Suspected Cutaneous Drug Reaction

In veterinary patients, the symptoms of cutaneous drug reactions can be highly variable. Follow this management tree to promptly  identify and treat reactions when they occur.

Author Insight

Adverse drug reactions can be highly variable:

• May be idiosyncratic or dose dependent

• May occur at any time during treatment, even if patient has tolerated the medication in the past

• Clinical appearance from one animal to another can be highly variable. 

Although several classes of medication (eg, antibiotics, NSAIDs, parasiticides) have been reported to commonly cause adverse drug reactions, any medication (including supplements) has the potential to do so.¹

Although this algorithm focuses primarily on suspected cutaneous drug reactions, it is important to remember that other body systems may also be affected.

• Medications with known dose-dependent toxicities can target specific organs (eg, nephrotoxicity with aminoglycoside antibiotics, cardiotoxicity with doxorubicin administration).

  • However, with idiosyncratic reactions, clinical signs can be highly variable and may include cutaneous reactions, hematologic abnormalities or blood dyscrasia, or hepatic toxicity.¹

• Additional diagnostic tests may be indicated when clinical signs other than skin lesions are observed.

  • CBC, serum biochemistry profiles, and urinalyses are recommended in most cases.

  • Additional supportive care may be necessary based on clinical abnormalities identified (eg, blood products for hemolytic anemia, administration of hepatoprotectants for hepatotoxicity).