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In most cases, anti-inflammatory drugs are required in addition to topical treatments and allergen-specific therapy to control residual pruritus and inflammation. The dose and treatment regime should be adapted according to how successful other treatments are, the response to treatment and the presence of allergen in the environment (for example, pollen is present in the summer but not the winter). The aim should be to use the minimum dose that gives effective control of pruritus.
 
In most cases, anti-inflammatory drugs are required in addition to topical treatments and allergen-specific therapy to control residual pruritus and inflammation. The dose and treatment regime should be adapted according to how successful other treatments are, the response to treatment and the presence of allergen in the environment (for example, pollen is present in the summer but not the winter). The aim should be to use the minimum dose that gives effective control of pruritus.
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Cyclosporine is an immunosuppressive drug that acts by suppressing T-cells, as well as mast cells and eosinophils. The doses used in atopy are immuno-modulating, and suppression of these cells impairs antigen presentation, IgE production and the development of inflammatory lesions.<sup>4</sup>. Studies have suggested that cyclosporine is at least as effective as prednisolone for controllin atopic dermatitis<sup>4</sup>, but is better tolerated than the corticosteroid. The most likely side effects are transient anorexia and vomiting, but this can be avoided by administering cyclosporine with food. Uncommonly, hirsutism, alopecia, ginvival hyperplasia, diarrhoea, tremors or erythema of the ears may be seen, but these effects are dose-dependent and reversible<sup>4</sup>.
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Cyclosporine is an immunosuppressive drug that acts by suppressing T-cells, as well as mast cells and eosinophils. The doses used in atopy are immuno-modulating, and suppression of these cells impairs antigen presentation, IgE production and the development of inflammatory lesions.<sup>4</sup>. Studies have suggested that cyclosporine is at least as effective as prednisolone for controllin atopic dermatitis<sup>4</sup>, but is better tolerated than the corticosteroid. The most likely side effects are transient anorexia and vomiting, but this can be avoided by administering cyclosporine with food. Uncommonly, hirsutism, alopecia, ginvival hyperplasia, diarrhoea, tremors or erythema of the ears may be seen, but these effects are dose-dependent and reversible<sup>4</sup>. Immunosuppresion is a potential concern, and so patients should be observed closely for opportunistic infections or infestations. Cyclosporine may also affect the efficacy of vaccination, and so some vets choose to treat with corticosteroids around this time instead. The drug minimally affects intradermal and serological allergy testing<sup>4</sup>.
Immunosuppression is a potential concern.
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Inhibition of cell-mediated immunity in particular
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could result in bacterial and protozoal infections,
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dermatophytosis and demodicosis. In practice,
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however, the risk appears to be very small and most
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atopic dogs experience fewer secondary infections
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following treatment. Inhibition of
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T-helper cell function and β-cell activation could
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affect the response to vaccination.-->steroids  Some authors
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advocate withdrawing treatment for up to two
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weeks either side of vaccination, although this
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will lead to worsening of the skin condition.
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Cyclosporine is administered for canine AD at a
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dose of 5 mg/kg once daily. Glucocorticoids can be initially coadministered
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to achieve more rapid remission.
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Approximately one third of treated dogs require
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daily dosing, one third every other day and one
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third twice weekly to maintain remission.
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Using cyclosporine as part of an integrated
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management program can be more cost-effective
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than relying on it alone.
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The effect on intradermal testing and serology is
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thought to be minimal, although the data is sparse.
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Anecdotal data suggests that cyclosporine does
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not affect the response to ASIT any more than
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glucocorticoids
      
====Phytopica™====
 
====Phytopica™====
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