With the availability of effective
topical flea products, shampoo therapy
had fallen by the wayside in veterinary
dermatology. However, recent evidence
has shown that percutaneous absorption
of allergens plays a significant role in
propagating, and possibly even
potentiating, allergies in our pets.
There are several guidelines to convey
to clients regarding the use of veterinary
shampoos. First, the use of cool water
and contact times of 5 to 15 minutes
allow for hydration of the skin and a
sufficient period for penetration and
action of the active shampoo ingredients.
Bathing frequency is also important and
depends on the presence of skin disease
as well as the shampoo to be used.
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Hartz Companion Animal - Shampoo Therapy in Dogs and Cats
1. A NEWSLETTER OF PRACTICAL MEDICINE FOR VETERINARY PROFESSIONALS
SEPTEMBER 2004 VOLUME 2, NUMBER 3
Shampoo Therapy in
Dogs and Cats
Anthony A. Yu, DVM, DACVD
Ontario Veterinary College
University of Guelph
Ontario, Canada
With the availability of effective is also dictated by seasonal influences. reaction to the shampoo by the patient
topical flea products, shampoo therapy Environmental variations in heat and and the bather also should be considered.
had fallen by the wayside in veterinary humidity influence dryness, scaliness, One of the most common signs of
dermatology. However, recent evidence greasiness, and the tendency to develop dermatologic problems in small animals
has shown that percutaneous absorption secondary bacterial or yeast infections. is excess scaling. The process of
of allergens plays a significant role in Shampooing technique is also keratinization is initiated within the
propagating, and possibly even important. I often recommend starting basal keratinocytes of the epidermis.
potentiating, allergies in our pets. with the worst affected area—usually Through many transformations, these
There are several guidelines to convey the belly, neck, or feet. The mechanical cells eventually migrate to the surface
to clients regarding the use of veterinary process itself is beneficial because it helps and die, progressing through the basal,
shampoos. First, the use of cool water to remove crusts, scales, dirt, organisms,
and contact times of 5 to 15 minutes and residual medication.
allow for hydration of the skin and a IN THIS ISSUE:
sufficient period for penetration and SHAMPOO SELECTION Shampoo Therapy in
action of the active shampoo ingredients. Human-grade shampoo, balanced at Dogs and Cats............................ 1
Bathing frequency is also important and pH 5.5 for the human scalp (compared
depends on the presence of skin disease with the neutral skin pH of 7.0 to 7.5 in Ethylene Glycol Poisoning:
as well as the shampoo to be used. A most dogs and cats), can cause irritation Effective Treatment Begins
client may have to shampoo two to three and damage to the epidermal skin barrier with Prevention ......................... 4
times weekly until adequate control of as well as unwanted changes in the Ask the Vet ................................ 7
scaling, grease, and odor is achieved, at superficial microbial flora. Thus, the
Sumitomo Corporation Acquires
which time they may decrease to a mildest veterinary-labeled product that The Hartz Mountain
maintenance frequency of once weekly or will address the patient’s condition should Corporation ............................... 8
monthly. Maintenance shampoo therapy be selected. The possibility of an allergic
3. latherability. Triclosan and chlorhexidine of benzoyl peroxide is generally glucan has been concentrated in certain
derivatives are sometimes added to considered to be an advantage. However, oatmeal-based shampoos because it is
enhance a shampoo’s antimicrobial activity. animals with sensitive skin may develop believed to provide oatmeal with its
excessive drying or irritation. This can be antiinflammatory effect.
Tar Shampoos relieved by alternating treatments with a Lastly, shampoos containing
Tar shampoos are often combined with milder product or using emollients. antiinflammatory agents such as
sulfur and salicylic acid, which permits Benzoyl peroxides tend not to lather well hydrocortisone, diphenhydramine, and
decreased concentrations while providing and have the potential to bleach fabrics essential fatty acids, have been introduced
the desired keratolytic activity. Treatments and haircoats. to the veterinary market to address
should be discontinued or followed by a inflammation at the local level. So far,
conditioning rinse if drying or irritation Antimicrobial Shampoos they have proven to be useful adjuncts in
occurs. Antimicrobial shampoos help eliminate our attempts to minimize the use of oral
Tars induce antimitotic, keratolytic, overgrowth of pathogenic organisms on medications to control itch. Strict
antipruritic, degreasing, and antiinflam- the skin surface. As previously mentioned, adherence to the 10- to 15-minute
matory effects. The antimitotic effects are benzoyl peroxide shampoos have the contact time rule, especially with these
due to suppression of epidermal growth greatest residual activity (48 hours). Other products, will help achieve optimal
and DNA synthesis of the stratum basale. antimicrobials include chlorhexidine, results.
