUND: Allergic pruritus and urticaria in the horse are challenging for veterinarians and owners; little is known about their long-term management. OBJECTIVES: To summarize intradermal allergen test results (IDT), and to assess owners' perceptions of skin disease and the effects of medical treatment and management changes in their atopic horses over time. ANIMALS: Eighty two horses with atopic dermatitis in southeastern England between 2006 and 2011. METHODS AND MATERIALS: The IDT results were reviewed retrospectively. Owners completed telephone questionnaires on skin changes, medication, effect of allergen-specific immunotherapy (ASIT) and management. RESULTS: Sixty one owners (74.4%) could be contacted, an average of 5.9 years (range 28-88 months) after IDT; of those, three could not be enrolled. Of the 58 remaining horses, eleven (19%) were deceased at the time of owner interview, including four (6.9%) euthanized due to uncontrollable skin disease. The remaining 47 owners reported that the signs of skin disease had not been seen for at least two years in 18 horses (38.3%), including two that only flared with known triggers. Twenty nine horses (61.7%) still required medication to control skin disease although 25 (53.2%) required less since testing. Owners reported benefit from ASIT in nine of 14 horses (64.3%) from glucocorticoids in 33 of 35 (94.3%) and from antihistamines in 17 of 28 (60.7%). Specific management changes were implemented for 22 horses and reported as beneficial in nine of 22 (40.9%). CONCLUSIONS: Equine atopic dermatitis may not always be chronic, but severe cases appear difficult to control. IDT may help to formulate ASIT and can help to guide management changes.

Functional electrical stimulation with exercises for standing balance and weight transfer in acute stroke patients: a feasibility randomized controlled trial.

OBJECTIVES: To test parameters needed for the design of a larger trial including the following: 1) identifying eligible participants, recruitment, and retention rates; 2) the feasibility and acceptability of delivering functional electrical stimulation (FES) to the gluteus maximus and quadriceps femoris for acute stroke patients in a hospital rehabilitation setting; 3) the outcome measures; 4) obtaining initial estimates of effect size; and 5) clarifying the relevant control group. MATERIALS AND METHODS: Twenty-one people with acute stroke-mean age = 68 (min to max: 33-87) years; weeks postonset = 4.6 (min to max: 1-14)-were randomized to three groups to receive two weeks of balance training with FES, balance training alone, or usual care. Symmetry in normal standing, weight transfer onto the affected limb, balance, mobility, and speed of walking were assessed before, shortly after the end of training, and two weeks later by a blinded assessor. RESULTS: 1) FES was successfully delivered but not with the planned eight sessions; 2) no trends in favor of FES were found; and 3) 4% of those screened took part but approaching 20% might be recruited in the future, no single outcome measure was suitable for all participants, and more routine physiotherapy was delivered to the control group. CONCLUSIONS: FES is feasible in this patient group but further feasibility and definitive trials are required.

Investigating head and trunk rotation in sitting: a pilot study comparing people after stroke and healthy controls.

BACKGROUND AND PURPOSE: Healthy individuals have a top-down coordination pattern when turning while walking; they first rotate the head, then the shoulders, the pelvis and, finally, the feet. The aim of this study was to compare spatial and temporal characteristics of head and trunk rotation in sitting between people early after stroke and healthy participants, and investigate change over time. METHODS: This was a pilot, quantitative, longitudinal study. We recruited participants from stroke wards and local groups. People with stroke were assessed at 3, 6 and 12 weeks after stroke. Healthy participants were examined with the same weekly intervals. Participants were in a seated position and were asked verbally to rotate their head and look at a visual signal placed at 90° to the left and to the right of the subject. CODAmotion (Charnwood Dynamics Ltd, Rothley, UK) was used for 3-D motion recording and analysis. RESULTS: Healthy participants (two women and four men; mean age 66 years) showed significant rotation of the head before rotation of the shoulders at all three time points; people with stroke (one woman and five men; mean age 71 years) did not show this top-down pattern of movement. There was no significant difference between start times of head and shoulder rotation at 3 (p = 0.167), 6 (p = 0.084) and 12 weeks after stroke (p = 0.062). Conclusions. The results of our pilot study warrant further investigation into the recovery and pattern of axial coordination after stroke. Future studies could provide insight into the mechanisms behind impaired postural control in people after stroke.

Kinematic analysis of head, trunk, and pelvis movement when people early after stroke reach sideways.

BACKGROUND: Sideways reaching with the unaffected arm while seated is a component of everyday activities and can be a challenging task early after stroke. Kinematic analysis of a lateral reach task may provide potential rehabilitation strategies. OBJECTIVE: The authors examined the difference between people with stroke and healthy controls in the movement sequence of head, trunk, and pelvis, as well as the difference in angle at maximum reach and peak velocity for each body segment during reach and return. METHODS: Twenty-four people within 12 weeks of a stroke and 20 healthy subjects performed a standardized lateral reach. Using CODAmotion, movement sequence was determined and angles and peak velocities were calculated. RESULTS: When reaching, people with stroke moved their pelvis first, followed by the trunk and head, whereas healthy controls started with their head and then moved their trunk and pelvis. Patients achieved significantly smaller angles at maximum reach compared with healthy subjects for all body segments and lower peak velocities during the reach (for head, trunk, and pelvis) and the return (for head and trunk). CONCLUSIONS: Lateral reaching to the unaffected side early after stroke revealed a different pattern than normal and patients reached less far and moved at a slower speed. Specific training strategies to improve reaching are needed.

