Cyclosporine is an immunosuppressive drug that has been used by veterinarians to treat the pruritus associated with many dermatologic conditions. Recently, the FDA approved a formulation of cyclosporine A for dogs. It is useful in patients that do not respond to glucocorticoids or those that could not tolerate long-term use. The initial use of cyclosporine is expensive, but pruritus can often be managed with therapy given 2 or 3 times a week. Cyclosporine can be used alone or with other immunotherapeutic agents. A trial period of 30 to 60 days may be necessary before determining if the drug is beneficial.

KEY POINT: This formulation alleviates the need for veterinarians to rely on the human formulation and makes it easier to dose small dogs. There are advantages to using cyclosporine instead of glucocorticoid therapy. Gluconeogenesis and protein catabolism do not occur, and there are no risks for adverse events, such as diabetes mellitus and silent urinary tract infections, that are associated with glucocorticoids.