Medrone V
Active substance
ATC code
Species
Dogs and cats
Indications
For the treatment of, or as part of a therapeutic regime for inflammatory and allergic conditions 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. immune-mediated disorders.
Dose to be administered and administration route
The dosage needed may vary according to individual clinical circumstances such as severity of the condition to be treated, the anticipated duration of therapy and even to take into account the individuals case history.
The following dosage recommendations are therefore initial guidelines and may require modification in the light of individual clinical circumstances.
|
Bodyweight |
Average total daily dosage |
|
1-5 kg |
1 mg |
|
5-9 kg |
2 mg |
|
9-18 kg |
2 to 4 mg |
|
18-36 kg |
4 to 8 mg |
The initial daily dose should be given in two equally divided doses.
In order to control clinical signs of certain autoimmune disorders e.g. Pemphigus vulgaris, the initial dosage may have to be higher than that suggested above.
As soon as a satisfactory clinical response is achieved, the daily dose should be reduced gradually, either to termination of treatment in the case of acute conditions or to the minimal effective maintenance dose level in the case of chronic conditions.
The veterinary surgeon may, at his/her discretion, use alternate day therapy in order to maintain minimal effective therapy of chronic conditions: dogs should be treated on every alternate morning and cats on every alternate evening.
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.
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. dosing to coincide with the time of the endogenous cortisol peak (i.e. in the morning with regard to dogs and the evening with regard to cats) and 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 longer term use.
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 g.i.t. ulceration may be exacerbated by steroids in patients given non-steroidal anti-inflammatory drugs and in animals with spinal cord trauma. Steroids may cause enlargement of the liver (hepatomegaly) with increased serum hepatic enzymes.
During a course of treatment the situation should be reviewed frequently by close veterinary supervision.
