Can I give NSAID to GSD on Atopica?

RE: Can I give NSAID to GSD on Atopica?

Adrienne McPartland — Sat, 11 Mar 2017 19:44:02 GMT

How about amantadine ? I've had some excellent results with labradors and ED, who have now come off NSAIDs due to dramatic improvement since the addition of amantadine.

RE: Can I give NSAID to GSD on Atopica?

Martin Atkinson — Fri, 13 Jan 2017 15:01:38 GMT

[quote user="Aisling McGrath"]

This dog is highly aggressive, with the owners struggling to muzzle it, so topical application is out of the question!

I discussed the options in depth with the clients. They are considering having the dog euthanised if she doesn't improve, so they just want her to be as comfortable and pain free as possible.

So she is now on Metacam, Atopica, Fungiconazol, and Cephacare... and tramadol.

[/quote]Sounds very much like my patient in every respect. Even the RVC didn't consider ketoconazole as a supplementary treatment to the cyclosporine, even less so any surgical intervention.

On the basis of don't let anything die without the benefit of the 'roids, try following the protocol my patient is on. We too were at the point of euthanasia and now he has good quality of life.

RE: Can I give NSAID to GSD on Atopica?

Aisling McGrath — Fri, 13 Jan 2017 13:33:53 GMT

Thank you for all the comments.

This dog is highly aggressive, with the owners struggling to muzzle it, so topical application is out of the question!

I discussed the options in depth with the clients. They are considering having the dog euthanised if she doesn't improve, so they just want her to be as comfortable and pain free as possible.

So she is now on Metacam, Atopica, Fungiconazol, and Cephacare... and tramadol.

RE: Can I give NSAID to GSD on Atopica?

Martin Atkinson — Fri, 13 Jan 2017 09:16:06 GMT

[quote user="Noweia"]

Could you add in a steroid instead of NSAID? Or switch to a steroid instead of Atopica?

[/quote]Read my first post.

[quote user="Sarah Keir"]

How about tacrolimus cream?

[/quote]This very much depends on the case, there is certainly no way you'd have anywhere my case's arse with a tube of cream!

RE: Can I give NSAID to GSD on Atopica?

Sarah Keir — Thu, 12 Jan 2017 20:38:40 GMT

How about tacrolimus cream?

RE: Can I give NSAID to GSD on Atopica?

Noweia — Thu, 12 Jan 2017 20:17:25 GMT

Could you add in a steroid instead of NSAID? Or switch to a steroid instead of Atopica?

RE: Can I give NSAID to GSD on Atopica?

Rob Davis — Thu, 12 Jan 2017 18:38:28 GMT

[quote user="Martin Atkinson"]It is also now on Cyclavance which is human liquid form of cyclosporin and is cheaper and easier for them to comply.[/quote]

Cyclavance is a veterinary licensed cycosporin liquid from Virbac, but I think it does work out a little cheaper then atopica.

I do have a GSD patient who has been on cyclavance and carprofen for some time with no ill effects. He also had a splenic stromal sarcoma removed over a year ago and a probable melanoma in his eye, and I have discussed the possibility of increased malignancy with cyclosporine, but both drugs have been necessary to keep him comfortable. So far so good.

PS He also gets topical tacrolimus (protopic) which his owners feel helps.

RE: Can I give NSAID to GSD on Atopica?

Martin Atkinson — Thu, 12 Jan 2017 18:19:18 GMT

[quote user="Hannah Wynne Richards"]With furunculosis I'd go for an antibiotic that dealt with anaerobes.[/quote]We tried this approach and the antibiotics that were indicated from culture and recommended by the RVC (Veraflox) were ineffective and prohibitively expensive. Oxytets are probably working because they are having at least in part an immunomodulatory effect and the owner is complying. Whatever the combination is effective.

Anyway the OP was if NSAIDs can be given with Atopica and in my experience they can.

RE: Can I give NSAID to GSD on Atopica?

Hannah Wynne Richards — Thu, 12 Jan 2017 16:28:52 GMT

With furunculosis I'd go for an antibiotic that dealt with anaerobes. Otherwise you're back to the longevity versus quality of life argument. I'd persuade the owners that quality is the more important.

Wynne

RE: Can I give NSAID to GSD on Atopica?

Martin Atkinson — Thu, 12 Jan 2017 15:10:49 GMT

I have been managing a difficult anal farunculosis case which was referred to the RVC for another concurrent issue but they also took over the farunculosis . It is as stable as it is possible to get it at present on a combination of Atopica, prednisolone and oxytets. Previously you could even look at its bum because it was so sore and it suffered from extreme dyschezia. Now its fistulae are nearly healed and it can defaecate normally although I have to say that it is very difficult to get accurate feedback from the owner, not sure even if they were complying with the treatment properly. Tramadol, Amantadine, Gabapentin were all useless but I did give it Carprodyl before it was put on the steroids by the RVC and that certainly helped with no apparent issues alongside the cyclosporin. It is also now on Cyclavance which is human liquid form of cyclosporin and is cheaper and easier for them to comply.

RE: Can I give NSAID to GSD on Atopica?

Michael Woodhouse — Thu, 12 Jan 2017 14:16:54 GMT

We've used Atopica and NSAIDs before with no problems. I really would urge you to dump the Tramadol and try some Pardale V - you'll be impressed

RE: Can I give NSAID to GSD on Atopica?

Aisling McGrath — Thu, 12 Jan 2017 13:46:04 GMT

I have already mentioned it to the owner, and mentioned about risk of kidney damage versus risk of untreated pain. I think we will put her back on Metacam and take the risk. As it's a combination I've not done before, I have no experience with how big of a risk it is?

For instance, all my elderly OA cats with CKD are all on Metacam with no problems (with informed owner consent of off license use, and lower dose), and I have no hesitation with that risk, it's just this is an unfamiliar risk...

RE: Can I give NSAID to GSD on Atopica?

Braden Collins — Thu, 12 Jan 2017 13:29:15 GMT

I would add in NSAIDS. I think quality of life issues means it is certainly worth trying. Have a chat with the owner beforehand to explain the small risk and ensure they accept it.