Page 1487 - Clinical Small Animal Internal Medicine

162 Autoimmune and Immune‐Mediated Skin Diseases 1425

Table 162.1 Immunosuppressive drug therapy
VetBooks.ir Drug Dose Comments

Pentoxifylline Dogs: 15–25 mg/kg PO q8–12h May require 8 weeks for maximum benefit
Tetracycline Dogs >10 kg receive 500 mg PO q8h This class of antibiotic combined with niacinamide
Dogs <10 kg receive 250 mg PO q8h may require 3 months for maximum benefit
Doxycycline Dogs: 5–10 mg/kg PO q12h Can be used when tetracycline is unavailable.
Use carefully in dogs with liver disease
Minocycline Dogs: 5–12.5 mg/kg PO q12h Can be used when tetracycline or doxycycline is
unavailable.
May cause more GI upset than other tetracyclines
Niacinamide Dogs >10 kg receive 500 mg PO q8–12h May cause GI upset
Dogs <10 kg receive 250 mg PO q8–12h
Prednisone Dogs: 1–3 mg/kg PO As a general rule, glucocorticoids should be
Prednisolone Cats: 2–4 mg/kg PO administered q24h until the disease is controlled.
Dexamethasone Dogs: 0.1–0.2 mg/kg PO Once the disease is controlled, they should be
Cats: 1.5 mg/average sized cat PO administered q48h or less. A slightly higher dose
administered q48h tends to have fewer side‐effects
Triamcinolone Dogs: 0.3–1 mg/kg PO than a daily dose, even if the daily dose is lower
Cats: 0.3–1 mg/kg PO
Methylprednisolone Dogs: 0.8–2 mg/kg PO or 4 mg/10 lb
Azathioprine 1.5–2.5 mg/kg PO q24–48h Dosing q48h reduces side‐effects. Monitor CBC/
chemistry q2 weeks for initial 3–4 months. May
require 2 months for maximum benefit. Do not
give to cats
Ciclosporin Dogs and cats: 5–10 mg/kg PO q24h Use the modified CSA formulation. CSA blood
level monitoring is generally not useful when
treating skin disease
Hydroxychloroquine Dogs: 5 mg/kg PO q24h
Omega 3 fatty acids Dogs: 180 mg EPA and 120 mg DHA/10 lb Use as adjunctive therapy. Benefit may not be
PO q24h noted before 8–12 weeks
Vitamin E Dogs: 200–800 IU PO q24h Use as adjunctive therapy
Chlorambucil Dogs and cats: 0.1–0.2 mg/kg PO Monitor CBC/chemistry as for azathioprine
q24–48h
Dapsone Dogs: 1 mg/kg PO q8h Monitor CBC/chemistry. Do not give to cats
Tacrolimus 0.1% Apply topically q12h
Betamethasone Apply topically q12h Topical steroids are useful for focal skin lesions.
valerate 0.1% Dermal atrophy may occur with prolonged use
Fluocinolone Apply topically q12h
(Synotic®, Zoetis)
CBC, complete blood count; CSA, ciclosporin; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; GI, gastrointestinal; IU, international
units; PO, by mouth (per os).

Differential diagnoses include systemic lupus erythe- Prognosis is generally good because DLE is limited to
matosus, pemphigus foliaceus, pemphigus erythemato- the skin. Chronic, untreated lesions may rarely progress
sus, vitiligo, trauma, and Vogt–Koyanagi–Harada‐like to squamous cell carcinoma.
syndrome.
Treatment involves sun avoidance, oral and/or topical
glucocorticoids, topical tacrolimus, niacinamide with Exfoliative Cutaneous Lupus Erythematosus
tetracycline, and ciclosporin (see Table 162.1). These Exfoliative cutaneous lupus erythematosus (ECLE) is an
therapies can be used alone or in combination, depend- autoimmune disease that affects German shorthaired
ing on response to therapy. Complications can include pointers. The disease occurs in puppies and young
secondary pyoderma. adults. Sex predilection has not been noted.