15.5 Review of data in cats In cats only open case series have been described, oral itraconazole at varying doses and intervals (Table 8, LoE=3, SoR=C-weak).[113, 251, 289] As for dogs, topical antifungal agents such as miconazole, chlorhexidine or climbazole are likely to be beneficial but there is no data to substantiate this, other than anecdotal reports. Table 8. Case series of Malassezia dermatitis in cats treated with oral itraconazole. Design Dose Frequency Clinical Adverse Comment LoE outcome effects Ordeix et OCS ; ITZ ± 5 Once ITZ+CH : 1 Nil 3 al 2007 topical CH mg/kg complete, 1 [n= 5], or partial ; with ITZ+AB : 3 antibiotic complete, 5 [n=8] partial et al OCS ; 6 5 Once daily Skin lesions Nil Marked 3 2007 seborrhoeic mg/kg for 7 d on, resolved at antifungal Devon Rex 7 d off, 7 d all sites efficacy cats on. except claw on fold [n=4] quantitiative and cultures interdigitally [n=2] Bensignor OCS ; 15 5-10 Once daily Nil Marked 3 ≥66% 2010 cats mg/kg for 4 reduction in antifungal weeks clinical efficacy scores; >75% based on reduction in quantitiative pruritus cultures + cytology CH, chlorhexidine ; OCS, open case series 15.6 Antifungal drug formulation
15.5 Review of data in cats In cats only open case series have been described, oral itraconazole at varying doses and intervals (Table 8, LoE=3, SoR=C-weak).[113, 251, 289] As for dogs, topical antifungal agents such as miconazole, chlorhexidine or climbazole are likely to be beneficial but there is no data to substantiate this, other than anecdotal reports. Table 8. Case series of Malassezia dermatitis in cats treated with oral itraconazole. Design Dose Frequency Clinical outcome Adverse effects Comment LoE Ordeix et al 2007 OCS ; ITZ ± topical CH [n= 5], or with antibiotic [n=8] 5 mg/kg Once ITZ+CH : 1 complete, 1 partial ; ITZ+AB : 3 complete, 5 partial Nil 3 et al 2007 OCS ; 6 seborrhoeic Devon Rex cats 5 mg/kg Once daily for 7 d on, 7 d off, 7 d on. Skin lesions resolved at all sites except claw fold [n=4] and interdigitally [n=2] Nil Marked antifungal efficacy on quantitiative cultures 3 Bensignor 2010 OCS ; 15 cats 5-10 mg/kg Once daily for 4 weeks ≥66% reduction in clinical scores; >75% reduction in pruritus Nil Marked antifungal efficacy based on quantitiative cultures + cytology 3 CH, chlorhexidine ; OCS, open case series 15.6 Antifungal drug formulation