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Pentoxifylline in canine dermatology (Proceedings)

November 1, 2010
Danny W. Scott, DVM, DACVD

Pentoxifylline (PTX) has been heralded as "the drug of the decade" and "a wonder drug". There is variably believable information (anecdotal-to-scientific) suggesting the therapeutic efficacy of PTX in a staggering number of dermatoses in human and veterinary (Table 1) medicine.PTX has been reported to have a steroid-sparing effect.

Pentoxifylline (PTX) has been heralded as "the drug of the decade" and "a wonder drug". There is variably believable information (anecdotal-to-scientific) suggesting the therapeutic efficacy of PTX in a staggering number of dermatoses in human and veterinary (Table 1) medicine.PTX has been reported to have a steroid-sparing effect.

Table 1. Dermatologic Conditions in Dogs that May Respond to PTX

PTX is a methylxanthine derivative with hemorrheologic and immunomodulatory properties (Table 2). The major mechanism of action of PTX is believed to be nonselective phosphodiesterase inhibition. PTX typically has a slow onset of action in dermatological disorders: from 4 weeks in atopic and contact dermatitis, to up to 3 months in familial dermatomyositis and vasculitides. PTX is contraindicated with significant renal or hepatic disease or bleeding disorders. Fetal abnormalities were produced when PTX was given to pregnant rodents.

Table 2. Some Effects of PTX

In dogs, treatment protocols prior to 2000 were totally empirical and anecdotal. Currently, we are using 25 mg/kg, q12h, PO with food. Side effects are rare and include nausea, vomiting, and diarrhea. Anecdotal side effects include thrombocytopenia, erythema multiforme, bone marrow suppression, and flushing.

PTX appears to be a useful therapeutic option in atopic dermatitis, allergic contact dermatitis,familial dermatomyositis, lupoid onychitis, and various vasculitides. PTX seems to be of little or no benefit in vesicular cutaneous lupus erythematosus and exfoliative cutaneous lupus erythematosus.

References

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Bryden SL, White SD, Dunston SM, et al. Clinical, histopathological and immunological characteristics of exfoliative cutaneous lupus erythematosus in 25 German short-haired pointers. Veterinary Dermatology 2005; 16:239-252.

Ely H. Is pentoxifylline the drug of the decade? Journal of the American Academy of Dermatology 1994; 30:639-640.

Jackson HA. Eleven cases of vesicular cutaneous lupus erythematosus in Shetland Sheepdogs and rough collies: clinical management and prognosis. Veterinary Dermatology 2004; 15:37-41.

Marks SL, Merchant S, Foil C. Pentoxifylline: wonder drug? Journal of the American Animal Hospital Association 2001; 37:218-219.

Marsella R, Kunkle GA, Lewis DT. Use of pentoxifylline in the treatment of allergic contact reactions to plants of the Commelinceae family in dogs. Veterinary Dermatology 1997; 8:121-126.

Marsella R, Nicklin CF, Munson JW, et al. Pharmacokinetics of pentoxifylline in dogs after oral and intravenous administration. American Journal of Veterinary Research 2000; 61:631-637.

Marsella R, Nicklin CF. Double-blinded, cross-over study on the efficacy of pentoxifylline for canine atopy. Veterinary Dermatology 2000; 11:255-260.

Mueller RS, Rosychuk RAW, Jonas LD. A retrospective study regarding the treatment of lupoid onychodystrophy in 30 dogs and literature review. Journal of the American Animal Hospital Association 2003; 39:139-150.

Nichols PR, Morris DO, Beale KM. A retrospective study of canine and feline cutaneous vasculitis. Veterinary Dermatology 2001; 12:255-264.

Rees CA, Booth DM, Boeckh A, et al. Dosing regimen and hematologic effects of pentoxifylline and its active metabolites in normal dogs. Veterinary Therapeutics 2003; 4:188-196.

Rees CA, Booth DM. Therapeutic response to pentoxifylline and its active metabolites in dogs with familial canine dermatomyositis. Veterinary Therapeutics 2003; 4:234-241.

Samlaska C, Winfield EA. Pentoxifylline. Journal of the American Academy of Dermatology 1994; 30:603-621.

Scott DW, Miller WH, Griffin CE. Muller & Kirk's Small Animal Dermatology, 6th ed. WB Saunders, 2001; p 241.

Scott DW, Miller WH. Pentoxifylline for the management of pruritus in canine atopic dermatitis: an open clinical trial with 37 dogs. Japanese Journal of Veterinary Dermatology 2007; 13:5-11.

Vitale CB, Gross TL, Magro CM. Vaccine-induced ischemic dermatopathy in the dog. Veterinary Dermatology 1999; 10:131-142.

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