Staphylococal toxins importance to pyoderma in dogs

Pyodermi är en hudsjukdom hos hundar som orsakas av Staphylococcus pseudintermedius (S. pseudintermedius), tidigare benämdes den S. intermedius. Pyodermi kan ge många olika symptom såsom klåda, håravfall, rodnad, varigt och blodigt exsudat, papler, pustler, sårskorpor och nekrotiserad hud. Ofta finns det bakomliggande orsaker och sjukdomar hos hunden som tillåter stafylokockerna att kolonisera huden. Staphylococcus pseudintermedius är en Grampositiv kock, den är koagulas-, DNas-, katalas- och ureaspositiv och ger dubbelhemolys på blodagar. Patogenesen vid pyodermi är ännu inte helt kartlagd. Staphylococcus pseudintermedius uttrycker ett stort antal virulensfaktorer men vilka som har betydelse vid utvecklingen av pyodermi är oklart. De viktigaste är exfolierande toxiner. De har visats ge symptom vid pyodermi när renat toxin har injicerats i försöksdjur. Även andra virulensfaktorer som till exempel leukotoxin, enterotoxiner, cellväggsassocierade proteiner, koagulas, proteas och protein A kan spela en viktig roll i utvecklingen av pyodermi. Slutsatsen är att pyodermi är en multifaktoriell sjukdom där många virulensfaktorer från bakterien och inre faktorer hos djuret samverkar.Pyoderma is a skin condition contracted by dogs that is caused by Staphylococcus pseudintermedius (S. pseudintermedius), previously renamed from Staphylococcus intermedius. The symptoms of pyoderma are many such as itching, alopecia, redness, hemorrhagic and purulent exudate, papules, pustules, crusts and necrotic skin. Pyoderma is most often a secondary infection and there are underlying causes or other diseases that allow the staphylococci to grow. Staphylococcus pseudintermedius is a Grampositive cocci, that is positive for coagulase, DNas, catalase and ureas. Dubbelhemolysis can be seen on bloodagar. The pathogenesis for pyoderma is not clear. Staphylococcs pseudintermedius express a large number of virulence factors but it is not determined which of these are significant in pyoderma. The most important are exfoliative toxins. These have shown to give symptoms of pyoderma when refined toxins have been injected in laboratory animals. Other virulence factors as leukotoxin, enterotoxins, cellwallassociated proteins, coagulase, proteas and protein A can have an important role in pyoderma. The conclusion is that pyoderma is a disease with many factors, both virulence factors from the bacteria and factors in the animal, and they can together give rise to pyoderma

Diagnostic criteria and C-reactive protein in Nova Scotia Duck Tolling Retrievers with immune-mediated disease

