Comparison of body surface area-based and weight-based dosing format for oral prednisolone administration in small and large-breed dogs

Nam, Aryung; Kim, S. M.; Jeong, Jong-Woo; Song, Kun; Koo, Tae‐Sung; Seo, Kyoung Won

doi:10.1515/pjvs-2017-0076

Cited by 10 publications

(11 citation statements)

References 6 publications

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“…Many BCCs and practitioners in PCPs made allowance for bodyweight when selecting doses of prednisolone for initial treatment of dogs with IMHA. This is important because metabolic rate is more closely related to surface area than bodyweight [ 28 ], meaning that lower total doses are required to achieve the same blood concentrations of prednisolone in larger dogs [ 29 ]. Consequently, dosing according to surface area may be an effective practice to limit adverse effects in larger dogs, as recommended previously [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional study of approaches to diagnosis and management of dogs with immune-mediated haemolytic anaemia in primary care and referral veterinary practices in the United Kingdom

et al. 2021

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Objectives To determine whether veterinarians in primary care practices (PCPs) and board-certified clinicians (BCCs) approach treatment of dogs with immune-mediated haemolytic anaemia (IMHA) similarly, and whether practitioners with more experience treat similarly to those with less experience. We hypothesised those in PCPs would show more variation in their approach to similar cases than BCCs. Methods A cross-sectional study was conducted by distributing a questionnaire to BCCs and veterinarians in PCPs. The questionnaire included direct questions and a number of clinical scenarios intended to capture approaches to common treatment problems. Results Questionnaire responses were received from 241 veterinarians, including 216 in PCPs and 25 BCCs. Veterinarians in both settings used similar tests for diagnosis of IMHA, but BCCs performed more tests to exclude underlying causes of ‘associative’ disease. All veterinarians reported use of similar initial dosages of glucocorticoids (median 2 mg/kg per day in both groups, p = 0.92) but those used by more experienced practitioners were higher than those with less experience. Most veterinarians made allowances for the weight of dogs, using lower prednisolone dosages in a clinical scenario involving a 40 kg dog compared to a 9 kg dog (p = 0.025 for PCP, p = 0.002 for BCC). BCCs reported greater use of combinations of immunosuppressive drugs (p<0.0001) and of antithrombotic drugs (p<0.0001); use of antithrombotic drugs was also less common among more experienced practitioners compared to less experienced. Conclusions Approaches to treatment of dogs with IMHA differ between BCCs and those in PCP. These differences may affect design and implementation of future research studies and clinical guidelines.

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Section: Discussionmentioning

confidence: 99%

Cross-sectional study of approaches to diagnosis and management of dogs with immune-mediated haemolytic anaemia in primary care and referral veterinary practices in the United Kingdom

et al. 2021

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“…Another explanation may be the signalment of dogs with SRMA that are substantially larger (median bodyweight of 29 kg in the present study) compared with dogs with MUO (typically small breed dogs). In large breed dogs different pharmacokinetics of steroids may result in more clinically relevant side effects 37 . Possibly using the body surface as a basis for the calculation of the prednisolone dosage instead of the bodyweight, some of the side effects could be reduced as suggested in a recent publication 37 .…”

Section: Discussionmentioning

confidence: 99%

“…In large breed dogs different pharmacokinetics of steroids may result in more clinically relevant side effects 37 . Possibly using the body surface as a basis for the calculation of the prednisolone dosage instead of the bodyweight, some of the side effects could be reduced as suggested in a recent publication 37 . A third reason might be different reporting schemes: while in the present study all clinical and laboratory abnormalities were reported during treatment, previous studies mainly included adverse events clearly related to the administration of CA.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

