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Study group celebrates 40 years

by
01 November 2016, at 12:00am

David Grant reports on the 40th anniversary meeting of the British Veterinary Dermatology Study Group held in September, with three of the founding members in attendance.

THE FIRST MEETING OF THE BVDSG was held in London on Friday 20th February, 1976. It was the first European veterinary dermatology study group to be established and since then similar organisations have been formed in many European countries.

The first organising committee consisted of Brian Bagnall, Mike Geary, Raymond Hopes, David Lloyd and Keith Thoday. 

A weekend meeting on 25th and 26th September to celebrate the 40th anniversary was attended by three of the founding members: David Lloyd, Keith Thoday and Brian Bagnall who had come all the way from Hawaii where he now lives in retirement.

The venue was the Oatlands Park Hotel in Weybridge, Surrey. Situated in grounds once owned by Henry VIII, it set the scene for an excellent, comfortable and very enjoyable weekend. The current committee had put together a fascinating programme under the theme “Then” – 40 years ago – and “Now”, and I have reviewed here, in the space available, the principal dermatological talks.

The first day was on bacterial diseases, fungal diseases and allergies all “then” and “now”.

Detailed double act

David Lloyd, professor emeritus of veterinary dermatology at the RVC, was up first, in a double act with Anette Loeffler, senior lecturer in veterinary dermatology, also at the RVC, and they treated the audience to a very detailed and amazingly well-researched session on bacterial diseases.

David exercised a bit of poetic licence and extended his contribution further back than 40 years, speaking of the early work (1658) of Athanasius Kirchner, who was able to identify plague bacteria microscopically from the blood of victims of the disease.

He made recommendations at that time for disease control such as burning contaminated clothes, wearing masks and other hygiene measures, but his recommendations were largely ignored, a feature common to other pioneers such as Semmelweis (1847) in Vienna, who recognised that puerperal fever in women could be prevented by good hand hygiene.

This advice was not followed and it is striking to consider that even today hand hygiene is a discipline that is not easy to implement in hospitals and clinics in spite of the huge increase in knowledge since the 19th century. 

Staphylococci were rst recognised in 1878 by Alexander Ogden in Aberdeen who was able to culture the bacteria on hen’s egg medium.

It wasn’t until 1975 that the importance of coagulase negative staphylococci was recognised and in 1976 the various biotypes of S. aureus were described and also for the first time S. intermedius.

S. intermedius is now called S. pseudintermedius and 40 years ago was largely susceptible to antimicrobial drugs with low levels of resistance to lincomycin, erythromycin, and potentiated sulphonamides. Thus, empirical selection of drugs for the systemic treatment of superficial and deep pyoderma was nearly always successful.

A survey at the RVC between 1980 and 1996 showed virtually no resistance against amoxicillin-clavulanic acid and enrofloxacin and less than 1% resistance to cefalexin.

Anette Loeffler brought us up to date with an equally detailed contribution concentrating on the “dark clouds” that first appeared in the 1990s, with multidrug-resistance to S. aureus and S. pseudintermedius now a very serious problem.

There was a clear explanation of the clinical relevance of meticillin-resistant staphylococci with an historical reflection on its emergence in recent times. Other bacteria are joining in with Pseudomonas a force to be reckoned with, along with the ability of such organisms to produce biofilms.

The conclusion was: “Multidrug- resistant bacteria will continue to be a challenge for small animal dermatology. Careful diagnostic procedures, including early sample submission for bacterial culture and susceptibility testing to an experienced laboratory, responsible use of antimicrobials, comprehensive owner education and rigorous hygiene measures have become more important than ever to limit the spread of resistance.”

Fungal diseases

The two presentations were a hard act to follow but Ross Bond, professor of veterinary dermatology at the RVC, rose to the challenge. His subject was “Fungal diseases (superficial mycoses) then and now”. 

He began with Malassezia dermatitis and otitis. Although Malassezia has been recognised for more than 100 years it wasn’t until 1983 when its signi cance as a cause of chronic canine dermatitis was described, by Dufait. In 1991 Mason and Evans documented the condition in 11 dogs. A year later, at the spring meeting of the BVDSG in Birmingham, Ken Mason introduced canine Malassezia dermatitis to the UK veterinary profession. 

Historical reflections on dermatophytosis followed with information on Microsporum canis, Microsporum gypseum, Microsporum persicolor, Trichophyton mentagrophytes and Trichophyton erinacei. This included the various methods of diagnosis and their relative merits, and Ross paid tribute to a key publication by Sparkes and others in 1993.

Griseofulvin was the standard treatment 40 years ago but this drug is now discontinued for small animals. There was a detailed description of topical therapy and systemic therapy with azole antifungal drugs.

