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Discussion on Altrtnate Day Therapy

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Rose Edwards
Member
Username: Rose15

Post Number: 3
Registered: 4-2005
Posted on Wednesday, Apr 6, 2005 - 7:54 pm:   Edit PostPrint Post

Dr. O.....I found your article on Alternate Day Therapy. After reading the part about intravenous
Dexasone at 0.06mg/lb and predisolone at 0.5mg/lb once daily I have a question, we used Dexasone orally for one week, then started on predisolone that was compounded into paste once a day. We did not use the drugs at the same time. The hives disappeared while we were on the Dexasone only to reappear when we used Predisolone 10cc once a day. Using your formula we would used Dexasone the first day and then use Predislone is this correct? Thank you.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 12483
Registered: 1-1997
Posted on Wednesday, Apr 6, 2005 - 10:16 pm:   Edit PostPrint Post

Yes usually a initial dose of dex is given IV, for fast action, then replaced with oral prednisolone. Generally dex is considered roughly 10 to 20 times as potent as pred on a mg basis which is why the pred dose is roughly 10 times as much. Also important is to realize the dex persists in the body much longer than the pred. The reasons for your treatment failure could be:
1. Inadequate pred dose
2. Too infrequent dosing
3. Worsening disease
DrO
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Rose Edwards
Member
Username: Rose15

Post Number: 4
Registered: 4-2005
Posted on Thursday, Apr 7, 2005 - 10:20 am:   Edit PostPrint Post

Dr O......we were on Dexasone 10cc orally for one week, then our vet had our mare on Predisolone paste 10cc for the last 2 weeks. We are still giving Predisolone but had a bad break through last night. Our vet had given her the shot for EEE,WWE, West Nile, Tetanus and flu. Don't know for sure if that could have triggered the outbreak or not. Just read an article on Dexamethasone from the AAEP convention in March that stated oral Dex had a longer duration of action than Dex administered IV. It was recommended to give before feeding. Do you feel that 10cc of Predisolone paste is not enough? Thank you so very much for your help. Rose
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Rose Edwards
Member
Username: Rose15

Post Number: 7
Registered: 4-2005
Posted on Thursday, Apr 7, 2005 - 7:37 pm:   Edit PostPrint Post

Dr. O.....thank you for your help, it sounds like we were reducing our dose from Dex 10cc to Prednisolone 10cc which is only about 5-10% of what our mare had been receiving so I can see why we would have a break through of hives. My son is a physician and he said while he didn't know vet medicine in human medicine that would be too
much of a drop without having a significant reaction. Would using an electroyte such as Biovet (individual packages to help retain consistant quality) be of help to our mare?
Thank you again for clarifying the facts, I really appreciate your help. Rose
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 12501
Registered: 1-1997
Posted on Friday, Apr 8, 2005 - 7:33 am:   Edit PostPrint Post

What where the concentrations of the preparations you where using? Just knowing the amount of preparation is not enough we must also know the concentration to calculate your dosage. As long as a trace mineral salt block block is available, supplemental minerals are not necessary.
DrO
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Rose Edwards
Member
Username: Rose15

Post Number: 10
Registered: 4-2005
Posted on Monday, Apr 11, 2005 - 1:12 pm:   Edit PostPrint Post

Dr. O...the concentrations of Dexasone is 2mg/ml giving 10cc orally, the Prednisolone is 100mg/5ml
giving 10 cc.
Rose Edwards
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 12555
Registered: 1-1997
Posted on Tuesday, Apr 12, 2005 - 9:50 am:   Edit PostPrint Post

Certainly lower doses and the change would not be harmful to the horse but as you found may not be therapeutic.
DrO
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