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Recurrent otitis externa is a common problem in dogs. Topical treatment for each flare is successful in the short term, but repeated cycles of inflammation and infection lead to chronic inflammatory changes, pain and aversion, and antimicrobial resistance. These make the flares more frequent and harder to control. Eventually, the changes become irreversible and require a total ear canal ablation/lateral bulla osteotomy or ablative laser surgery. Most ear canal surgery is avoidable if recurrent otitis is properly managed at an earlier stage. This requires a different mindset and approach to these cases, taking advantage of recent research and clinical findings. Most importantly, clinicians must appreciate that all recurrent ear infections in dogs are secondary. To achieve a good long-term outcome, it is essential that all the underlying factors in each case are diagnosed and managed using the primary, secondary, predisposing, and perpetuating framework. This means that the primary condition must be diagnosed and managed, the secondary infection treated, predisposing risks identified and corrected, and the perpetuating factors reversed. Treatment is in 2 phases: induction to get the ears in remission and then long-term maintenance therapy to prevent relapses. Treatment should be appropriate to each dog but will typically involve ear cleaning, topical antimicrobial therapy, and topical or systemic glucocorticoids. Novel treatments for infection and inflammation will offer additional options in the future. Understanding the triggers for recurrent otitis in dogs will help clinicians plan effective management regimens that will make a huge difference to the quality of life of their patients and their owners.

Background Middle ear effusion is common in brachycephalic dogs with similarities to otitis media with effusion in children. Association with the cranial and eustachian tube morphology and bacterial infection is suspected in both species. Hypothesis/objectives To determine cytological and bacteriological features of middle ear effusions in dogs, provide information on histological features, and further assess the dog as a model of the human disease. Animals Sixteen live dogs, 3 postmortem cases of middle ear effusion, and 2 postmortem controls. Methods Prospective; clinical investigation using computed tomography, magnetic resonance imaging, video-otoscopy, myringotomy; cytological assessment of 30 and bacteriology of 28 effusions; histology and immunohistochemistry (CD3 for T-lymphocytes, Pax5 for B lymphocytes and MAC387 for macrophages) of 10 middle ear sections. Results Effusions were associated with neurological deficits in 6/16 (38%) and concurrent atopic dermatitis and otitis externa in 9/16 (56%) of live cases. Neutrophils and macrophages predominated on cytology (median 60 [range 2%-95.5%] and 27 [2%-96.5%]) whether culture of effusions was positive or not. In histology sections, the mucosa was thickened in affected dogs but submucosal gland dilatation occurred in affected and unaffected dogs. There was no bacterial growth from 22/28 (79%) of effusions. Bacteria isolated from the other 6 (21%) were predominantly Staphylococcus pseudintermedius (4/6, 67%). Conclusions and clinical importance Clinical, morphological, and cytological findings in middle ear effusions of dogs and people suggest similar pathogeneses. Middle ear effusion of dogs could be a useful model of human otitis media with effusion. Such comparisons can improve understanding and management across species.