Ross managed to find photographs from around 1976 of David Lloyd and David Grant and also made reference to the extremely hot summer of that year. I will not forget the picture of a man dressed in a raincoat surveying a completely dried up reservoir!

Allergies

And so this marvellous first day continued. Claude Favrot is a graduate of the Alfort veterinary school in France and is currently professor of veterinary dermatology at the Zurich veterinary school. His presentation was on allergies and he began by describing the initial use of the term atopy by Coca and Cooke in 1923, and then the first description of atopy in a dog, by Wittich in 1941.

Since 1974 Claude was able to access some 750 articles on canine atopic dermatitis, but reminded the audience that more than 40 years later we still do not have a reliable study on the prevalence of this disease. He reviewed aspects of the genetics of atopy and the role of allergens, while emphasising the complexity of its pathogenesis. Included here was the recently recognised role of Interleukin 31. The significance of microbial factors was outlined before discussing treatment and management.

Forty years ago glucocorticoids, antihistamines and allergen-specific immunotherapy were the recommended tools. Recently, new routes for allergen-specific immunotherapy have been described (intralymphatic and sublingual) along with two new drugs, Ciclosporin A and Oclacitinib.

Claude concluded that other drugs would soon be available. This is because atopy in humans is prevalent, the subject of much research and the dog is considered the best natural model.

A more holistic approach is needed, so we can expect the role of food, epidermal barrier treatments and antibacterial peptides to be extensively investigated and implemented in the near future. He continued the theme in another lecture the next day on new drugs in dermatology.

There was a welcome reception and gala dinner in the evening – a true celebration of the 40 years. Brian Bagnall gave a short and charming speech before dinner was served. In it he mentioned his friend and mentor Arthur Rook, a world-renowned dermatologist in the human field and an initial author of a dermatology textbook which first appeared in 1968; it is now in its 5th edition and is still affectionately called “The Rook Book”.

In the supplement to the proceedings entitled “40 years of BVDSG – A celebration 1976- 2016”, Brian gives a summary of his professional life in which he pays tribute to Arthur Rook. He was a great believer in comparative dermatology and very supportive of the BVDSG in its early years, including getting out of his sick bed to ensure that he was able to give a presentation at the first meeting.

Brian, in search of adventure and a desire to widen his experience, managed to get a year’s experience in the Vienna veterinary school in 1971- 72. Hugo Schindelka, a professor in Vienna at the beginning of the 20th century, is considered to be the father of veterinary dermatology. In 1902 he published the first textbook on skin diseases in domestic animals, Hautkrankheiten bei Haustieren, followed in 1908 by a second edition.

Brian somehow acquired an original copy of the 1908 edition while he was in Vienna and brought it to the meeting where he presented it to Keith Thoday for safe keeping.

This was a truly international celebration and it was really good to welcome Lluis Ferrer on Sunday morning. Previously at the Barcelona veterinary school, Lluis is currently professor of veterinary dermatology in the Boston veterinary school.

Originally from Mallorca, he is equally at home in Catalan, Spanish, German (he did his PhD in Hannover) and English. He was kept busy with contributions entitled “Flea control made easy”, “Parasitic diseases – then and now” and a presentation based on some recent articles in the veterinary literature.

Q&A on fleas

His talk on fleas was in question and answer form including, for example, “Is it better to use a systemic or topical product?” and “Are the systemic parasiticides adequate in dogs with flea allergic dermatitis?” Also included were considerations of collars and the question of whether it is necessary to prescribe insect growth regulators.

The conclusion was that year-round treatment of an adulticide on all pets can be adequate. He provided a reference from 2016 that answered the question “Should I worry about resistance to the different products?” In short: not especially. New product resistance has not been documented and apparent failure is in most cases poor compliance.

His contribution on parasitic diseases concentrated on demodicosis and scabies with up-to-date information on the isoxazolines. These have been demonstrated to be safe and very effective for canine generalised demodicosis and scabies (and also feline demodicosis). As always, in addition to scientific excellence, Lluis entertained with his trademark humour.

What a meeting this was! Superb venue, great speakers, excellent attendance throughout, a wonderful social gathering, renewing of friendship – everything was perfect and it was one of those meetings that stays with you. The organising committee deserves a medal for all the hard work.

I make special mention of Sarah Warren, the proceedings editor. We were presented with the beautiful “40 years of BVDSG souvenir”, along with the proceedings. Having done a stint of newsletter editing in the 80s I know how difficult this can be, but in recent times these proceedings are always excellent and on time. 

  • Membership of the BVDSG is great value with two annual meetings in the spring and autumn. The next, on 5th April 2017, is at the ICC in Birmingham, on “Vector borne and travel dermatitis”. See www.bvdsgmeetings.com.