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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>.
 
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>.
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====Phytopica™====
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Phytopica™, a compound derived from Rehmannia
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glutinosa, Paeonia lactiflora and Glycyrrhiza
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uralensis improved canine AD in a preliminary
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study (14). In a recent randomized, double-blind
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and placebo-controlled trial of 120 dogs Phytopica™
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(200 mg/kg/day) appeared to be an efficacious,
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safe and palatable non-steroidal treatment for
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canine AD, although the effect was modest with
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most dogs achieving a 20-50% improvement in
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clinical signs (15). Responses are typically evident
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within four weeks (Figure 4). Adverse effects are
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self-limiting gastro-intestinal disturbances such as
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diarrhea and vomiting. This is generally a better
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safety profile than has been reported for other
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anti-inflammatory therapies (16).
      
====Glucocorticoids====
 
====Glucocorticoids====
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