Rachel Allbaugh explains recent advancements and treatments for equine patients with squamous cell carcinoma 

Video interview with Rachel Allbaugh, DVM, MS, DACVO

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 at the Fetch Kansas City conference in Kansas City, Missouri, Rachel Allbaugh, DVM, MS, DACVO, a professor of ophthalmology at Iowa State University, discussed the latest developments in treating and managing squamous cell carcinoma (SCC) in horses. While she highlighted some exciting new advancements, such as photodynamic therapy, Allbaugh also acknowledged that not all practitioners may have access to these options, emphasizing that relying on proven, historically effective treatments can still provide significant benefits. 

: Probably the most recent advancement that we really like to utilize is photodynamic therapy, and this allows us to combine our surgical excision of the visible mass with the adjunctive treatment, where we give a light sensitive dye injected into the tissue, painted on the surface, and then we activate it with a special laser. The success rates with this photodynamic therapy are equal to, if not greater than the other adjunctive therapies, and really for the eyelid disease I have seen phenomenal healing capacity from these eyelids, which was not as disfiguring as some of the other therapies that we used in the past, and so that's the reason why that's probably my favorite advance. 

But having said that, if you don't have that accessible in your area, it's definitely not a problem to use the other adjective, therapies that have been tried and true and can still offer benefit for the horses.

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Rachel Allbaugh, DVM, MS, DACVO, summarizes some of the recent advancements available for treating and managing this disease

Advancements in squamous cell carcinoma treatment and management

The FDA announced earlier today that ilunocitinib tablets (Zenrelia; Elanco) has received its approval. The latest drug from Elanco will be used to control pruritus associated with allergic dermatitis as well as controlling atopic dermatitis in canines at least a year of age.

This ilunocitinib tablet is an immunosuppressant that is given to patients orally once a day, with or without food. The drug contains a nonselective Janus kinase (JAK) inhibitor and is the second JAK inhibitor the FDA has approved for this indication.

“Today is a historic day for Elanco with our first of several expected entries into the fast-growing global canine dermatology market, bringing veterinarians and pet owners a highly effective new solution that got more dogs back to normal levels of itch in a head-to-head study with the current JAK inhibitor on the market2*,” Jeff Simmons, President and CEO, Elanco Animal Health, said in a news release.

“We are excited to offer veterinarians and pet owners a solution that can relieve the burdens of itch, while also becoming just the second animal health company to offer veterinarians a comprehensive portfolio, including parasiticides, vaccines, pain and other therapeutics, and now, dermatology,” he added.

Elanco conducted a head-to-head noninferiority study as a way to compare the safety of oclacitinib tablets (for canine itch relief) and ilunocitinib tablets for submission in the European Union. The study was randomized and double blind with 338 client-owned canine patients that had atopic dermatitis. The study was conducted over 25 study sites within 4 countries. The findings displayed that a single dose of ilunocitinib tablets daily is at least as effective as the market incumbent JAK inhibitor at the primary end point on Day 28.

The safety of ilunocitinib tablets was demonstrated in multiple clinical and toxicity safety studies. According to Elanco, the drug’s required margin on the safety study was conducted in health dogs given placebos, 1, 2, 3, or 5 times the label dose daily for 6 months. All the dogs completed the study with no serious adverse effects.

The FDA shared in their release that ilunocitinib tablets are safe and effective when used in according to the label, but the product labeling has a boxed warning stating that dogs should not be vaccinated at least 28 days before and after treatment with the drug. This warning is because of fatal vaccine-induced disease and inadequate immune response to vaccines.

“Zenrelia has been demonstrated to be safe and highly effective in a number of studies,” Mara Tugel, DVM, dermatology medical strategic lead at Elanco, said in the release.

 “We recognize that veterinarians need clinically relevant data to guide treatment choices, and plan to pursue additional studies to evaluate vaccine response in Zenrelia-treated dogs. We will continue to work to improve the label over time.”

