Fluticasone
Fluticasone is a potent glucocorticoid used in veterinary medicine chiefly as an inhaled anti-inflammatory treatment. Its principal applications are long-term control of feline asthma, canine chronic bronchitis and selected equine asthma cases. Delivery to the airways provides local activity, while extensive first-pass metabolism of swallowed drug limits systemic exposure from that fraction.
Group
Inhaled glucocorticoid
Mechanism of Action
Fluticasone binds intracellular glucocorticoid receptors in airway cells and modifies transcription of inflammatory genes. It reduces cytokine, chemokine and adhesion-molecule expression and suppresses recruitment and activation of inflammatory cells. These changes reduce mucosal inflammation, edema and airway hyperresponsiveness. It can also support beta2-receptor responsiveness, complementing bronchodilator therapy in inflammatory airway disease.
Dose Rates
Dog
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory airway disease — Initial | 220 mcg/animal | INHALATION | Every 12 h | Delivered using an appropriate metered-dose inhaler and spacer. |
| Inflammatory airway disease — Maintenance | 110 mcg/animal | INHALATION | Every 12 h | Taper lower if control permits. Delivered using an appropriate metered-dose inhaler and spacer. |
| Chronic tracheobronchial disease | 440 mcg | INHALATION | Every 12 h | Two actuations of the 220 mcg/puff inhaler using a tightly fitting mask and spacer; allow 7–10 breaths. |
Cat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory airway disease — Initial | 44 mcg/animal | INHALATION | Every 12 h | Delivered using an appropriate metered-dose inhaler and spacer. |
| Inflammatory airway disease | 110 mcg/animal | INHALATION | Every 12 h | Escalation if needed. Delivered using an appropriate metered-dose inhaler and spacer. |
| Inflammatory airway disease | 220 mcg/animal | INHALATION | Every 12 h | Further escalation if needed. Delivered using an appropriate metered-dose inhaler and spacer. |
| Asthma | 44 mcg | INHALATION | Every 12 h | One actuation of a 44 mcg metered-dose inhaler with spacer and mask; study efficacy does not ensure adequate control in every cat. |
Horse
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Airway disease | Reference only | INHALATION | Source gives 1–2 mg per horse twice daily but equates this to 6–12 puffs of 220 mcg, which actually equals 1.32–2.64 mg. Resolve intended puff count before calculation. Delivered using an appropriate metered-dose inhaler and spacer. | |
| Long-term airway management | Reference only | INHALATION | Start at 2 mg per horse daily, then taper toward 1.5 mg every other day. Device-specific puff rounding and taper require a dedicated plan. Delivered using an appropriate metered-dose inhaler and spacer. | |
| Recurrent airway obstruction | 6 mg | INHALATION | Every 12 h | EquineHaler study regimen for exacerbation prevention; less effective than systemic dexamethasone for short-term treatment. Device delivery is critical. |
| Inflammatory airway disease taper | Reference only | INHALATION | Using a 220 mcg/actuation device: 2,200 mcg (10 puffs) twice daily for weeks 1–2, then once daily for weeks 3–4. Albuterol 450 mcg (five puffs) precedes the steroid and is also given approximately 30 minutes before exercise. Reassess at four weeks. |
Indications
- Long-term anti-inflammatory control of feline asthma and chronic inflammatory bronchial disease.
- Treatment of chronic inflammatory bronchitis and selected other steroid-responsive airway disorders in dogs.
- Adjunctive inhaled anti-inflammatory treatment of equine asthma, including recurrent airway obstruction.
Contraindications
- Use cautiously with respiratory or oral infection.
Interactions
- Systemic steroid effects can add to other corticosteroids; NSAIDs increase GI risk.
Adverse effects
- Adrenal suppression can occur despite low systemic exposure.
Monitoring and Administration
Use an appropriate spacer and mask; allow several breaths after each actuation. Monitor respiratory control and signs of infection.
Keep the pressurized inhaler intact. Strength per puff cannot be encoded using the schema’s permitted preparation denominators.
This is a maintenance anti-inflammatory treatment, not a rapid rescue bronchodilator.
Metered-dose propionate inhalers are described at 44, 110 and 220 mcg per puff; retain device strength without inventing an mL denominator.