As a busy working mum who is usually running around spinning multiple plates alongside the added joy of homeschooling, I’ve always really appreciated the ‘what’s new’ webinars. I usually have very little time to keep up to date on emerging diseases and new drugs especially as I rarely get to see the reps in practice, so these ‘what’s new’ sessions are invaluable and long may they continue.
This webinar was led by RCVS and European specialist Jon Hardy MA VetMB MvetMed DipECVD MRCVS who went on to deliver a plethora of information on new drugs and advances within dermatology. One example includes the newly available topical ear treatment for dogs called ‘Neptra’ which contains all the usual components of a topical ear medication, an antibiotic, antifungal, and anti inflammatory but, uniquely, can be used as a single application product. This will no doubt prove to be very popular amongst our dog owning clients. Jon explained the ear canal does need to be cleaned and dried prior to the application of Neptra and the studies carried out only used saline to clean the ears. Jon advised he was therefore unsure if the use of our standard in practice ear cleaner to perform this procedure would have any effect the efficacy of the product. It is also important to remember that Neptra may take up to 28 days to have its maximal effects and it is advised not to clean the affected ear within this period. Neptra’s in vitro activity against pseudomonas is also low according to Jon, suggesting it is a treatment aimed at those ‘1st presentation’ cases rather than those patients presenting with dreaded pus filled pseudomonas ears!
Jon also discussed drugs already familiar to us within practice including the group of acaracides and insecticides known as the isoxazolones which include afoxolaner, flurolaner and sarolaner. These are all now licensed for the treatment of demodex and have become the treatment of choice for both cats and dogs according to the Consensus Guidelines for the World Association of Veterinary Dermatology. Jon explained this group of drugs are easy to administer, have minimal side effects and are effective. In fact they are so effective it may be that we will rarely see cases of demodicosis. Jon does however question if this could potentially cause problems in the future as we know it is normal for dogs to have low numbers of demodex mites as skin inhabitants. Could this lack of mites cause some form of imbalance with other microbes within the skin leading to deleterious effects? Currently there is just not enough information to make any assumptions but will be worth taking into consideration especially if there are any significant changes to the normal patterns observed within canine skin disease
Updates on immunotherapy protocols were also discussed by Jon and included the use of ‘adjuvanted’ immunotherapy vaccines which are thought to enhance the immune response thereby improving the efficacy of immunotherapy vaccines. The results from one study did look promising but only a small number of dogs were used so further studies are needed. There have also been trials on the use of intralymphatic immunotherapy where a small amount of allergen is injected directly into lymph nodes (usually the submandibular or popliteal) on a monthly basis. It seems safe and well tolerated and it was hoped that injections directly into the lymphatic system may offer longer lasting benefits so dogs were not having to be injected on a monthly basis. Unfortunately this has not yet been proven to be the case and again further studies will be needed to find out if intralymphatic immunotherapy vaccines have potential in the future of immunotherapy.
Other advances discussed by Jon included the use of the monoclonal antibody lokibtemab, a new disease description, Mucocutaneous lupus erythematosis, PCR testing for dermatophytes, the use of palmitoylethanolamide (PEA), and last but definitely not least, an update on allergen serology testing. As you can appreciate there was a lot of really useful information on many different aspects of dermatology within this webinar which coupled with Jon’s enthusiastic and practical approach makes this a must see for any first opinion small animal vet.
You can catch this webinar here