Ilunocitinib tablets are only available by prescription from a licensed veterinarian and will be available in scored tablets in 4 strengths: 4.8 mg, 6.4 mg, 8.5 mg, and 15 mg. Each tablet strength is available in 10 and 30 count blister packages and 90 count bottles.

 Veterinarians can now order ilunocitinib tablets and learn more at Zenreliaforvets.com.

On Friday, September 20, 2024, Elanco will hold a conference call at 8:00 AM EST to discuss this approval with the investment community and any other interested parties. The conference call will also have a live webcast that can be accessed through the link posted on Elanco’s website and a replay will be available on the site shortly after the completion of the call.

FDA Approves New Treatment for Allergic Skin Conditions in Dogs. News release. US Food and Drug Administration. September 19, 2024. Accessed September 19, 2024. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-approves-new-treatment-allergic-skin-conditions-dogs?utm_medium=email&utm_source=govdelivery

Elanco Announces FDA Approval and Launch of Zenrelia™ (ilunocitinib tablets), Offering An Effective, Safe Solution in Canine Dermatology. News release. Elanco Animal Health Incorporated. September 19, 2024. Accessed September 29, 2024. 

https://www.elanco.com/en-us/news/elanco-announces-fda-approval-and-launch-of-zenreliatm-ilunocitinib-tablets

Articles

The approval for Elanco's Zenrelia will serve as a new therapy for canine patients 

Treatment for allergic skin conditions receives FDA approval 

Cornell University’s College of Veterinary Medicine and NY FarmNet have partnered with Rural Minds to launch a free online course, “Mental Health and Suicide Prevention in Rural America.”

 The course is designed to provide learners with support strategies and to serve as a resource for the navigation of mental health challenges in rural communities.

The course is designed with veterinarians, agribusiness professionals, and veterinary students in mind. It provides practical tips to help handle mental health challenges, including recognition and response to warning signs. Information about resources, from crisis hotline numbers to local support options, are included in the course, which can be 

“As a dairy farmer, I know firsthand that veterinarians are an integral part of all rural communities,” Jeff Winton, chairman of Rural Minds, and Cornell University alum, said in a news release.

 “[Veterinarians] may be among the first to see warning signs that a client is experiencing a mental health challenge but may not recognize those same signs in themselves.”

The CDC reports that, since 2000, suicide rates have been consistently higher in rural America than in more urban areas.

 Rates have increased 46% in non-metro areas, compared to 27.3% in metro areas. The same demographic of rural Americans are 1.5 times more likely to visit an emergency department for nonfatal self-harm.

A 2019 study confirmed that suicide is more likely among veterinarians than the general population. Specifically, 1.6 and 2.4 times more likely, for male and female veterinarians, respectively.

 Suicide is 5 times more likely for male technicians and technologists, and 2.3 more likely for female technicians and technologists, compared to the general population.

These higher rates can be attributed to a number of factors, including pressure to perform, emotionally draining work, debt and financial pressures, long work hours, among other things. Considering the significantly higher prevalence of suicide in both rural areas and throughout the veterinary profession, rural veterinarians and agribusiness workers find themselves at a dangerous intersection.

“Professionals working in rural-agricultural regions face immense challenges related to stress and mental health,” Adam Howell, outreach director at NY FarmNet, said in a news release.

 “NY FarmNet is proud to see this new educational initiative come to fruition as we work together to alleviate the mental health crisis afflicting rural communities across America.”

NY FarmNet, part of Cornell University’s College of Agriculture and Life Sciences (CALS), serves as a general resource for farmers across New York State.

 Founded in 1986 in response to the national farm crisis, the organization offers farmers, agribusiness employees, and their families with free and confidential consultations. The program also operates an 800-help line for on-demand, year-round support.

Rural Minds was founded by Jeff Wilson after losing his own nephew to suicide in rural America.

 Growing up on a farm, he had always been aware of the prevalence of mental illnesses, and the lack of resources in rural areas.

