Small Animal Dermatology, 3rd edition

196 DISEASES/DISORDERS

Minimum maintenance: 0.5 mg/kg q48–72h

Taper dosage at 2–4-week intervals.

Cytotoxic agents:

More than half of patients require the addition of other immunomodulating

drugs.

Synergistic with corticosteroids, allowing reduction in dose and side effects.

Azathioprine (2 mg/kg or 50 mg/m^2 PO q24h, then q48–72h); rarely used

in cats due to marked bone marrow suppression; feline dose 1 mg/kg

q24–48h

Chlorambucil (0.2 mg/kg daily): primary choice for cats and small dogs

Mycophenolate mofetil: 20–40 mg/kg/day PO divided BID to TID

Chrysotherapy: auranofin (0.1–0.2 mg/kg PO BID to q24h).

Cyclosporine, microemulsion:

Alternative or supplemental therapy with corticosteroids

Initial dosage: 5–10 mg/kg/day until remission; then EOD or twice weekly.

Tacrolimus topical (Protopic): apply to individual lesions daily to twice weekly.

 PE and PEP:
Cycline antibiotics: tetracycline (250 mg PO q8h dogs<10 kg; 500 mg PO q8h

dogs>10 kg); doxycycline (10 mg/kg PO q24h); minocycline (5 mg/kg PO BID);

often administered with niacinamide 250 mg PO for dogs<10 kg and 500 mg PO

for dogs>10 kg

Topical corticosteroids – betamethasone diproprionate 0.05% or fluocinolone

0.1%: apply sparingly q24h for 14 days; then EOD or twice weekly; if in remis-

sion, switch to less potent product (e.g., 0.5% or 2.5% hydrocortisone)

Topical tacrolimus 0.1%: apply sparingly q24h for 14 days; then EOD or twice

weekly

Prednisolone: 1–2 mg/kg PO BID initially tapered to EOD or twice weekly either

alone or in combination with cytotoxic immunosuppressive drugs

Azathioprine: 2 mg/kg or 50 mg/m^2 PO daily until remission; then EOD or twice

weekly; not for use in cats

Chlorambucil: 0.1–0.2 mg/kg/day until remission; then EOD or twice weekly

Cyclosporine, microemulsion: 5–10 mg/kg/day until remission; then EOD or

twice weekly.

Leflunomide: 2–4 mg/kg/day or divided BID

Mycophenolate mofetil: 20–40 mg/kg/day PO divided BID to TID

Vitamin E: 10–20 IU/kg PO q12h; may help reduce inflammation.

 PP:
Identify underlying neoplasia and resolve or control
Additional treatment similar to PF/PE.

Drugs of Choice – Pemphigoid Complex

 Cycline antibiotics: tetracycline (250 mg PO q8h dogs<10 kg; 500 mg PO q8h

dogs>10 kg); doxycycline (10 mg/kg PO q24h); minocycline (5 mg/kg PO BID); often

administered with niacinamide 250 mg PO for dogs<10 kg and 500 mg PO for dogs

>10 kg.