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  1. Han HS, Kano R, Chen C, Noli C
    Vet Dermatol, 2017 Feb;28(1):156-e32.
    PMID: 28133872 DOI: 10.1111/vde.12417
    BACKGROUND: Feline sporotrichosis is common in Malaysia. Thermosensitivity and effects of azole treatment on fungal susceptibility are unknown.

    OBJECTIVES: To evaluate thermotolerance and antifungal susceptibility of feline Malaysian Sporothrix isolates, compare microdilution (MD) and E-test results, and investigate changes in susceptibility during azole therapy.

    METHODS: Sporothrix schenckii sensu stricto was isolated from 44 cats. Thermotolerance was determined via culture at 37°C for 7 days. Susceptibility to itraconazole (ITZ), ketoconazole (KTZ) and terbinafine (TRB) was assessed in 40 isolates by MD; to amphotericin B (AMB), KTZ, ITZ, fluconazole (FLC) and posaconazole (POS) by E-test. Results were statistically compared by Pearson's Product Moment. In eight ketoconazole treated cats, susceptibility testing to itraconazole and ketoconazole was repeated every two months for six months.

    RESULTS: Thermotolerance was observed in 36 of 44 (82%) isolates. Assuming that isolates growing at antifungal concentrations ≥4 mg/mL were resistant, all were resistant on E-test to FLC and AMB, 11 (28%) to POS, 6 (15%) to ITZ and 1 (3%) to KTZ. On MD, 27 of 40 (68%) were resistant to TRB, 2 (5%) to ITZ and 3 (8%) to KTZ. There was no correlation between E-test and MD results (KTZ r = 0.10, P = 0.54, and ITZ r = 0.11, P = 0.48). MD values for ITZ and KTZ did not exceed 4 mg/L during KTZ therapy.

    CONCLUSION: The majority of feline isolates in Malaysia are thermosensitive. Lack of correlation between E-test and MD suggests that the E-test is unreliable to test antifungal susceptibility for Sporothrix spp. compared to MD. KTZ was the antifungal drug with the lowest MIC. Prolonged KTZ administration may not induce changes in antifungal susceptibility.

  2. Han HS, Sharma R, Jeffery J, Noli C
    Vet Dermatol, 2017 Apr;28(2):239-e62.
    PMID: 27918123 DOI: 10.1111/vde.12403
    BACKGROUND: Infestation of wounds with the larvae of Callophorid flies is relatively common in countries where these parasites are found. The most common species associated with infections in Southeast Asia is Chrysomya bezziana (Ch. bezziana), the Old World screw worm. Treatment consists of either subcutaneous injection of ivermectin or oral administration of nitenpyram combined with aggressive tissue debridement under general anaesthesia.

    OBJECTIVES: To describe the treatment of cutaneous myiasis in three dogs caused by the larvae of Ch. bezziana in Malaysia and their treatment with spinosad plus milbemycin.

    RESULTS: In all dogs, a single oral dose of spinosad plus milbemycin at the recommended dosage of 31-62 mg/kg and 0.5-1.0 mg/kg, respectively, was able to kill all larvae within 8 h. Most dead larvae fell off the host and those remaining on the host were dead and easily removed with simple saline flushing and gentle debridement. Neither general anaesthesia nor aggressive mechanical debridement were needed in any patient.

    CONCLUSIONS AND CLINICAL IMPORTANCE: Oral spinosad plus milbemycin is a safe, licensed and effective treatment at the recommended dose for the rapid elimination of Ch. bezziana myiasis, with no need for sedation or anaesthesia.

  3. Han HS, Toh PY, Yoong HB, Loh HM, Tan LL, Ng YY
    Vet Dermatol, 2018 Oct;29(5):442-e148.
    PMID: 30066413 DOI: 10.1111/vde.12672
    BACKGROUND: Cutaneous screw-worm myiasis in companion animals either due to the New World screw-worm, Cochliomyia hominivorax or the Old World screw-worm, Chrysomya bezziana, has been reported particularly in tropical and subtropical regions of the world. Although treatment of screw-worm myiasis in dogs has been described, few studies have been conducted regarding its clinical and epidemiological aspects in companion animals.

