Page 1464 - Clinical Small Animal Internal Medicine

1402 Section 12 Skin and Ear Diseases

nitenpyram, lufenuron (+/‐ milbemycin oxime), spino- extra-label for the treatment of parasitic diseases such as
VetBooks.ir sad (+/‐ milbemycin oxime), and the newest class of par- demodicosis, sarcoptic mange, cheyletiellosis, and oto-
dectes in dogs and cats.
asiticides called isoxazolines, which include fluralaner,
afoxolaner, sarolaner and lotilaner.
Ivermectin, doramectin, moxidectin, and milbemy-
cin oxime are macrocyclic lactones that have been Systemic Medications for the Treatment
of Hormonal Disorders
used successfully to treat diseases caused by Otodectes,
Sarcoptes, Notoedres, Demodex, and Cheyletiella in Systemic medications commonly used for the treatment
dogs and cats under numerous extra‐label dosage and of hormonal disorders include mitotane, trilostane, mel-
administration regimens. atonin, and levothyroxine sodium.
Selamectin is also a macrocyclic lactone and is labeled Mitotane is an adrenolytic agent that selectively
for use in dogs and cats for the prevention and treatment destroys the zonas fasciculata and reticularis of the adre-
of fleas, ticks and biting lice, and treatment of sarcoptic nal cortex, while generally sparing the zona glomerulosa.
mange in dogs and otoacariasis in dogs and cats. It has Mitotane is indicated for the treatment of pituitary‐
also been used for the treatment of cheyletiellosis with dependent hyperadrenocorticism in dogs and may also
good results. be used in cases of adrenal‐dependent hyperadrenocorti-
Nitenpyram is a neonicotinoid labeled for the control cism; however, the induction dose may be higher and the
and treatment of flea infestation in dogs and cats. Since duration longer compared to pituitary‐dependent cases.
it is an adulticide, it should be combined with an insect Trilostane is an adrenal suppressant that reversibly
growth regulator. blocks 3‐beta‐hydroxysteroid dehydrogenase, an enzyme
Lufenuron is a benzoylurea compound that is used necessary for steroid synthesis in the adrenal cortex.
as an insect growth regulator for flea control in dogs Trilostane is approved for the treatment of hyperadreno-
and cats. corticism of pituitary or adrenal origin in dogs and may
Spinosad stimulates the nicotinic acetylcholine recep- also be beneficial for the treatment of hyperadrenocorti-
tor in insects with efficacy against adult fleas in dogs cism in cats and alopecia X or hair cycle arrest in dogs.
and cats. Melatonin is a hormone synthesized in the pineal
Isoxazolines work by selective inhibition of GABA- and gland used in dogs to treat alopecia X with anecdotal
glutamate-gated chloride channels, leading to hyper- success in 50% of cases. It may take 3–4 months for
excitation and death of the flea or tick. They are indicated beneficial effects to be noticed.
for the treatment and prevention of adult fleas and tick Levothyroxine sodium is indicated for the treatment of
infestations. Additionally, they have been used successfully hypothyroidism in dogs and cats.

Further Reading

Foy DS, Trepanier LA. Antifungal treatment of small Miller WH, Griffin CE, Campbell KL. Muller and Kirk’s
animal veterinary patients. Vet Clin North Am Small Small Animal Dermatology, 7th edn. St Louis, MO:
Anim Pract 2010; 40(6): 1171–88. Elsevier, 2013.
Graham‐Mize CA, Rosser EJ. Absorption, Nuttall T, Cole LK. Ear cleaning: the UK and US
bioavailability and activity of prednisone and perspective. Vet Dermatol 2004; 15(2): 127–36.
prednisolone in cats. In: Hillier A, Foster AP, Plumb DC. Plumb’s Veterinary Drug Handbook, 8th edn.
Kwochka KW, eds. Advances in Veterinary Dermatology, Ames, IA: Wiley‐Blackwell, 2015.
vol. 5. Oxford, UK: Blackwell Publishing, 2005, Viviano KR. Update on immunosuppressive therapies for
pp. 152–8. dogs and cats. Vet Clin North Am Small Anim Pract
Koch SN, Torres SMF, Plumb DC. Canine and Feline 2013; 43(5): 1149–70.
Dermatology Drug Handbook. Ames, IA: Wiley‐ White SD. Systemic treatment of bacterial skin infections
Blackwell, 2012. of dogs and cats. Vet Dermatol 1996; 7(3): 133–43.