Table 69-7.
TREATMENT OF INFLAMMATORY BOWEL DISEASE
| Drug | Product (Manufacturer) | Preparations | Dosage |
|---|---|---|---|
| Anti-inflammatory Drugs/Immunosuppressives | |||
| Prednisone* | Many | Tab: 5, 10, 20, 50 mg | Dog: 1–2 mg/kg PO q24h |
| Cat: 2–3 mg/kg PO q24h | |||
| Budesonide | Entocort (AstraZeneca) | Cap: 3 mg | Dog: 1–3 mg PO q24h |
| Cat: 1 mg PO q24h | |||
| Methylprednisolone acetate | Depo-Medrol (Upjohn) | Inj: 40 mg/ml | Cat: 20 mg IM q2–4wk |
| Azathioprine† | Imuran; Azasan (Salix) | Tab: 25, 50, 75 mg | Dog: 1–2 mg/kg PO q24–48h |
| Cat: 0.3–0.5 mg/kg PO q24–48h | |||
| Chlorambucil | Leukeran (Glaxo) | Tab: 2 mg | 0.1–0.2 mg/kg PO q24–48h, or 2–3 mg/m2 PO q24–48h, or 15–20 mg/m2 PO once every 3 weeks (cats) |
| Cyclosporine | Atopica (Novartis) | Cap: 10, 25, 50, 100 mg | 5 mg/kg PO q24h |
| Colonic Anti-inflammatory Drugs | |||
| Sulfasalazine‡ | Generic | Tab: 500 mg | Dog: 10–30 mg/kg PO q8–12h |
| Cat: 10–20 mg/kg PO q12–24h | |||
| Olsalazine | Dipentum (Celltech) | Cap: 250 mg | Dog: 10–20 mg/kg PO q12h |
| Mesalamine | Asacol (Procter & Gamble) | Tab: 400 mg | Dog: 10–20 mg/kg PO q8–12h |
| Pentasa (Shire) | Tab: 250 mg | ||
| Anti-inflammatory Retention Enemas§ | |||
| 5-Aminosalicylate | Rowasa (Solvay) | Enema: 4 g/60 ml | To be determined |
| Hydrocortisone | Cortenema (Reid-Rowell) | Enema: 100 mg/60 ml | 20–60 ml rectally q24h |
| Antibiotics | |||
| Metronidazole | Flagyl (Searle) or generic | Tab: 250 mg, 500 mg | 10–20 mg/kg PO q8–12h |
| Tylosin tartrate¶ | Tylan Soluble (Elanco) | Powder: 2270 mg/tsp | Dog: 20–40 mg/kg PO q12h |
| Cat: 10–20 mg/kg PO q12h | |||
| Opioid Motility/Secretory Modifier | |||
| Loperamide | Imodium AD | Tab: 2 mg | Dog: 0.1–0.2 mg/kg PO q8–12h |
| Liq: 0.2 mg/ml | Cat: 0.1–0.3 mg/kg PO q12–24h | ||
| Adjunct Therapy | |||
| Cobalamin | Generic | Inj: 1000 mg/ml | Dog: 250–1000 mg weekly |
| Cat: 250 mg weekly | |||
| Psyllium | Metamucil (Procter & Gamble) | Powder | Dog: 1–3tbsp/day with food |
| Cat: 1–3tsp/day with food | |||
In some cats with severe colitis, prednisone dosage may need to be increased to 5 mg/kg/day, divided bid. In dogs, if steroidal side effects become a problem, decrease dosage and combine with azathioprine, metronidazole, or both.
May cause myelotoxicity, so monitor the complete blood count; formulate as an oral suspension for accurate dosing of cats.
Dosage may need to be increased to 25–50 mg/kg q8h to achieve effect in some dogs; may cause keratoconjunctivitis sicca in dogs and salicylate toxicosis in cats.
Retention enemas for topical therapy of the distal colon may relieve signs of tenesmus and urgency in some animals with proctitis.
Tylan Soluble can be mixed with dextrose or cornstarch. Tylosin powder is bitter-tasting and thus best tolerated when mixed with food. Cap, capsules; Inj, injectable; Liq, elixir, suspension, or drops; Tab, tablets.