RESUMEN
OBJECTIVE: To compare efficacy between cyclosporine and prednisone for treatment of primary immune-mediated polyarthritis (IMPA) in dogs. DESIGN: Randomized controlled clinical trial. ANIMALS: 20 client-owned dogs with primary IMPA. PROCEDURES: Dogs were randomly assigned to receive prednisone (starting at 1 mg/kg [0.45 mg/lb], PO, q 12 h; n = 10) or cyclosporine (5 mg/kg [2.3 mg/lb], PO, q 12 h; 10) for 90 days. Cyclosporine-treated dogs also received carprofen, tramadol, or both for the first 7 days for analgesia. Data collection, physical examination, and cytologic analysis of synovial fluid samples were performed on days 0, 14, 45, and 90. Trough whole blood cyclosporine concentrations were determined on days 7 to 17 for cyclosporine-treated dogs. Treatment failure was defined as lack of clinical improvement by day 14, lack of cytologic improvement by day 45, or need to change treatment because of adverse effects. RESULTS: Treatment was successful for 7 prednisone-treated dogs and 7 cyclosporine-treated dogs. Absence of synovial fluid cytologic abnormalities on day 45 was identified for 5 prednisone-treated dogs and 8 cyclosporine-treated dogs. Prednisone-treated dogs were more likely to develop polyuria, polydipsia, and polyphagia than were cyclosporine-treated dogs. Opportunistic infections (ie, demodicosis or Erysipelothrix bacteremia) were identified in 2 cyclosporine-treated dogs and 0 prednisone-treated dogs, and diarrhea developed in 1 cyclosporine-treated dog, requiring treatment discontinuation. CONCLUSIONS AND CLINICAL RELEVANCE: Although the number of dogs evaluated was small, limiting generalizability, results of this study suggested that cyclosporine offers promise as a suitable alternative to prednisone for treatment of IMPA in dogs.
Asunto(s)
Antiinflamatorios/uso terapéutico , Antirreumáticos/uso terapéutico , Artritis Reumatoide/veterinaria , Ciclosporina/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Prednisona/uso terapéutico , Administración Oral , Analgésicos Opioides/uso terapéutico , Animales , Antiinflamatorios/efectos adversos , Antiinflamatorios no Esteroideos/uso terapéutico , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Artrocentesis/veterinaria , Carbazoles/uso terapéutico , Ciclosporina/efectos adversos , Perros , Quimioterapia Combinada/veterinaria , Femenino , Masculino , Prednisona/efectos adversos , Encuestas y Cuestionarios , Tramadol/uso terapéuticoRESUMEN
OBJECTIVE: To determine results of diagnostic testing, including detection of nasal or frontal sinus fungal plaques, in dogs with nasal aspergillosis. DESIGN: Retrospective case series. ANIMALS: 46 dogs with nasal aspergillosis. PROCEDURES: Medical records were reviewed for information on computed tomographic findings; rhinoscopic findings, including whether fungal plaques were seen in the nasal cavity; results of frontal sinus trephination and sinuscopy, including whether fungal plaques were seen in the frontal sinus; and results of histologic examination of biopsy specimens. RESULTS: In 38 (83%) dogs, fungal plaques were seen in the nasal cavity during rhinoscopy, whereas in the remaining 8 (17%), fungal plaques were not seen in the nasal cavity but were seen in the frontal sinus. Duration of clinical signs, proportions of dogs in which the referring veterinarian had performed a nasal examination prior to referral, proportions of dogs with computed tomographic evidence of nasal cavity cavitation or sinus involvement, and proportions of dogs with rhinoscopic evidence of destructive rhinitis were not significantly different between dogs with nasal fungal plaques and dogs with fungal plaques only in the frontal sinus. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirm that frontal sinus involvement is common in dogs with nasal aspergillosis and suggest that frontal sinus trephination and sinuscopy may aid in the diagnosis of aspergillosis in dogs, particularly dogs with rhinoscopic evidence of destructive rhinitis and computed tomographic evidence of sinus involvement that lack detectable fungal plaques in the nasal cavity.