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Management
The response to oral steroid therapy is generally very good, although achievement of total lack of symptoms
is not always obtained. Prednisolone is initiated at a dosage of 0.5 to 1 mg/kg (in severe cases) q 12h the  rst week; the same dose is given on alternate days during the second week, and then the dosage is progressively and gradually reduced on alternated days until maintenance dosage. Since chronic oral steroid therapy may unfortunately lead to well-recognized systemic side effects (i.e iatrogenic hyperadrenocorticism) and since
its use can also be contraindicated in dogs with other concomitant health problems such as diabetes mellitus, obesity or cardiac diseases, alternative treatment with inhaled steroid therapy (IST) has been increasingly
used in the past years in both human and veterinary medicines, with the suggested advantages to provide both high drug concentrations within the airways and a reduced systemic and potentially deleterious absorption. Inhaled corticosteroids therapy is well tolerated, result
in improvement in clinical signs and reduction in side effects, and allow a reduction of oral steroid dosage
in steroid-dependent animals 89. However, it seems that treatment of EBP with long term IST alone does not allow a proper management in all affected dogs and that sustained long term IST may induce inhibition of pituitary–adrenal axis (PAA)9. Other drugs with immunomodulatory effect have not been proposed, but no published trial results are available to date.
Prognosis
Relapse frequently occurs within weeks to months after drug discontinuation although some dogs may remain asymptomatic after discontinuation.
Take home message
Eosinophilic bronchopneumopathy (EBP) is a disease characterized by eosinophilic in ltration of the lung and bronchial mucosa, as demonstrated by cytological examination of either bronchoalveolar lavage  uid or bronchial brush  uid cytospin preparations or histologic examination of the bronchial mucosa. In idiopathic EBP, hypersensitivity to aeroallergens is suspected. However, the precise cause is often unknow. The diagnosis relies on typical history and clinical signs, demonstration
of bronchopulmonary eosinophilia by cytology or histopathologic examination, and exclusion of known causes of lower airway eosinophilia. Most dogs display an excellent response to oral corticosteroid therapy; however, treatment can rarely be discontinued and side effects can be limiting./ in most cases, corticosteroids will be used for long periods of time, if not lifelong/
An Urban Experience
Nebulized administration of corticoisteroid can help reducing the oral dosages or even replace oral therapy.
1. Peeters D, Peters IR, Helps CR, Gabriel A, Day MJ, Clercx C. Distinct tissue cytokine and chemokine mRNA expression in canine sino-nasal aspergillosis and idiopathic lymphoplasmacytic rhinitis. Vet Immunol Immunopathol. 2007;117(1-2):95-105. doi:10.1016/j. vetimm.2007.01.018.
2. Clercx C, Peeters D, Snaps F, et al. Eosinophilic bronchopneumopathy in dogs. J Vet Intern Med. 2000;14(3):282- 291.
3. Clercx C, Peeters D, German AJ, et al. An immunologic investigation of canine eosinophilic bronchopneumopathy. J Vet Intern Med. 2002;16(3):229-237.
4. Rajamäki MM, Järvinen A-K, Sorsa T, Maisi P. Clinical  ndings, bronchoalveolar lavage  uid cytology and matrix metalloproteinase-2 and -9 in canine pulmonary eosinophilia. Vet J. 2002;163(2):168- 181.
5. Clercx C, Peeters D. Canine eosinophilic bronchopneumopathy. Vet Clin North Am Small Anim Pr. 2007;37(5):917-35, vi. doi:10.1016/j. cvsm.2007.05.007.
6. Mesquita L, Lam R, Lamb CR, McConnell JF. COMPUTED TOMOGRAPHIC FINDINGS IN 15 DOGS WITH EOSINOPHILIC BRONCHOPNEUMOPATHY. Vet Radiol Ultrasound. 2015;56(1):33- 39.
7. Maksimov P, Hermosilla C, Taubert A, et al. GIS-supported epidemiological analysis on canine Angiostrongylus vasorum and Crenosoma vulpis infections in Germany. Parasit Vectors. 2017;10(1):108. doi:10.1186/s13071-017-2054-3.
8. Bex eld NH, Foale RD, Davison LJ, Watson PJ, Skelly BJ, Herrtage ME. Management of 13 cases of canine respiratory disease using inhaled corticosteroids. J Small Anim Pr. 2006;47(7):377-382.
9. Canonne A-M, Bolen G, Peeters D, Billen F, Clercx C. LONG TERM FOLLOW UP IN DOGS WITH IDIOPATHIC EOSINOPHILIC BRONCHOPNEUMOPATHY TREATED WITH INHALED STEROID THERAPY. J Small Anim Pract. 2016;57(10):537-542.
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