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18 Cards in this Set
- Front
- Back
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What can cause "prednisone-resistant" pruritis
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Probably not an actual condition
-different disease (ie food allergy) -secondary infection ocurring - Malassezia, Staph infection |
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What are the benefits of Fatty acid supplements
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-30-60% of animals will show some relief
- Can modify other treatments ○ Drop Glucocorticoid dose by 25% ○ Higher effiicacy of antihistamine |
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What did the Scott study show from a omega 3/6 fatty acid diet change alone
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44% good - excellent response
lost response once diet stopped younger dogs most likely to respond |
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What tool can be used to reduce the dose needed of cyclosporin
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Ketaconazole administration - Slows down metabolism of any drugs metabolized in the liver
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What are the adverse effects of Cyclosporin
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Vomiting
Papillomatosis Gingival hyperplasia Infections (long term) $$$ |
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What are the benefits of combination therapy
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superior to single drug tx programs
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What are the indications for allergen-specific immunotherapy
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-symptomatic therapy is not effective alone
-Patient cannot tolerate medical options -Patient has conflicting concurrent medical conditions -Main manifestation of atopy is infections (Staph pyoderma) -Treats the cause not the symptoms |
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What is the process of hyposensitization
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-a gradual exposure to increasing doses of allergen
-Form IgG as a blocking ab -Results in a shift from Th2 to Th1; higher ratio of IFNy/IL4 |
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What is the hyposensitization schedule
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-weekly injections until maximum efficacy (4-9 mos)
-Reduce to every 10-14 days -Reduce every 2-4 mos based on response -seasonal variation is often necessary -reduce dose once maintenance interval is established |
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IF there is no efficacy with hyposensitization what can you try
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Lower dose
try tapered dose before stopping totally |
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What is the overall success rate with hyposensitization
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40-70%
-33% do great, little other therapy -33% do well but need additional therapy -33% show no benefit |
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What are possible adverse effects with hyposensitization
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-Increased pruritis
-swelling at injection site -Uticaria / angioedema -Anaphylaxis |
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What can cause Tx failure
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-Incorrect diagnosis
-Perpetuating factors -Concurrent pruritic disease -Incorrect doses -Poor owner/pet compliance |
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What are key management points
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-Confirm diagnosis
-Identify and control perpetuating factors -Combo therapy is better -Consider adjunctive dietary therapy -Hyposensitization is part of therapy -If replase occurs go back and check for perpetuating factors |
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What Glucocorticoids should NOT be used to treat atopy
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Long lasting injectable glucorticoids - Dexamethasone, Flumethasone
affects the h-p axis and adrenal gland |
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What can you use when patient has excessive side effects with prednisone
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Other glucocorticoids
-Prednisolone -Methylprednisolone -Triamcinolone -Dexamethasone Divided daily doses Give SC or IM |
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What are the indications for Genesis - Virban (0.015% triamcinolone)
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spot therapy
intermittent use |
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What are possible side effects associated with overuse of Genesis - Virban (0.015% triamcinolone)
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Cutaneous hypoadrenocorticism:
-Follicle dilation - comedones -Friable |
