corticoidea Therapy

Allergic diseases: Atopia allergic Dermatitis to the puncture of fleas nourishing Allergy Dermatitis of contact

Diseases autoinmunes: Complex pénfigo - vulgar, erythematous, foliáceo- bulloso Penfigoide erythematous Lupus - sistémico, discoide-

INTRODUCTION

In canine and feline dermatology the diseases are numerous that can be controlled by means of the administration, in the long term, of corticoids. These diseases have one generally patogenia immune, being in this useful case to classify them like of allergic nature and nature autoinmune (to see table).

First they have as main sign picazón, reason why we speak of the ?control steroid of the prurito?. The base of the therapy in these processes is to avoid or to reduce the contact with the implied alergenos, which usually is feasible in the cases of allergic dermatitis to the puncture of fleas (DAPP) - by means of a strict control of ectoparásito-, in the allergy to foods - devoid diet in injurious foods, and in the contact dermatitis. Nevertheless, in the atópicos animals, although the possibility of the hiposensibilización exists, nowadays still are controlled in great proportion by means of the single administration of antipruriginosos.

The corticoids, as it is known, have numerous and intense indirect effect when they are used in the long term, emphasizing the appearance of the syndrome of iatrogénico Cushing who, although is more probable to observe it when slowed down injectable forms of reiterated way are used, even can be caused after the continuous application of topical corticoids. The main signs that appear are poliuria, polidipsia, polifagia and cushingoide aspect, with abdomen pendulum, symmetrical bilateral alopecia, etc, besides to favor the presentation of diabetes mellitus and esteroidea hepatopatía, and to increase the susceptibility of the patient to the infections.

Also, the long term administration of corticoids characterizes itself by the suppression of the hipotálamo-hipófisis-adrenal axis, due to the inhibition of the secretion of the liberating hormone of corticotropina (CRH) at hipotalámico level and of the stimulating hormone of the adrenal crust (ACTH) at hipofisario level, which produces atrophy of the adrenal crust and diminution of the endogenous cortisol secretion. The abrupt cease in the administration of exogenous corticoids or the appearance of a situation of intense stress - traumatismos, surgery, infections can trigger an acute crisis of adrenocortical insufficiency.

HANDLING FARMACOLÓGICO OF THE PRURITO

Before entering detail, we thought that he is preferable to summarize the existing present tendency in the control of the canine and feline prurito.

In dogs, safe in the allergy to foods, the corticoids work very well, although their indirect effect in the long term induce to look for alternatives, which are not so effective, which forces to make tests in each patient.

On the contrary, in cats, the antihistamine use of H1 allows an suitable control of the prurito, with few indirect effect. In addition the use to long term corticoids much less raises intense indirect effect that in dogs, which even allows the use of slowed down parenterales formulations, avoiding ?annoying? the daily administration of oral forms.

Esteroidea therapy

Conditions that define the use of the long term corticoids, to the object exist for slowing down the appearance of the indirect effect; if it is possible they must use:

• only when they are essential
• with the smaller dose than it controls the process
• to alternating days, using corticoids of short life; - prednisona, prednisolona, metilprednisolona- (to see table)
• only when other treatments have failed
• always oral route, never parenteralmente - an injection can alter to the adrenal function 1 month
• in the tip of endogenous glucocorticoid liberation: matinal in dogs and diurnal cats, and vespertine in nocturnal cats.

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