Usually – Prednisone + Imuran (Azathioprine) + Gastroprotectants

Oral Prednisone (usually used in combination with Azathioprine – see below for doses)

Two referenced protocols – both will work well but it always depends on how the dog is
improving, and coping with the drugs.

1 Ref: Clinical Immunology of the Dog & Cat by Michael J Day – Professor of Veterinary Pathology, University of Bristol, UK and WSAVA – Chairman of Scientific Advisory Committee.

This example is base on a dog receiving an induction dose of 1.0mg/kg/q12hrs –

(q = every)

Dose Duration (based on clinical effect)

1.0mg/kg/q12h 10-28 days
0.75mg/kg/q12h 10-28 days
0.5mg/kg/q12h 10-28 days
0.25mg/kg/q12h 10-28 days
0.25mg/kg/q24h 10-28 days
0.25-0.5mg/kg/ Every other day at least 21 days
0.25-0.5 mg/kg/ Every third day at least 21 days

2 Ref: Canine Medicine and Therapeutics by Neil Gorman

1-2mg/kg/q12hrs for 10-28 days (starting at the lowest immunosuppressive dose)

Assuming clinical signs and blood results are good, and there is no evidence of immune destruction
on the blood smear etc., and the dog is coping with the side effects of the drugs,
the dose can be reduced by up to 50%.

This dose is given for another 10-21 days when the dose is reduced again by up to
50%. This is given for another 10-21 days.

This dose is given for another 10-21 days when the dose is reduced again by up to
50%. This is given for another 10-21 days.
This dose is given for another 10-21 days when the dose is reduced again by up to
50%. This is given for another 10-21 days.

For the next reduction the dose remains the same but given every other day. The
EOD dosing is reduced by up to 50% every month or so until the dose is so low a
decision can be made to keep the dog on this low maintenance dose or withdraw
altogether. Every reduction is made after consideration to clinical signs and
blood results.

Azathioprine (Imuran)

Azathioprine (a cytotoxic drug)  – otherwise known as Imuran – can be used in combination with prednisone at 2mg/kg/24 or 48 hrs and dose gradually reduced, when remission is achieved, over a period of months.

Don’t forget the Gastroprotectants!

Please visit this page for a lot of very useful information about immune suppression and what to expect during treatment. Once again our thanks go to CIMDA for their great advice

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