    OBJECTIVES: To describe clinical and epidemiological aspects of canine and feline screw-worm myiasis.

    ANIMALS: Naturally infested dogs and cats, presented to five veterinary clinics in four Malaysian states from September 2017 to February 2018.

    METHODS AND MATERIALS: Cutaneous screw-worm myiasis was diagnosed based on clinical signs and visual examination of burrowing larvae within lesion. Age, breed, gender, anatomical site of infestation and suspected underlying predisposing causes were investigated.

    RESULTS: A total of 55 dogs and 21 cats were included in the study. Intact male mixed breed dogs (mean age 58 months) and intact male domestic short hair cats (mean age 24 months) with suspected fight-related wounds were most commonly presented with exudative and ulcerative lesions associated with screw-worm myiasis. The most common anatomical sites of infestation in the dogs were the external ear canals, followed by the perineum and medial canthus. For the cats, the most commonly affected areas were paws and tail. Five cats with screw-worm myiasis were concurrently infected with sporotrichosis.

    CONCLUSION AND CLINICAL RELEVANCE: Aggression between unneutered animals is a likely underlying cause for cutaneous screw-worm myiasis in both cats and dogs. Sporotrichosis was also a potential predisposing cause for screw-worm myiasis in cats.

  4. Chan WY, Hickey EE, Khazandi M, Page SW, Trott DJ, Hill PB
    Vet Dermatol, 2020 Apr;31(2):138-145.
    PMID: 31710159 DOI: 10.1111/vde.12803
    BACKGROUND: The emergence of antimicrobial resistance represents a serious human and animal health risk. Good antimicrobial stewardship is essential to prolong the lifespan of existing antibiotics, and new strategies are required to combat infections in man and animals.

    HYPOTHESIS/OBJECTIVES: To determine the in vitro interaction of ionophores (narasin or monensin) with antimicrobial adjuvants (N-acetylcysteine (NAC), Tris-EDTA or disodium EDTA) against bacterial strains representing pathogens associated with canine otitis externa (OE).

    ANIMAL/ISOLATES: American Type Culture Collection (ATCC) strains Staphylococcus aureus 29213, Pseudomonas aeruginosa 27853 and P. aeruginosa biofilm producer PAO1, and a clinical isolate of Proteus mirabilis from a case of canine OE were tested.

    METHODS AND MATERIALS: A 2D microdilution checkerboard method was used, allowing calculation of fractional inhibitory concentration index (FICI), dose reduction index (DRI) and plotting of isobolograms.

    RESULTS: The combination of narasin with either Tris-EDTA or disodium EDTA produced additive effects (FICI = 0.75) against P. aeruginosa ATCC 27853 and P. aeruginosa biofilm producer ATCC PAO1. An additive effect (FICI = 0.53-0.75) was found against S. aureus ATCC 29213 when narasin or monensin were combined with NAC. The highest DRI (32-fold) was found with monensin/NAC where the MIC of monensin was reduced from 4 to 0.125 μg/mL.

    CONCLUSIONS AND CLINICAL IMPORTANCE: The combination of narasin with Tris-EDTA or disodium EDTA is a promising strategy to inhibit the intrinsic resistance elements of Gram-negative bacteria. These novel combinations potentially could be useful as a multimodal approach to treat mixed infections in canine OE.

  5. Han HS, Yasmin L
    Vet Dermatol, 2020 Aug;31(4):335-e87.
    PMID: 32323413 DOI: 10.1111/vde.12855
    The most common fly species associated with screwworm myiasis in Southeast Asia is Chrysomya bezziana (Ch. bezziana), the Old-World screwworm. Treatment of screwworm myiasis in cats traditionally has comprised subcutaneous injection of ivermectin or oral administration of nitenpyram, combined with aggressive tissue debridement and larval removal under general anaesthesia. Two cats diagnosed with cutaneous myiasis caused by the larvae of Ch. bezziana were treated with lotilaner. In both cats, a single dose of lotilaner at 6-26 mg/kg, killed all larvae within 24 h, negating the need for general anaesthesia. Both cats were simultaneously infested with Lynxacarus radovskyi (L. radovskyi) which also was eradicated with lotilaner. No adverse reactions were observed and both cats recovered without complications.
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