Case study: Atopy monitoring with Heyrex


The following case study outlines the Heyrex monitoring of a 2 year old, male neutered, crossbreed 
with hypersensitivity to the plant Tradescantia fluminensis (Wandering Jew).

Long term view: scratching

Increase in scratching
Following exposure to Tradescantia fluminensis on 9 January the patient displayed a marked increase in scratching, easily identified by reference to the long term scratching graph on Heyrex.

atopy_webgraph_1.jpg

Daily view: scratching

Nocturnal scratching profile
Reference to a single 24 hour period during this episode revealed that the majority of scratching occurred between the hours of midnight and 6am, making it difficult for owners to detect, but again easy to recognise using Heyrex.

atopy_webgraph_2.jpg

Daily view: scratching

Treatment has insufficient duration
Treatment was instigated, comprising BID applications of topical steroid cream to the affected areas. Treatment efficiency was monitored via Heyrex revealing that BID applications of cream were not providing total relief from pruritus.

atopy_webgraph_3.jpg

Daily view: scratching

Treatment adjustment with Heyrex
Based on evidence from the Heyrex graphs, treatment was modified to TID applications which provided 24 hour relief from symptoms.

atopy_webgraph_4.jpg

History

A 31kg, 2 year old, brindle Bull Terrier cross presented with pruritus and erythema.The dog was wearing a collar with Heyrex biosensor attached - allowing all scratching activity to be monitored. The sensor clearly showed that scratching started around the 9th of January and, apart from a single low level on 22nd January, had continued.

Examination of the daily scratch patterns showed that most of the scratching activity occurred between midnight and 06:00hrs. Scratching was severely disruptive to sleep during this period.

Veterinary examination

The veterinary examination revealed severe papular eruptions ventrally. There was severe interdigital erythema with palmar ulceration accompanied by muzzle erythema. There was also mild periocular erythema (particularly around the left eye) and moderate to severe bilateral purulent conjunctivitis. There was suspected Tradescantia fluminensis (Wandering Jew) hypersensitivity. Other hypersensitivies, with secondary infection, were also certainly possible.

Cytology of a skin biopsy from the groin revealed no significant findings. Cytology from the feet revealed 2-4 yeasts per oil immersion field. A skin scraping was negative for Demodex. A Tradescantia test patch caused significant erythema and a marked increase in scratching as measured by the Heyrex biosensor worn by the dog.

Response to treatment

At the conclusion of the first veterinary consult the patient was given an injection of Dexamethasone. This settled the degree of erythema, but had little effect on the scratching activity measured by the Heyrex biosensor. The challenge with Tradescantia increased scratching activity to the highest level recorded in this dog. On the 11th February the client administered topical cream to the ventral surface which decreased scratching activity immediately.

Examination of the daily scratching activity patterns shows that the cream gave relief for around 8 hours following application last thing at night and before the caregiver left the house in the morning. The scratching patterns over the day show that the dog started scratching late in the afternoon and would benefit from another application when the caregiver got home from work. This was instigated and the beneficial relief was clear.


Edwards J.D., Gibson, D.J.M. 2011. Novel Technology for the Remote Monitoring of Canine Patients. World Veterinary Congress, Cape Town, October 2011

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