Localized alopecia and suppression of hypothalamic-pituitary-adrenal (HPA) axis in dogs following treatment with difluprednate 0.05% ophthalmic emulsion (Durezol®)

BMC Veterinary Research

Jacquelyn M. Del Valle¹  Erica L. Noland²  Jessica B. Burn³  Katelin Quantz³  Laurence M. Occelli³  Chris G. Pirie³  András M. Komáromy³  Annette D. Petersen³  Christine D. Harman³  Daniel K. Langlois³  Amanda L. Anderson³  Simon M. Petersen-Jones³ 

[1] Campus Animal Resources, Michigan State University, East Lansing, MI, USA;Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA;Department of Small Animal Clinical Sciences, Michigan State University, Veterinary Medical Center, 736 Wilson Road, 48824, East Lansing, MI, USA;

关键词: Alopecia;    Canine;    Corticosteroids;    Difluprednate (Durezol®);    Follicular atrophy;    Hypothalamic-pituitary-adrenocortical (HPA) axis;    Ophthalmic;   

DOI  :  10.1186/s12917-021-03072-9

来源: Springer

【 摘 要 】

BackgroundDespite the common use of topical ophthalmic corticosteroids in dogs, detailed reports on systemic and dermatologic adverse effects are limited.ResultsNine purpose-bred research Beagles were treated with difluprednate 0.05% ophthalmic emulsion in one or both eyes 2–3 times daily. Some difluprednate treated dogs developed mild to severe alopecia of the periocular region, face, and distal pinna (5/9). The median duration of treatment prior to onset of dermatologic signs for difluprednate treated dogs was 550 days (453–1160 days). Diagnostic testing included complete blood count (CBC) and serum biochemistry, adrenocorticotropic hormone (ACTH) stimulation testing combined with endogenous ACTH measurement, and skin biopsy. The CBC and chemistry were within normal limits for all dogs. There were varying degrees of suppression of the hypothalamic-pituitary-adrenocortical (HPA) axis with difluprednate treatment. Dogs with the most profound alopecic changes had less pronounced HPA axis suppression compared to dogs with no integumentary changes. Skin biopsies demonstrated follicular atrophy and follicular keratosis. When topical difluprednate was reduced to unilateral therapy, the hair regrew on the untreated side of the face. In addition to the affected research dogs, a 7-year old female spayed Chihuahua that was being treated as a clinical patient with long-term difluprednate 0.05% ophthalmic emulsion developed generalized hypotrichosis on the head and body and a potbellied appearance. ACTH stimulation testing revealed suppression of the HPA axis with a mild increase in serum alkaline phosphatase (ALP) activity and a urine specific gravity of 1.016. The combination of clinical signs and laboratory abnormalities was supportive of iatrogenic hyperadrenocorticism.ConclusionsIn dogs long-term use of difluprednate ophthalmic emulsion results in HPA axis suppression and in some cases iatrogenic hyperadrenocorticism. A novel pattern of localized alopecia is suspected to be related to dermal absorption and local action due to superior potency and penetration compared to other commonly utilized ophthalmic corticosteroids.

【 授权许可】

CC BY