The primary clinical application of tar which is a synthetic biguanide with
shampoos is to treat the extremely greasy broad-spectrum activity against bacteria, CONCLUSION
dog. The higher the concentration, the fungi, and yeasts but exhibits no Finally, a plethora of shampoos
better the effects of the tar, but the patient antiseborrheic effects. It is characterized with advanced time-released microsomes
might be more susceptible to developing a by rapid kill and 36-hour residual activity. has also become available for use in
contact allergy, excessive drying, or skin When combined with water, ethyl veterinary medicine. This technology
irritation. Tar shampoos should be avoided lactate forms lactic acid, which provides improves residual activity of the
in cats. antimicrobial activity, and ethanol, a aforementioned active shampoo
good degreaser without the drying effects ingredients and minimizes any drying
Selenium Sulfide of tar and benzoyl peroxides. A gentle, effects by slowly releasing emollients and
Selenium sulfide is antiseborrheic but antiseptic, and keratoplastic shampoo conditioners.
has limited usage due to its staining, containing a 10% concentration of ethyl With all these recent advances in
drying, and irritating effects on mucous lactate is available for use in dogs and cats shampoo therapy, it may seem a daunting
membranes and the scrotum. Selenium of any age with bacterially infected task to choose the most appropriate
sulfide causes keratoplastic and keratolytic seborrheic dermatitis. product for your pet. However, by simply
activity by depressing epidermal cell Iodine preparations have good activity understanding the principles of the
turnover rate and interfering with against bacteria, viruses, and fungi, various categories of shampoos, you can
hydrogen bond formation in the keratin. especially when combined with select and use a medicated shampoo that
Selenium sulfide also is a potent degreaser. pyrrolidone nitrogen. Residual effects, will most benefit your patients.
This product is definitely not recommended however, last only 6 to 8 hours. Side
for use in cats. effects include irritation, staining, and Suggested Readings
Chesney CJ: Water: Its form, function and importance in
contact hypersensitivity. Iodine shampoos the skin of domestic animals. J Small Anim Pract
Benzoyl Peroxide are not recommended for use in cats. 34:65–71, 1993.
Benzoyl peroxide induces excellent Griffin CE, Kwochka KW, MacDonald JM: Current
veterinary dermatology, in The Science and Art of
keratolytic activity, and a residual Antipruritic Shampoos Therapy. St Louis, Mosby, 1993.
antibacterial spectrum of 48 hours Topical antipruritic therapy is gaining Halliwell REW: Rational use of shampoos in veterinary
also makes it one of the most active increasing interest as an adjunct to control dermatology. J Small Anim Pract 32:401–407, 1991.
Kwochka KW: Rational shampoo therapy in veterinary
antibacterial agents. It is the only product itching. The main source of relief evolves dermatology. Proc 11th Annual Kal Kan Symp
available that has follicular flushing from oatmeal-based shampoos. It is Treatment Small Anim Dis, 1988.
properties, which enhance removal of believed that harmful agents and allergens Lin AN, Reimer RJ, Carter DM: Sulfur revisited. J Am
Acad Dermatol 18(3):553–558, 1988.
scale, glandular secretions, and bacteria are absorbed through the skin, resulting Miller WH: Antiseborrheic agents in dermatology, in
from hair follicles. It is often used before in itching. Oatmeal is formulated as a Kirk RW (ed): Current Veterinary Therapy IX.
treatment for generalized demodicosis colloid to provide a large surface area for Philadelphia, WB Saunders, 1986, pp 596–601.
Muller GH, Kirk RW, Scott DW: Small Animal
because it flushes mites from hair adsorption and subsequent elimination of Dermatology, ed 6. Philadelphia, WB Saunders,
follicles. The excellent degreasing activity these mediators. In addition, oat beta 2004.
HARTZ® COMPANION ANIMALSM • SEPTEMBER 2004 • VOL. 2, NO. 3 3
4. Ethylene Glycol Poisoning:
Effective Treatment Begins
with Prevention
Steven R. Hansen, DVM, MS, DABT, DABVT
ASPCA Animal Poison Control Center
Urbana, Illinois
Ethylene glycol (1,2-ethanediol) is volumes of ethylene glycol solutions. vomiting, weakness, and dyspnea. In-
used in many commercial and household Ethylene glycol is rapidly absorbed, clinic diagnostic tests (EGT KitTM, PRN
products, including automobile antifreeze, yielding peak blood concentrations in Pharmacal) are available.
