Fine Bubble Baths For Itching?

Hello, Summarians!

Can the type of bathing equipment affect how the animal’s skin responds to treatment plans? It would appear so… This dynamic could help a variety of species by simply changing the showerhead. Read and enjoy 🙂 

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Biome in Perianal Fistulas in Dogs

Perianal fistulas, painful ulcers or sinus tracts around the anus, predominantly affect German shepherd dogs, causing dyschezia, tenesmus, and colitis. A shared genetic basis with Crohn's disease and ulcerative colitis in humans has been suggested, positioning dogs as a potential model for human fistulising Crohn's disease. These fistulas are immune-mediated, with a dysregulated immune response to microbes in the anal region. While faecal dysbiosis in affected dogs has been noted, the microbiota of cutaneous and mucosal regions has not been extensively studied. 

Oral ciclosporin, often combined with ketoconazole, is the primary treatment, though long-term therapy is expensive and can have side effects, leading to euthanasia in severe cases. This study aimed to characterize the microbiota in German shepherd dogs with perianal fistulas compared to healthy dogs, investigate microbiota shifts during lesion remission, and evaluate the impact of immunomodulatory therapy on the microbiota of a distant cutaneous site. It was found that the rectal and perianal microbiota are similar and influenced by the enteric microbiota, paralleling findings in human Crohn's disease. 

Ciclosporin and ketoconazole therapy has shown efficacy, but risks include adverse effects and variability in drug levels. Dysbiosis in affected dogs includes increased Bacteroides vulgatus and Escherichia coli, and decreased Megamonas spp. and Prevotella copri. Prevotella spp., in particular, seem critical in immune regulation, and their manipulation might offer therapeutic benefits. Staphylococcus abundance was higher in affected dogs, possibly due to persistent ulcers, though not necessarily pathogenic. 

Unexpectedly, Staphylococcus levels were also higher in the axilla of affected dogs, hinting at a broader immune dysfunction. German shepherds are prone to other immune-mediated conditions, and immune pattern recognition receptor defects, such as NOD2 gene polymorphisms, may play a role. The study's limitations include prior ciclosporin treatment in some dogs and individual microbial variation. 

The study concludes that microbiota changes occur in German shepherd dogs with perianal fistulas and shift with immunomodulatory therapy. Further research is needed to understand the role of the microbiota, particularly Prevotella spp., in disease progression and treatment. Ciclosporin therapy minimally affects nonlesional skin microbiota, but dysbiosis may indicate a widespread immune response dysfunction in these dogs. 

Cain CL, White E, Citron LE, Zheng Q, Morris DO, Grice EA, et al. Longitudinal evaluation of the cutaneous and rectal microbiota of German shepherd dogs with perianal fistulas undergoing therapy with ciclosporin and ketoconazole. Vet Dermatol. 2024; 35: 375–385. https://doi.org/10.1111/vde.13249 

Bottom line — Dysbiosis may lead to altered immune response.

Fine Bubble Therapy to Help Atopic Dogs

Canine atopic dermatitis (cAD) is a chronic skin disease characterized by pruritus and inflammation, often linked to elevated IgE levels in response to environmental allergens. Skin barrier defects and imbalanced microbial flora further exacerbate the condition, potentially leading to secondary bacterial infection or Malassezia overgrowth. The 2015 ICADA treatment guidelines recommend various topical therapies to address cAD, focusing on improving skin barrier function and hygiene in cases without infections, and using gentle, low-irritant antimicrobial shampoos for secondary infections. While these treatments aim to reduce the excessive use of systemic antimicrobials, they can sometimes induce AD flare-ups and should be tailored to individual patients. 

Despite the recognized importance of skin hygiene in cAD management, there are limited options available. The guidelines specifically mention Allermyl (Virbac) and DOUXO Calm (Ceva Sante Animale) shampoos. Recent studies suggest new bathing methods, such as using fine bubbles (FB), which have shown potent bactericidal effects and beneficial impacts on AD in mouse models. FB therapy involves generating ultrafine and microbubbles that can effectively clean the skin surface, potentially improving skin barrier function. 

A study compared the clinical effectiveness of FB therapy to low-irritant shampoo methods in dogs with AD, measuring parameters like stratum corneum hydration (SSH) and transepidermal water loss (TEWL), alongside clinical improvements using CADESI-04 and a pruritus Visual Analog Scale (PVAS). Results showed that dogs treated with FB bathing once a week for four weeks had significant reductions in CADESI-04 scores, while those treated with shampoo did not show significant improvements. This difference might be due to variations in inclusion criteria between studies. 

FB bathing has been found to be more effective in cleaning than traditional methods due to the action of bubbles at the gas/solution interface. This method can potentially alleviate clinical signs in dogs with AD by mechanically removing allergens and microorganisms from the skin. However, more extensive clinical trials are needed to fully understand the mechanisms and confirm the effectiveness of FB in veterinary dermatological practice. 

In conclusion, while no significant changes in skin barrier function parameters were observed, FB bathing demonstrated potential as a new cleansing tool with high tolerability and the ability to improve clinical signs in cAD treatment, with less impact on skin barrier function than frequent shampooing. The study acknowledges the need for further trials with larger sample sizes and longer durations to better understand the efficacy of FB in managing cAD. 

Taguchi N, Onishi I, Iyori K, Hsiao Y-H. Preliminary evaluation of a commercial shampoo and fine bubble bathing in the treatment of canine atopic dermatitis: A single-blinded, randomised, controlled study. Vet Dermatol. 2024; 35: 400–407. https://doi.org/10.1111/vde.1324 

Bottom Line - Alternative therapy that shows early promise

Delayed Release Capsules for Dogs

The study investigates the release sites of traditional gelatin and delayed-release (DR) capsules in dogs' gastrointestinal tracts. Traditional gelatin capsules, made from gelatin and water, dissolve quickly in the stomach, while DR capsules, made from pH-resistant materials, are designed to release their contents beyond the stomach. Despite their intended design, the study found that both capsule types released their contents in the stomach of dogs, which contrasts with the behavior of DR capsules in humans. 

The study also explored the impact of various factors such as meal size, encapsulation method, and capsule size on the release timing and location. Feeding dogs a larger meal prolonged the time before DR capsules released their contents, but did not change the release location. Double encapsulation similarly extended the release time but failed to achieve small intestinal release. Smaller capsule sizes did not improve the passage through the stomach into the intestines. 

These findings have significant implications for the use of DR capsules in veterinary medicine, particularly for therapies like fecal microbiota transplantation (FMT), which could be compromised by gastric release. The study highlights the need for further research with larger sample sizes and different capsule formulations to better understand the variables influencing capsule dissolution and to ensure effective drug delivery in dogs. 

Stone, C. B., Rudinsky, A. J., Urion, R. J., March, S. B., & Winston, J. A. (2024). Gastrointestinal release site for delayed release and gelatin capsules in healthy dogs. Journal of Veterinary Pharmacology and Therapeutics, 47, 266–273. https://doi.org/10.1111/jvp.13439 

Bottom line — Delayed response capsules did not work in dogs in this study.

Just putting things in perspective …