Gingival hyperplasia caused by cyclosporine in an atopic dog
Amongst the various potential adverse effects of cyclosporine in dogs is a gingival hyperplasia. It’s not dramatic in this patient: they can be much worse.
The same phenomenon is seen in people. In human medicine it can be managed with azithromycin in capsule or toothpaste formulation. In dogs this approach has proved less successful:
Evaluation of azithromycin in systemic and toothpaste forms for the treatment of ciclosporin-associated gingival overgrowth in dogs.
In my experience, this kind of thing usually suggests that blood levels are quite high. The patient pictured was working to a budget and for that reason was receiving concurrent ketoconzole and cyclosporine (to reduce elimination, and thus required dose, of cyclosporine): which always makes blood levels a bit more unpredictable. The same financial constraints prevented us from doing rigorous drug monitoring and I suspect that plasma concentrations were higher than necessary.
