Studies show triamcinolone topical spray is as safe as placebo and as effective as oral prednisone
Recent research has shown that topical low-concentration (0.015%) triamcinolone acetonide spray is safe and effective for the treatment of allergic pruritus, including flea allergic dermatitis in dogs.
Douglas DeBoer, DVM, DACVD, led a study in which 103 pruritic adult dogs with known or suspected allergic skin disease were treated with topical triamcinolone spray or a topical placebo alone.1
"Topical triamcinolone is a good first choice providing you've ruled out an infection or condition that might require a different specific treatment, such as a parasitism," Dr. DeBoer says. "Once you have decided to nonspecifically treat the itch with a corticosteroid, then topical triamcinolone is a good alternative to oral prednisone."Study participants were treated according to label directions for 28 days, the approved length of treatment time. Dr. DeBoer and his fellow researchers graded skin disease by clinical score and defined treatment success as an improvement of at least two of six grades in overall score. Treatment success was evident in 67% of dogs treated with topical triamcinolone spray and 24% of dogs treated with the placebo. For several criteria (including pruritus, erythema, skin eruption, and overall score), topical triamcinolone spray was significantly more effective than the placebo at reducing clinical signs.
Researchers monitored side effects both by clinical score and by hematologic changes. Minor hematologic changes, when seen, only included slightly lower total leukocyte, lymphocyte, and eosinophil counts. Minor side effects such as increased thirst, urination, or appetite, along with minor gastrointestinal signs and spray discomfort, were reported by owners in 12% of the dogs treated with topical triamcinolone and 18% of the dogs treated with placebo. Dr. DeBoer says the low risk of side effects is an important factor.
"Many owners do not want to use a systemic corticosteroid because of the side effects, which can range from the merely annoying—urinating frequently, drinking excessively, panting—to the more serious, such as liver toxicity," Dr. DeBoer says. "None of these side effects are seen with the spray."
Application of the triamcinolone spray is generally well tolerated. In the study, some dogs disliked being sprayed simply because they were afraid, but most animals are not bothered, Dr. DeBoer says.
In another study, triamcinolone topical spray was shown to be as effective as oral prednisone in the treatment of experimental canine flea allergic dermatitis.2
These studies demonstrate that triamcinolone topical spray is effective for short-term alleviation of pruritus associated with allergic dermatitis, including flea-allergic dermatitis.
"If veterinarians have ruled out infectious and parasitic causes and don't want the dog to experience the side effects associated with oral corticosteroids, then triamcinolone spray is a good choice for providing temporary relief from significant itch," Dr. DeBoer says.
1. DeBoer DJ, Schafer JH, Salsbury DS, et al. Multiple-center study of reduced-concentration triamcinolone topical solution for the treatment of dogs with known or suspected allergic pruritus. Am J Vet Res 2002;63:408-413.
2. Frank GR, Clarke KB, Goodman FW, et al. Efficacy of a 0.015% triamcinolone acetonide topical spray in experimental canine flea allergic dermatitis (abst). Vet Dermatol 2003;14:210-236.