brake fluid, disinfectants and cleaners, dogs within 1 to 4 hours. The plasma When in-clinic qualitative tests are
paints, sealants, and solvents. Ethylene half-life for unmetabolized ethylene used, false-positive results can occur from
glycol concentrations vary from about glycol is 3 to 5 hours. The lethal dose of propylene glycol (and other glycols),
90% in automobile antifreeze to less than undiluted ethylene glycol is 4.4 to 6.6 metaldehyde, glycerol, and formaldehyde
1% in some paints. Most significant ml/kg in dogs and 1.4 ml/kg in cats. ingestion. False-positives do not result
poisonings in dogs and cats are from Metabolism occurs primarily in the from ethanol, methanol, or isopropanol
exposure to automobile antifreeze liver, with excretion of both unmetabolized ingestion. Definitive quantitative analyses
solutions containing ethylene glycol. ethylene glycol and metabolites via the are typically available at diagnostic
The ASPCA Animal Poison Control kidneys. Ethylene glycol is initially laboratories. Local human hospitals or
Center (APCC) managed 510 animal metabolized by alcohol dehydrogenase. It veterinary diagnostic laboratories can
exposures to ethylene glycol between July is at this first rate-limiting metabolic step provide analytic capabilities, including
1995 and December 1997. Dogs and cats that competitive inhibition by the quantification of parent ethylene glycol and
represented 98% of exposed species, administration of fomepizole in dogs some metabolite concentrations. Other
although dogs are two to three times more (Antizol-VetTM, Orphan Medical) and diagnostic findings include an increased
likely to be exposed than cats. The ethanol in cats can be lifesaving. osmolar gap (>20 mOsm/kg), acidosis, an
majority of animals were adults, with an Continued processing of ethylene glycol increased anionic gap (>25 mEq/L),
equal gender distribution. Most exposures metabolites yields intermediates that hypocalcemia, and calcium oxalate
occurred around the home and resulted cause acidosis, renal tubular nephrosis crystalluria,3 but the absence of crystalluria
from container spills and engine flushes or (Figures 1 and 2), and death. Clinical does not rule out ethylene glycol toxicosis.
leaks. Three percent of cases were assessed effects, including depression and
as intentional. Of cases with known ataxia, occur early from unmetabolized Treatment
outcomes, 59% did not develop clinical ethylene glycol. During the next 12 to The rapid absorption of ethylene
signs and 28% died or were euthanized. 24 hours, metabolic acidosis results in glycol coupled with short plasma half-life
Ethylene glycol exposures accounted for cardiopulmonary effects, including underscores the necessity for early,
0.5% of case volume for the data collection tachypnea, tachycardia, central nervous aggressive intervention. Since a delay in
period.1 Generally, cats, rabbits, and system (CNS) depression, seizures, and treatment is often fatal, presumptive cases
humans are considered the most sensitive pulmonary edema. Oliguric renal failure of ethylene glycol poisoning based on
species. Dogs, pigs, rodents, and cattle are may begin as early as 12 hours after clinical presentation and available
considered of intermediate sensitivity. ingestion in cats but not beyond 72 hours diagnostics with or without known
in cats or dogs. Death results from exposure warrant initiation of treatment
Mechanism of Action cardiopulmonary or renal effects.2 before definitive laboratory confirmation.
Ethylene glycol is commercially Initial treatment in an asymptomatic
available for automobile use as a Diagnosis animal within an hour of exposure may
concentrated solution that is typically The most common clinical signs include the administration of an emetic
mixed 50:50 with water. Dogs and cats reported to the APCC include such as hydrogen peroxide (3%, 1 ml/lb;
will unpredictably consume various depression, ataxia, seizures, tremors, maximum dose: 45 ml) via oral syringe or
4 HARTZ COMPANION ANIMAL
® SM
• SEPTEMBER 2004 • VOL. 2, NO. 3
5. stomach tube after feeding a moist meal
such as canned food. Activated charcoal
(1–3 g/kg) can be administered early,
preferably within the hour, to potentially
reduce gastrointestinal absorption.