BackgroundTopical antimicrobials are recommended for first line treatment of surface and superficial infections in dogs. This is especially important given the increasing prevalence of antimicrobial resistant infections. Antimicrobial wipes have become popular, but there are a lack of controlled studies assessing their in vitro antimicrobial and in vivo residual activity. We aimed to assess the antimicrobial efficacy of two commercial antimicrobial wipes against frequently isolated pathogens.Ten clinical and one reference isolate each of meticillin-susceptibleStaphylococcus pseudintermedius(MSSP), meticillin-resistantS. pseudintermedius(MRSP),Escherichia coli(EC), extended spectrum beta-lactamase (ESBL) producingE. coli(ESBL-EC),Pseudomonas aeruginosa(PA) andMalassezia pachydermatis(MP) were tested using a modified Kirby-Bauer technique. Each isolate was tested against 6 mm discs of chlorhexidine (CHX) and acetic acid/boric acid (AABA) wipes, and positive and negative controls either overnight (bacteria) or for 3 days (Malassezia).Healthy dogs were treated with the wipes and distilled water on a randomised flank (n = 5 each). Hair samples (1 cm; 0.1 g) taken at days 0, 1 and 3 were inoculated with an isolate of each organism. Zones of inhibition (ZI) were measured.ResultsAll isolates produced confluent growth with AABA and control wipes, except for the cleansing wipes and MP (median ZI 12 mm; 95% CI 8.2–15.8). The median (95% CI) CHX wipe ZIs (mm) were: MP 48.0 (47.0–49.0), MSSP 15.6 (14.2–17.0), MRSP 14.0 (13.6–14.4), EC 13.6 (12.0–15.2) and ESBL-EC 10.0 (9.4–10.6). PA showed confluent growth. The differences between the bacterial isolates was significant (Kruskal-Wallisp EBSL-EC > PA). Confluent growth was visible with all the hair samples.ConclusionCHX but not AABA showed in vitro efficacy against MSSP, MRSP, EC and MP. ESBL-EC were less susceptible and there was no activity against PA. There was no residual activity on hair. Additional studies are required to determine efficacy of these products in clinically affected patients.

Feline allergic skin disease and asthma occur regularly in small animal practice.To provide evidence-based recommendations for small animal practitioners on the treatment of feline atopic syndrome (FAS).The authors reviewed the literature available before February 2020, prepared a detailed evidence-based literature review and made recommendations based on the evaluated evidence.Sixty-six papers and abstracts were identified describing treatment interventions for FAS and evaluated to establish treatment recommendations. For many treatment options, the papers were retrospective, open studies or case reports.In this review, there was good evidence for the efficacy of systemic glucocorticoids and ciclosporin, and limited evidence for the efficacy of topical glucocorticoids, oclacitinib and allergen-specific immunotherapy in feline atopic skin syndrome. Evidence pointed to low-to-moderate efficacy for antihistamines, fatty acids and palmitoyl ethanolamide. In feline asthma, there was good evidence for the efficacy of oral and inhaled glucocorticoids, and limited evidence of moderate efficacy for allergen-specific immunotherapy. Evidence supported low-to-moderate efficacy of mesenchymal stem cells, inhaled lidocaine and oclacitinib as treatments for feline asthma. For almost all therapeutic options (with the exception of glucocorticoids and ciclosporin), more randomised controlled trials are needed.背景: 猫特应性综合征(FAS)涵盖了一系列超敏反应疾病, 以高度多样化的临床表现为特征, 包括皮肤、胃肠道和呼吸系统。这些疾病包括猫特应性皮肤综合征(FASS), 其中超敏反应通常与环境过敏原相关, 尽管食物过敏可能同时存在。也可能累及其他器官系统 (如哮喘)。由于其高度异质性的临床表现, FASS的诊断可能具有挑战性。 目的: 国际动物过敏性疾病委员会(ICADA)的一个亚组的任务是总结FASS临床表现的最新信息, 并制定诊断指南。 方法: 检索在线引文数据库和国际会议摘要中与猫过敏相关的出版物。必要时结合专家意见。 结果: 共找出107篇与本综述相关的出版物。