A Pilot Randomized Trial to Compare Polyuria and Polydipsia during a Short Course of Prednisolone or Methylprednisolone in Dogs with Atopic Dermatitis

Simple Summary Glucocorticoids (a.k.a. steroids) are often used to treat allergic skin diseases in dogs, but they commonly cause side-effects, such as increased drinking (polydipsia) and urination (polyuria). Veterinarians have long believed that the steroid methylprednisolone causes less drinking and urination than prednisolone. We performed a clinical trial in which dogs with atopic dermatitis were treated either with prednisolone or methylprednisolone at the beginning of an elimination diet. After two weeks, the owners did not notice any significant increase in drinking. Most dogs had a reduction in the specific gravity (that is the density) of the urine, which signals a more diluted and abundant urine, but there was no significant difference between the two steroids for urine dilution. In conclusion, there were no significant changes in either drinking and urine dilution when giving prednisolone or methylprednisolone to allergic dogs for two weeks. A longer treatment duration or higher doses might give different results, however. Glucocorticoids are widely used to treat canine allergic disorders, but they frequently cause polyuria and polydipsia (PUPD). At equipotent dosages, oral methylprednisolone is believed to cause less PUPD than prednisolone. We performed a pilot randomized, open, parallel trial with 22 dogs with nonseasonal AD receiving either prednisolone or methylprednisolone at equipotent dosages, once daily for 14 days during the first phase of a restriction-provocation dietary trial. Before and on days 3, 7, and 14 after starting the glucocorticoids, owners estimated water consumption for 24 h. On the same days and before the glucocorticoid was given, owners collected the first-morning urine to determine the urine specific gravity (USG). There were no significant differences between the prednisolone and methylprednisolone groups on days 3, 7, and 14 when comparing the changes in water intake from baseline. Most dogs from both groups exhibited a slight reduction in USG during the study. Still, there was no significant difference in USG changes between the groups on any of these three reevaluation days. In conclusion, the administration of two weeks of oral prednisolone and methylprednisolone at equipotent anti-inflammatory dosages at the beginning of an elimination diet did not lead to significant differences in water intake and USG

A randomised controlled trial testing the rebound-preventing benefit of four days of prednisolone during the induction of oclacitinib therapy in dogs with atopic dermatitis

Background A rebound of pruritus occasionally occurs after oclacitinib dose reduction in dogs with atopic dermatitis (AD). Objectives To determine whether an initial 4-day course of prednisolone decreases the probability of a pruritus rebound after reducing the frequency of oclacitinib administration. Animals Forty dogs with mild-to-moderate AD lesions and moderate-to-severe pruritus. Materials and Methods Dogs were randomised to receive oclacitinib at 0.4-0.6 mg/kg twice daily for 14 days then once daily, alone or with prednisolone at 0.5 mg/kg, orally, twice daily for the first 4 days. Clinicians graded the Canine Atopic Dermatitis Extent and Severity Index (CADESI)4 and 2D-investigator global assessment (IGA) before and after 28 days; owners assessed the pruritis Visual Analog Scale (PVAS)10 and Owner Global Assessment of Treatment Efficacy (OGATE) on Day (D)0, D4, D14, D21 and D28. We considered a rebound any increase greater than one PVAS10 grade at D21 compared to D14. Results On D21, there were significantly fewer rebounds in the dogs receiving prednisolone (three of 20, 15%) compared to those given oclacitinib alone (nine of 20, 45%; Fisher's test, p = 0.041). Compared to oclacitinib monotherapy, the concurrent administration of prednisolone for the first 4 days led to significantly lower PVAS10 on D4 and D28, CADESI4 and 2D-IGA on D28, and OGATE on D21 and D28 (Wilcoxon-Mann-Whitney U-tests). Adverse effects of therapy were minor, intermittent and self-resolving. Conclusions and Clinical Relevance The initial addition of 4 days of prednisolone significantly decreased the probability of a rebound of pruritus 1 week after oclacitinib dose reduction. This short concomitant glucocorticoid administration led to a higher skin lesion improvement and improved perception of treatment efficacy with minimal adverse effects

A Pilot Randomized Trial to Compare Polyuria and Polydipsia during a Short Course of Prednisolone or Methylprednisolone in Dogs with Atopic Dermatitis

Glucocorticoids are widely used to treat canine allergic disorders, but they frequently cause polyuria and polydipsia (PUPD). At equipotent dosages, oral methylprednisolone is believed to cause less PUPD than prednisolone. We performed a pilot randomized, open, parallel trial with 22 dogs with nonseasonal AD receiving either prednisolone or methylprednisolone at equipotent dosages, once daily for 14 days during the first phase of a restriction–provocation dietary trial. Before and on days 3, 7, and 14 after starting the glucocorticoids, owners estimated water consumption for 24 h. On the same days and before the glucocorticoid was given, owners collected the first-morning urine to determine the urine specific gravity (USG). There were no significant differences between the prednisolone and methylprednisolone groups on days 3, 7, and 14 when comparing the changes in water intake from baseline. Most dogs from both groups exhibited a slight reduction in USG during the study. Still, there was no significant difference in USG changes between the groups on any of these three reevaluation days. In conclusion, the administration of two weeks of oral prednisolone and methylprednisolone at equipotent anti-inflammatory dosages at the beginning of an elimination diet did not lead to significant differences in water intake and USG