The use of a spot-on composed of polyunsaturated fatty acids and essential oils for treating kerato-seborrheic disorders: open study

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1 The use of a spot-on composed of polyunsaturated fatty acids and essential oils for treating kerato-seborrheic disorders: open study By A. Jamoteau and E. Bensignor Summary Kerato-sebrorrheic disorders are less frequent in cats than in dogs. It is however frequent to observe scaling and bad coat quality on obese cats, who are fed with a hypocaloric diet. For these cats, any supplement in polyunsaturated fatty acids is potentially counter-indicated due to animals overweight, and it seems interesting to propose therapeutic alternatives. In this open study, 10 obese cats under hypocaloric diet presenting a dorsal scaling and a seborrhea have been treated by a weekly spot-on application containing polyunsaturated fatty acids and essential oils (Dermoscent, Laboratoire LDCA). Various criteria have been scored (coat quality, scale quantity, veterinarian and pet owner subjective appreciations) during the inclusion visit and during the follow-up visit after a one-month treatment. All cats, except one, have shown an improvement of cutaneous lesions, with a good to very good global appreciation from pet owners and from the veterinarian investigator. Key Words: Kerato-seborrheic disorders, cat, dermatology, spot-on, essential oils. Introduction A frequent cutaneous abnormality on obese cats under hypocaloric diet is the presence of a dorsal kerato-sebborrheic disorder. This disorder is due simultaneously to the absence of a sufficient self-grooming of the animal (often difficult for obese cats) and probably also to the relative deficiency in lipids from lipid-deprived diets. The treatments choices for kerato-seborrheic disorders consist in regular shampoos and oral in-takes to improve kerato-regulation especially through essential fatty acids.

2 These two treatments are difficult to apply on obese cats: frequent shampoos are hardly tolerated by cats while supplements enriched with fatty acids are not potentially indicated as suitable for obese animals. A recently marketed spot-on containing polyunsaturated fatty acids and essential oils, indicated for cutaneous aspect improvement of pets, could be an interesting treatment to for these animals. This pilot study, open and noncontrolled, has the purpose of evaluating the interest of applying this spot-on (Dermoscent, Laboratoire LDCA) in this indication in cats. Material and Methods Ten cats have been selected for this open and non-controlled study. The animals were initially not presented for a dermatological consultation, but for a vaccination. However all cats showed kerato-seborrheic disorders and a bad coat quality. Animals treated with oral drugs for less than 2 weeks such as antihistamines, antibiotics, anti-inflammatory or anti-fungal medications are excluded from the study as well as those treated with steroids injections during the month before the inclusion. Animals diagnosed with ecto-parasites or a cutaneous infection by cutaneous scrapings or brushing, as well as cytology by adhesive cellophane test were also excluded from the study. For each case, epidemiological and clinical data have been collected. A clinical scoring has been implemented for 3 criteria: scaling, dry/oily skin, coat quality. Each evaluation criterion has been scored by the veterinarian investigator from 0 (absence of scaling, of seborrhoea, normal skin) to 4 (strong presence of scaling, of seborrhoea, bad coat quality). Cats have received a weekly application of the spot-on during the study (Dermoscent Essential 6 for cats, Laboratoire LDCA) for 4 weeks. The dosage of the pipette is specifically adapted for cats, and contains 0.6 ml of the product whichever the cat weight is. The application is classically made directly onto the skin, on the neck or between the shoulders, at 1 or 2 points by carefully spreading apart the hair. No other treatment is authorized during the study period. Only an insecticidal/acaricidal spot-on (Frontline, Mérial, Advantage, Bayer) can be applied during the inclusion visit. The animals included in the study have been examined after 28 days treatment (thus after the weekly application of 4 pipettes). A scoring of skin lesions and of cosmetological aspects of the animal has been realized as during the inclusion visit. Moreover, the veterinarian investigator has also evaluated subjectively product efficacy from 0 (no effect) to 4 (very net improvement); while the owner has given its opinion on the product efficacy: 0 (unsatisfied) to 4 (very satisfied).

