phone / fax: serum test results - artuvet · 2020. 1. 6. · • secondary infection (yeast,...
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Serum Test results
200 250
< 200Scores of less than 200 should be considered questionable and only be included if the aller-gens are found in the pet’s environment and they relate to the clinical history.
200-250Scores in this range should be considered significant if the allergens are found in the pet’s environment and they relate to the clinical history.
> 250Scores of 250 or above are unusually high. These allergens are significant especially if they are found in the pet’s environment and relate to the clinical history.
* Elisa Absorbance Units. EA indicate the level of allergens specific IgE detected. The magnitude of the signal does not necessarily correlate with the severity of the disease but does reflect the pet’s immune response to allergens.
Owner name:Animal Name:Species: Veterinarian:Veterinary practice:Practice details: Phone / Fax: Email:Test type:Date tested:Test number:Customer number:
Allergen EA Units*
1
ExampleExampleDogJ. LeiteArtuvet Animal HealthVijzelweg 11, 8243 PM Lelystad, NL
Complete environmental17/12/2019211
Orchard grass
Timothy grass
Perennial ryegrass
Kentucky bluegrass
Bermuda grass
Oat pollen
Rye pollen
Rape pollen
Copra mite
Farinae mite
Hay mite
House dust mite
Grain mite
Flea
Birch
Elm
Sycamore
Willow
Privet
Cypress
Olive
Common mugwort
Stinging nettle
English plantain
Lamb's quarter
Dandelion
Sorrel, sheep/red
Common ragweed
Alternaria alternata
Aspergillus fumigatus
Cladosporium herbarum
Malassezia
841
717
809
698
902
355
160
21
564
492
325
136
220
13
21
16
4
19
15
7
59
15
161
54
387
178
244
127
22
9
32
47
CCD's are blocked and removed from sample
Serum Testtreatment advice
Step 1 - Select a treatment option
Go to the next page for step 2 - Ordering
Treatment option 2
When costs or compliance influence the treatment, pollen mixtures can be an alternative to treatment option 1.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.
Treatment option 1
This treatment option contains indivi- dual allergens only. Most dermatologists recommend to include individual allergens in the treatment.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. Positive, what now?
Once all other causes for the symptoms have been ruled out, atopy is the diagnosis. Since IgE has been found for one or more allergens, you can proceed with immuno-therapy. Where there are a high number of positive allergens, this does not affect the efficacy of the immunotherapy.
How to proceed with immunotherapyPlease select a treatment option from Step 1 or select the allergens yourself by composing your own treatment. Allergens should be selected based on the clinical history of the patient. Once you have completed Step 1 move onto Step 2 overleaf.
This option results in: subcutaneous
immunotherapy
*Also available in sublingual immunotherapy (oral spray)
This option results in: subcutaneous
immunotherapy
*Also available in sublingual immunotherapy (oral spray)
2
Questions about the treatment options? Read the following pages or call us at +31 320 783 111.
Compose it yourself
Prefer to compose your own therapy based on the clinical history? Please enter the desired allergens below.
Artuvetrin® subcutaneous immuno- therapy: up to 8 allergens and/or allergen mixtures can be included into 1 vial. For cases with more than 8 allergens, additional vial(s) will be produced.
Orchard grassTimothy grassPerennial ryegrassKentucky bluegrassBermuda grassOat pollenCopra miteFarinae miteHay miteGrain miteLamb's quarterSorrel, sheep/red
2 vials
Grass pollen mixWeed pollen mix 2Copra miteFarinae miteHay miteGrain mite
1 vial
Artuvetrin® subcutaneous immunotherapy It lasts for 9 to 10 months of treatment
Serum Testordering treatment
Read more on the next page for Step 3 - Starting the treatment 3
Confirm your order
Step 2 - Ordering the treatmentSelect your preferred product
recommended
Veterinary practice:
Delivery address:
Alternative delivery address (if applicable):
Date:
Signature:
Order your treatment quick and easily online
Visit artuvet.com and click ‘online ordering’.At your personal dashboard you can request serum tests, order treatment and download brochures. Reorders can be done easily in your order history.
After selecting the treatment option and product, please email this form to [email protected] order through our website artuvet.com
Do you need support?If you have any questions or if you need support in the diagnosis or treatment of a patient, please contact our medical department by phone +31 320 783 111 or by email [email protected]
Sublingual immunotherapy (oral spray)
Sublingual immunotherapy can be an alternative for cases with an aversion to needles, do not show improvement to subcutaneos injections or when a daily dosage is prefered.
Sublingual immunotherapy single (1 x 30ml) Treatment lasts for 3-5 months*
Sublingual immunotherapy double (2 x 30ml - same allergens/composition) Treatment lasts for 6-10 months*
*depending on the weight of the animal: < 10kg - 5 months (10 months when ordering a double 2 x 30ml) > 10 kg - 3-4 months (6-8 months when ordering a double 2 x 30ml)
For more information contact us at [email protected]
alternative option
Online orderingOnline ordering
Delivery within 8-10 days
Serum Teststarting treatment
Step 3 - Starting the treatmentFrequently asked questions
Read more on the next page for more information about Next+ 4
What is the dosage schedule?
Subcutaneous injections are administered with gradually increasing dosages. The schedule below is applicable for dogs, cats and horses. Please keep an eye on the patient for at least 30 minutes after every injection for any side effects.
Is it possible to deviate from the standard dosing schedule?
Yes, however this depends on the situation. Please contact our medical department at +31 320 783 111 for advice and support.
What is the success rate of Artuvetrin®?
The success rate of Artuvetrin® Therapy is 75% for dogs, 70% for cats and 84% for horses. Patients who respond, may expect a recovery from 50% up to 100%. Symptomatic medication might be stopped com-pletely or decreased significantly.