Nova Scotia Duck Tolling Retriever, eller tollare som de kallas i dagligt tal, är överrepresenterade för vissa immunmedierade sjukdomar. I Sverige är framförallt den SLE (systemisk lupus erythematosus)-relaterade sjukdomen immunmedierad reumatisk sjukdom (IMRD) samt steroid responsiv meningit-arterit (SRMA) uppmärksammade. Detta arbete är indelat i tre delstudier. Den första delen består av en litteraturöversikt över förekomsten av IMRD och SRMA samt C-reaktivt protein (CRP) vid immunmedierade polyartriter. I andra delen undersöktes vilka diagnoskoder som hade tilldelats tollare med IMRD respektive SRMA. Journalanteckningar från sjuka tollare studerades, 31 journaler i respektive sjukdomsgrupp. Den vanligaste diagnoskoden vid IMRD var hälta och vid SRMA akut meningit. De flesta av diagnoskoderna som användes var ospecifika för sjukdomarna men de specifika diagnoskoder som togs fram i den här undersökningen kan användas i vidare undersökningar om förekomst av IMRD och SRMA. I den här delen av arbetet sammanställdes även sjukdomsdata från en enkätundersökning omfattande 777 enkäter besvarade under åren 1999 till 2014. Det vanligast rapporterade kliniska fyndet hos dessa tollare var hälta. I enkäten fanns frågor om fyra sjukdomar/sjukdomskomplex som skulle kunna representera IMRD och SRMA. Dessa var meningit, artrit, tollarsjuka och allmän autoimmun sjukdom. Tillsammans hade de en förekomst på 7,9 %. Meningit och tollarsjuka hade båda en förekomst på 3,0 % var för sig. I sista delen i arbetet undersöktes C-reaktivt protein (CRP) hos tollare med konstaterad IMRD (ANA-positiva) och misstänkt IMRD (ANA-negativa), dessa jämfördes mot en frisk kontrollgrupp. En statistiskt signifikant skillnad kunde ses mellan den ANA-positiva gruppen (median 11,8 mg/l) och den friska kontrollgruppen (median 2,4 mg/l) och även mellan alla hundar med IMRD (median 10,6 mg/l) och den friska kontrollgruppen. Ingen signifikant skillnad kunde ses mellan den ANA-negativa gruppen (median 7,9 mg/l) och den friska kontrollgruppen. CRP-värdena hos hundar med konstaterad IMRD var i den här undersökningen lindrigt förhöjda. Vid SLE hos människa är CRP lindrigt till måttligt förhöjt till skillnad mot många andra autoimmuna polyartriter där värdena ofta är högre. Resultaten i denna studie kan stödja att IMRD är en SLE-relaterad sjukdom. I den ANA-negativa gruppen fanns flera avvikande värden, både höga och låga. Vid andra sjukdomar som orsakar liknande symptom som vid IMRD kan CRP vara lågt t.ex. vid osteoartrit, eller högt t.ex. vid idiopatisk polyartrit. De varierande resultaten i denna grupp kan bero på att vissa hundar egentligen har en annan sjukdom. Undersökningen visar att CRP skulle kunna användas som hjälpmedel i diagnostiken av IMRD.Nova Scotia Duck Tolling Retrievers, or Tollers, are over-represented for certain immune-mediated diseases. In Sweden a SLE (systemic lupus erythematosus)-related disease called immune-mediated rheumatic disease (IMRD) and steroid-responsive meningitis-arteritis (SRMA) have been identified. This study is divided into three parts. The first part is a literature study of IMRD and SRMA and C-reactive protein (CRP) in immune-mediated polyarthritis. In the second part the diagnostic codes that had been assigned Tollers with IMRD and SRMA respectively were examined, using 31 records from each disease group. The most commonly used diagnostic code in Tollers with IMRD was lameness and in SRMA acute meningitis. Most of the diagnostic codes used were non-specific for the diseases. However, the specific diagnostic codes that were observed in this study may be used in further investigations of IMRD and SRMA. The second part of the study also consisted of a survey comprising 777 questionnaires. During the years 1999-2014 owners of Tollers have had the opportunity to answer questionnaires about diseases of their own dog. The most frequent clinical finding according to the questionnaires was lameness. There were also questions about four diseases/disease complexes that could represent IMRD and/or SRMA. These were meningitis, arthritis, “tollarsjuka” and general autoimmune disease. At least one of these diagnoses were reported in 7.9% of the dogs. Meningitis and “tollarsjuka” were reported in 3.0% of dogs respectively. In the last part of the study C-reactive protein (CRP) of Tollers with confirmed IMRD (ANA-positive) and suspected IMRD (clinical signs of IMRD but ANA negative) were examined. These were compared to a healthy control group of Tollers. A statistically significant difference was seen between the ANA-positive group (median 11.8 mg/l) and the healthy control group (median 2.4 mg/l) and also between all dogs with IMRD (median 10.6 mg/l) and the healthy control group. No significant difference was seen between the ANA-negative group (median, 7.9 mg/l) and the healthy control group. CRP levels in dogs with confirmed IMRD were in this investigation mildly elevated. In SLE in humans CRP is mildly to moderately elevated in contrast to many other autoimmune polyarthritides where the values are usually higher. The results of this study may support the fact that IMRD is a SLE-related disease. In the ANA-negative group with suspected IMRD there were several outliers, both high and low. In other diseases that cause similar clinical signs as IMRD, CRP may be low, e.g. in osteoarthritis, or high e.g. idiopathic polyarthritis. The varying results in the group of suspected IMRD may be due to the fact that some dogs actually suffer from another disease. The study shows that CRP could be used as an aid in the diagnosis of IMRD

Serum C-reactive protein concentrations in Nova Scotia Duck Tolling Retrievers with immune-mediated rheumatic disease

Abstract Nova Scotia Duck Tolling Retrievers (NSDTRs) are a dog breed often affected by immune-mediated rheumatic disease (IMRD), a disorder characterised by chronic stiffness and joint pain. Most, but not all, dogs with IMRD, have antinuclear antibodies (ANA), which are also commonly present in the autoimmune disease systemic lupus erythematosus (SLE). The clinical and diagnostic findings of IMRD indicate that it is an SLE-related disorder. C-reactive protein (CRP), an acute phase protein, is a quantitative marker of inflammation for many diseases and is used for diagnosing and monitoring systemic inflammation in both humans and dogs. However, in human SLE, CRP concentrations are often elevated but correlate poorly with disease activity; they can be low in individual patients with active disease. The aim of the study was to investigate CRP in a group of NSDTRs with the SLE-related disorder IMRD. The hypothesis was that CRP concentrations would be increased in dogs with IMRD compared to healthy dogs, but that the increase would be mild. Serum CRP concentrations were measured in 18 IMRD-affected NSDTRs and 19 healthy control NSDTRs using two different canine-specific CRP assays. Dogs with IMRD and ANA had higher CRP concentrations than the control dogs, but the concentrations were below the clinical decision limit for systemic inflammation for most of the IMRD dogs. These results indicate that CRP concentrations were increased in dogs with IMRD and ANA, but the increase was mild, similar to what has been observed in human SLE