汇编这些资料能够制定FASS临床特征的详细描述和制定指南, 重点是系统性消除具有相似临床特征的其他皮肤疾病。由于皮肤科医生经常使用过敏试验来支持FASS的临床诊断, 因此还对这些方法进行了简要综述。 结论和临床重要性: 与犬特应性皮炎相似, FASS的临床诊断是基于相符的临床症状,并排除具有相似临床特征的其他疾病。在确诊FASS之前, 必须消除或排除跳蚤/跳蚤过敏、其他寄生虫、感染和食物过敏。.CONTEXTE: le syndrome atopique félin (FAS) décrit un spectre d’hypersensibilités caractérisées par diverses présentations cliniques comprenant la peau, le système digestif et le système respiratoire. Parmi ces atteintes, il y a le syndrome cutané atopique félin (FASS), pour lequel l’hypersensibilité est typiquement associée à des allergènes environnementaux, bien que l’allergie alimentaire puisse coexister. D’autres organes (par exemple asthme) peuvent être aussi impliqués. En raison de cette grande hétérogénéité clinique, le diagnostic du FASS peut être un défi. OBJECTIFS: Un sous-groupe de l’ICADA (International Committee on Allergic Diseases of Animals) a été chargé de résumer les informations les plus actuelles sur les présentations cliniques du FASS et de développer des recommandations de diagnostic. MÉTHODES: Les citations des bases de données en ligne et les résumés des congrès internationaux ont été recherchés pour les publications en lien avec les allergies félines. Ceci a été combiné avec des opinions d’experts quand nécessaire. RÉSULTATS: Un total de 107 publications pertinentes a été identifié. La compilation de ces données a permis le développement d’une description détaillée des critères cliniques du FASS et le développement de recommandations ciblant une élimination systématique des autres atteintes cutanées avec des caractéristiques cliniques semblables. Alors que les tests allergiques sont fréquemment utilisés par les dermatologues pour soutenir le diagnostic clinique du FASS, une revue rapide de ces méthodologies a aussi été réalisée. CONCLUSIONS ET IMPORTANCE CLINIQUE: De façon semblable à la dermatite atopique canine, le FASS est un diagnostic clinique basé sur la présence compatible avec les signes cliniques et l’exclusion d’autres maladies ayant des critères cliniques semblables. L’élimination ou l’exclusion des puces/de l’allergie aux puces, d’autres parasites, des infections et de l’allergie alimentaire est necessaire avant d’établir un diagnostic de FASS.Das Feline atopische Syndrom (FAS) beschreibt ein Spektrum von Hypersensibilitätserkrankungen, die durch sehr unterschiedliche klinische Präsentationen auf der Haut, dem Gastrointestinaltrakt und dem Respirationstrakt charakterisiert sind. Unter diesen Erkrankungen ist auch das Feline Atopische Haut Syndrom (FASS), bei dem eine Hypersensibilität typisch mit Umweltallergenen in Zusammenhang steht, obwohl eine Futterallergie gleichzeitig bestehen könnte. Es können auch andere Organsysteme mit involviert sein (z.B. Asthma). Aufgrund der hochgradig heterogenen klinischen Präsentation kann die Diagnose der FASS eine Herausforderung darstellen.Eine Untergruppe des International Committee on Allergic Diseases of Animals (ICADA) sollte die gängigste Information über die klinischen Präsentationen vom FASS zusammenfassen und diagnostische Richtlinien entwerfen.Es wurden Online Literaturstellen und Abstracts von internationalen Treffen auf Publikationen über Allergien der Katze durchsucht. Diese wurden, wenn nötig, mit einer Expertenmeinung kombiniert.Es wurden insgesamt 107 Publikationen, die für dieses Thema relevant waren, identifiziert. Eine Erfassung dieser Daten erlaubte die Entwicklung einer detaillierten Beschreibung der klinischen Merkmale des FASS und die Entwicklung von Richtlinien, die sich auf die systematische Eliminierung von anderen Hauterkrankungen mit ähnlichen klinischen Charakteristika konzentrieren. Da Allergietests von Dermatologen häufig verwendet werden, um eine klinische Diagnose des FASS zu untermauern, wurde eine kurze Review dieser Methoden durchgeführt.In einer ähnlichen Weise wie bei der atopischen Dermatitis der Hunde, ist das FASS eine klinische Diagnose, die auf dem Vorkommen von kompatiblen klinischen Zeichen und einem Ausschluss anderer Krankheiten mit ähnlichen klinischen Merkmalen beruht. Eine Eliminierung von Flöhen/Flohspeichelallergie, anderer Parasiten, Infektionen und Futterallergie sind zwingend notwendig, bevor die Diagnose einer FASS getroffen werden kann.