Administration of activated charcoal
products may yield false-positive results
from in-clinic ethylene glycol test kits
because of propylene glycol cross-
Figure 1— Ethylene glycol– Figure 2— Ethylene glycol–
reactivity. Overuse of activated charcoal induced renal tubular nephrosis. induced nephrosis showing
in small or dehydrated animals must be (Photo courtesy Dr. Sharon Gwaltney, birefringent crystals. (Photo courtesy
avoided because of the risk for electrolyte APCC; hematoxylin–eosin, original Dr. Sharon Gwaltney, APCC;
abnormalities, including hypernatremia. magnification ×100) hematoxylin–eosin, original
Successful management of ethylene magnification ×40; shown under
glycol toxicosis depends on competitive used to correct acidosis. Furosemide polarized light)
inhibition of alcohol dehydrogenase. (2.2–4.4 mg/kg IV bid) combined with
Currently accepted treatment in dogs dopamine (2–5 µg/kg/min) may increase often can dispose of ethylene glycol
includes the use of fomepizole or ethanol. urine output in oliguric patients. antifreeze properly or inform the pet
Fomepizole is advantageous in dogs because Peritoneal dialysis or hemodialysis, if owner about approved disposal techniques.
it is approved for this use, is effective and available, should be considered for anuric Some antifreeze formulations contain
easy to administer, and does not contribute patients. Recovery depends on how propylene glycol; these formulations are
to CNS depression or acidosis. In dogs, quickly treatment can be started. Initiation significantly less toxic than ethylene glycol
fomepizole is administered in four doses at of treatment within the hour—and formulations but are not nontoxic and still
12-hour intervals, each given slowly over 15 possibly up to 4 hours—in nonazotemic require the same vigilance regarding
to 30 minutes. The first dose is 20 mg/kg, patients may prove successful. Severely storage, use, and disposal.
followed by 15 mg/kg at 12 and 24 azotemic or anuric patients, especially A significant amount of recent
hours and then 5 mg/kg at 36 hours. In animals whose care is initiated 12 hours legislative debate has focused on
cats, fomepizole may be effective at high or longer after exposure, warrant a grave requiring that bittering or other aversive
doses early, but the product is not labeled as prognosis. Ultimately, recovery may be agents be added to antifreeze and other
such. In cats, ethanol is generally the complete or residual renal insufficiency household products. The APCC does not
preferred treatment. may remain. support this requirement. The promotion
Ethanol administration is inexpensive of products containing aversive agents by
but time intensive, produces additional Prevention manufacturers would lead to a false sense
CNS depression, and exacerbates Veterinary professionals are encouraged of security among pet owners that could
metabolic acidosis. Cats (and dogs if to address poison prevention during unintentionally lead to poisonings. In
fomepizole is unavailable) should be routine client visits. Pet owners should animals, poison prevention must focus on
given 8.6 ml/kg of a 7% (70 mg/ml) read and understand all labels, follow proper storage and disposal and not on
ethanol solution as a slow bolus over 30 product use and disposal recommendations, the unlikely protective mechanism
minutes followed by maintenance store all garage/household products and afforded by taste-aversive agents.
administration of 100 to 200 mg/kg/hr pharmaceuticals out of reach of children
constant-rate infusion.4 When medical- and pets, and understand that childproof References
1. Kahn SA, Schell MM, Trammel HL, et al: Ethylene
grade ethanol solutions are not available, lids and packaging are easily destroyed glycol exposures managed by the ASPCA National
vodka can be used, preferably with an (and contents consumed) by even the Animal Poison Control Center from July 1995 to
December 1997. Vet Hum Toxicol 41(6):403–406, 1999.
in-line filter.5 To produce a 7% ethanol smallest and most timid of pets. Pet
2. Richardson JA, Gwaltney-Brant SM: Ethylene
solution, a volume of 175 ml should be owners should search the garage and home toxicosis in dogs and cats. NAVC Clin Brief
removed from a 1.0 L bag of D5W or for items that are accessible by the pet, Jan:13–19, 2003.
other appropriate solution and replaced including items on counters. Proper 3. Thrall MA, Grauer GF, Connally HE, et al: Small
Animal Toxicology: Ethylene Glycol. Philadelphia, WB
with 175 ml of 80 proof vodka. disposal of automobile antifreeze is critical. Saunders, 2001, pp 33–504.
Supportive care designed to promote Exposure often occurs from used product 4. Plunkett SJ: Ethylene glycol, in Emergency Procedures
diuresis, maintain renal function, and drained from cars and farm machinery. for the Small Animal Veterinarian, ed 2. Philadelphia,
WB Saunders, 2000, pp 319–326.
correct acid–base imbalance remains Local recycling/garbage collection 5. Plumb DC: Veterinary Drug Handbook, ed 3. Iowa
important. Sodium bicarbonate can be companies or automobile repair facilities State University Press, 1999, pp 257–258.
HARTZ® COMPANION ANIMALSM • SEPTEMBER 2004 • VOL. 2, NO. 3 5
7. Albert Ahn, DVM, is a veterinarian, Corporate Vice President, and
Chief Scientific Officer of The Hartz Mountain Corporation.
