Dr. Bloom welcome dermatology questions from veterinarians and veterinary technicians.
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Q. What is your dosing protocol for long-term cyclosporine therapy in dogs? Do you treat dogs seasonally?
A. First, let's look at appropriate situations in which to use modified cyclosporine in atopic dogs. Keep in mind that in all of these situations, the patient should have moderately severe or severe pruritus, have been found to have atopic dermatitis due to environmental allergies, and have had cutaneous adverse food reactions, flea allergy dermatitis, pyoderma, and Malassezia dermatitis ruled out as a cause of the allergies. As long as dogs meet these criteria, I use modified cyclosporine:
GETTY IMAGES / LUIS ALVAREZ
- To be able to withdraw corticosteroids from dogs that have been receiving them for more than two continuous months—I use it to try to prevent exacerbation of pruritus.
- To control pruritus in patients in which I want to perform intradermal testing, since patients cannot have received prednisone orally or topically for 30 days before testing, a triamcinolone injection for 30 days before, or a methylprednisolone injection for 90 days before
- To control pruritus in patients as I await response to allergen-specific immunotherapy (six to 12 months)
- In dogs that have unacceptable side effects to corticosteroids
- In cases in which owners have what I call steroidphobia—in other words, they don't ever want to their dogs to receive corticosteroids but the pruritus is intense
- In dogs that have diseases that are complicated by corticosteroids, such as diabetes mellitus or recurrent pyoderma.