背景: ネコアトピー症候群 (FAS) は、皮膚、胃腸、呼吸器系を含む非常に多様な臨床症状を特徴とする一連の過敏症を説明している。これらの障害の中には、食物アレルギーが共存する可能性があるものの、過敏症が通常環境アレルゲンと関連しているネコアトピー性皮膚症候群 (FASS) がある。他の臓器系 (喘息など) の関与も発生する可能性がある。その非常に不均一な臨床症状のために、FASSの診断は困難な場合がある。 目的: 動物のアレルギー性疾患に関する国際委員会 (ICADA) のサブグループは、FASSの臨床症状に関する最新情報を要約し、診断ガイドラインを作成する任務を負った。 方法: オンライン引用データベースと国際会議の要約を検索して、猫アレルギーに関連する出版物を探した。これらは、必要に応じて専門家の意見と組み合わされた。 結果: このレビューに関連する合計107の出版物が特定された。これらのデータの編集により、FASSの臨床的特徴の詳細な説明の開発および、同様の臨床的特徴を持つ他の皮膚状態の体系的な排除に焦点を当てたガイドラインの開発が可能になった。アレルギー検査はFASSの臨床診断をサポートするために皮膚科医によって頻繁に使用されるため、これらの方法論の簡単なレビューも行われた。 結論と臨床的重要性: 犬アトピー性皮膚炎と同様に、FASSは、互換性のある臨床徴候の存在と、同様の臨床的特徴を持つ他の疾患の除外に基づく臨床診断である。 FASSの診断に達する前に、ノミ/ノミアレルギー、他の寄生虫、感染症、および食物アレルギーの排除または排除が義務付けられている。.A síndrome atópica felina (SAF) descreve um espectro de distúrbios de hipersensibilidade caracterizados por uma apresentação clínica altamente diversa, incluindo a pele, sistema gastrointestinal e respiratório. Dentre esses distúrbios está a síndrome atópica cutânea felina (FASS, feline atopic skin syndrome), na qual hipersensibilidade é tipicamente associada a alérgenos ambientais, apesar de alimentos poderem coexistir. O envolvimento de outros sistemas (ex: asma) pode também ocorrer. Devido a essa apresentação clínica altamente heterogênea, o diagnóstico da FASS pode ser desafiador.Um subgrupo do International Committee on Allergic Diseases of Animals (ICADA) foi designado a sintetizar as informações mais recentes sobre as apresentações clínicas da FASS, e a desenvolver diretrizes diagnósticas. MÉTODOS: Bancos de dados de citações online e resumos de congressos internacionais foram utilizados para buscar publicações relacionadas a alergias em felinos. Quando necessário, estes foram combinados com as opiniões dos experts.Um total de 107 publicações relevantes a essa revisão foram identificados. A compilação desses dados permitiu o desenvolvimento de uma descrição detalhada das características clínicas da FASS e o desenvolvimento de diretrizes focando a eliminação sistemática de outras dermatopatias com características similares. Como os testes alérgicos são frequentemente utilizados por dermatologistas para apoiar o diagnóstico clínico de FASS, uma rápida revisão destas metodologias foi realizada. CONCLUSÕES E IMPORTÂNCIA CLÍNICA: Semelhante à dermatite atópica em cães, a FASS é um diagnóstico clínico baseado nos sinais clínicos compatíveis e exclusão de outras doenças com características clínicas similares. A eliminação de pulgas/alergia à picada de pulgas, outros parasitas, infecções e alergia alimentar é mandatória antes de se fechar o diagnóstico da FASS.INTRODUCCIÓN: el síndrome atópico felino (FAS) describe un espectro de trastornos de hipersensibilidad caracterizados por presentaciones clínicas muy diversas que incluyen la piel, los sistemas gastrointestinal y respiratorio. Entre estos trastornos se encuentra el síndrome de piel atópica felina (FASS), en el que la hipersensibilidad se asocia típicamente con alérgenos ambientales, aunque la alergia alimentaria puede coexistir. También puede producirse la afectación de otros sistemas orgánicos (por ejemplo asma). Debido a su presentación clínica altamente heterogénea, el diagnóstico de FASS puede ser difícil. OBJETIVOS: Se encomendó a un subgrupo del Comité Internacional sobre Enfermedades Alérgicas de los Animales (ICADA) que resumiera la información más actual sobre