ASK TH E VET
Q In reference to Dr. Littman’s June
2004 article, “Update on Frequently
Asked Questions About Canine
toxicity (Adrade SF, Sakate M: The comparative
efficacy of yohimbine and atipamezole to treat
amitraz intoxication in dogs. Vet Hum Toxicol
Lyme Disease: Diagnosis and Treatment,” 45(3):124–127, 2003), but this dose and route of
can atipamezole be used to treat amitraz administration need more study before I recommend
collar intoxication and at what dose? it for clinical use in patients.
Also, what dose of yohimbine is used to Meryl P. Littman, VMD, DACVIM
treat amitraz toxicoses? School of Veterinary Medicine
A
University of Pennsylvania
Author Response: Philadelphia, Pennsylvania
Rarely have dogs eaten the discarded cut-off ends
of collars or, more rarely, the collars themselves.
“If a dog ingests a . . . collar and exhibits [amitraz]
intoxication (primary sign is severe depression),
induce vomiting, administer non-oily laxative,
Q How much taurine is required in cat/
kitten food?
activated charcoal, and enema. Provide supportive
therapy until collar fragments are voided. If dog
cannot be roused, Yohimbine, 0.1 mg/kg by
A Taurine is a very important amino acid for cats
and kittens. Deficiency of taurine in cats may
result in fetal abnormalities, reproductive failure,
intravenous injection is antidotal. Repeat as needed.” abnormal development, retinal degeneration,
and/or cardiomyopathy. Cats can synthesize
I thank Dr. Ken Drobatz (Director of Emergency
taurine only on a limited basis. Cats also need
Service at the University of Pennsylvania’s Ryan
taurine to conjugate bile acids.
Veterinary Hospital), who told me that yohimbine
(Yobine®, Lloyd Laboratories) is still their first choice According to nutrient profiles of the AAFCO
for amitraz intoxication. If yohimbine is unavailable, (Association of American Feed Control Officials),
atipamezole (Antisedan®, Pfizer Animal Health) can the minimum requirement for taurine for cat food
be used at 0.055 mg/kg IM. is 0.10% in dry foods and 0.20% in canned foods.
Supplementation with vitamins containing taurine
By literature search, I found that atipamezole was would be required in cases where the levels of
given experimentally at 0.2 mg/kg IV for amitraz taurine in the cat’s diet are below this level.
Articles found in the Hartz Companion Animal sm newsletter can be copied and distributed to your colleagues, staff, and clients.
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HARTZ® COMPANION ANIMALSM • SEPTEMBER 2004 • VOL. 2, NO. 3 7
8. Sumitomo Corporation Acquires
The Hartz Mountain Corporation
Sumitomo Corporation of America (SCOA), together with products and technological solutions that will ensure their pets
its parent, Sumitomo Corporation (SC), an integrated global lead longer, happier, and healthier lives. Hartz Mountain also
trading company, purchased JWC Hartz Holdings, Inc., the actively contributes to the pet care community and is dedicated
holding company of The Hartz Mountain Corporation, the to the health and well-being of companion animals.
leading U.S. pet supplies company, from J.W. Childs Equity The acquisition will allow Hartz the opportunity to
Partners II, L.P. undertake a number of new business initiatives, such as
The announcement was made on June 21, 2004, by Atsushi enhanced cross-border sourcing and development of new
Nishijo, President and CEO of Sumitomo Corporation of markets and distribution channels in Asia and Europe.
America, and Robert Devine, President and CEO of The Hartz “Hartz is a brand name with a very strong history and great
Mountain Corporation. credibility,” said Atsushi Nishijo, President and CEO of SCOA.
“The change in ownership is a very positive development for “This is a significant acquisition for SCOA and SC, and we are
our business,” said Robert Devine. “Hartz will continue the very pleased that the Hartz management team will be part of the
effort to reposition the brand and drive growth with new SCOA family.”
products and technologies. Sumitomo Corporation of America was established in 1952
We also envision a number of valuable synergies emerging and is the largest wholly owned subsidiary of Sumitomo
from this new relationship, not the least of which is a chance for Corporation. An integrated global trading company with
us to expand our reach into markets and channels with a high diversified investments and trading businesses, SCOA works
degree of sophistication and a history of pet ownership. The closely with its parent as an organizer of multinational projects
new Hartz Mountain will be stronger and more global.” and a financier. SCOA is an investor in several venture capital
For over 78 years, Hartz Mountain has been committed to funds and participates as a strategic Japanese partner with
providing pet lovers across America with the most innovative companies in the biotech and life sciences communities.
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