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A successful international exploitation artist, Ovidio G. Assonitis never met a movie he couldn't make a quick buck off of...especially if there was an even more successful movie to use as a springboard. As a producer / director he crafted his own take on The Exorcist (1974's Beyond the Door), Jaws (1977's Tentacles) and even an unofficial sequel to Piranha (1981's Piranha 2: The Spawning) on which he hired then fired director James Cameron. Probably the least notable is Madhouse, produced the same year, which is a bit of a kitchen sink giallo with elements of The Shining and a decade worth of slasher movies rolled into one. But of all the films mentioned, it's probably the most slick and cohesive of the bunch, lifting disparate batch of second-hand horror clichés - devil dogs, deformed siblings and family curses - into an often confounding but gleefully entertaining watch.

Julia (Trish Everly) and her emotionally abuse identical twin, Helen, haven't seen each other for years. But Julie agrees to a hospital visit when Father James (Dennis Robertson) insists that her sister is disfigured and close to death. Only a day later, Helen escapes from the facility and people start dying by means of a trained Rottweiler, the very same breed Helen doted on as a child. Julia, fearing for her own life, is even more shocked when one of her students at a school for deaf children winds up being the next victim.

Just what did Helen do to Julia as a child? And is her live-in doctor boyfriend, Sam (TV regular Michael MacRae) somehow involved? What about Father James who seems a little too personally involved? As we're treated to a mysterious montage of POV shots, the real killer racks up a body count that's part of a big birthday celebration...and boy won't Julia be surprised!

Assonitis’ direction is more than adept, making Madhouse look about as slick as a De Palma film on a quarter of the budget. Only the acting, which reaches a ridiculous fever pitch as the film comes to a close, betrays the exploitation origins with a pair of “gotcha” moments lifted right from the Carrie playbook. Trish Everly, who apparently never made another film, has a great '70s holdover look and plays a convincingly befuddled heroine. But in an era of strong final girls, her passive demeanor - an advanced age for a slasher target - isn't very endearing. The rest of the cast is allowed to run wild, spouting inane nursery rhymes and improvising evil with impunity.

A bit of a kitchen sink giallo, Madhouse's most famous scene is likely the same one that got it added to the list of Video Nasties in the UK, generating more interest and publicity than it ever would have otherwise. Without ruining the surprise, the fact that it involved an animal - although obviously a puppet - makes the gore more disturbing than usual...and truth be told, it's a real showstopper! Madhouse slips between so many mental cracks that its plot is hard to justify in any real narrative sense. But Assonitis know what buttons to push and like true Pavlovian dogs, horror fans likely won't be able to resist.

Arrow Video's Blu-ray / DVD combo features a stunning 2K transfer from the original camera negative along with an audio commentary from regular group contributors The Hysteria Continues. But you'll probably get more out of the new sit-down interviews with Assonitis, cinematographer Roberto D'Ettorre Piazzoli and actress Edith Ivey, a local from Savannah, Georgia, where the film was shot. Other perks includes trailers, alternate opening titles and a collectible booklet.