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Triamcinolone acetonide 0.015 %
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Topically every 12–24 hours
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Indicated for acute flares and localized lesions
Best suited for short-term use (7–14 days); adverse effects include cutaneous atrophy and calcinosis cutis
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Topically every 12–24 hours
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Topically every 12–24 hours
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Topically every 12–24 hours
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Induction or initial dose: 0.5–1 mg/kg, PO, every 24 hours
target dose after tapering: 0.25–0.5 mg/kg, PO, every 48 hours
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Indicated for acute flares
Broad, nonspecific anti-inflammatory response
Many potential adverse effects
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Initial dose: 5 mg/kg, PO, every 24 hours; tapered to the lowest dose that controls the disease
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Indicated for longterm management
Can take 4–6 weeks to achieve clinical improvement
Not suitable for treatment of acute flares
Most common adverse effects are GI signs
Indicated for localized lesions
Appears to be safe for short-term use
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Topically every 12–24 hours
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5 mcg/kg, PO, every 8 hours
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Phosphodiesterase inhibitors
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10 mg/kg, PO, every 12 hours, or 20 mg/kg, PO, every 8 hours
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May be best suited as adjunctive therapy for chronic conditions
Slow onset of action (4–6 weeks)
Not suited for acute flares
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18 mg/kg, PO, every 24 hours
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Helpful for mild pruritus
Best as part of combination therapy
Sparing agents for glucocorticoids
Not suitable for acute flares
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2 mg/kg, PO, every 12 hours
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Hydroxyzine + chlorpheniramine
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(20.9 mg + 0.7 mg)/10 kg (divided), PO, every 12 hours
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0.5–1 mg/kg, PO, every 12 hours
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High-quality fish oil (with EPA and DHA)
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300 mg/4.5 kg, PO, every 24 hours
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No current evidence of superior efficacy of any particular combination, dosage, ratio, or formulation to improve skin and coat quality and reduce pruritus
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0.4–0.6 mg/kg, PO, every 12 hours for 2 weeks, then every 24 hours
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Indicated for acute flares and longterm management
Fast onset of action (within 24 hours) for pruritus control
Most common adverse effects are GI signs
Contraindicated in dogs with serious infections or neoplasia
May increase susceptibility to infections, demodicosis, and neoplastic conditions
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2 mg/kg, SC, every 2–8 weeks
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Indicated for acute flares and longterm management
Fast onset of action (1–3 days) for pruritus control
Most common adverse effects are lethargy and vomiting
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Subcutaneous allergen-specific immunotherapy (SCIT)
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Various protocols exist; adjust dosage and schedule for each patient
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Very specific targeted effect
Slow onset of action (up to 12 months)
Not useful for acute flares
Most common adverse reaction is worsening of pruritus
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Oral immunotherapy (SLIT)
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Pump dispenser directly onto oral mucosa, between the lip and the gum, every 12 hours
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Most common adverse reactions are face rubbing, transient worsening of pruritus, and GI signs
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