CHAPTER 41 PRE- AND PARANEOPLASTIC SYNDROMES 625
Cutaneous lymphocytosis:
Prednisolone: 0.5 mg/kg PO q24h until remission; then EOD or twice
weekly
Chlorambucil: 0.1–0.2 mg/kg PO q24h until remission; then EOD or twice
weekly
Lomustine: 40–60 mg/m^2 PO every 3–6 weeks; or 10 mg PO every 3 weeks. Feline paraneoplastic dermatoses:
Pancreatic/hepatic paraneoplastic alopecia:
Removal of tumor by partial pancreatectomy may be curative; prognosis is
grave; majority of cases have metastatic disease; ultrasonography and tho-
racic radiographs may demonstrate progression
Chemotherapy or other medications: no reported response
Affected animals rapidly deteriorate; euthanasia should be suggested as
humane intervention
Supportive care: only if owners refuse to consider euthanasia; feed highly
palatable, nutrient-dense foods and/or tube feed
Progressive deterioration; death most often occurs within 2–20 weeks after
onset of skin lesions
Exfoliative dermatitis with thymoma:
Prognosis guarded
Complete surgical removal of the thymoma and sternal lymph nodes pro-
duces resolution of clinical signs within months (average 4–5 months)
Radiation therapy recommended for unresectable tumors.COMMENTS
Preneoplastic dermatoses require regular monitoring for early detection of developing
neoplasia.
Paraneoplastic dermatoses require treatment of underlying etiology (if identified) to
prevent recurrences of symptoms.
Corticosteroids: may cause polyuria, polydipsia, polyphagia, temperament changes,
diabetes mellitus, pancreatitis, and hepatotoxicity.
Azathioprine: may cause pancreatitis.
Chlorambucil: monitor CBC weekly until remission; then every 3–6 months.
Lomustine: monitor CBC 1 week after and just prior to next dosage; serum
chemistries prior to next dosage.
Isotretinoin: may cause keratoconjunctivitis sicca; extreme teratogen; do not use in
intact females because of severe and predictable teratogenicity and the extremely long
withdrawal period; women of child-bearing age should not handle this medication;
monitor serum chemistries including triglycerides, and tear production.