Interobserver reliability of Feline Dermatitis Extent and Severity Index (FEDESI) and Scoring Feline Allergic Dermatitis (SCORFAD) and the relationship between lesion scores and pruritus

Background: Assessment of the severity of pruritus is difficult in cats, because they manifest discomfort by increased licking, increased scratching or both.Hypothesis/Objectives: Our objective was to develop and validate a felinespecific pruritus scale (VAScat). Methods:The scale was designed as a double Visual Analog Scale (VAS), one VAS for licking and one for scratching, with severity and behavioural descriptors. The highest score (VAS-max) on either VAS was taken as the pruritus score for each cat. Owners of 153 cats with skin diseases and of 108 healthy cats scored their pet's pruritus using the VAScat. Ninety-six of 153 cats with skin diseases also were re-evaluated after four to eight weeks of treatment.Results: Pearson's correlation value between VAS-licking and VAS-scratching scores was r = 0.26 (p < 0.01), and Cronbach's alpha was 0.41. Both indexes indicated that the two scales measure different manifestations of pruritus and supported the use of a dual assessing system. Comparison with a numerical pruritus severity scale (0, absent; 1, mild; 2, moderate; 3, severe) suggested that VAS-licking and VAS-scratching scales taken alone are unsuitable for measuring absent to mild pruritus (grades 0-1), while VAS-max is (p = 0.001). VAS-licking, VAS-scratching and VAS-max all were suitable to assess higher levels of pruritus (grades 2-3, p < 0.01). The VAScat was able to measure pruritus improvement following therapy, as post-treatment scores were significantly decreased compared to pre-treatment ones (p < 0.0001). Conclusions and clinical importance:The VAScat proved to be a useful tool to assess pruritus in cats and for monitoring the response to treatment for pruritus.

Section: Discussionmentioning

confidence: 99%

Development and validation of an owner‐assessed Visual Analog Scale for feline pruritus severity scoring (VAScat)

Colombo¹,

Sartori²,

Schievano³

et al. 2022

“…Although IDT is occasionally used as a second‐line diagnostic to confirm negative SPT results in people, the clinical significance of these confirmatory positives is questionable 4 . A recently completed study by the authors, which utilised SPT for testing cats, showed that this technique allowed for very rapid testing (1/8th the time needed for IDT) and could usually be conducted without sedation 5 . These advantages make SPT a very attractive option for the allergen testing of atopic pets.…”

Section: Introductionmentioning

confidence: 99%

Pilot study to determine the concordance between skin prick and intradermal test (IDT) reactivity to environmental allergens in atopic dogs using IDT as the gold standard

Fleischman

Morris

2023

Self Cite

BackgroundPrick testing is widely used as the first‐line in vivo test for environmental allergens in people owing to its noninvasive nature and speed of performance.ObjectivesTo determine concordance between skin prick testing (SPT) and intradermal testing (IDT) reactivity to environmental allergen mixes in dogs with atopic dermatitis (cAD).AnimalsForty client‐owned dogs with cAD.Materials and MethodsSkin prick testing (GREER Pick System; Stallergenes Greer) and IDT were performed on 40 dogs using seven glycerinated and aqueous environmental allergen mixes, respectively (tree, grass and weed pollens, house dust mites and three mould mixes). Reactions for IDT and SPT were evaluated both subjectively and objectively (mean wheal diameter; MWD) and compared to saline and histamine controls.ResultsUsing IDT as the gold standard, with subjective scoring, SPT was 47.0% sensitive [95% confidence interval (CI) 36.0%–58.7%], 92.1% specific (95% CI 87.6%–95.3%) and agreement was moderate (79%, Cohen's kappa = 0.424). The positive predictive value of SPT was 36% and negative predictive value was 95%. Objective and subjective scores had only fair agreement.Conclusions and Clinical RelevanceSkin prick testing with allergen mixes was specific yet poorly sensitive as compared to IDT. For both IDT and SPT, 95% (38 of 40) dogs failed to react to an allergen mix, despite showing a positive reaction to at least one component. Future studies comparing SPT and IDT should test individual allergens rather than mixes to prevent the dilution of individual components, which may have resulted in false negatives.

Use of a modified SCORFAD scale to define localised reaction patterns associated with a flea burden in cats

Sampeck,

Sutherland,

Canfield

et al. 2024

BackgroundThe SCORing Feline Allergic Dermatitis scale (SCORFAD) is a validated dermatological scale assessing reaction patterns associated with allergic dermatitis in cats. While no pathognomonic reaction pattern is recognised with flea allergy dermatitis (FAD), miliary dermatitis is more common.Hypothesis/ObjectiveThis study aimed to document regional cutaneous reaction patterns of cats with fleas using a modified SCORFAD (mSCORFAD).AnimalsIn total, 142 owned cats from West Central Florida enrolled over three study periods. To be included, each cat and household environment had five or more fleas on Day (D)0.Materials and MethodsCats were examined on D0, D7, D14, D21, D28, D44, D56 and D80. On D0 they were treated with an isoxazoline and treatment continued through the study. Ten body regions were assessed using mSCORFAD to give a regional score for each of four reaction patterns. These were compared using the Wilcoxon rank sum test.ResultsAt D80 there was an 80% reduction in total mSCORFAD representing clinical response to ectoparasite control only. The most commonly affected region was the ventral abdomen with a mean mSCORFAD score of 1.8 (95% confidence interval = 1.5–2.1) compared with other body regions (p < 0.01). The most common reaction patterns were self‐induced alopecia on the ventral abdomen and miliary dermatitis in the cervical region (p < 0.0001).Conclusions and Clinical RelevanceThe mSCORFAD suggests that self‐induced alopecia on the ventral abdomen and miliary dermatitis in the cervical region is more strongly associated with a flea burden in cats.