las presentaciones clínicas de FASS y que desarrollara pautas de diagnóstico recomendadas. MÉTODOS: Se realizaron búsquedas en la red de bases de datos de referencias y resúmenes de reuniones internacionales relacionadas con alergias felinas. Éstos se combinaron con la opinión de expertos cuando fue necesario. RESULTADOS: Se identificaron un total de 107 publicaciones relevantes para esta revisión. La recopilación de estos datos permitió el desarrollo de una descripción detallada de las características clínicas de FASS y el desarrollo de pautas centradas en la eliminación sistemática de otras afecciones de la piel con características clínicas similares. Dado que los dermatólogos utilizan con frecuencia las pruebas de alergia para respaldar un diagnóstico clínico de FASS, también se realizó una breve revisión de estas metodologías. CONCLUSIONES E IMPORTANCIA CLÍNICA: De manera similar a la dermatitis atópica en perros, FASS es un diagnóstico clínico basado en la presencia de signos clínicos compatibles y la exclusión de otras enfermedades con características clínicas similares. La eliminación o exclusión de pulgas/alergia a pulgas, otros parásitos, infecciones y alergia alimentaria es necesaria antes de llegar a un diagnóstico de FASS.

Case summary A 12-year-old female neutered indoor–outdoor domestic longhair cat presented with frequent sneezing and a nodular, suppurative lesion on its dorsal nose. Histopathological examination revealed a fungal granuloma. PCR and sequencing of the ribosomal internal transcribed spacers (ITS) regions (ITS-F and ITS-R) confirmed an infection with a Sporothrix species. Further sequencing of the beta-tubulin and calmodulin genes confirmed Sporothrix humicola, which lies within the Sporothrix pallida complex. The cat had concurrent diabetes mellitus, which responded to insulin therapy and diet. Oral itraconazole at 10 mg/kg PO q24h resulted in resolution of the lesions after 12 months. Treatment was well tolerated. Relevance and novel information This is the first report of sporotrichosis in a cat in the UK and only the fifth worldwide involving the S pallida complex. Clinicians, pathologists and microbiologists need to be aware of the potential of Sporothrix infections in the UK and the ability of S pallida complex to cause opportunistic infections. Molecular techniques can achieve rapid and accurate identification of rare fungal organisms. A precise diagnosis with molecular testing can provide information regarding prognosis, treatment and zoonotic implications.

Staphylococcus aureus is an important pathogen of both humans and animals, implicated in a wide range of infections. The emergence of antibiotic resistance has resulted in S. aureus strains that are resistant to almost all available antibiotics, making treatment a clinical challenge. Development of novel antimicrobial approaches is now a priority worldwide. Bacteria produce a range of antimicrobial peptides; the most diverse of these being bacteriocins. Bacteriocins are ribosomally synthesised peptides, displaying potent antimicrobial activity usually against bacteria phylogenetically related to the producer strain. Several bacteriocins have been isolated from commensal coagulase-negative staphylococci, many of which display inhibitory activity against S. aureus in vitro and in vivo. The ability of these bacteriocins to target biofilm formation and their novel mechanisms of action with efficacy against antibiotic-resistant bacteria make them strong candidates as novel therapeutic antimicrobials. The use of genome-mining tools will help to advance identification and classification of bacteriocins. This review discusses the staphylococcal-derived antimicrobial peptides displaying promise as novel treatments for S. aureus infections.

