Dog Allergies - Treatment With Cyclosporine (Atopica)
Cyclosporine is an immunossupresant drug that is commonly used in allergic dogs. Although the exact mechanism of action is not understood, it appears to decrease allergy symptoms by dampening the cell-mediated immune response. The trade name for the veterinary version of the drug is Atopica. I usually start therapy with a daily dose for 30 days and then taper off to the least amount possible that will also keep the dog comfortable. Clients are instructed to give the drug at least one hour prior to or two hours after a meal for best effect.
In my experience, the most common side affects of cyclosporine are related to the gastrointestinal system; vomiting, diarrhea and anorexia. It may also cause excessive growth of the gums (gingival hyperplasia) as well as warts (papillomatosis). Regular dental care is needed to address these issues. The drug is not recommended in patients who have suffered with malignant cancer and is used with caution in animals with a history of liver or kidney problems.
The biggest hurdle to this therapy is cost. The drug is expensive to use, especially in large or giant breed dogs. Depending on the patient, cyclosporine may be given with another drug, ketoconazole, that is commonly used to treat fungal infections. Ketoconazole increases the duration of action by inhibiting the breakdown of cyclosporine allowing the dose to be cut by a third or so in most cases.
If your pet is on cyclosporine, do not give any other medications without first speaking to your veterinarian. Cyclosporine cross- reacts with many drugs. It may also take weeks to months to see improvement in your pet's allergies on this drug. A typical dog will show moderate improvement in 30 days and then plateau over the next 2 to 4 months. If a dog's symptoms have not improved at all after 6 weeks of therapy, I generally switch to another form of therapy because not all dogs will respond to cyclosporine.
Some in the profession believe cyclosporine is a safer alternative than utilizing steroids. I believe the jury is still out. I know of no study which provides a conclusive answer to the long-term effects of cyclosporine use versus steroids. So, if your animal is on this treatment, stay close to your veterinarian as time unfolds to insure your pet stays healthy.
In my experience, the most common side affects of cyclosporine are related to the gastrointestinal system; vomiting, diarrhea and anorexia. It may also cause excessive growth of the gums (gingival hyperplasia) as well as warts (papillomatosis). Regular dental care is needed to address these issues. The drug is not recommended in patients who have suffered with malignant cancer and is used with caution in animals with a history of liver or kidney problems.
The biggest hurdle to this therapy is cost. The drug is expensive to use, especially in large or giant breed dogs. Depending on the patient, cyclosporine may be given with another drug, ketoconazole, that is commonly used to treat fungal infections. Ketoconazole increases the duration of action by inhibiting the breakdown of cyclosporine allowing the dose to be cut by a third or so in most cases.
If your pet is on cyclosporine, do not give any other medications without first speaking to your veterinarian. Cyclosporine cross- reacts with many drugs. It may also take weeks to months to see improvement in your pet's allergies on this drug. A typical dog will show moderate improvement in 30 days and then plateau over the next 2 to 4 months. If a dog's symptoms have not improved at all after 6 weeks of therapy, I generally switch to another form of therapy because not all dogs will respond to cyclosporine.
Some in the profession believe cyclosporine is a safer alternative than utilizing steroids. I believe the jury is still out. I know of no study which provides a conclusive answer to the long-term effects of cyclosporine use versus steroids. So, if your animal is on this treatment, stay close to your veterinarian as time unfolds to insure your pet stays healthy.
Our mini schnauzer was on cyclosporine and ketoconazole long term because she is an allergic dog. As time went on, she was acting like she was aging quickly. She was getting slower and she started getting crusty bumps all over her body. At first we thought it was just part of her allergies but then she couldn't even walk right or jump. We stopped giving her the drugs and within two weeks we were seeing a HUGE improvement. Her skin looks great and she is getting more pep. One thing she can't do is eat dry food kibble. It's like her stomach won't process it. It's better if we soak the food first but she does much better on canned food or chicken and rice. We are now working on trying to get a little more weight on her. I hope the drugs didn't permanently damage her insides.
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One of the common side effects of cyclosporine is papillomatosis. The papillomas look like warts with a thick top that dries into a crust. I would guess your dog's crusty bumps are probably papillomas that should go away once the drug is stopped.
The problem walking or jumping is something I have not seen from cyclosporine or ketoconazole. I did a little research on this topic and found an article called "Neurotoxicity Of Cyclosporine". Since it is written in another language, either German or Polish, I cannot give you the Journal or authors except one named K. Ciechanowski. I am limited to the English summary that stated cyclosporine is a neurotoxin that may cause problems ranging from tremors to seizures, nothing mentioned about problems walking or jumping. Novartis Animal Health (Atopica) states that the warning for seizures is a carry-over from the human field. There is nothing I could find that would explain the problems you describe.
Since both ketoconazole and cyclosporine are hard on the liver, I would recommend performing blood work to check for liver function. In my experience, dogs with liver disease experience weight loss, weakness, vomiting, diarrhea and anorexia. Perhaps the problems walking and jumping come from weakness. If the liver function deteriorates far enough, they might even seizure from a condition called hepatic encephalopathy. I have had good luck treating liver problems with special diet and Sam-E. I don't mean to sound like a broken record, but please contact your veterinarian immediately for further help.
Good luck with your dog and thanks for writing.
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I had a similar problem with my 10 year old bichon frise and cyclosporine. She has on-going and severe allergy issues, and over the course of our investigation of her condition we did try cyclosporine. After about 2 weeks she began to stagger when she walked and had no energy and was having difficulty keeping her food down. the symptoms disappeared within 2 weeks of taking her off the medication. We had better results with kenocotizole.
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Our sheltie has seasonal allergies starting in August until the first hard freeze. Atopica has been the only pill that seems to help him. Does anyone have any suggestions for administering the pill? The strong odor is impossible to hide in any type of food, and it is a fight to force the pill down his throat. He is a gentle dog, but will bite when we try to get this certain pill down him. Any ideas? We've tried hiding it in all sorts of food and he cannot be tricked.
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Shetland sheepdogs are smart with a great sense of smell which makes them tough to medicate. I have had good luck with a product called Pill Pockets®. They come in two sizes (large for capsules and small for tablets) and two flavors (beef and chicken). If your dog has food allergies, get the hypoallergenic one.
Because your dog is so smart, you need to be very careful with how you load the medicine into the pocket and handle it. I would start by giving your dog an empty pocket for several days until he is no longer suspicious. When he thinks the pocket is a treat, move onto the next step. Put him in another room while you load the cyclosporine(Atopica®) into the pocket. Be careful not to touch the pocket with your fingers that touched the pill or you will transfer the cyclosporine scent and tip off your dog. With the capsule inside, pinch the open end of the pocket together. Make sure it is well sealed to keep the scent inside. Now, bring the loaded pocket to your dog in the other room. Do not let your dog into the room where you loaded it because he might pick up the leftover smell and refuse the pocket.
If this product does not work, contact your local compounding pharmacy about formulating the cyclosporine with a flavor like chicken or beef. If you do not know your dog's preference, ask for a small sample of both and let him choose. My cat liked the beef flavor the best. Good luck as these smart dogs do challenge us!
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