Glucocorticoids, Cyclosporine, Azathioprine, Chlorambucil, and Mycophenolate in Dogs and Cats

The treatment of immune-mediated disease in dogs and cats continues to evolve as new therapies are adapted from human medicine. Glucocorticoids remain the first-line treatment followed by second-line therapies including cyclosporine, azathioprine (dogs), chlorambucil, or mycophenolate. Second-line therapies are introduced due to the patient's lack of response or intolerable effects to glucocorticoids or may be introduced early in the disease treatment due to the patient's severe life-threatening clinical presentation. The goals of immunosuppressive treatment are to achieve disease remission while minimizing drug side effects. Ultimately, gradual drug tapering to the lowest dose to maintain disease remission or successful drug withdrawal.