Cyclosporin has been increasingly used for the treatment of skin diseases in small animals. Reported uses include the treatment of atopy, cutaneous lupus erythematosus, feline acquired alopecia resembling pseudopelade of humans, pemphigus erythematosus, pemphigus foliaceus, perianal fistulae and sebaceous adenitis. In addition, cyclosporin has been used anecdotally for several other skin diseases. Few side effects have been noted at doses therapeutic for dermatologic diseases. Current suggestions for monitoring, and the value of trough cyclosporin serum concentrations for prediction of toxicity and efficacy are discussed.
Background
Prednisone doses of up to 8 mg/kg/day have been used to treat feline pemphigus foliaceus (PF). Oral prednisolone has more favourable pharmacokinetics in cats than prednisone; therefore, lower doses of prednisolone may be effective in treating feline PF.
Hypothesis/Objectives
To assess the dose of prednisolone required to induce and maintain remission of PF in cats.
Animals
Thirty‐seven client‐owned cats with a diagnosis of PF treated with prednisolone monotherapy for induction of remission.
Methods
A retrospective analysis of records of a veterinary dermatology referral practice between the years of 1995 and 2013 was carried out. History, clinical signs, cytological and/or histopathological findings, lack of response to antimicrobials, absence of fungal hyphae on periodic acid Schiff staining and/or negative fungal culture and positive response to immunosuppressive therapy were used to confirm the diagnosis. Cats were included in the study if prednisolone was used as the monotherapy induction protocol.
Results
Complete remission was achieved within 8 weeks in 97% of cats with a median induction dose of 2 mg/kg prednisolone daily. In cats requiring ongoing treatment, 67% were maintained in remission with prednisolone monotherapy. The median maintenance dose was 1.2 mg/kg/week. In 14% of cats, medication was eventually discontinued.
Conclusions and clinical importance
Daily prednisolone at 2 mg/kg is an effective dose for inducing remission of PF in cats. Adverse effects were uncommon with this dose. In a small population, permanent remission may be induced. Secondary bacterial overgrowth and exudate in claw folds resolved in all cases with immunosuppressive therapy; therefore, antimicrobial therapy may be unnecessary.
Pyoderma gangrenosum is a rare disease distinguished by rapid progression of painful, necrolytic, cutaneous ulcers with irregular, violaceous undermined borders. Azathioprine with glucocorticoids may lead to a better outcome than ciclosporin and glucocorticoids (currently the first-line treatment in humans and the only reported treatment in dogs).
Cyclosporin was well tolerated and efficacious in the symptomatic treatment of atopic dermatitis in dogs attending two veterinary dermatology referral centres in Australia, under Australian field conditions, when administered at 5 mg/kg/day for 6 weeks.
An 8-month-old, crossbred dog, presented with a painful, swollen face. The problem was of 4 weeks duration and had not responded to antibiotics. A diagnosis of canine juvenile cellulitis was based on the clinical presentation and supportive cytological and histopathological changes. Attempts to identify canine distemper virus were not successful. Complete resolution occurred with glucocorticoid therapy. This is the first report of canine juvenile cellulitis in a dog of this age.
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