3 Clinical publication on IDV July 2007 Results Ten cats were included in the study. Various breeds were represented: 6 European short-hair, 3 Persians and 1 Siamese. The average age was 6 years, varying from 2 to 10 (the age was unknown for one animal). The epidemiological data is reported in the table I. Photo 1: Close-up of the dorso-lumbar vertebra area of a cat before treatment: dry hair and moderated scaling Photo 2: The same animal as shown on the photo 1, yet the cosmetic improvement is clear and net.

4 Table I: Epidemiological characteristics of animals on trial Numero Breed Sex Age (years) 1 siamese FS 4 2 european FS 5 3 european MS 7 4 european F 9 5 persan F 4 6 persan MS 10 7 european FS 8 8 european F? 9 european MS 2 10 persan FS 6 F: female M: male S: sterile Although these animals were not initially presented for a dermatological consultation, kerato-seborrheic disorders with pytiriasiform scales and poor coat quality (dry or oily) were observed in each of these 10 cases. No other dermatological sign was associated, and no prurit was present. The scaling had been present from 2 months up to 1 year depending on the cases (in average of 6.5 months) while the lesions observed during the inclusion varied in a considerable manner among the 10 cats. Some presented a high clinical score (maximal note was 7/8 according to our scoring system), others a more moderated score (minimal note was 4/8) (table II and picture 1). In 5 cases, the skin and coat quality were considered as very abnormal: 3 cases too dry, 2 cases too oily. During the follow-up visit, a net improvement has been observed in every case, except one according to the study criteria. For the Scaling criterion, the average score fell from 3.3/4 at the inclusion visit to an average of 0.6/4 after treatment. Five out of ten cats were considered as clinically normal on this date. For 1 case (case n 8), the result has been considered as poor, with the persistence of scaling after 1 month, although diminished. For the skin and coat criterion, the average score fell from 2.4/4 at the inclusion visit to 1/4 after treatment. Two cats have recuperated an excellent skin and coat quality. The veterinarian appreciation on the spot-on efficacy is in general very good with an excellent score for 2 cats and one case out of ten considered as rather inefficient. The owners are generally satisfied except one. The individual results for each evaluation criterion are reported in the tables II and III. No undesirable effect was reported by the pet owners.

5 Table II: clinical score criteria, before and after treatment squames scoring (0 to 4) skin & coat scoring (0 to 4) D0 D28 D0 D28 Cat Cat Cat Cat Cat Cat Cat Cat Cat Cat for scalings : 0- absence; 1- low presence; 2- moderate presence; 3- medium presence; 4- significant presence for skin aspect: 0- normal; 1- a bit dry or a bit oily; 2- medium dry or oily; 3- rather dry or oily; 4- very dry or oily Table III: appreciation criteria by the owner and the veterinarian (0 to 4) (0 to 4) D28 D28 Cat Cat Cat Cat Cat Cat Cat Cat Cat Cat for the owner: 0- unsatisfied ; 1- rather unsatisfied; 2- rather satisfied ; 3- satisfied ; 4- very satisfied for the veterinarian: 0- inefficient ; 1- rather inefficient ; 2- rather efficient ; 3- efficient ; 4- very efficient Discussion Kerato-seborrheic disorders are a frequent cause of dermatological consultations for dogs, but rather rare in cats. In cats, kerato-sebborrhoeic disorders reported in dermatological litteratures are from parasitic origin (cheyletiellosis for example) or more serious disorders associated for example with an internal neoplasia or with pre-lymphomatous conditions.

