Original Article ㅣ 2021-06-30 146 17

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Abstract : Canine atopic dermatitis (CAD) is a genetically predisposed inflammatory and pruritic skin disease presenting characteristic clinical features in dogs. Despite oclacitinib and lokivetmab being commonly used, no study has compared their efficacies in CAD. This study aimed to compare the efficacy, safety, and control of CAD-associated pruritus and skin lesions between oclacitinib and lokivetmab. It also investigated whether switching to lokivetmab from oclacitinib or prednisolone had any benefits. Twenty-five client-owned dogs, newly diagnosed with CAD, were allocated to the oclacitinib (n = 20) and lokivetmab (n = 5) groups and administered oclacitinib (0.4-0.6 mg/kg orally, twice daily for 14 days, then once daily) and lokivetmab (2 mg/kg subcutaneously, every month) for 8 weeks, respectively. The switching group included five dogs previously administered with oclacitinib (n = 4) or prednisolone (n = 1) who were switched to lokivetmab directly at the start of the study. The pruritus visual analog scale (PVAS) and Canine Atopic Dermatitis Extent and Severity Index (CADESI-04) values were surveyed at weeks 0, 4, and 8. Oclacitinib and lokivetmab significantly reduced the PVAS and CADESI- 04 scores. Switching from oclacitinib or prednisolone to lokivetmab maintained the severity of pruritus (4 weeks: p = 0.068; 8 weeks: p = 0.068) and dermatitis (4 weeks: p = 0.144; 8 weeks: p = 0.068) at the levels measured at baseline. Thus, both oclacitinib and lokivetmab reduced CAD-associated pruritus by a similar degree. Switching to lokivetmab maintained the severity of pruritus and dermatitis at the same level as the previous treatment.

Case Report ㅣ 2021-06-30 128 9

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Abstract : A 2-year-old intact female Maltese dog was presented with generalized involuntary tremors and nystagmus without regular direction. The dog was conscious the whole time while it was trembling. Its involuntary tremors were alleviated at rest or during sleep. Magnetic resonance imaging (MRI) revealed asymmetric hydrocephalus and caudal occipital malformation. In cerebrospinal fluid (CSF) analysis, a trace of protein was found and total nucleated cell count (TNCC) was slightly increased. However, infectious pathogens were not found. In complete blood count, there was a mild leukocytosis. After the patient received anticonvulsants (midazolam, phenobarbital, KBr), diuretics (furosemide) with an anti-inflammatory drug (prednisolone, 0.5 mg/kg PO bid), and a proton-pump inhibitor (omeprazole), it showed no improvement. The patient was tentatively diagnosed with corticosteroid responsive tremor syndrome. So the anticonvulsants and diuretics were discontinued and the dose of prednisolone was increased to an immunosuppressive dose (1 mg/kg PO bid). After administering the immunosuppressive dose of prednisolone, the patient did not show nystagmus. Its tremors were much alleviated. However, they did not disappear. Five weeks later, the patient showed gradual improvement but still was trembling when moving around. Nine weeks later, its tremors were similar to before. So diazepam (0.3 mg/kg PO sid) was added to the treatment. After that, its tremors were alleviated more. Prednisolone and diazepam were maintained for about five months, with tapering of the dose of prednisolone (until 0.5 mg/kg PO sid). About 7 months later after the treatment was started, the dog was trembling rarely except when it was excited. Therefore, diazepam was discontinued. This case describes a refractory white dog shaker syndrome successfully managed with long-term administration of a steroid and diazepam.

Case Report ㅣ 2021-06-30 124 6

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Abstract : 3-year-old spayed female beagle dog was presented with epiphora, severe hemorrhagic and purulent ocular discharge in the right eye (OD). A reflux of the discharge through the other canaliculi, associated with signs of chronic inflammation, was observed on cytology. Dacryocystorhinography revealed retention of contrast media ventral to the lower punctum, indicating complete obstruction and the potential presence of radiolucent foreign body. Ocular discharge subsided after the first treatment, including flushing of the nasolacrimal duct and application of topical antibiotics and corticosteroids, but clinical symptoms of the dacryocystitis waxed and waned thereafter. Surgical treatment was delayed for 8 months due to Dirofilaria immitis infection, and topical treatment and monthly flushing were maintained. On the day of operation, a foreign body was released through the fistula, while flushing for disinfection under general anesthesia, just before the surgery. Dacryocystectomy was performed to remove necrotic tissue and residual foreign body around the nasolacrimal cyst. Upon histopathologic findings, the removed foreign body was considered to be a plant, and the nasolacrimal cyst was comprised of chronic active ulcerative inflammation and necrotic tissues. At the 1-week recheck, improvement of epiphora and ocular discharge and healing of the surgical site was noted. In conclusion, nasolacrimal duct foreign body can be considered in recurrent dacryocystitis, despite nasolacrimal flushing and topical medication. In this study, dacryocystectomy was curative without recurrence of dacryocystitis or epiphora.

Case Report ㅣ 2021-08-31 118 21

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Abstract : A 10-year-old castrated male Shih-tzu dog presented with a history of generalized demodicosis, refractory to conventional therapy with ivermectin and amitraz for a year. The patient was also diagnosed with concurrent deep pyoderma, Malassezia dermatitis, and otitis externa. Treatment with amoxicillin-clavulanate, antifungal drugs (itraconazole, miconazole), and milbemycin oxime resulted in a good response for 90 days. Approximately 4 months later, the first relapse of demodicosis occurred and the miticidal therapy was changed to ivermectin. Additional diagnostic tests were performed to investigate an underlying cause for the recurrence of demodicosis, and endocrinopathies and allergic dermatitis were excluded based on the results. Although ivermectin therapy was sustained for 440 days, a second relapse occurred and amitraz baths were added to the therapy. Despite this therapy, the demodicosis persisted, and the miticidal therapy was changed to oral fluralaner, which led to rapid resolution. Demodicosis did not recur again before death approximately 920 days after administration of oral fluralaner. This case report describes the complete resolution of refractory demodicosis using oral fluralaner in a dog.

