Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005–2011)

Barnoon, Itai; Shamir, Merav H.; Aroch, Itamar; Bdolah‐Abram, Tali; Srugo, I.; Konstantin, Lilach; Chai, Orit

doi:10.1111/vec.12399

Cited by 34 publications

(62 citation statements)

References 24 publications

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“…Recommended starting dosages for mycophenolate mofetil in dogs have varied from 10 to 20 mg/kg PO q12h, but gastrointestinal signs at the higher end of the dosage range often will necessitate dose reductions. Reported prevalence of diarrhea can be ≥20%, and may be delayed for 1‐2 weeks after starting treatment . Generally, starting dosages of 7‐10 mg/kg PO q12h (14‐20 mg/kg total daily dose) are associated with a much lower prevalence of diarrhea .…”

Section: Results and Recommendationsmentioning

confidence: 99%

“…Although the most commonly used form of mycophenolate (mycophenolate mofetil) is generally well tolerated in dogs, gastrointestinal adverse effects can sometimes limit the use of the drug. 6,50,[94][95][96][97][98] In some cases, ulcerative colitis may develop that warrants discontinuation of the drug.…”

Section: Rationalementioning

confidence: 99%

“…Reported prevalence of diarrhea can be ≥20%, and may be delayed for 1-2 weeks after starting treatment. 6,50,[94][95][96][97][98] Generally, starting dosages of 7-10 mg/kg PO q12h (14-20 mg/kg total daily dose) are associated with a much lower prevalence of diarrhea. 99,100 In stable patients, therefore, a starting dosage of 8-12 mg/kg q12h is recommended.…”

Section: Rationalementioning

confidence: 99%

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ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs

Swann

Garden

Fellman

et al. 2019

Veterinary Internal Medicne

187

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Immune‐mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. To address this inconsistency and provide evidence‐based guidelines for treatment of IMHA in dogs, we identified and extracted data from studies published in the veterinary literature. We developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria, explanation of treatment regimens, and validity of statistical methods. In combination with our clinical experience and comparable guidelines for humans afflicted with autoimmune hemolytic anemia, we used the conclusions of this process to make a set of clinical recommendations regarding treatment of IMHA in dogs, which we refined subsequently by conducting several iterations of Delphi review. Additionally, we considered emerging treatments for IMHA in dogs and highlighted areas deserving of future research. Comments were solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted for publication. The resulting document is intended to provide clinical guidelines for management of IMHA in dogs. These guidelines should be implemented pragmatically, with consideration of animal, owner, and veterinary factors that may vary among cases.

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Section: Results and Recommendationsmentioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

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ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs

Swann

Garden

Fellman

et al. 2019

Veterinary Internal Medicne

187

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“…Fundus changes were discovered at a higher rate than previously described, although remained mild compared with the extent of vision disturbance and ERG changes. Mycophenolate mofetil treatment resulted in two dogs experiencing minor adverse effects including lethargy, vomiting, and diarrhea, similar to the 20%–67% incidence of similar adverse effects reported in other studies . Adverse effects were ameliorated by dose reduction, as also noted in another study .…”

Section: Discussionmentioning

confidence: 99%

“…We selected the immunomodulatory medication MMF as the therapeutic drug in this pilot clinical trial due to its rapid onset of action, and its published use as sole agent to treat immune‐mediated diseases in veterinary patients . Side effects in dogs include gastrointestinal upset, lethargy, and weight loss; however, these are infrequent, generally mild, and commonly responsive to dose reduction . Mycophenolate mofetil is metabolized to mycophenolic acid, a potent, selective, and reversible inhibitor of inosine‐5‐monophosphate dehydrogenase (IMPDH), which is required for synthesis of guanosine nucleotides.…”

Section: Introductionmentioning

confidence: 99%

Clinical therapeutic efficacy of mycophenolate mofetil in the treatment of SARDS in dogs—a prospective open‐label pilot study

Young

Williams

et al. 2018

Veterinary Ophthalmology

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Expression of platelet‐derived growth factor receptor‐α/ß, vascular endothelial growth factor receptor‐2, c‐Abl, and c‐Kit in canine granulomatous meningoencephalitis and necrotizing encephalitis

Song

Hwang

et al. 2020

Veterinary Medicine & Sci

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Background Given the active research on targeted therapy using tyrosine kinase (TK) inhibitors (TKIs) in the field of oncology, further studies have recently been conducted to evaluate their use in autoimmune disorders. Based on immunological investigations, previous studies have suggested that granulomatous meningoencephalomyelitis (GME) and necrotizing encephalomyelitis (NE) are similar to multiple sclerosis (MS), which is a human autoimmune demyelinating central nervous system disease. Objectives Considering this perspective, we hypothesized that canine GME and NE have significant expression of one or more TKs, which are associated with human MS pathogenesis. Methods To determine the possible use of conventional multi‐targeted TKIs as a treatment for canine GME and NE, we characterized the immunohistochemical expression of platelet‐derived growth factor receptor (PDGFR)‐α, PDGFR‐ß, vascular endothelial growth factor receptor (VEGFR)‐2, c‐Abl and c‐Kit in GME and NE samples. Results Histological samples from four dogs with GME and three with NE were retrieved. All samples stained positive for PDGFR‐ß (7/7 [100%]). PDGFR‐α and c‐Kit were expressed in 3/7 (42.8%) samples each. c‐Abl was identified in 2/7 (28.5%) samples; no sample showed VEGFR‐2 (0%) expression. Co‐expression of TKs was identified in 6/7 (85.7%) dogs. Conclusions All samples were positive for at least one or more of PDGFR‐α, PDGFR‐ß, c‐Kit and c‐Abl, which are known as the target TKs of conventional multi‐targeted TKIs. Their presence does suggest that these TKs may play a role in the pathogenesis of GME and NE. Therefore, multi‐targeted TKIs may provide benefits in the treatment of canine GME and NE by suppressing the activity of these TKs.

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Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005–2011)

Cited by 34 publications

References 24 publications

ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs

ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs

Clinical therapeutic efficacy of mycophenolate mofetil in the treatment of SARDS in dogs—a prospective open‐label pilot study

Expression of platelet‐derived growth factor receptor‐α/ß, vascular endothelial growth factor receptor‐2, c‐Abl, and c‐Kit in canine granulomatous meningoencephalitis and necrotizing encephalitis

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