Therapies to get patients through a tough allergy season - DVM
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Therapies to get patients through a tough allergy season


DVM360 MAGAZINE


Cyclosporine for atopy appears to be a work in progress, and we still are adding to the list of side effects seen with long-term use. Some owners will start using cyclo sporine for the more rapid relief of allergy symptoms, then elect to start immunotherapy injections because of the expense.

Steroids

While steroids can give immediate relief to atopic patients, the key is to use them infrequently, at low doses (preferably short-acting and every other day) and monitor their use.

Because they do tend to work well, owners get in a habit of administering them as a daily routine without regard to whether the pet actually needs the drug.

Soon you have an iatrogenic Cushingoid dog that you as the veterinarian see, but the owner has no idea what they've created. So be stingy in dispensing steroids and maintain close communication with the owner, so that the dog is not on prolonged steroid use.

One way to use less steroid is to change to Temaril P, which is a combination of anti histamine (not to be used in seizure patients) and steroid. It can be a good first attempt of getting a patient from using prednisone 20mg daily to one or two tablets of Temaril P daily, which would total 2 mg to 4 mg prednisolone daily — quite a reduction.


Alice Jeromin DVM, Dipl. ACVD
Short-term use of low-dose, alternate-day, short-acting steroids such as prednisone may be acceptable in getting the atopic patient through a tough few weeks of their season, but now that cyclosporine is available as an alternative, or even topicals such as Resicort may suffice, try those first instead.

Dr. Jeromin is a pharmacist and veterinary dermatologist in private practice in Cleveland, Ohio. She is a 1989 graduate of The Ohio State University College of Veterinary Medicine and an adjunct professor at Case Western Reserve University's College of Medicine in Cleveland.


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Source: DVM360 MAGAZINE,
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