Section: Veterinary Care In-depth
Treatment In-depth
Concurrent treatment with bactericidal antibiotics with a broad spectrum and prednisone at immunosuppressive doses is the most consistently effective for this condition. Response to antibiotics is favorable in only 1/3 of cases confirming that the bacterial infection is secondary and not the primary cause of this condition. The induction phase of prednisone usually lasts 10 to 14 days. The most severe adverse effect of high doses of steroids is the development of gastrointestinal ulcerations. Pets should be carefully monitored for vomiting, diarrhea, dark tarry stools or the presence of blood in the stools.
Once lesions start drying up, steroids can be slowly tapered over a period of several weeks. Some dogs may not respond to prednisone and other glucocorticoids may need to be tried. Dexamethasone is usually used.
Relapses after treatment is discontinued are not common but have been reported. In rare cases, it may be necessary to add another immunosuppressive drug (e.g. oral azathioprine) besides the glucocorticoids. In these cases, close monitoring of complete blood cell count is recommended, due to the potential for severe bone marrow suppression. Pancreatitis and liver inflammation have been reported with this drug.
If azathioprine is not tolerated, chlorambucile may be tried. It is considered safer than azathioprine but still has the potential of causing bone marrow suppression.
Concurrent arthritis resolves with treatment of the juvenile cellulitis.
Topical therapy is not recommended, due to the pain and the increased risk for scarring.
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