Glucocorticoids, Cyclosporine, Azathioprine, Chlorambucil, and Mycophenolate in Dogs and Cats

Viviano, Katrina R.

doi:10.1016/j.cvsm.2022.01.009

Cited by 22 publications

(25 citation statements)

References 145 publications

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“…The secondary immunosuppressive agents studied in MUO include antiproliferative agents (e.g., lomustine, procarbazine, cyclophosphamide), antimetabolites (e.g., cytosine arabinoside, azathioprine, mycophenolate mofetil, leflunomide) and calcineurin inhibitors (e.g., cyclosporine) ( 2 , 4 ). Many of these more established medical second line immunosuppressive agents carry the risk of side effects, including gastrointestinal disturbances ( 36 , 37 ), the potential risk for hepatotoxicity ( 38 ), myelosuppression ( 12 ) and more drug-specific side effects ( 3 , 39 , 40 ). Thus, alternative treatments for MUO are required.…”

Section: Discussionmentioning

confidence: 99%

A shortened whole brain radiation therapy protocol for meningoencephalitis of unknown origin in dogs

et al. 2023

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IntroductionA variety of treatment options have been described for canine meningoencephalitis of unknown origin (MUO). Few studies focused on radiation therapy as a second line immunomodulating treatment, implicating its effective use. However, a standard radiation therapy protocol is lacking, and further research will help to evaluate the effect of different dose regimens.MethodsTen dogs diagnosed with MUO based on MRI and CSF findings were prospectively enrolled. The dogs were treated with a shortened whole brain radiation therapy protocol (5 × 4 Gy) in combination with prednisolone. Neurologic changes were quantified using an established scoring scheme. Follow-up MRI and CSF examination was scheduled three months after radiation therapy. Overall survival and time to progression were calculated. Histopathology of the brain was performed in case of death.ResultsSeven dogs were diagnosed de novo and three had a history of relapsing MUO. Neurological status improved in all 10 dogs during radiation therapy, with 4/10 returning to normal shortly after radiation therapy. Three dogs died within the first three months after radiation therapy. At follow-up MRI lesions completely resolved in two dogs, partially resolved in five dogs, and progressed in one dog. After follow-up MRI, dogs were further treated with prednisolone monotherapy (two dogs) and additional immunosuppressant drugs (five dogs). Overall, four dogs showed disease progression, with a mean time to progression of 691 days (95%CI: 396–987) and mean overall survival for all dogs was 723 days (95%CI: 436–1011) (both medians not reached). Histopathology confirmed MUO in three dogs but was suggestive for oligodendroglioma in one dog. Radiation induced side effects were not seen.ConclusionShortened whole-brain radiation therapy could be an additional treatment option for MUO in conjunction to prednisolone, specifically for cases that require rapid relief of symptoms and with relapsing history.

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Section: Discussionmentioning

confidence: 99%

A shortened whole brain radiation therapy protocol for meningoencephalitis of unknown origin in dogs

et al. 2023

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“…1,5 however, independent of this 'devil's advocate' point of view, the authors' appeal for the rational use of glucocorticoids by veterinarians is soundly grounded in a potential and biologically plausible risk factor, and in strong, confident research results. Despite glucocorticoids being the cheaper and generally most effective immunomodulatory drugs on the market, clinicians should attempt to assess the presence of other potential CDM risk factors in an animal before prescribing, consider other immunomodulatory options, 29 and critically evaluate the need for such treatment. Another interesting area covered by heeley and colleagues' study relates to the impact of the intestinal microbiome on the pathogenesis of diabetes.…”

Section: What You Need To Knowmentioning

confidence: 99%

Canine diabetes mellitus: assessing risk factors to inform preventive measures

Pöppl

2023

Veterinary Record

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“…Immunosuppressive drugs, such as glucocorticoids, cyclosporine, or tumour chemotherapeutics, are commonly used in cats with various diseases [ 119 , 120 ]. If used short-term, vaccination should be postponed until at least three months after the end of the treatment, but some cats require long-term therapy.…”

Section: Cats Receiving Immunosuppressive Therapymentioning

confidence: 99%

Vaccination of Immunocompromised Cats

Hartmann¹,

Möstl

Lloret

et al. 2022

Viruses

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Immunocompromise is a common condition in cats, especially due to widespread infections with immunosuppressive viruses, such as feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV), but also due to chronic non-infectious diseases, such as tumours, diabetes mellitus, and chronic kidney disease, as well as treatment with immunosuppressive drugs, such as glucocorticoids, cyclosporins, or tumour chemotherapy. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of experts in feline medicine from eleven European countries, discusses the current knowledge and rationale for vaccination of immunocompromised cats. So far, there are few data available on vaccination of immunocompromised cats, and sometimes studies produce controversial results. Thus, this guideline summarizes the available scientific studies and fills in the gaps with expert opinion, where scientific studies are missing. Ultimately, this review aims to help veterinarians with their decision-making in how best to vaccinate immunocompromised cats.

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Glucocorticoids, Cyclosporine, Azathioprine, Chlorambucil, and Mycophenolate in Dogs and Cats

Cited by 22 publications

References 145 publications

A shortened whole brain radiation therapy protocol for meningoencephalitis of unknown origin in dogs

A shortened whole brain radiation therapy protocol for meningoencephalitis of unknown origin in dogs

Canine diabetes mellitus: assessing risk factors to inform preventive measures

Vaccination of Immunocompromised Cats

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