Small Animal Dermatology, 3rd edition

516 DISEASES/DISORDERS

 Feline leprosy syndrome:
Multiple drug oral therapy recommended
Clofazamine: 25–50 mg/cat PO q24h or rifampin 10–15 mg/kg PO q24h or clar-

ithromycin 62.5–125 mg/cat PO q24h with pradofloxacin 3 mg/kg PO q24h

Doxycycline: 5–7.5 mg/kg PO q24h

Amikacin: 10–15 mg/kg subcutaneously q24h.

 Canine leproid granuloma:
Doxycycline: 5 mg/kg PO BID
Rifampin: 10–15 mg/kg PO q24h with clarithromycin 7.5–12.5 mg/kg PO BID to

TID.

 Systemic nontuberculous mycobacteriosis:
In vitrosensitivity testing may be used to choose chemotherapy for these cases;

antibiotics reported to be effective against various isolates are macrolides, sul-

fonamides, tetracyclines, aminoglycosides, and fluoroquinolones

Anti-TB drugs are not generally effective

Multiple drug oral therapy recommended

Fluoroquinolone antibiotics, trimethoprim-sulfonamides, aminoglycosides,

tetracyclines, and clarithromycin are useful for some individual isolates; long-

term therapy should be based on sensitivity testing

Treatment should be continued for 2–6 months

Relapses upon cessation of treatment or during the course of treatment are

common.

COMMENTS

Client Education/Prognosis

 Tuberculosis: guarded but in reality, currently undefined because experience with

modern drugs that are better tolerated for long courses is limited.

 Feline leprosy: guarded to poor for syndrome 1; fair for syndrome 2, especially if

lesions are amenable to surgical excision.

 Canine leproid granuloma: prognosis is good.

 Subcutaneous and systemic nontuberculous infections: relapses are common, but

aggressive surgical approaches and multiple drug therapy may improve the outlook

over what is reported in the literature.

Patient Monitoring

 Antituberculosis and antileprosy drugs: examine at least monthly; monitor for

anorexia and weight loss.

 Hepatotoxicity: rifampin, clarithromycin, clofazamine; monitor liver enzymes

monthly.

 Nephrotoxicity: amikacin; monitor urinalysis and renal chemistries weekly.

 Gastrointestinal adverse effects: clofazamine, doxycycline.

 Instruct owners to report cutaneous lesions immediately.