Canine acute radiation dermatitis, a survey of current management practices in North America

Abstract

Acute radiation-induced dermatitis (ARID) is a common sequela of radiation therapy in dogs. There is no consensus regarding ARID management in human medicine and the standard of care in veterinary medicine has not been reported. The objective was to report the practice standards for ARID management in dogs in North America. The design used was a questionnaire survey. Fifty-eight private and university teaching veterinary hospitals were contacted, 54 participated. The topical and oral medications used to treat ARID, prevent or treat bacterial infection, control pain and the indications for and timing of treatment initiation were the outcome measures. A minority of facilities (4/54, 7.5%) use exactly the same protocol regarding all parameters. There was agreement (>75% of facilities) with respect to the general use of oral antibiotics (77.8%), the need for pain control (92.6%) and the use of tramadol for pain control (76%), although the details of their use varied widely. There is a divergence of opinions regarding all details of ARID management in dogs except the general use of oral antibiotics and pain control medications.

Acute radiotherapy toxicity in 57 dogs with gross and microscopic mast cell tumours

“…Corticosteroids are frequently prescribed to canine radiotherapy patients: a survey in North America published in 2007 documented that oral steroids were routinely prescribed in 57% of radiotherapy practices, either prior to or upon development of clinical signs of acute toxicity . A subsequent prospective, randomized, placebo‐controlled study comparing the effects of prednisone vs placebo (initiated at the start of radiotherapy) on the severity (both clinically and histopathologically) of ARID showed no difference .…”

The clinical and histopathological effects of prednisone on acute radiation‐induced dermatitis in dogs: a placebo‐controlled, randomized, double‐blind, prospective clinical trial

“…This is the first clinical study to examine the effect of prednisone on ARID severity in dogs undergoing fractionated RT. Despite the lack of information on the benefits and risks of prednisone therapy during radiation, it is widely used by veterinary radiation oncologists, medical oncologists and internists providing radiation therapy in university teaching hospitals and private specialty practices throughout North America 25 . In fact, there is no evidence in the veterinary literature to support any specific treatment of ARID.…”

“…Potential causes for a false lack of treatment effect in this study include: insufficient prednisone dosage relative to the severity of inflammation, insufficient case numbers, effect of biopsy or effect of bacterial infection. This study evaluated an anti‐inflammatory prednisone dosage in order to mimic the current practices of veterinary specialists 25 . A prednisone and a placebo group that did not receive biopsies were needed to exclude the possibility that the procedure had an effect on outcome.…”

“…If there were no dermatological abnormalities, cytology was performed of the normal‐appearing skin. Slides were examined for bacteria and yeast as previously described 25,26 …”

“…A recent survey showed that 57% of veterinarians in North America routinely prescribe glucocorticoids to decrease ARID severity in dogs 25 . Clinical trials have not been conducted to evaluate the efficacy of prednisone for treatment or prevention of ARID.…”