Original Article ㅣ 2021-06-30 110 12

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Abstract : Intra-articular injection of ELHLD peptide is considered to have a therapeutic effect in osteoarthritis (OA) through the inhibition of transforming growth factor–β1. This study aimed to assess the efficacy of intra-articular injections of high-dose ELHLD peptide (100 μg/kg) in canine stifle OA. Six client-owned dogs diagnosed with stifle OA were included. Selected dogs were treated with an intra- articular injection of high-dose ELHLD peptide (100 μg/kg). Outcome measures, including orthopedic examination, gait analysis, and Canine Brief Pain Inventory (CBPI) score, were evaluated four times after injection. Orthopedic examination, gait analysis, and owner’s assessment (CBPI) improved significantly from 4 weeks after injection. In conclusion, we obtained sufficient evidence from this small sample that high-dose ELHLD peptide improves clinical signs of canine OA not only through subjective assessment but also through objective evaluation.

Case Report ㅣ 2021-08-31 106 23

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Abstract : A 10-year-old spayed female beagle referred to the Veterinary Teaching Hospital of Chungnam National University presented with acute diarrhea, depression, anorexia, and emaciation. The laboratory findings of the dog showed leukocytosis, high C-reactive protein, and low albumin levels. Fecal examinations revealed severe infection with Strongyloides (S.) stercoralis, with a high fecal score (6/7). Consequently, the dog was diagnosed with hyperinfection of S. stercoralis, and thus, was treated with fenbendazole and ivermectin after discontinuation of prednisolone treatment. The dog showed negative on the Fecal Dx^® Antigen Panel (IDEXX Laboratories Inc., Westbrook, ME, USA) after treatment, and clinical signs disappeared with normal stool consistency.

Case Report ㅣ 2021-08-31 99 27

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Abstract : A nine-year-old neutered male cat was presented with chronic cough and vomiting. Thoracic radiography showed regions of fatty opacity in the right caudoventral region. On positive contrast celiography, contrast agent did not move into thoracic cavity. Computed tomography revealed 7-mm diameter of defect at the right diaphragmatic crus and a 2-mm diameter defect at the left ventral diaphragmatic crus. Through the right diaphragmatic defect omental herniation was confirmed by the presence of contrast enhanced omental vessel running across the diaphragm. On exploratory thoracotomy, the omentum protruded into the thorax through the right diaphragmatic defect, and it contained a yellowish lipomatous mass. The protruded omentum containing a mass in the thorax was removed, and the right diaphragmatic defect was closed. Histopathologic examination revealed that the protruded omentum showed normal omental structure and the adipose mass showed lipoma surrounded by fibrous tissue. In conclusion, a thorough examination is necessary to confirm the origin of the mass located near the diaphragm.

Case Report ㅣ 2021-08-31 93 17

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Abstract : A seven-month-old castrated male Chihuahua weighing 1.6 kg presented with generalized tonic-clonic seizure following ingestion of isoniazid. Emergency treatment with three doses of diazepam (total 1.5 mg/kg, intravenous [IV]) and phenobarbital (15 mg/kg IV) was administered. The seizure stopped after administration of propofol (constant rate infusion [CRI]; 0.2 mg/kg/min). Blood analyses showed mildly increased serum blood glucose concentration, hyperkalemia, and hyperphosphatemia. On suspicion of isoniazid toxicity, activated charcoal (1 g/kg, orally), lipid emulsion (CRI; 9 mL/hr), and pyridoxine hydrochloride (70 mg/kg IV) were added to the treatment regimen. Twelve hours after presentation, the dog showed increased serum liver enzyme activities, serum blood urea nitrogen, and creatinine concentrations indicating hepatic and renal failure. Twenty-two hours after presentation, blood analysis still revealed increased liver enzyme activities, blood urea nitrogen, and creatinine concentrations with low blood glucose concentration. Twenty-six hours after presentation, the dog’s vital signs deteriorated and the owner elected for the dog to be euthanized. This is the first report of the clinical course of isoniazid toxicosis in a dog in South Korea. Furthermore, to our best knowledge, this is the first report where secondary multiple organ failure was observed due to isoniazid toxicosis. Clinicians should be aware of the possibility of isoniazid toxicosis in dogs. Rapid initiation of treatment after clinical recognition is warranted in such cases.

Original Article ㅣ 2021-06-30 92 14

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Abstract : This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

Case Report ㅣ 2021-08-31 90 26

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Abstract : A 10-year-old spayed female Maltese with a history of vomiting and lethargy was referred to the hospital. Physical examination revealed dehydration and severe pain following abdominal palpation. A large mass was observed in the cranial abdomen through radiography and ultrasonography. Laparotomy was performed to find the origin of the mass. The mass was about 8 cm originating from the cecum and subsequently removed. Histopathologic evaluation revealed that the cecal mass was suspected to be a mesenchymal-derived tumor. Through immunohistochemistry, the mass was diagnosed as a gastrointestinal stromal tumor (GIST) based on the c-kit expression. Given its recurrence, postoperative preventive therapy was initiated with masitinib mesylate, which is a tyrosine kinase inhibitor. The animal did not show any side effects during the medication period. After 6 months of therapy, it was well controlled without any recurrence. In this case, we introduced a novel postoperative management of GIST using masitinib mesylate.