Inhaled steroid therapy in dogs

Re: Inhaled steroid therapy in dogs

Stephen Courtney — Sat, 01 Oct 2011 21:46:39 GMT

[quote user="newgradvet"]

Being an asthmatic with a steroid inhaler I have often wondered whether inhaled steroids have much effect of HPA axis. Nice to know they do, even if the doctor does neglect to tell me these things.

[/quote]

My asthma got so bad over the years - cats, bunnies, chinchillas and horses, in ascending severity - that being put on seretide was a life-saver ( well, a career-saver!) My HPA axis has not caused me any problems, but I can lead an almost normal life and hardly ever have to use a ventolin, when I used to flatten a 200 dose inhaler in 10 days

Re: Inhaled steroid therapy in dogs

Andrew Kent — Sat, 01 Oct 2011 15:40:43 GMT

In addition to the above I am told that beclomethasone inhalers may be unavailable in the near future as they have been largely replaced by fluticasone.

Andy

Re: Inhaled steroid therapy in dogs

Kate Richardson — Sat, 01 Oct 2011 11:54:04 GMT

Fluticasone is reported to be more efficaceous and has less systemic absorption compared to beclomethasone. It can taken a couple of weeks for effective concentrations of either to build up in the lungs, so you usually need to keep on oral pred initially when starting to use inhlaed therapy.

Re: Inhaled steroid therapy in dogs

Rob Loxley — Sat, 01 Oct 2011 11:50:26 GMT

Considering the cost difference between futicasone and beclomethasone inhalers, is there any evidence of difference in efficacy or side effects in cats or dogs?

Re: Inhaled steroid therapy in dogs

Hannah Wynne Richards — Fri, 30 Sep 2011 18:38:50 GMT

Another who agrees with 1 puff of flixotide bid and aerodawg inhaler

Wynne

Re: Inhaled steroid therapy in dogs

Martin Atkinson — Fri, 30 Sep 2011 17:25:10 GMT

Excellent answer from Andrew, I would have said exactly the same and my experience matches it. However, I would have less concerns over suppression of the HPA axis, it may be theoretical but I always considered that the dose by inhalation was so low that the side effects were minimal and this was the huge advantage of delivering steroids by this route. With cats at least, I advise clients to have a salbutomol inhaler on hand in case of an acute asthma attack. IME patients either have a chronic cough/wheeze or acute life threatening attacks but not both.

Re: Inhaled steroid therapy in dogs

Claire McConnell — Fri, 30 Sep 2011 16:48:49 GMT

Being an asthmatic with a steroid inhaler I have often wondered whether inhaled steroids have much effect of HPA axis. Nice to know they do, even if the doctor does neglect to tell me these things.

Re: Inhaled steroid therapy in dogs

Andrew Kent — Fri, 30 Sep 2011 15:50:22 GMT

Hi Ruth,

This certainly sounds like a candidate for inhaled medication. You will need a spacer device first, I use aerodawg where possible but have used paediatric spacers occasionally where cost limitations.

There are a number of different inhaled steroid medications available, I now most commonly use Fluticasone (flixotide) inhalers which come in a variety of strengths. I normally use either the 125ug or 250ug and would start on 1 puff twice daily and adjust as necessary, often can reduce to once daily. I have use beclometasone inhalers as well but these seem to be harder to get now.

The other medication you could try if inhaled meds are working would be a bronchodilator in the form of salbutamol (ventolin) inhalers.

Most dogs and cats will eventually tolerate inhaled techniques well but take it gently to avoid putting them off.

Inhaled steroids will suppress the HPA axis so the risk of iatrogenic cushings is still there if reduced.

Hope that helps,

Andy