Small Animal Dermatology, 3rd edition

324 DISEASES/DISORDERS

not recommended for cats – associated with idiosyncratic toxicity (bone marrow sup-

pression).

 Ketoconazole: efficacy unknown – dogs: 10–15 mg/kg PO divided BID to TID;

anorexia and vomiting are the most common side effects; not recommended in cats;

best for medium to large dogs.

 Fluconazole: dogs: 5–10 mg/kg PO BID; cats: 10 mg/kg PO BID; less effective than

itraconazole.

 Voriconazole: dogs: 5–6 mg/kg PO BID; cats: 4 mg/kg PO as a loading dose followed

by 2 mg/kg every other day; associated with neurotoxicity in cats at high doses

(10 mg/kg); miosis and hypersalivation common at therapeutic doses.

 Terbinafine: dogs and cats: 30–40 mg/kg PO q24h; alternate weekly dosing after the

first 2 weeks of daily dosing is an option.

Topical Therapy

 Scissor clipping often recommended in long-coated patients; may help prevent envi-

ronmental contamination and allow easier application of topical therapy.

 Lime sulfur (1:16 dilution or 8 oz per gallon of water) rinses; twice weekly; odiferous

and can stain; commercial rose garden sprayer can be used to saturate the skin and

hair coat.

 Enilconazole 10% emulsion: environmental treatment or sponged directly on the ani-

mal at 0.2% solution (dilute from 10% emulsion to 0.2%) applied every 3–4 days; not

currently available in the United States.

 Miconazole 2%: available in both shampoo and “leave-on” preparations.

 Chlorhexidine 2%: when used alone, the response to chorhexidine is variable; works

synergistically with other antifungals (e.g., miconazole) to increase effectiveness.

 Bleach (Na hypochlorite) – dilute solutions applied topically as a rinse.

 Elizabethan collar, particularly in cats, is recommended to prevent ingestion of topical

products.

Precautions

 Griseofulvin:
Highly teratogenic; do not administer to pregnant animals
Bone marrow suppression (anemia, pancytopenia, and neutropenia) can occur

as an idiosyncratic reaction or with prolonged therapy

Neutropenia: fatal reaction in cats; persists after discontinuation of drug; can be

life-threatening in cats with FIV or FeLV infection

Neurologic side effects.

 Ketoconazole:
Reduces metabolism of many drugs, requiring dosage alteration
Hepatopathy has been reported and may be severe
Inhibits endogenous production of steroid hormones in dogs
Vomiting and diarrhea
Rare thrombocytopenia in dogs