 Coming together with Cornell University and NY FarmNet to launch this free course, Wilson continues his mission, providing rural veterinarians with the support they need.

If you or someone you know needs support, call or text 988, or chat at 988lifeline.org.

Free suicide prevention course available for rural veterinarians, farm workers. News release. Cornell University College of Veterinary Medicine. September 18, 2024. Accessed September 19, 2024.

Roberts L. Online course helps veterinarians support rural mental health. 

 September 18, 2024. Accessed September 19, 2024. 

https://news.cornell.edu/stories/2024/09/online-course-helps-veterinarians-support-rural-mental-health

Program. New York FarmNet. Accessed September 19, 2024. 

Our mission. Rural Minds. Accessed September 19, 2024. 

Suicide in Rural America. US Centers for Disease Control and Prevention. Accessed September 19, 2024. 

https://www.cdc.gov/rural-health/php/public-health-strategy/suicide-in-rural-america-prevention-strategies.html

Nett R., Witte T., Spitzer E., Edwards N., Fowler K. Suicide Risk for Veterinarians and Veterinary Technicians. US Centers for Disease Control and Prevention. September 4, 2019. Accessed September 19, 2024. 

https://blogs.cdc.gov/niosh-science-blog/2019/09/04/veterinary-suicide/

The course provides tips and resources for recognizing and handling mental health challenges

Free suicide prevention course for rural veterinarians 

Pacagen's "Cat Food Topper." (Photo courtesy of Pacagen)

A new cat food topper that aims to neutralize feline allergens was launched today. Engineered by Pacagen, a biotechnology company that produces solutions for human allergies to cats, the new anti-allergen food topper utilizes alpaca-inspired proteins to neutralize feline allergens. According to the company, this chicken-flavored topper has a 98% efficacy rate.

Cats produce the allergen Fel d 1 in their saliva, which is the primary cause of feline allergies. Alpacas naturally create proteins, called nanobodies, that can render allergens unrecognizable to the immune system.

 To make its' allergen-neutralizing cat food topper, Pacagen recreated these nanobodies using a nonpathogenic variant of 

. Similar to alpacas’ nanobodies, the company’s nanobodies have the ability to bind to Fel d 1 and neutralize the allergen, inhibiting a person’s allergic response.

“Allergies are caused by allergens, which are small proteins that animals, plants, [and] other organisms make and emit. Cats have one major allergen called Fel D1. Pacagen engineers therapeutic-grade protein binders to neutralize this allergen. The specific ones we use are inspired by the alpaca natural immune system called nanobodies,” Evan Zhao, PhD, CEO and cofounder of Pacagen, explained in an email to 

“This new product is a cat food topper that people can sprinkle onto the cat food. This way, while the cat is eating, the nanobodies can neutralize the allergens in its mouth. To the cat, what we are feeding it is just protein that it uses as a nutrient, so it loves the topper,” Zhao continued.

The product was inspired by Miaomiao, a British Shorthair cat adopted by Zhao and his wife, Siyang Han, PhD, cofounder of Pacagen. After Miaomiao’s adoption, Han began experiencing severe allergy symptoms, including exacerbated asthma. According to the founders, the idea for a solution to Han’s allergies came from a subject Zhao studied on nanobodies, during his time at Princeton University in New Jersey.

“We found out that my wife was very allergic but really wanted to keep [M]iaomiao so we engineered a new solution together,” Zhao told 

According to the company, each serving of the cat topper contains a healthy amount of protein and fats. Moreover, the nanobodies themselves are healthy proteins that contribute additional nutrition once the cat consumes it, according to Pacagen,

in an email. Furthermore, because of their short circulatory half-life, these nanobodies have been thoroughly tested to be safe for consumption, showing few to no unexpected effects, according to the company.
“My wife, Siyang…can now freely hug and hold [M]iaomiao,” said Zhao to 

 of the topper’s impact on people with allergies. “Miaomiao hates this, but it’s brought us all much closer together.”

