Use of Glucocorticoids Flashcards
Are apoquel and cyclosporine steroids?
No, they have steroid like effects without some of the side effects but are much more expensive
What is the general rule for using steroids?
Use an appropriate dose and the shortest acting effective agent for the intended purpose
What are the two broad stages in treating immune mediated disease with steroids?
Induction of remission: high dose once daily
Maintenance of remission: alternate day GC therapy with synergistic non-steroidal immunosuppressants
What is the dose of prednisolone required to induce remission in dogs with immune mediated disease?
2-3mg/kg/24h
why are cats more steroid resistant than dogs?
Possibly due to decreased GC receptors in various organs cf dogs
What is the induction dose rate of prednisolone in cats?
4-5mg/kg/day
How long do you use the induction dose for (prednisolone)?
10 days
What should the dose rate be in dogs for days 10-20 when using pred to treat immune mediated disease?
2mg/kg/day
What is the non steroidal immunosuppressant of choice to be used in conjunction with pred for maintenance of remission in dogs and cats?
dogs-azathioprine
cats-chlorambucil
What is the maintenance dose of pred for dogs from day 20?
2mg/kg EVERY OTHER DAY
When should you start your alternate day azathioprine/chlorambucil?
Day 1 of induction treatment
How often should you taper the dose?
every 2-4 weeks. Want to get the dose as low as maintainable in this phase without having clinical signs.
Why is it important to achieve a prednisolone dose of
Any greater than this does not allow the adrenal gland to ‘rest’ on the off day
Should you give gastroprotectants to animals on glucocorticoids?
Can do if it makes you happy but there’s no evidence for it
What are the two most common side effects of GC therapy?
PUPD
Polyphagia
both psychogenic
