Cyclosporine and ketoconazole for the treatment of perianal fistulas in dogs

Alison J. Patricelli Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53762.
Present address is VCA Veterinary Care Animal Hospital, 9901 Montgomery Blvd, Albuquerque, NM 87111.

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Robert J. Hardie Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53762.

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Jonathan F. McAnulty Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53762.

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 DVM, PhD

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Abstract

Objective—To evaluate efficacy and cost of using cyclosporine and ketoconazole for the treatment of perianal fistulas in dogs.

Design—Clinical trial.

Animals—12 dogs with perianal fistulas.

Procedure—Dogs received cyclosporine and ketoconazole orally (target whole blood trough cyclosporine concentrations of 400 to 600 ng/ml). Study endpoints were resolution of clinical signs, remission, and recurrence of disease. Adverse effects and cost of medications were reported. Results were compared with those from previous studies in humans and in dogs in which single agent cyclosporine treatment for perianal fistulas was used.

Results—All dogs had resolution of clinical signs. Eight dogs went into remission; however, 5 of those 8 had recurrence of fistulas. Adverse effects of treatment were minimal and well tolerated. Cost of treatment was comparable to traditional surgical options and less than single agent cyclosporine treatment.

Conclusions and Clinical Relevance—Administration of cyclosporine with ketoconazole is an effective and cost-comparable treatment for perianal fistulas in dogs. (J Am Vet Med Assoc 2002;220:1009–1016)

Abstract

Objective—To evaluate efficacy and cost of using cyclosporine and ketoconazole for the treatment of perianal fistulas in dogs.

Design—Clinical trial.

Animals—12 dogs with perianal fistulas.

Procedure—Dogs received cyclosporine and ketoconazole orally (target whole blood trough cyclosporine concentrations of 400 to 600 ng/ml). Study endpoints were resolution of clinical signs, remission, and recurrence of disease. Adverse effects and cost of medications were reported. Results were compared with those from previous studies in humans and in dogs in which single agent cyclosporine treatment for perianal fistulas was used.

Results—All dogs had resolution of clinical signs. Eight dogs went into remission; however, 5 of those 8 had recurrence of fistulas. Adverse effects of treatment were minimal and well tolerated. Cost of treatment was comparable to traditional surgical options and less than single agent cyclosporine treatment.

Conclusions and Clinical Relevance—Administration of cyclosporine with ketoconazole is an effective and cost-comparable treatment for perianal fistulas in dogs. (J Am Vet Med Assoc 2002;220:1009–1016)

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