Background: Esophageal feeding tubes are commonly utilized to allow nutritional demands to be met in animals that are unable or unwilling to achieve this themselves. The placement of these tubes is relatively easy and they are well tolerated; however, they are not entirely without side effects. Objectives: To evaluate the complications associated with esophageal tube placement in cats across two referral centers, and to identify whether there were any factors predisposing to these complications, including stoma site infection and death.Animals: Cats which had an esophageal feeding tube placed (n = 248). Methods: Clinical records were interrogated across two referral centres to find cats that had esophageal tubes placed. Clinical data was collected for signalment, clinical indication, method of placement, time of removal and any complications. Logistic regression was then employed to assess the odds of an increase in complications, including infection, and death, over several variables. Results: The median time that the tubes were in place for, in those cats that survived to discharge, was 11 days. Complications occurred in 35.8% of the cats, with the most common being tube dislodgement (14.5%), followed by stoma site infections (12.1%). Cats which survived to discharge had a complication rate of 48%, with varying degrees of severity. In the multivariate models, cats receiving immunosuppressive medications (OR = 3.91) and experiencing discharge at the stoma site (OR = 159.8) were at an increased odds of developing a stoma site infection, whereas those with a lower weight (OR = 0.75) and certain disease processes (pancreatic (OR = 4.33), neoplastic (OR = 15.44), respiratory (OR = 19.66), urogenital (OR = 5.78), and infectious diseases (OR = 11.57)) had increased odds of death. The duration of time in place and the patient being discharged with the tube in place were not associated with an increased risk of infection or mortality.Conclusions and clinical importance: The risk of complications is relatively high at 35.8%, with infections identified in 12.1% of cases. Patients receiving immunosuppressive medications are at a higher risk of infection, and this should be taken into account when placing and maintaining esophageal feeding tubes. The duration of time in place and the patient being discharged with the tube in place were not associated with an increased risk of infection or mortality. Esophageal feeding tubes can be a crucial part of patient management; however, owners should be made aware of the potential risks involved.

Chronic pododermatitis with interdigital furunculosis is a common and frustrating problem in dogs. It is characterised by the presence of recurrent interdigital furunculosis. It is a multifactorial condition with primary, predisposing and perpetuating causes that lead to the secondary infections. Almost any skin disease can trigger the initial inflammation, but atopic dermatitis, adverse food reactions and abnormal conformation are the most common. Predisposing factors such as short hairs, excess weight, and altered weight bearing may lead to the development of the interdigital furunculosis. Perpetuating changes prevent resolution; these include weight bearing on haired skin, conjoined pads, new pad formation, deep tissue pockets, ingrown hairs and sinus tracts. All of the contributing factors in each case must be identified and managed. Supportive care includes analgesia, weight loss, using boots, keeping the interdigital skin clean, and using lubricating creams. Secondary bacterial and/or Malassezia spp. infections should be managed with appropriate topical and/or systemic antimicrobials. Bacterial infections can be deep, mixed and/or antimicrobial resistant, and culture and antimicrobial susceptibility testing must be used to select effective drugs. Chronic inflammatory changes can be managed with topical or systemic glucocorticoids, topical 0.1% tacrolimus, ciclosporin or cytotoxic drugs. Chronic proliferative changes are poorly responsive to medical management alone, therefore surgical fusion or laser podoplasties should be considered. Long-term treatment of the primary, predisposing and perpetuating problems is required to maintain remission and prevent recurrence.

Antimicrobial resistance (AMR) is a global challenge facing both human and animal healthcare professionals; an effective response to this threat requires a ‘One-Health’ approach to antimicrobial stewardship (AMS) to preserve important antibiotics for urgent clinical need. However, understanding of barriers and enablers to effective antimicrobial stewardship behaviour in companion animal veterinary practice is currently limited.We conducted a Delphi Study of 16 nationally recognised experts from UK based veterinary policy makers, university academics, and leaders of professional bodies. This Delphi study sought to identify veterinary behaviours which experts believe contribute to AMR and form vital aspects of AMS. Analysis of Delphi findings indicated a perceived hierarchy of behaviours, the most influential being antibiotic prescribing behaviours and interactions with clients. Other veterinary behaviours perceived as being important related to interactions with veterinary colleagues; infection control practices; and the use of diagnostic tests to confirm infection. Key barriers and enablers to AMS within each of these behavioural domains were identified. Specific interventions to address important barriers and enablers are recommended. To the authors’ knowledge, this is the first study to establish expert consensus at a national level about which ‘behaviours’ (aspects of veterinarian practice) should be targeted in relation to antimicrobial resistance and stewardship in companion animal veterinary practice.

