Page 1253 - Small Animal Internal Medicine, 6th Edition

CHAPTER 72 Treatment of Primary Immune-Mediated Diseases 1225

TABLE 72.2
VetBooks.ir Immunosuppressive Drugs Used in Treatment of Immune-Mediated Diseases in Dogs and Cats

DRUG DOSE (DOG) DOSE (CAT) ADVERSE EFFECTS RECOMMENDED
MONITORING
Prednisone 2-4 mg/kg/day 2-8 mg/kg/day Signs of History and physical
hyperadrenocorticism, examination, CBC,
gastrointestinal biochemical panel;
ulceration, predisposition monitor parameters of
to infection disease progression
Azathioprine 2 mg/kg/day initially. Not recommended Bone marrow suppression, CBC, platelet count,
Dose can be gastrointestinal upset, liver enzymes
decreased to every hepatotoxicity, biweekly for 2
other day to reduce pancreatitis months, then monthly
risk of toxicity
Chlorambucil 0.1-0.2 mg/kg PO 0.1-0.2 mg/kg PO Myelosuppression CBC and platelet count
q24h initially, then q24h initially, then weekly initially; may
taper to every other q24-72h decrease to biweekly
day once a response or monthly once
is seen stable
Cyclosporine 5-10 mg/kg PO 3-5 mg/kg PO q12h Gastrointestinal upset, CBC and biochemical
q12-24h Recommend using infection, gingival panel monthly
Recommend using only only Atopica® due hyperplasia,
Atopica® due to to concerns for papillomatosis,
concerns for bioavailability of increased shedding
bioavailability of other products
other products.
Lower doses of
1-2.5 mg/kg q12h if
in conjunction with
ketoconazole (see
Table 72.4)
Vincristine 0.02 mg/kg IV as a NA Myelosuppression, Daily CBC and platelet
single dose for thrombophlebitis if count to monitor
treatment of ITP allowed to extravasate response of platelets
outside vein
hIVIG 0.25-1.5 g/kg as an NA Vomiting, mild Monitor animal during
IV infusion over thrombocytopenia in administration by
6-12 h (one dose normal dogs frequent TPR
only) measurements, CBC
and platelet count for
disease monitoring
Mycophenolate 10 mg/kg PO q12h 10 mg/kg PO q12h Gastrointestinal upset, CBC and biochemical
mofetil hemorrhagic diarrhea panel monthly
Leflunomide 2-4 mg/kg PO q24h NA Decreased appetite,
lethargy, mild anemia,
and hematemesis or
hematochezia

CBC, Complete blood count; hIVIG, human intravenous immunoglobin; ITP, immune-mediated thrombocytopenia; NA, not applicable; TPR,
total parenteral nutrition.

monitoring is available to assess the degree of T-cell sup- 39762; [662]312-8836). There is considerable interindividual
pression achieved by a given dose of cyclosporine. This variability in the concentration of cyclosporine required to
monitoring is available through the Pharmacodynamic Lab- achieve a therapeutic goal. Therefore following the guidelines
oratory at Mississippi State University (Diagnostic Labora- of individual laboratories regarding the therapeutic range is
tory Services, 240 Wise Center Drive, Mississippi State, MS important. However, clinical response is a very important