The evaluation of three treatment protocols using oral prednisone and oral meloxicam for therapy of canine idiopathic lymphoplasmacytic rhinitis: a pilot study

Abstract

BackgroundIdiopathic lymphoplasmacytic rhinitis (LPR) is a common inflammatory disorder of the nasal cavity in dogs due to unknown etiology. It is characterised by non-specific clinical signs, including nasal discharge, epistaxis and breathing problems. Diagnosis is usually based on the histopathologic identification of infiltrating plasmocytes and lymphocytes in the nasal mucosa and the exclusion of other underlying diseases. Treatment strategies include glucocorticoids, non-steroidal anti-inflammatory drugs, antibiotics and antifungal medications. The aim of this study was to evaluate the efficacy of various therapeutic protocols for managing canine lymphoplasmacytic rhinitis based on the results of clinical, endoscopic and histological examinations, and to determine the relapse rate for LPR in dogs.Twenty dogs of different breeds and both sexes, aged 1 to 14 years, were divided into four groups, each consisting of five dogs, including three experimental groups diagnosed with LPR and a control group.The dogs from the first experimental group were administered prednisone orally at 1 mg/kg/day in the first 4 weeks and 0,5 mg/kg/day in the following 2 weeks. The second group of dogs was administered meloxicam orally at 0,1 mg/kg/day in the first 3 weeks, followed by prednisone at 1 mg/kg/day in the following 2 weeks and 0,5 mg/kg/day in the last week of the treatment. The dogs from the third experimental group were administered meloxicam orally at 0,1 mg/kg/day for 6 weeks. The control group of dogs was administered empty gelatin capsules (placebo) orally for 6 weeks. Clinical signs, endoscopic and histopathologic lesions were scored before and after treatment. Groups were compared using Chi- squared statistics in a 2 × 2 table for pre- versus post-treatment scores.ResultsClinical signs persisted in the group treated with meloxicam and were mostly resolved in prednisone-treated dogs. However, endoscopic and histological changes were still observed in these two groups after treatment. The severity of all diagnostic features was reduced in the group treated with meloxicam for 3 weeks followed by prednisone for 3 weeks. The significant differences (p < 0.05) were noted between experimental and control groups. The dogs showed a statistically significant reduction in characteristics of the LPR before and after treatment, as measured by clinical signs (Group 1vs.4 p = 0.00, group 2 vs 4 p = 0.00, group 3 vs 4 p = 0,01), by endoscopy (1 vs 4 p = 0,01, 2 vs 4 p = 0,00, 3 vs 4 p = 0,03), and by histopathology (groups 1 vs 4 p = 0,00, 2 vs 4 p = 0,00, 3 vs 4 p = 0,03). The significant differences were noted between experimental groups, as measured by endoscopy (group 2vs 3 p = 0,04), and by relapse rate (groups 1 and 2 p = 0,03, groups 2 and 3 p = 0,01).ConclusionsThe three treatment protocols administered to dogs improved clinical, endoscopic and histological status. However, oral administration of meloxicam for 3 weeks, followed by prednisone for 3 weeks, appeared to be the most successful treatment. These patients remain...

Pharmacokinetics of Oral Prednisone at Various Doses in Dogs: Preliminary Findings Using a Naïve Pooled-Data Approach

“…Due to their broad and dose-dependent biological effects, from physiologic replacement to anti-inflammatory and immunosuppression, glucocorticoids represent one of the most commonly prescribed classes of medication in veterinary medicine (1,2). In fact, according to a survey of three veterinary practices in the UK, 14.5% (2,913/20,019) of canine consults result in the use of systemic glucocorticoid therapy (3), including various indications such as atopic dermatitis (4), idiopathic lymphoplasmacytic rhinitis (5), and immune-mediated thrombocytopenia (6). However, the clinical benefits of corticotherapy are often accompanied by significant limitations such as variability in therapeutic response to labeled dosage and concerns for systemic toxicity; for instance, systemic adverse effects were reported in 10-81% of dogs receiving oral corticosteroids for the treatment of atopic dermatitis (4).…”

Upper digestive tract abnormalities in dogs with chronic idiopathic lymphoplasmacytic rhinitis

“…Instead, anti‐inflammatory drugs and antibiotics have shown variable therapeutic effects 2,4 . Other treatment strategies include the combination of a glucocorticoid and a nonsteroidal anti‐inflammatory drug; 8 a combination of glucocorticoids, cyclosporine and desensitization, 4 and use of antifungal medications and inhaled steroids 2,53 . In our study, all dogs that received previous symptomatic treatment for respiratory clinical signs failed to show resolution or sustained improvement.…”

“…No specific protocols are available for treating the disease, and only a single clinical trial has been reported. 8 In human medicine, CILPR remains a major problem of public health worldwide. 9 Many studies have postulated a relationship between CILPR and gastrointestinal clinical signs such as those related to gastroesophageal reflux disease (GERD).…”

“…Moreover, CILPR is not only a diagnostic but also a therapeutic challenge for clinicians. No specific protocols are available for treating the disease, and only a single clinical trial has been reported 8 . In human medicine, CILPR remains a major problem of public health worldwide 9 .…”

Severe chronic idiopathic suppurative lymphoplasmacytic rhinitis in a dog

“…No specific protocols are available for treating the disease, and only a single clinical trial of 6 weeks' duration has been reported. 12 Although chronic idiopathic lymphoplasmacytic rhinitis is not a life-threatening disease, owners are often distraught at the dog's nasal obstruction or the need to clean up nasal discharge or nasal blood frequently in the house. Despite earlier reports in the literature, systemic or topical corticosteroids are seldom effective in controlling clinical signs 12 and actually may worse them.…”