Feline hyperesthesia syndrome (FHS) was first reported in 1979and described as an accentuation of an otherwise normal behaviorin cats consisting in episodes of tail chasing, biting or licking thelumbar area, flank, anal area or tail; skin rippling and musclespasms; excessive and unusual vocalizations, wild and uncontrolledjumping and running and presumed hallucinations. FHS has beenanecdotally reported in association with dermatological, behavioural,orthopaedic and neurological conditions. Treatment withphenobarbital, gabapentin, prednisolone, amitriptyline, fluoxetine,clomipramine and multivitamin supplements have been used withinconsistent responses. However, we are not aware of any clinicalscientific investigation on Feline Hyperesthesia Syndrome.We retrospectively collected data on the history, signalment,diagnostic workup and treatment from three referral veterinarycenters. The inclusion criteria were a history of attacking or overgroomingthe tail, flank or perineal area associated with eithervocalization or lumbar hyperesthesia, manifested as rippling of thethoracolumbar skin occurring spontaneously or induced by gentletouch. Information on physical and neurological examination, anddiagnostic work up were also necessary for inclusion in the study.Thirteen cats were included in the study. The median age ofpresentation was 1 year (1–7 years). Eleven cats were attacking orover-grooming their tails and two cats their flank or perineal area.Tail mutilation was reported in 9/13 cats, rippling of the thoracolumbarskin in 10/13 cats and 6 cats presented with unusualvocalization during the episodes. The episodes occurred multipletimes per day in 12/13 of the cases, and multiple times per week in1/13. No consistent triggers were reported. Results of CBC andbiochemistry were available for 12/13 cats, spinal radiographs for7/13, magnetic resonance imaging for 6/13, cerebrospinal fluidanalysis for 3/13, electromyography for 3/13, dermatologicalassessment for 7/13, and joint fluid analysis for one cat. The diagnosticwork up led to the diagnosis of allergic dermatitis in 2 casesand immune-mediated polyarthritis in one case, but a definitivediagnosis was not reached in the remaining 10 cases. Treatmentincluded corticosteroids in 7/13 of the cats, gabapentin in 8/13,clomipramine in 4/13, topiramate in 2/13, phenobarbital in 2/13and cyclosporine in 6/13. The majority of the cases (10/13)received a combination of 2 or more drugs.Our study confirmed previous anecdotal reports of FHS affectingyoung cats and the possibility of that FHS signs are secondaryto inflammatory skin conditions. A definitive diagnosis was notreached in 10 cases. However, not all the cases had the samediagnostic work up and not all had a full behavioral and dermatologicalassessment. Based on the results of this retrospectivestudy, specialists in neurology, behavior and dermatology haveformulated a standardized questionnaire and proposed a rationaldiagnostic approach for investigation and treatment of this constellationof clinical signs in cats and as a platform for futureprospective studies.

Otitis is one the most common problems seen in dogs. Most acute cases can be managed with topical polyvalent ear preparations. However, these cases frequently evolve into chronic or recurrent otitis that is much harder to resolve. Ongoing cycles of infection and inflammation will lead to chronic pathological changes and select for antimicrobial resistance that make management much more challenging. Diagnosis and management of the underlying triggers for the otitis is crucial, but clinicians must also understand how best to treat the ongoing infection and inflammation. Knowing how to recognise and understanding the significance of biofilms is important, as these are under diagnosed and have a major impact on antimicrobial efficacy. Cytology should be performed in all cases to determine the type of infection and the likely nature of the micro-organisms. Bacterial culture and antimicrobial susceptibility, in contrast, are less useful. The tests are based on systemic treatment, and vets need to know how to interpret the results when using topical treatment. Topical therapy is generally much more effective, and there are a very wide range of anti-microbial and anti-inflammatory options available (although not all are licensed for use in animals). Long-term remission of recurrent otitis relies on managing the inflammation in the ear canals to prevent flares. Getting clients to understand this is critical. Choosing appropriate products and demonstrating how to apply them are also important in ensuring good compliance and a good long term outcome.

