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January 2024
Case Report of the Month
In an attempt to avoid the systemic side effects associated with oral steroids for chronic bilateral uveitis, a bichon frise was given oral cyclosporine after discontinuing the oral steroid. However, the cyclosporine was also discontinued one month later, because of severe vomiting. Read on to find out if oral leflunomide is a viable treatment option for canine idiopathic immune-mediated uveitis.
The Eyes Have It
Is oral leflunomide a viable treatment option for canine idiopathic immune-mediated uveitis?
In an attempt to avoid the systemic side effects associated with oral steroids for chronic bilateral uveitis, a bichon frise was given oral cyclosporine after discontinuing the oral steroid. However, the cyclosporine was also discontinued 1 mo later, because of severe vomiting.
Leflunomide (2 mg/kg q 12 hr) was initiated, and the uveitis symptoms resolved after 2 mo. The dose was tapered according to the remission of clinical signs, with no relapse during the following 13 mo. Leflunomide therapy was then discontinued due to vomiting caused by severe gastroenteritis and pancreatitis, and topical prednisolone monotherapy was continued.
At 8 mo after discontinuation of leflunomide, bilateral uveitis recurred, and leflunomide therapy was resumed. However, the patient lost vision due to the progression of clinical signs at 33 mo after commencing leflunomide, and evisceration of the glaucomatous right eye was performed at 43 mo.
Read the outcome in the full report, “Leflunomide for the Treatment of Immune-Mediated Uveitis in a Dog,” in the January/February 2024 issue of JAAHA at jaaha.org.