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Discussion on Reducing Dexamethasone Dosage

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SLJ
New Member
Username: shirliej

Post Number: 1
Registered: 9-2008
Posted on Tuesday, Nov 18, 2008 - 1:59 am:   Edit PostPrint Post

Dr O
Our 6 tear old Hanoverian gelding has been on Dexamethasone since September for the treatment of severe hives. (We have had blood tests, have eliminated all but hay in his diet, eliminated sprays etc. but are still not sure what is causing the “allergic” reaction. He started on 2ml (10 mg) Dexamethasone IM .We have been reducing the dose by .1ml every four days i.e. 1.9ml for 4 days, then 1.8 for 4 days etc. When we get to 1.1 ml the hives always recur. We have tried to substitute oral medication but the same dose orally does not seem to control the hives as well as the IM does.
My questions are;
1. How long is it safe to give 1.1-1.2mls Dex? We had blood tests taken recently to determine if there were any effects from the Dex and our vet said that the tests were normal.
2. Could you please tell me the best way to lower dosage of Dexamethasone to obtain the lowest effective level with eventual goal of discontinuing altogether?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21770
Registered: 1-1997
Posted on Tuesday, Nov 18, 2008 - 9:27 am:   Edit PostPrint Post

Welcome SLJ,
Are you sure about the mg dosage SLJ? Dex comes as a 1, 2, and 4 mg/ml preparation commonly. I have not seen a 5 mg/ml preparation. We explain principles of long term dexamethasone use at "Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Dexamethasone". Look at the dosage subtopic. I would also review the article on hives as we give other treatments that may ameleorate the amount of steroid required, see Diseases of Horses » Skin Diseases, Wounds, and Swellings » Bumps / Nodules / Warts / Tumors » Hives, Wheals, and Urticaria in Horses.
DrO
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SLJ
New Member
Username: shirliej

Post Number: 2
Registered: 9-2008
Posted on Wednesday, Nov 19, 2008 - 1:30 am:   Edit PostPrint Post

Thanks Dr Oglesby for your reply. Yes the dosage is correct. The product is Dexamethasone 5 (5mg/ml). It is manufactured by Vetoquinol N.A. Inc. in Quebec, Canada. I am currently reading the articles you suggested. Thanks again
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