Rush immunotherapy has been shown to be as safe as conventional immunotherapy in canine atopic patients. Rush immunotherapy has not been reported in the feline atopic patient. The purpose of this pilot study was to determine a safe protocol for rush immunotherapy in feline atopic patients. Four atopic cats diagnosed by history, physical examination and exclusion of appropriate differential diagnoses were included in the study. Allergens were identified via liquid phase immunoenzymatic testing (VARL: Veterinary Allergy Reference Labs, Pasadena, CA). Cats were premedicated with 1.5 mg triamcinolone orally 24 and 2 h prior to first injection and 10 mg hydroxyzine PO 24, 12 and 2 h prior to first injection. An intravenous catheter was placed prior to first injection. Allergen extracts (Greer Laboratories, Lenoir, North Carolina) were all administered subcutaneously at increasing protein nitrogen units (pnu) every 30 minutes for 5 h to maintenance dose of 15,000 pnus ml-1. Vital signs were assessed every 15 minutes. Two cats developed mild pruritus and the subsequent injection was delayed 30 minutes. No changes in either cat's vital signs were noted, nor was there any further pruritus. All four cats successfully completed rush immunotherapy. Two cats developed a dermal swelling on the dorsal neck one week later. In these four cats, this protocol appeared to be a safe regimen to reach maintenance therapy. A larger sample of feline patients is needed to determine the incidence of adverse reactions and to follow the success of ASIT based upon this method of induction.

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Topical 0.1% tacrolimus was used for treatment of localized lesions associated with 10 cases of discoid lupus erythematosus (DLE) and two cases of pemphigus erythematosus (PE) either as a sole therapy (n=2) or as an adjunctive treatment (n=10). Eight of 10 dogs with DLE and both dogs with PE were improved following 8 weeks of topical application. In six of the eight dogs that improved, other medications were discontinued. No adverse effects in clinical or laboratory parameters were noted throughout the study.

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Skin lesions of discoid lupus erythematosus (DLE) and pemphigus erythematosus (PE) are often localized to the nasal planum, dorsal muzzle and less commonly, pinnae, periocular skin and lips. The objective of this study was to explore the use of 0.1% tacrolimus as a topical therapy in the management of localized DLE and PE lesions in dogs. Ten cases of DLE and two cases of PE in various breeds were included. Degree of erythema, crust, ulceration or erosion, depigmentation and scarring were evaluated at the start of the trial and after 2, 4 and 8 weeks of therapy. Complete blood count, serum chemistry and whole blood tacrolimus concentrations (Abbot IMx Microparticle Immunoassay; Abbot IMx, Chicago, IL, USA) were performed at each evaluation. Ten cases of DLE and two cases of PE were treated using the lotion either as a sole therapy (both DLE) or as an adjunctive treatment (eight DLE and two PE). Five of the cases evaluated had an excellent response (three DLE and two PE), five a partial response (all DLE), and two dogs (both DLE) showed no appreciable difference after receiving topical tacrolimus therapy. Concurrent medications were discontinued in eight of the ten dogs that improved. No adverse effects in clinical or laboratory parameters were noted throughout the study. However, measurement of tacrolimus concentrations by the MEIA assay was of little benefit due to false‐positive measurements. Results of this study indicate that topical 0.1% tacrolimus may be a safe and effective adjunctive therapy for DLE and PE, with fewer systemic and topical adverse effects than current treatment modalities.