Assessment of clotrimazole gels for in vitro stability and in vivo retention in the frontal sinus of dogs

Mathews, Kyle G.; Linder, Keith E.; Davidson, Gigi; Goldman, R; Papich, Mark G.

doi:10.2460/ajvr.70.5.640

Cited by 18 publications

(29 citation statements)

References 17 publications

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“…Poloxamer 25% gel is a unique polymeric drug carrier that undergoes reverse gelation (gels as it warms to body temperature) and likely remains in the frontal sinuses longer than the commercially available cream . It has been shown to be safe when placed in the frontal sinuses of normal dogs, and appears to be safe when placed in dogs with cribriform lysis based on the results of our study . The preparation of compounded clotrimazole in poloxamer gel has been described, and many compounding pharmacies that supply sterile preparations are able to provide this product .…”

Section: Discussionmentioning

confidence: 72%

“…Four of the last 5 dogs were treated with surgical debridement of fungal granulomas followed by instillation of clotrimazole pluronic gel alone. Poloxamer 25% gel is a unique polymeric drug carrier that undergoes reverse gelation (gels as it warms to body temperature) and likely remains in the frontal sinuses longer than the commercially available cream . It has been shown to be safe when placed in the frontal sinuses of normal dogs, and appears to be safe when placed in dogs with cribriform lysis based on the results of our study .…”

Section: Discussionmentioning

confidence: 78%

“…Treatment protocols changed over time and were based on surgeon preference and information available in the scientific literature over the last 20 years. Numerous authors have studied the distribution of different antifungal compounds . Four of the last 5 dogs were treated with surgical debridement of fungal granulomas followed by instillation of clotrimazole pluronic gel alone.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown to be safe when placed in the frontal sinuses of normal dogs, and appears to be safe when placed in dogs with cribriform lysis based on the results of our study . The preparation of compounded clotrimazole in poloxamer gel has been described, and many compounding pharmacies that supply sterile preparations are able to provide this product . This method of topical therapy is relatively rapid compared with those involving a 1‐hour infusion of clotrimazole solution.…”

Section: Discussionmentioning

confidence: 99%

“…Topically applied drugs have become the standard treatment for fungal rhinitis in dogs. Numerous topical medications have been investigated including enilconazole solution, bifonazole cream, clotrimazole solution, clotrimazole cream, clotrimazole gel, and iodine cadexomer dressings . Various procedures have been developed to administer topical antifungal medications.…”

Section: Introductionmentioning

confidence: 99%

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Sinonasal aspergillosis: Outcome after topical treatment in dogs with cribriform plate lysis

Belda

Petrovitch

Mathews

2018

Veterinary Internal Medicne

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BackgroundCribriform lysis has been considered a contraindication for topical treatment of sinonasal aspergillosis (SNA) because of concerns about drug extravasation with resultant neurologic signs or death.Objective/HypothesisTo describe dogs with SNA and cribriform plate lysis treated with topical antifungal medications. Our hypothesis was that the conventional dogma that topical therapy should be avoided in these cases is incorrect.AnimalsNine client‐owned dogs with SNA and lysis of the cribriform plate, lysis of the floor of a frontal sinus or both detected by computed tomography (CT).MethodsA retrospective review of medical records was performed. Dogs that met inclusion criteria (ie, SNA confirmed by at least 1 laboratory test, braincase affected on CT, and topical treatment applied) were included. Size of lesions, ancillary diagnostic test results, topical therapy, and adjuvant PO treatments were recorded. Outcome was determined by phone calls.ResultsFour dogs were alive at the time of the manuscript submission with follow‐up ranging from 188 to 684 days without neurological signs observed. All dogs were discharged without major complication 1‐7 days postoperatively. One dog that had presented with a history of seizures experienced seizure activity 2 months after treatment.Conclusions and Clinical ImportanceTopical therapy did not result in complications in these dogs in which lytic regions as large as 16 × 22 mm2 were noted. Sinonasal aspergillosis associated lysis of the cribriform plate; lysis of the floor of a frontal sinus or both detected on CT is not necessarily a contraindication to topical therapy.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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