Antimicrobial resistant bacteria are increasingly detected from canine samples but few studies have examined commensal isolates in healthy community dogs. We aimed to characterise faecal Escherichia coli from 73 healthy non-veterinarian-visiting and non-antimicrobial treated Labrador retrievers, recruited from dog shows in the North West United Kingdom between November 2010 and June 2011. Each enrolled dog provided one faecal sample for our study. E. coli were isolated from 72/73 (99%) faecal samples. Disc diffusion susceptibility tests were determined for a range of antimicrobials, including phenotypic extended-spectrum beta-lactamase (ESBL) and AmpC-production. PCR assay detected phylogenetic groups and resistance genes (blaCTX-M, blaSHV, blaTEM, blaOXA, blaCIT, qnr), and conjugation experiments were performed to investigate potential transfer of mobile genetic elements. Multivariable logistic regression examined potential risk factors from owner-questionnaires for the presence of antimicrobial resistant faecal E. coli. Antimicrobial resistant, multi-drug resistant (≥ 3 antimicrobial classes; MDR) and AmpC-producing E. coli were detected in 63%, 30% and 16% of samples, respectively. ESBL-producing E. coli were detected from only one sample and conjugation experiments found that blaCTX-M and blaCIT were transferred from commensal E. coli to a recipient strain. Most isolates were phylogenetic groups B1 and A. Group B2 isolates were associated with lower prevalence of resistance to at least one antimicrobial (P < 0.001) and MDR (P < 0.001). Significant at P ≤ 0.003, was the consumption of raw meat for clavulanate-amoxicillin (OR: 9.57; 95% CI: 2.0-45.7) and third generation cephalosporin resistance (3GCR) (OR: 10.9; 95% CI: 2.2-54.0). AMR E. coli were surprisingly prevalent in this group of non-antimicrobial treated and non-veterinarian-visiting dogs and consumption of raw meat was a significant risk factor for antimicrobial resistance. These findings are of concern due to the increasing popularity of raw-meat canine diets, and the potential for opportunistic infection, zoonotic transmission and transmission of antimicrobial resistant determinants from commensal isolates to potential pathogenic bacteria.

Ciclosporin (Atopica; Novartis Animal Health) has been licensed for canine atopic dermatitis (AD) since 2002. Adverse events (AEs) have been reported in 55 per cent of 759 dogs in 15 clinical trials, but are rare in pharmacovigilance data (71.81 AEs/million capsules sold). Gastrointestinal reactions were most common, but were mild and rarely required intervention. Other AEs wererare (≤1 per cent in clinical trials

Systemic antimicrobials are critically important in veterinary healthcare and resistance is a major concern. Antimicrobial stewardship will be important in maintaining clinical efficacy by reducing the development and spread of antimicrobial resistance. Bacterial skin infections are one of the most common reasons for using systemic antimicrobials in dogs and cats.Appropriate management of these infections is therefore crucial in any policy for responsible antimicrobial use. The goals of therapy are to confirm that an infection is present, identify the causative bacteria, select the most appropriate antimicrobial, ensure that the infection is treated correctly, and to identify and manage any underlying conditions. This is the first of two articles that will provide evidence-led guidelines to help practitioners address these issues. This article covers diagnosis, including descriptions of the different clinical presentations of surface, superficial and deep bacterial skin infections, how to perform and interpret cytology, and how to best use bacterial culture and sensitivity testing. The second article, to be published in a subsequent issue of Veterinary Record, will discuss therapy,including choice of drug and treatment regimens.