Small Animal Dermatology, 3rd edition

660 DISEASES/DISORDERS

THERAPEUTICS

 The zoonotic nature of sporotrichosis must be considered when treating an animal

with this disease; outpatient therapy increases the potential for human exposure;

human infection has been reported without history of an injury or wound.

 Sensitivity testing is particularly difficult due to the dimorphic nature ofSporothrix

spp. as well as a lack of standardization for testing methods; geographic differences in

sensitivity have been reported; the broth microdilution assay is most often utilized.

Drugs of Choice

 Supersaturated solution of potassium iodide (SSKI: potassium iodide oral solution):
Dogs: 40 mg/kg PO BID with food
Cats: initial dosage 2.5 mg/kg PO q24h with food, increasing every 5 days until

clinical remission or toxicity is noted; final dosage typically 10–20 mg/kg

Treatment continued for at least 30 days after resolution of the clinical lesions;

typical treatment length 2 months

Discontinue treatment for 1 week if signs of iodism are noted; reinstitute at a

lower dosage and increase in increments of 2.5 mg/kg to the highest dosage that

does not cause signs of iodism

Signs of iodism:

Dogs: dry or scaly hair coat, nasal or ocular discharge, inappetance or vom-

iting, depression or collapse; if symptoms are severe or recurrent, other

drugs should be considered

Cat: depression, vomiting, anorexia, twitching, hypothermia, or cardiovas-

cular collapse.

 Imidazole and triazole antifungals:
Dogs:
Ketoconazole 5–15 mg/kg PO BID: side effects (mild) include anorexia,
vomiting
Itraconazole 5–10 mg/kg PO q24h or divided BID: side effects (uncommon)
include hepatotoxicity (elevated ALT), vasculitis
Posaconazole 5–10 mg/kg PO q24h or divided BID: side effects include
anorexia, vomiting, hepatotoxicity
Cats:
Ketoconazole 5–10 mg/kg PO q24h: side effects (common) include
anorexia, vomiting, depression, fever, hepatotoxicity, neurologic distur-
bances
Itraconazole 5–15 mg/kg PO q24h or divided BID: side effects (uncommon)
include anorexia, vomiting, depression, hepatotoxicity
Posaconazole 5–7.5 mg/kg PO q24h or divided BID: side effects include
anorexia, vomiting, hepatotoxicity, facial pruritus
Treatment continued for at least 30 days after resolution of the clinical lesions;

typical treatment length 3 months.