title: Treatment of canine leproid granuloma syndrome: preliminary findings in seven dogs.
abstract: OBJECTIVE
  To determine effective treatment strategies for patients with refractory canine leproid granuloma syndrome.
  
  
  METHODS
  Multi-institutional retrospective/prospective case series using client-owned dogs.
  
  
  METHODS
  Seven dogs (four Boxers, one Dobermann, one Bullmastiff and one Bullmastiff cross-bred; ages 3 to 11 years) with leproid granulomas were treated successfully using a variety of treatment regimens. These cases were recruited because: lesions were either widely distributed over the dog; progressive, despite routine therapy, or were associated with particularly disfiguring lesions. The treatment regimen evolved during the course of the clinical study.
  
  
  RESULTS
  Combination therapy using rifampicin (5 to 15 mg/kg p.o., every 24 h) and clarithromycin (8 to 24 mg/kg p.o. daily; dose divided every 8 or every 12 h) was used most frequently and proved to be effective and free from side effects. Total daily doses of clarithromycin in excess of 14 mg/kg were considered optimal and long treatment courses, in the order of 1 to 3 months, were used. Combination therapy using rifampicin (25 mg/kg; that is, higher than the recommended dose) and clofazimine was effective in one case, but resulted in hepatotoxicity. A topical formulation of clofazimine in petroleum jelly was used as an adjunct to oral rifampicin and doxycycline in another patient treated successfully.
  
  
  CONCLUSIONS
  Based on our evolving clinical experience, a combination of rifampicin (10 to 15 mg/kg p.o., every 24 h) and clarithromycin (15 to 25 mg/kg p.o. total daily dose; given divided every 8 to 12 h) is currently recommended for treating severe or refractory cases of canine leproid granuloma syndrome. Treatment should be continued (typically for 4 to 8 weeks) until lesions are substantially reduced in size and ideally until lesions have resolved completely. A topical formulation, containing clofazimine in petroleum jelly may be used as an adjunct to systemic drug therapy. Further work is required to determine the most cost effective treatment regimen for this condition.
authors.affiliation: Department of Veterinary Clinical Sciences, University of Sydney, New South Wales 2006. R.Malik@vetc.usyd.edu.au
authors.forename: R
authors.initials: R
authors.lastname: Malik
authors.forename: P
authors.initials: P
authors.lastname: Martin
authors.forename: D
authors.initials: D
authors.lastname: Wigney
authors.forename: D
authors.initials: D
authors.lastname: Swan
authors.forename: P S
authors.initials: PS
authors.lastname: Slatter
authors.forename: D
authors.initials: D
authors.lastname: Cibilic
authors.forename: J
authors.initials: J
authors.lastname: Allen
authors.forename: D H
authors.initials: DH
authors.lastname: Mitchell
authors.forename: S C
authors.initials: SC
authors.lastname: Chen
authors.forename: M S
authors.initials: MS
authors.lastname: Hughes
authors.forename: D N
authors.initials: DN
authors.lastname: Love
authors.forename: P S
authors.initials: PS
authors.lastname: Sattler
mesh_terms: D000818:Animals; D017291:Clarithromycin / Q000008:administration & dosage*; D004283:Dog Diseases / Q000188:drug therapy* / Q000473:pathology; D004285:Dogs; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D007917:Leprostatic Agents / Q000008:administration & dosage*; D015440:Leprosy, Lepromatous / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D009517:New South Wales; D011446:Prospective Studies; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage*; D013577:Syndrome
chemical_list: D007917:Leprostatic Agents; D017291:Clarithromycin; D012293:Rifampin