dmega3 The Evidence Based Veterinary Medicine (EBVM) approach to Atopic Dermatitis and related consequences PHA Highly purified Omega 3 from fish oil

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1 PHA INNOVATION dmega3 The Evidence Based Veterinary Medicine () approach to Atopic Dermatitis and related consequences

2 DOI : / 1 j x Thisarticle isendorsed by theworldsm Small Animal Veterier naryassociationion for providinging valuable informa tionforallsmall animal vet eri narians Amendment made28 th June 2011 Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis The International Task Force on Canine Atopic Dermatitis defined this disorder as a genetically-predisposed inflammatory and pruritic allergic skin disease with characteristic clinical features associated with IgE antibodies most commonly directed to environmental allergens. 1 «The diagnosis of canine AD relies primarily on the patient s signalment, clinical signs and disease history, and not on a laboratory test» 8 List of criteria recently recommended as an aid for diagnosing AD in dogs: 1. Onset on signs under 3 years of age 2. Dog living mostly indoors 3. Glucocorticoid-responsive pruritus 4. Pruritus sine materia at onset (i.e. alesional pruritus) 5. Affected front feet 6. Affected ear pinnae 7. Nonaffected ear margins 8. Nonaffected dorso-lumbar area Source: Favrot C, Steffan J, Seewald W et al. A prospective study on the clinical features of chronic canine atopic dermatitis and its diagnosis. Veterinary 2010;21:23-30

3 Essential fatty acids supplementation has a steroid sparing effect in dogs with atopic dermatitis. 3 Mean prednisolone dosage (mg kg -1 bw) The mean dose of prednisolone in mg per kg body weight received in the active group (n = 28) ( ) and the placebo group (n = 29) ( ) in the test period (day 1 to 84). Days The recommended amount of EPA that is administered should be approximately 40 mg/kg body weight per day, administered for a minimum of 60 days mg/kg bw per day, min. 60 days For their safety and potential benefits, PUFA should be considered as a part of the therapy for canine AD. 7

4 INNOVATION dmega3: 3 Reasons to Use 1. Top quality in the market 9 Very High Concentration in Omega 3 Very High Dosage in EPA (mg) Very High Dosage in Mixed Tocopherols (mg/g) Unsurpassed purification levels 90% odorless colorless 2. Evidence Based Veterinary Medicine indications Dogs with Atopic Dermatitis (AD) and all skin conditions secondary to AD: inflammation, pruritus, dandruff. 3. Evidence Based Veterinary Medicine dosage EPA: 40 mg/kg of body weight (1 softgel capsule/8 kg bw)

5 dmega3 Scientific Background Atopic Dermatitis (AD) is a chronic skin disease that can affect dogs. The International Task Force on Canine Atopic Dermatitis defined this disorder as a genetically-predisposed inflammatory and pruritic allergic skin disease with characteristic clinical features associated with IgE antibodies most commonly directed to environmental allergens. 1 The treatment of canine AD involves the concurrent use of multiple interventions. 2 Omega 6 and Omega 3 Polyunsaturated Fatty Acid (PUFA) have been proposed for reducing signs of AD in dogs for more than 25 years. Multiple combinations of PUFA are available on the market, either in capsule or liquid forms, and most commercial diets now have enriched their PUFA content and many Randomized Controlled Clinical Trials (RCCTs) reported the efficacy of PUFA supplementations in dogs with AD. In one high-quality RCCT, PUFA supplementation decreased glucocorticoid usage after 8 weeks of treatment, 3 supporting the possibility that PUFA supplementation may be useful in reducing the daily dosage of glucocorticoid and their possible adverse effects. 4 In one study of high design quality, the efficacy of a PUFA-containing supplement and shampoo was considered as similar to that of prednisolone. 5 The supplementation of the Omega 3 Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) to the diet can promote the displacement of Arachidonic Acid (AA) with EPA or DHA and can cause a consequent decrease in the production of pro-inflammatory eicosanoids from AA for the less inflammatory eicosanoids of EPA. 6 For their safety and potential benefits, PUFA should be considered as a part of the therapy for canine AD. Omega 3 fatty acids do not form the inflammatory eicosanoid, Arachidonic Acid, and therefore, a product containing high concentration of Omega 3 should be used. 7 Based on a study, 7 the recommended amount of EPA that is administered should be approximately 40 mg/kg body weight per day, administered for a minimum of 60 days. Bibliography 1. Halliwell R. Revised nomenclature for veterinary allergy. Vet Immun Immunopat 2006;114: Olivry T, Sousa CA. The ACVD task force on canine atopic dermatitis (XIX): general principles of therapy. Vet Immun Immunopat 2001;81: Saevik BK, Bergvall K, Holm BR et al. A randomized, controlled study to evaluate the steroid sparing effect of essential fatty acid supplementation in the treatment of canine atopic dermatitis. Vet Derma 2004;15: Olivry T, Foster AP, Mueller RS et al. Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled trial. Vet Dermat 2010;21: Re`me CA, Lloyd DH, Burrows A et al. Anti-allergic shampoo and oral essential fatty acid combination therapy to relieve signs of canine atopic dermatitis: a blinded, prednisolone-controlled trial (abstract). Vet Dermat 2005;14: Logas D, Kunkle GA. Double-blinded crossover study with marine oil supplementation containing high-dose for the treatment of canine pruritic skin disease. Vet Dermatol 1994;5: Bloom P. Nonsteroidal, Nonimmunosuppressive Therapies for Pruritus. Vet Clin Small Anim 2013;43: Olivry T, DeBoer DJ, Favrot C, et al. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 2010;21: Product Technical Data Sheet.

6 PHA INNOVATION dmega3 dmega3 softgel capsules is specifically addressed for dogs affected by Atopic Dermatitis (AD) and all skin conditions secondary to Atopic Dermatitis (AD) such as: skin inflammation, pruritus, dandruff. alicubi.it pack of 30 capsules in blister pack of 80 capsules in blister How to use: dmega3 should be administered on a daily base, according to the following dosage: - up to 8 kg bw: 1 cap kg bw: 2 caps kg bw: 3 caps - above 24 kg bw: 4 caps Daily dose could be varied in accordance with your Veterinarian s suggestion. Highly purified Fish Oil: ODORLESS COLORLESS NO Heavy Metals and Pollutants NO free cholesterol NO Vitamin D & A Pharmacross Co. Ltd 60, Suite 6, G Cali Street, TA XBIEX XBX MALTA