6 In daily practice, it is not so rare to find cats presenting an important or moderate scaling, associated with a bad coat quality (too oily or too dry) due to insufficient self-grooming. According to our experience, this situation is frequent among obese cats under lipid-deprived diet, maybe due to the relative insufficiency in essential fatty acids that cannot be synthesized de novo by the cats. For these animals, the exact cause of the appearance of scaling is not understood: increase or decrease of the proliferation or the differentiation of keratinocytes? Abnormality of corneocytes exfoliation? The classical treatments of these types of cutaneous abnormalities are mainly topical treatments, particularly kerato-modulating shampoos as well as oral supplements based on essential fatty acids. It seems however paradoxical to prescribe oral in-takes based on essential fatty acids to animals under hypo caloric diet. Above all, shampoos are so often difficult to apply on cats. The aim of this study is to evaluate the interest of a spot-on formulation containing essential oils and essential fatty acids in this indication. This spot-on has already shown efficacy on dogs and on cats for coat aspect improvement, and on dogs to decrease cutaneous lesions associated with kerato-seborrheic disorders, as a complementary treatment to shampoos. We find here similar results as in previous studies on the same formulation: a significant decrease of scaling and an improvement of skin aspect, for the pet owner as for the veterinarian. The obtained effects could be linked to the re-hydrating action on stratum corneum. As a matter of fact, the essential oils and polyunsaturated fatty acids, particularly the linoleic acids and the hemp oil contained in this formulation enable the restoration of the hydrolipidic film, the reduction of transepidermal water-loss and the increase in epidermal hydration. The spot-on formulation has an obvious interest compared to shampoos, sprays, pump-sprays or lotions, particularly for cats known as rather reluctant for these topical treatments. Pet owners are also much more motivated to use this product thanks to its practical and easy application. The observance is therefore much better. No secondary effect has been reported, none in this trial nor in other previous studies. Statistics were not calculated due to the relatively small number of cats included in this study. Results obtained here are not necessarily significant without a placebo group. Nevertheless, the improvement in terms of clinical symptoms is clearly present and significant. Conclusion The use of a spot-on based on essential oils and essential fatty acids (EFA) seems to be a potentially interesting solution, as a practical and efficient treatment for kerato-seborrheic disorders in cats. This product could be a good alternative not only to shampoos often difficult to use in cats and much longer to

7 apply, but also to sprays which often scare cats. Other studies in the future, particularly with a placebo group, with a bigger number of cats or as an adjuvant treatment of others cutaneous disorders, could be realized in order to determine further beneficial properties of this formulation. Bibliography 1. Carlotti DN, Bensignor E, Management of keratoseborrheic disorders. Eur J Comp Anim, 2002, 12, Halliwell REW, Rational use of shampoos in veterinary dermatology, J Small Anim Pract, 32: Campbell KJ, Schaeffer DJ, Effects of four veterinary shampoos on transepidermal water losses, hydratation of the stratum corneum, skin surface lipid concentration, skin surface ph and corneocyte count in dogs. In: Proceedings of the ninth annual meeting of the American Academy of Veterinary Dermatology and American College of Veterinary Dermatology, San Diego, 1993, Campbell KJ, Byrne KP, Henshaw JJ, Button LD, Schaeffer DV, Effects of four veterinary shampoos on transepidermal water losses, hydratation of the stratum corneum, skin surface lipid concentration, skin surface ph and corneocyte count in dogs. In: Proceedings of the ninth annual meeting of the American Academy of Veterinary Dermatology and American College of Veterinary Dermatology, Charleston, 1994, Cheysney CJ, The intimate envelope: water and the skin. In: Adv. Vet. Derm. III, Kwochka KW, Willesme T, Von Tscharner C, Butterworth Heinemann, Oxford, 1998, Bensignor E, Bordeau W, Utilisation d un spot-on à base d acides gras et d huiles essentielles pour carnivores domestiques: étude ouverte. Inf Dermatol Vet, 2005, 10, Campbell KJ, Kirkwood AR, Effects of topical oils on TEWL in dogs with seborrhea sicca. In: Adv. Vet. Derm. II, Ihrke PJ, Masson IS, White SD. Pergamon Press, Oxford, 1993, Cheysney CJ, Water: Its form, function and importance in the skin of domestic animals. J Small Anim Pract, 1993, 34: Wernerlinde Y. Dry skin in atopic dermatitis. Acta Dermatol. Venereol., Stockholm, 1992, suppl 177, Scott DW, Miller WH, Griffin CE, Small Animal Dermatology, 6 th Ed, WB Saunders, Philadelphia, Guaguère E et Bensignor E. Thérapeutique dermatologique du chien. PMCAC/Masson edrs, Paris, Bensignor E, Utilisation d un spot-on à base d huiles essentielles dans le traitement des états kératoséborrhéiques du chien : étude prospective contrôlée. Inf Dermatol Vet, Bensignor E, Germain P-A. Dermatologie du chien et du chat, eds Med com, Paris, 2005