Depo-Medrone™ V
Active substance
ATC code
Species
Dog, cat and horse.
Indications
Injectable corticosteroid in dogs, cats and horses.
For the treatment of, or as part of a therapeutic regime for, inflammatory and allergic conditions in dogs and cats such as allergic or non-specific inflammatory dermal conditions, musculo-skeletal conditions, ocular/otic inflammatory conditions and other inflammatory/allergic conditions that are likely to respond to corticosteroid therapy e.g. autoimmune disorders. For the treatment of, or as part of a therapeutic regime for, musculo-skeletal conditions in horses.
Dose to be administered and administration route
The dosage needed may vary according to individual clinical circumstances such as the severity of the condition to be treated, size of animal, and clinical response.
The following dosage recommendations are therefore initial guidelines and may need slight alteration in the light of individual response. An insulin type syringe should be used to measure and administer volumes of less than 1ml.
Local: Aseptic precautions are important.
Horses: The average initial dose for a large synovial space is 120 mg (3 ml). Smaller spaces will require a correspondingly lesser dose. The intratendinous dose ranges from 80-400 mg (2-10 ml) depending on the size of the tendon.
Dogs: The average initial dose for a large synovial space is 20 mg (0.5 ml). Smaller spaces will require a correspondingly lesser dosage.
Procedure for intrasynovial injection: the anatomy of the area to be injected should be reviewed in order to ensure that the product is properly placed and that large blood vessels and nerves are avoided. The injection site is located where the synovial cavity is most superficial. The area is prepared for aseptic injection by shaving and disinfection. If there is an excess of synovia and more than 1 ml of the product is to be injected, it is advisable to aspirate a volume of fluid comparable to that which is to be injected. With the needle in place, the aspirating syringe is removed and replaced by a second syringe containing the proper amount of the product to be injected. In some animals, a transient pain or synovial flare may be elicited immediately upon injection and may last for up to two to three days. After injection, the structure may be moved gently a few times to aid mixing of the synovial fluid and the product. The site may be covered with a small sterile dressing.
Following injection, relief from clinical signs may be experienced within 12-24 hours and be sustained for a variable period but averages three to four weeks, with a range of one to more than five weeks. The continued or prolonged use of the product is discouraged.
Intramuscular:
Horses: The usual intramuscular dose for horses is 200 mg (5 ml).
Dogs and cats: The usual intramuscular dose for dogs and cats is 1-2 mg/kg.
Injections may be repeated in accordance with the severity of the condition and clinical response. Relief from clinical signs is usually sustained for up to three weeks but may range from one to more than four weeks.
For maintenance therapy in chronic conditions, initial doses should be gradually reduced until the smallest effective dose is established.
Adverse reactions
Anti-inflammatory corticosteroids, such as methylprednisolone, are known to exert a wide range of side-effects. Whilst single high doses are generally well tolerated, they may induce severe side-effects in long term use and when esters possessing a long duration of action are administered. Dosage in medium to long term use should therefore generally be kept to the minimum necessary to control clinical signs. The continued or prolonged use of this product is not generally recommended.
Steroids themselves, during treatment, may cause Cushingoid symptoms involving significant alteration of fat, carbohydrate, protein and mineral metabolism, e.g. redistribution of body fat, muscle weakness and wastage and osteoporosis may result. During therapy, effective doses suppress the Hypothalamo-Pituitary-Adrenal axis. Following cessation of treatment, signs of adrenal insufficiency extending to adrenocortical atrophy can arise and this may render the animal unable to deal adequately with stressful situations. Consideration should therefore be given to means of minimising problems of adrenal insufficiency following the withdrawal of treatment, e.g. a gradual reduction of dosage (for further discussion see standard texts).
Systemically administered corticosteroids may cause polyuria, polydipsia and polyphagia, particularly during the early stages of therapy. Some corticosteroids may cause sodium and water retention and hypokalaemia in long term use. Locally applied steroids may cause thinning of the skin and systemic corticosteroids have caused deposition of calcium in the skin (calcinosis cutis).
Corticosteroids may delay wound healing and the immunosuppressant actions may weaken resistance to or exacerbate existing infections. In the presence of bacterial infection, anti-bacterial drug cover is usually required when steroids are used. In the presence of viral infections, steroids may worsen or hasten the progress of the disease.
Gastrointestinal ulceration has been reported in animals treated with corticosteroids and gastrointestinal ulceration may be exacerbated by steroids in patients given non-steroidal anti-inflammatory drugs and in corticosteroid treated animals with spinal cord trauma. Steroids may cause enlargement of the liver (hepatomegaly) with increased serum hepatic enzymes.