The topper is an addition to Pacagen’s existing cat allergen product line, which includes a neutralizing spray that also utilizes the same nanobodies.

Removes 98% of active cat allergens. Pacagen. Accessed September 19, 2024. 

Our science. Pacagen. Accessed September 19, 2024. 

Pacagen’s novel product uses nanobodies to neutralize cat allergens 

New feline food topper reduces cat allergy symptoms 

Wedgewood shared earlier today that it has added molnupiravir to its formulary. The medication was first developed to treat human viral infections, including COVID-19 but has recently shown promise for treating feline infectious peritonitis (FIP).

The addition makes Wedgewood the first United States veterinary compounding pharmacy to offer feline-friendly formulations of molnupiravir, according to an organizational release.

 The treatment will also be available in various doses to fight against multiple forms of the diseases, including effusive, noneffusive, neurological, and ocular. Molnupiravir will be available in:

50mg/ml and 100mg/ml Flavored Oral Oil Suspensions

25mg, 40mg, 50mg, 60mg, 70mg and 80mg Capsules

"At Wedgewood, we are always looking for innovative treatment options that truly make a difference. The introduction of molnupiravir for FIP is a significant step forward in addressing an often devastating disease. By offering feline-friendly formulations like fish- and chicken-flavored oral liquids, we give veterinarians more tools to help their patients recover and improve their quality of life. We’re excited to see the impact this treatment will have on the cats and pet owners we serve" said Alejandro Bernal, DVM and CEO of Wedgewood, in the release.

Toward the end of 2023, the Wedgewood product team met with FIP Global Cats to begin exploring treatment options under study for FIP with 2 studies prompting Wedgewood to pursue molnupiravir. A study published in the American College of Veterinary Medicine’s 

conducted by Okihiro Sase from the You-Me Animal Clinic in Japan reported considerable remission from the majority of the cats that were treated with molnupiravir.

 Sase also noted that those 18 cats, presented with minimal side effects.

The research conducted by Sase aligned with a different study investing molnupiravir’s potential as a primary and rescue treatment for patients with FIP. This study identified 80 potential participants through FIP support groups and social media and 37 survey invitations were sent to participants with available contact information.

 Thirty-three surveys were submitted and 22 participants received follow-up emails. After multiple follow-ups and requests for additional information, 30 cats were selected for this study.

Once completed, the study disclosed that this treatment appears to be effective for suspected FIP, both as a first-line and rescue therapy. The researchers also noted minimal reported side effects at the dosage they used, 12-15 mg/kg every 12 hours, and showed the possibility of survival with the clinical remission signs of FIP.

“The availability of compounded molnupiravir marks a significant advancement in FIP treatment for cats in the US. With its proven safety and efficacy in both published and ongoing studies, molnupiravir has already demonstrated its value in countries where it's legally available, notably in curbing the FIP outbreak in Cyprus,” expressed Nicole Jaques, cofounder of FIP Global CATS.

“Critically, it serves as a vital rescue option for cats that may have developed resistance to other antivirals. FIP Global CATS is elated that US veterinarians and cat owners now have access to this powerful treatment. We're confident this development brings us closer to our goal of making safe, effective, and affordable regulated FIP treatment the standard of care worldwide,” she continued.

Molnupiravir is available at Wedgewood in dosages of 10-20 mg/kg, based on international veterinary research, and tailored to meet the needs of individual feline patients. Anyone interested in learning more or accessing educational resources about molunpiravir can visit the Wedgewood website.

Wedgewood Launches Compounded Molnupiravir for the Treatment of Feline Infectious Peritonitis (FIP). News release. Wedgewood. September 19, 2024. Accessed September 19, 2024. https://www.wedgewood.com/newsroom/wedgewood-launches-compounded-molnupiravir-for-the-treatment-of-feline-infectious-peritonitis-fip-/

Sase O. Molnupiravir treatment of 18 cats with feline infectious peritonitis: A case series. 

