Oral dexamethasone sodium phosphate solution significantly reduces pruritus and clinical lesions in feline hypersensitivity dermatitis: an open‐label study

Abstract

Background There are no liquid oral glucocorticoids labelled for management of pruritus and clinical lesions of feline hypersensitivity dermatitis (feline HD). Hypothesis First, to demonstrate that dexamethasone sodium phosphate (DexSP, DexajectSP, Henry Schein; Dublin, OH, USA; 4 mg/mL), an intravenous glucocorticoid, can be absorbed by healthy cats when administered orally. Second, to demonstrate the efficacy of orally administered DexSP for reducing pruritus and clinical lesions in patients with feline HD. Animals Seven healthy and 12 client‐owned cats with HD. Methods and materials Healthy cats were administered a single dose of 0.2 mg/kg DexSP p.o. and serum concentrations were measured using enzyme‐linked immunosorbent assay (ELISA). Feline HD patients were assessed with SCORing Feline Allergic Dermatitis (SCORFAD) and pruritus Visual Analog Scale (pVAS) at Visit 1 (V1) and after 20–31 days of receiving 0.2 mg/kg/day DexSP p.o. (V2). Complete blood cell counts, serum chemistry profile, and urinalysis were performed in 50% of feline HD patients at both visits. Results Healthy cats had detectable serum concentrations of DexSP following oral administration; concentrations ranged from 0.7 to 92.3 ng/mL. Feline HD patients showed significant decreases in SCORFAD and pVAS scores from V1 to V2. Conclusions DexSP was absorbed when administered orally to healthy cats and 0.2 mg/kg/day DexSP is an efficacious dose to rapidly improve the pruritus and clinical lesions associated with feline HD.

Is oclacitinib a suitable alternative to oral glucocorticoids for the control of pruritus in cats?

“…This study's primary outcome was the improvement of the cats' pVAS scores, with the secondary outcomes including improvements in their SCORFAD and QoL scores. However, while the pVAS has been adopted for reporting clinical trials in cats, 2 it has only been formally validated for the assessment of dogs with skin disease.…”

Response to Letter to the Editor by Coyner et al.

“…4 By contrast, the dosage of DSP solution in our study was 2.5fold lower (0.2 mg/kg), with the study duration being between 21 to 30 days. 2 A single patient in our study developed transient hyperglycaemia and glucosuria, 2 which was interpreted in the letter as a diagnosis of transient diabetes mellitus. The diagnosis of feline diabetes mellitus requires laboratory changes and the presence of classic clinical signs such as polyuria, polydipsia, polyphagia and weight loss.…”

“…3 There were no clinical signs of congestive heart failure in seven cats receiving oral daily dexamethasone at 0.55 mg/kg for 56 consecutive days. 4 None of the cats in our DSP study 2 showed clinical signs of congestive heart failure or any abnormalities on routine monitoring of heart rate, rhythm and presence of murmurs. However, we agree with Coyner et al that future studies of any glucocorticoid in cats for longer durations should evaluate glucocorticoid-induced cardiac remodelling using echocardiography and simultaneous electrocardiograms.…”

“…We read with interest the letter by Coyner et al 1 concerning our publication, "Oral dexamethasone sodium phosphate solution significantly reduces pruritus and clinical lesions in feline hypersensitivity dermatitis: an open-label study." 2 We want to respond to some concerns raised in the letter regarding the interpretation of our reported study findings.…”

Concerns regarding McClintock et al. Oral dexamethasone sodium phosphate solution significantly reduces pruritus and clinical lesions in feline hypersensitivity dermatitis: an open‐label study

“…We read with interest the recent article "Oral dexamethasone sodium phosphate solution significantly reduces pruritus and clinical lesions in feline hypersensitivity dermatitis: an open-label study" by McClintock et al 1 We have been using oral dexamethasone sodium phosphate solution (Dex SP, Henry Schein; Dublin, OH, USA) (4 mg/mL) in atopic cats for several years with good success and were very pleased to see a publication documenting its efficacy. However, we were concerned by the 21 to 30 day duration of the daily dexamethasone dosing.…”