Drake Gabby J, Nuttall Tim, López Javier, Magnone William, Leclerc Antoine, Potier Romain, Lécu Alexis, Guézénec Maëlle, Kolter Lydia, Nicolau Amélie, Lemberger Karin, Pin Didier, Cosgrove Sallie B
J Zoo Wildl Med. 2017 Sep;48(3):818-828. doi: 10.1638/2016-0239.1.
Andean bear (Tremarctos ornatus) alopecia syndrome (ABAS) commonly affects captive bears, particularly sexually mature females. ABAS is characterized by bilaterally symmetrical predominantly flank alopecia with or without profound pruritus and secondary bacterial and Malassezia infections. There is no effective treatment and severely affected bears have been euthanized. This paper describes the successful management of ABAS in three female Andean bears. Skin biopsies and cytology revealed a mixed dermal inflammatory infiltrate, alopecia, hyperkeratosis, and Malassezia dermatitis. Allergen specific serology was positive for environmental allergens in one case. Hematology, serum biochemistry, and thyroid and adrenal function were normal in all cases. There was no consistent response to novel diet trials, antifungals, antihistamines, allergen specific immunotherapy, or topical antimicrobials. There was a partial response to ciclosporin (Atopica® cat, Novartis Animal Health; 5 mg/kg po, sid) in one case and oral glucocorticoids in all cases (dexamethasone sodium phosphate, [Colvasone 0.2%, Norbrook], 0.15 mg/kg po, sid or prednisolone [Deltacortene, Bruno Farmaceutici, and Megasolone 20, Coophavet], 0.3-1.2 mg/kg po, sid), but treatment was withdrawn following adverse effects. Treatment with oclacitinib maleate (Apoquel®, Zoetis; 0.46-0.5 mg/kg po, bid) resulted in rapid and complete resolution of the pruritus with subsequent improvement in demeanor and fur regrowth. After 5 mo, the bears were almost fully furred and off all other medication. Treatment was tapered to the lowest dose that prevented relapse of the pruritus (0.23-0.4 mg/kg po, sid). No adverse effects have been noted. ABAS is usually an intractable condition, and, to our knowledge, oclacitinib is the first treatment shown to result in sustained clinical improvement. Further studies on the etiology of ABAS, and on efficacy and long-term safety of oclacitinib are needed.
安第斯熊（眼镜熊，Tremarctos ornatus）脱毛综合征（ABAS）常见于圈养熊，尤其是性成熟的雌性熊。ABAS的特征是双侧对称的主要为胁腹脱毛，伴有或不伴有剧烈瘙痒以及继发性细菌和马拉色菌感染。目前尚无有效治疗方法，病情严重的熊已实施安乐死。本文描述了对三只雌性安第斯熊成功治疗ABAS的情况。皮肤活检和细胞学检查显示有混合性真皮炎症浸润、脱毛、角化过度和马拉色菌性皮炎。一例病例的变应原特异性血清学检查显示对环境变应原呈阳性。所有病例的血液学、血清生化以及甲状腺和肾上腺功能均正常。对新型饮食试验、抗真菌药、抗组胺药、变应原特异性免疫疗法或局部抗菌药均无一致的反应。一例病例对环孢素（Atopica®猫用，诺华动物保健公司；5毫克/千克口服，每日一次）有部分反应，所有病例对口服糖皮质激素均有反应（地塞米松磷酸钠，[Colvasone 0.2%，Norbrook]，0.15毫克/千克口服，每日一次或泼尼松龙[Deltacortene，Bruno Farmaceutici，以及Megasolone 20，Coophavet]，0.3 - 1.2毫克/千克口服，每日一次），但因出现不良反应而停药。用马来酸奥克拉替尼（Apoquel®，硕腾公司；0.46 - 0.5毫克/千克口服，每日两次）治疗导致瘙痒迅速完全缓解，随后熊的行为举止改善，毛发再生。5个月后，这些熊几乎完全被毛，且停用了所有其他药物。治疗逐渐减量至预防瘙痒复发的最低剂量（0.23 - 0.4毫克/千克口服，每日一次）。未观察到不良反应。ABAS通常是一种难治性疾病，据我们所知，奥克拉替尼是首个显示能带来持续临床改善的治疗药物。需要对ABAS的病因以及奥克拉替尼的疗效和长期安全性进行进一步研究。