What if the patient did not respond at all?
If the patient did not show any improvement at all after 12 months, please contact our medical department on +31 320 783 111. There can be several reasons for a 0% response: concomitant food allergy, reaction to new allergens or not effective. We are happy to evaluate each case and help you with the relevant follow up.
If the symptoms are seasonal, can I administer only during that time?
No, it should be administered continuously and life-long. If discontinued for a long period the immunological tolerance may be decreased and the treatment will have to be restarted from the initial dosage.
What is the best time to start the treatment?
The treatment can be started at any time. It is recommended to have the skin under control before starting Artuvetrin®.
Do I need to stop symptomatic medication before starting Artuvetrin®?
Symptomatic medication does not need to be stopped and it can help to keep the skin calm and under control in the initial phase (increasing dosage) of the desensitisation. Symptomatic medication does not affect the efficacy of the treatment and can be continued.
When can I expect to see improvements?
In general, improvement can be noticed after 4 to 6 months. In some cases only after 1 month. If there is no improvement atall after 6 months, please contact us at +31 320 783 111. We are happy to help you with your case.
What to do with cases where the symptoms come back?
In case of a flare-up, the symptoms suddenly appear or worsen. This means that the animal has risen above the pruritic threshold. It can happen for different reasons:• increased contact with allergens• secondary infection (yeast, bacterial, etc.)• other skin irritation due to fleas, swimming, more or less washing, etc.
With a flare-up, it is important to find the cause and prevent it. If the cause is unknown, it can sometimes be sufficient to correct the symptoms with temporary symptomatic medication.
Can I stop the treatment if the symptoms are not present anymore?
No, it is life long and should not be stopped. When stopping there is a significant chance the symptoms will come back and restarting the treatment will not be as affective as before.
Artuvetrin® is a life-long treatment and compliance is keyAllergy is a chronic disease and every 10 months a follow-up vial is required.
Continue with 1.0 ml every 4 weeks for at least 12 months.If noticeable results, Artuvetrin® is a lifelong treatment.
Dosage
0.2 ml
1.0 ml
0.6 ml
1.0 ml
0.4 ml
1.0 ml
0.8 ml
1.0 ml
Adviced schedule
Week 1
3 weeks later (week 10)
2 weeks later (week 5)
4 weeks later (week 17)
2 weeks later (week 3)
3 weeks later (week 13)
2 weeks later (week 7)
4 weeks later (week 21)
Serum Testabout Next+
5
About Next+Frequently asked questions
If there are a lot of positives, will immuno- therapy be useful?
Where there are a high number of positive allergens, this does not affect the efficacy of the immunotherapy.
What can the owner do to prevent exposure to the positive allergens?
Many things can be done to prevent or reduce contact with aller-gens. Please request our Allergen Guide, this brochure contains tips for all allergens we test for.
What if Malassezia is positive?
Malassezia is mostly a secondary problem of atopic dermatitis. If Malassezia is suspected to be causing the allergy, consider including it in the immunotherapy.
What if moulds are positive?
Moulds are only clinically relevant if the animal lives in a moist environment indoors. Should this be the case, we recommend to lower the humidity indoors or remove the moulds with mould cleaner first. Please refer to our Allergen Guide for more tips for moulds. If these adjustments give no or partial improvement, consider including it in the immunotherapy.
What if flea has been tested positive?
A flea bite hypersensitivity reflects type I and type IV hypersensi-tivity reaction. As immunotherapy only works for Type 1, the best treatment is a good flea treatment in all seasons of the year.
Do the units correlate with the clinical signs?
No, the magnitude of the units does not necessarily correlate with the severity of the disease but does reflect the animal’s immune response to allergens.
Can symptomatic medication affect the result?
Corticosteroids may affect the serum test results if administered longer than 2-3 months (oral medication).
What are CCDs?
CCDs are cross-reactive carbohydrate determinants – the carbohydrate chains found in glycoproteins. CCDs are part of a structure of many allergy-causing proteins, especially plant-based allergens like pollen.
How are CCDs involved in the allergic reaction?
During an allergic reaction, IgE is produced against the carbohydrate chains as well as the allergen proteins. Studies have confirmed that this occurs in 30% of humans, dogs and cats1-3. The IgE against CCD chains do not seem to be clinically relevant.
Why is it important to block CCDs?
Blocking CCDs means that the specificity of the in vitro test is enhanced. Evidence shows that the correlation with intra-dermal testing is also improved3.
Do you have any additional questions?Please call our medical department on +31 320 783 111 or send an email to [email protected].
1 Petersen A et al Ubiquitous structures responsible for IgE cross-reactivity between tomato fruit and grass pollen allergens J Allergy Clin Immunol 1996 Oct; 98(4):805-152 Mari A et al Specific IgE to cross-reactive carbohydrate determinants strongly affect the in vitro diagnosis of allergic diseases J Allergy Clin Immunol 1999; 103(6):1006-10113 Gedon NKY et al Agreement of serum allergen test results with unblocked and blocked IgE against cross-reactive carbohydrate determinants (CCD) and intradermal test results in atopic dogs Vet Dermatol 2019; 30(3):195
Figure 1. CCD blocking reduces non-relevant positive allergens.
With CCD blocker
375
52
47
32
49
50
21
52
35
66
60
81
415
108
2
Without CCD blocker
486
352
247
259
409
205
121
205
235
316
100
181
428
358
7
Allergens
Phleum pratense
Rumex acetosella
Corylus avellana
Dactylis glomerata
Ambrosia eliator
Urtica spp.
Ulmus americana
Poa pratensis
Artemisa vulgaris
Plantago lanceolata
Salix viminalis
Lolium perenne
Betula pendula
Chenopodium album
Positive allergens