Management of canine atopic dermatitis using the plant extract PYM00217: a randomized, double-blind, placebo-controlled clinical study.

This study evaluated PYM00217, a proprietary blend of plant extracts, in the management of canine atopic dermatitis (AD). One hundred and twenty dogs were diagnosed with perennial AD on the basis of history, clinical signs, a positive test for perennial allergens and elimination of other dermatoses. Exclusion criteria included antimicrobials within 7 days, antihistamines within 14 days, oral/topical glucocorticoids or ciclosporin within 28 days, and parenteral glucocorticoids, essential fatty acids or immunotherapy within 56 days. Flea control, shampoos and ear cleaners were permitted. Dogs with a minimum canine atopic dermatitis extent and severity index (CADESI) of 25 were randomly allocated to receive PYM00217 (100, 200 or 400 mg kg-1 day-1) or placebo for 12 weeks. The mean reductions in CADESI (intention-to-treat population) were 3.9% (placebo; n=29), 4.4% (100 mg kg-1 day-1; n=30), 23.4% (200 mg kg-1 day-1; n=29) and 8.5% (400 mg kg-1 day-1; n=29). The reduction in the 200 mg kg-1 day-1 group was significant (P<0.01). For dogs with a baseline CADESI>or=50, the mean changes were +10.6% (placebo; n=12), +0.6% (100 mg kg-1 day-1; n=14), -29.3% (200 mg kg-1 day-1; n=14) and -3.4% (400 mg kg-1 day-1; n=15). The 200 mg kg-1 day-1 dose was significantly more effective than placebo (P=0.038). No serious adverse effects were reported. Minor adverse effects seen in 10% (placebo and 100 mg kg-1 day-1), 24% (200 mg kg-1 day-1) and 42% (400 mg kg-1 day-1) of cases were mainly minor gastrointestinal disorders and only five cases required cessation of dosing. Two dogs (one in each of the 100 mg kg-1 day-1 and 200 mg kg-1 day-1 groups) refused to eat the medicated food. In conclusion, PYM00217 at 200 mg kg-1 appears to be an effective, palatable and well-tolerated treatment for canine AD.

Estimation of heritability of atopic dermatitis in Labrador and Golden Retrievers.

OBJECTIVE: To estimate the heritability of atopic dermatitis in Golden and Labrador Retrievers. ANIMALS: 429 dogs related to 13 dogs with atopic dermatitis. PROCEDURE: Atopic dermatitis was defined on the basis of the type and frequency of clinical signs recorded in the clinical records, and each dog was classified with atopic dermatitis or probable atopic dermatitis or as nonatopic. By use of data from atopic and nonatopic dogs, regression analyses of parental status on offspring status were performed to estimate heritability. RESULTS: There was no difference in the frequency of atopic dermatitis between sexes or between breeds. There was a marked association between the atopic status of the parent and that of the offspring, particularly for sires. By use of data from 32 litters in which the status of both parents was known and considering only those dogs classified with atopic dermatitis or as nonatopic, the heritability (+/- SE) of atopic dermatitis was estimated to be 0.47 (+/- 0.17). CONCLUSIONS AND CLINICAL RELEVANCE: Atopic dermatitis has a strong genetic component, and breeding of dogs with clinical signs of atopic dermatitis should be discouraged.

Equine Cutaneous Lymphoma: A Case Report.

Résumé- Les commémoratifs, les symptômes, l'histologie et la réponse au traitement d'un cheval de 15 ans atteint de lymphome cutané sont décrits. La jument présente de multiples nodules cutanés depuis 11 ans. Un diagnostic de lymphome cutané est poséà l'examen histologique de biopsies réalisées 2 fois à 4 ans d'intervalle. Des marquages immunihistochimiques identifient ces cellules comme appartenant à la lignée T. Ceci est la première description du marquage immunophénotypique d'un lymphome cutané chez le cheval. La jument a été traitée par des glucorticoïdes intralésionnels et des progestagènes oraux ce qui a entrainé une régression complète des nodules. Resumen- Describimos la historia clinica y los hallazgos clinicos e histológicos de un caballo de 15 años con un linfoma cutáneo. La yegua tenia una historia clinica de multiples nédules cutáneos en los últimos 11 años. Se diagnosticó un linfoma cutáneo mediante estudio histológico de dos biosias tomadas con unos cuatro años de separación. Tinciones inmunohistoquimicas ulteriores identificaron la linea celular de ünfocitos T. Este es el primer estudio que caracteriza el linfoma equino a nivel inmunofenotipico. La yegua fue tratada con glucocorticoides intralesionales y progestágenos orales, lo que resultó en curación total de los nódulos. Abstract- The history, clinical and histological features and response to treatment of a 15-year-old horse with cutaneous lymphoma are described. The mare had an 11 year history of multiple cutaneous nodules. A diagnosis of cutaneous lymphoma was made on histological examination of biopsy material taken on two separate occasions some 4 years apart. Subsequent immunohistochemical staining identified the cell lineage as T-lymphocytes. This is the first report of immunophenotypic characterisation of cutaneous lymphoma in the horse. The horse was treated with intralesional glucocorticoids and oral progestins, and complete resolution of the nodules resulted.