. 2023;37(5):1876-1880. doi:https://doi.org/10.1111/jvim.16832

Roy M, Jacque N, Novicoff W, Li E, Negash R, Evans SJM. Unlicensed Molnupiravir is an Effective Rescue Treatment Following Failure of Unlicensed GS-441524-like Therapy for Cats with Suspected Feline Infectious Peritonitis. 

. 2022;11(10):1209. Published 2022 Oct 20. doi:10.3390/pathogens11101209

Molnupiravir has shown to be a promising option for treating feline infectious peritonitis as a first- and second-line therapy

Wedgewood announces FIP treatment

Ease, an innovative provider of virtual specialty behavior care, has expanded nationwide, partnering with veterinary clinics across 18 different states just 5 months after its initial launch. The service is in collaboration with trusted veterinarians across the country and 3 Diplomates of the American College of Veterinary Behaviorists (DACVBs) and offers virtual care for pet behavioral challenges including reactivity, separation anxiety, and noise phobias. The rapid expansion highlights the nationwide demand for affordable and accessible pet behavior care solutions.

“Board-certified veterinary behaviorists are the gold standard in behavior care, but there aren’t enough to meet the demand, leaving many pets without the help they need,” Brandy Kuentzel, co-founder and CEO of Ease, said in a news release.

 “Ease bridges this gap by supporting local veterinarians with our specialists, bringing top-tier behavior solutions to more pets and families.”

The company launched in April 2024 after a successful beta.

 Through the combination of virtual support and in-person care, the collaboration highlights the specialized knowledge of Ease’s experts, not only making services more accessible to pet owners, but making complex cases simpler for veterinarians.

Ease’s online Vet Portal is available at no cost to veterinary practices. The portal allows veterinarians to easily refer behavior cases and receive specialist recommendations, including insight into behavior medications.

The online Pet Portal, on the other hand, is designed for use by pet owners. A veterinary referral is required to access the Ease platform, and it will cost pet owners a one-time fee of $197. The Pet Portal offers step-by-step treatment plans, educational videos, and 1-on-1 email support, among other features.

According to the American College of Veterinary Behaviorists (ACVB),

 early interest in basic animal behavior, and the application of behavioral information to clinical problems, began to emerge during the 1960s. Over the next couple of decades, behavior was introduced into the veterinary curriculum and practitioners began to offer clinical services. This was drive by the demand of pet owners, more than administrators.

Alongside increased veterinary interest in behavior, Bonnie Beaver, DVM, MS, from Texas A&M University suggested leaders in the field come together to form a society addressing their interest. With this, the American Veterinary Society for Animal Behavior (AVSAB) was launched in 1976—though, at the time it was called the American Society of Veterinary Ethology (ASVE).

Leaders in the field knew that the discipline would never advance unless it was a board-certified specialty by the American Veterinary Medical Association (AVMA). After years of campaigning, and increased demand in the specialty, the ACVB received provisional approval from the American Board of Veterinary Specialties (ABVS) in 1993, and the first certifying exam was administered in 1995. In the decades since, demand for behavioral care has continued to grow.

Ease was founded in 2023, looking to make a difference and meet increased demand in the veterinary behavioral care sector. With their expressed interest in continued expansion, they are maintaining their commitment to making specialty behavioral care available to every pet owner, and every pet, according to the company.

Ease Expands Nationwide: Bridging the Gap in Pet Behavior Care in 18 States. News release. Ease. September 3, 2024. Accessed September 18, 2024. 

https://www.globenewswire.com/news-release/2024/09/04/2940181/0/en/Ease-Expands-Nationwide-Bridging-the-Gap-in-Pet-Behavior-Care-in-18-States.html

You’ve got questions. Ease has answers. Ease. Accessed September 18, 2024. 

History. The American College of Veterinary Behaviorists. Accessed September 19, 2024. 

Ease makes pet behavior care more accessible across 18 newly covered states