FluticasoneDose, contraindications and adverse effects for Cats, Dogs and Horses.

Potent inhaled corticosteroid used for feline asthma/chronic bronchitis and canine allergic airway disease, minimizing systemic absorption. The inhaled aerosol formulation of fluticasone is used for treatment of canine chronic bronchitis, feline asthma and chronic bronchitis, and equine asthma. The optimal dosing of inhaled corticosteroids is unknown, and currently there are no studies specifically showing any advantages of inhaled corticosteroids over oral prednisolone in dogs and cats with naturally occurring airway disease.

Dogs: NOTE: Most commonly, when starting fluticasone, oral gluco- corticoid therapy is continued for 10 to 14 days with a tapering overlap.14 Adjunctive treatment for chronic tracheobronchial disease (ex- tra-label): Using 110 – 220 µg/puff MDI, administer 1 puff 2 to 4 times daily via an appropriate delivery device.15-17 Adjust dose based on clinical response. Eosinophilic bronchopneumopathy (extra-label): 100 – 250 µg/puff MDI twice daily8,15; dose can be adjusted based on clinical response.

Like other glucocorticoids, fluticasone has potent anti-inflammatory activity. Fluticasone has an affinity 18 times more than dexamethasone for human glucocorticoid receptors. In a feline study, inhaled fluticasone significantly reduced airway eosinophilia. For a more thorough discussion of glucocorticoid effects, refer to Glucocorti- coid Agents, General Information.

Fluticasone is contraindicated in patients hypersensitive to it, and is not indicated for treatment of acute bronchospasm (eg, status asthmaticus); cases of fluticasone-induced paradoxical bronchospasm have been reported in humans. When transitioning patients from systemic steroid therapy to inhaled steroids, wean slowly off systemic therapy to avoid acute adrenal insufficiency.

In humans, the most likely adverse effects are pharyngitis and upper respiratory infection. Although inhaled steroids generally cause significantly fewer adverse effects than injectable or oral therapy, suppression of the HPA axis can occur.

■ Efficacy: control of cough and/or other respiratory signs (eg, exercise intolerance, tachypnea, wheezing) ■ Clinical signs of iatrogenic hyperadrenocorticism (eg, polyuria/ polydipsia, polyphagia)