et al. 2020

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BackgroundRelapses in steroid-responsive meningitis-arteritis (SRMA) are frequently observed but specific treatment protocols to address this problem are sparsely reported. Standard treatment includes prolonged administration of glucocorticoids as monotherapy or in combination with immunosuppressive drugs. The aim of this study was to assess the safety and efficacy of cytosine arabinoside (CA) in combination with glucocorticoids for treatment of SRMA relapses in 12 dogs on a retrospective basis.MethodsDogs with recurrent episodes of SRMA and treated with a combination of CA and prednisolone were included. Information about clinical course, treatment response and adverse events was collected from medical records. Ethical approval was not required for this study.ResultsTen dogs (10/12) responded well to the treatment with clinical signs being completely controlled. One dog is in clinical remission, but still under treatment. One dog (8%) showed further relapse. Mean treatment period was 51 weeks. Adverse events of variable severity (grade 1–4/5) were documented in all dogs during treatment according to the veterinary cooperative oncology group grading. Three dogs developed severe adverse events. Laboratory findings showed marked changes up to grade 4. Diarrhoea and anaemia were the most often observed adverse events (6), followed by dermatitis (4), alopecia (3) and pneumonia (3). Including blood chemistry changes (13), 50 adverse events were found in total.ConclusionTreatment with CA and glucocorticoids resulted in clinical remission in 10/12 dogs, but a high incidence of adverse events occurred requiring additional measures. All adverse events could be managed successfully in all cases.

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“…In contrast, the enzyme's activity is limited in cats, which explains why oral prednisolone is preferred over prednisone in this species (7). In fact, prednisolone is frequently selected over its prodrug in dogs as no further hepatic biotransformation is required (19,20), and the PK data available in the scientific literature is more robust for prednisolone than prednisone (10,(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Oral Prednisone at Various Doses in Dogs: Preliminary Findings Using a Naïve Pooled-Data Approach

Sebbag

Mochel

2020

Front. Vet. Sci.

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This pilot study aimed to determine the plasma pharmacokinetics of prednisone and its active metabolite prednisolone following oral prednisone administration in dogs-using dosing regimens that cover anti-inflammatory to immuno-suppressive biological effects. Six healthy Beagle dogs were given 0.5, 1, 2, and 4 mg/kg prednisone orally once daily for 5 days, each successive course separated by a washout period of 9 days. At steady-state (Day 4), a sparse sampling design allowed for collection of blood from 2/6 individuals for each of the following time points: 0, 15, 30, 60, 90, 120, 240, 480, and 720 min. Prednisone and prednisolone were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Oral prednisone was rapidly converted to prednisolone in dogs (≤30 min), with plasma prednisolone reaching ∼6-fold greater levels (0-656.1 ng/mL) than prednisone (0-98.8 ng/mL) overall. The ratio of plasma prednisolone/prednisone was constant across the dosing regimens, indicating a non-saturation of the hepatic 11-β-hydroxysteroid dehydrogenase that converts the prodrug to the active metabolite in dogs. The level of both corticosteroids increased with increasing dosing regimens, albeit in a non-linear manner. Non-compartmental pharmacokinetic parameters are described, including peak concentration (C max), time of peak concentration (T max), area under the concentration-time curve (AUC last), and the elimination half-life (t 1/2) for both corticosteroids, as well as clearance and volume of distribution during the terminal phase (V z) for the administered drug (prednisone). In sum, the present study utilizes a sparse sampling and naïve pooled-data approach to estimate pharmacokinetic parameters for prednisone and prednisolone, providing supporting preliminary knowledge that can be used to optimize corticosteroid efficacy and minimize toxicity in canine patients.

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Comparison of body surface area-based and weight-based dosing format for oral prednisolone administration in small and large-breed dogs

Cited by 10 publications

References 6 publications

Cross-sectional study of approaches to diagnosis and management of dogs with immune-mediated haemolytic anaemia in primary care and referral veterinary practices in the United Kingdom

Cross-sectional study of approaches to diagnosis and management of dogs with immune-mediated haemolytic anaemia in primary care and referral veterinary practices in the United Kingdom

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

Pharmacokinetics of Oral Prednisone at Various Doses in Dogs: Preliminary Findings Using a Naïve Pooled-Data Approach

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