Triamcinolone
Triamcinolone is a synthetic glucocorticoid supplied in several derivatives, including acetonide, diacetate and hexacetonide formulations. Veterinary applications include systemic inflammatory or immune-mediated disease and local treatment of joints or skin lesions. The derivative and dosage form influence solubility, potency and persistence, so their clinical delivery characteristics differ.
Group
Glucocorticoid
Mechanism of Action
Triamcinolone-derived glucocorticoid activity is mediated through intracellular glucocorticoid receptors. Changes in gene transcription reduce inflammatory cytokines, leukocyte activation and vascular inflammatory responses. These effects provide anti-inflammatory or immunosuppressive activity according to exposure. Slowly dissolving suspensions prolong local or systemic delivery, while different derivatives influence receptor activity and tissue persistence.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation — Initial | 0.1–0.2 mg/kg | PO | Every 24 h | |
| Inflammation — Initial | 0.11–0.22 mg/kg | PO | Every 24 h | Separate manufacturer starting range. |
| Inflammation — Maintenance | 0.1 mg/kg | PO | Every 48 h | |
| Inflammation — Maintenance | 0.03–0.055 mg/kg | PO | Every 48 h | Lower long-term alternative after control. |
| Immune-mediated disease — Initial | 0.2–0.6 mg/kg | PO | Every 24 h | |
| Immune-mediated disease — Maintenance | 0.1–0.2 mg/kg | PO | Every 48 h | |
| Injectable inflammation treatment | 0.1–0.2 mg/kg | IM, SC | Every 168–240 h | Acetonide suspension; repeat after 7-10 days. |
| Inflammation fixed alternative | 2 mg/animal | PO | Every 24 h | Up to 7 days; Fixed-dose oral alternative for 7 days. |
| Inflammation divided-dose alternative | 0.05 mg/kg | PO | Every 8–12 h | |
| Inflammation — Initial | 0.11 mg/kg | PO | Every 24 h | Increase to 0.22 mg/kg if inadequate; taper no later than 2 weeks when feasible. |
| Inflammation daily maintenance alternative — Maintenance | 0.028–0.055 mg/kg | PO | Every 24 h |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation — Initial | 0.2 mg/kg | PO | Every 24 h | |
| Inflammation — Maintenance | 0.1 mg/kg | PO | Every 48 h | |
| Inflammation — Maintenance | 0.5 mg/animal | PO | Every 48 h | Common fixed feline alternative. |
| Inflammation — Maintenance | 0.05 mg/kg | PO | Every 48 h | Lower dose adequate for some cats. |
| Immune-mediated disease — Initial | 0.2–0.6 mg/kg | PO | Every 24 h | |
| Immune-mediated disease — Maintenance | 0.1–0.2 mg/kg | PO | Every 48 h | |
| Injectable inflammation treatment | 0.1–0.2 mg/kg | IM, SC | Every 168–240 h | Acetonide suspension; repeat after 7-10 days. |
| Inflammation fixed alternative | 0.25–0.5 mg/animal | PO | Every 24 h | Up to 7 days; Fixed-dose oral alternative for 7 days. |
| Inflammation — Initial | 0.11 mg/kg | PO | Every 24 h | Increase to 0.22 mg/kg if inadequate; taper no later than 2 weeks when feasible. |
| Inflammation daily maintenance alternative — Maintenance | 0.028–0.055 mg/kg | PO | Every 24 h | |
| Pododermatitis or plasmacytic pharyngitis | 2–4 mg/animal | PO | Every 24–48 h | |
| Pododermatitis or plasmacytic pharyngitis | 0.4–0.6 mg/kg | PO | Every 24 h | |
| Pemphigus complex | 0.4–0.8 mg/kg | PO | Every 24 h | |
| Miliary dermatitis | 0.2–0.6 mg/kg | PO | Every 24 h | Up to 14 days; 10-14-day initial course then taper. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Fixed-amount inflammation treatment | Reference only | IM | 12-20 mg/horse IM is listed with a simultaneous 0.05 mg/kg maximum; fixed amount depends on body weight and cannot be encoded as an unconditional dose. | |
| Inflammation | 0.022–0.044 mg/kg | IM | Once | Acetonide suspension. |
| Recurrent airway obstruction | 0.09 mg/kg | IM | Once | This airway dose exceeds the same guidance stated maximum 0.05 mg/kg IM; conflicting indication-specific guidance needs clarification. |
| Glucocorticoid effects | 0.011–0.022 mg/kg | PO | Every 12 h | |
| Glucocorticoid effects | 0.011–0.022 mg/kg | IM, SC |
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Glucocorticoid effects | 0.02–0.04 mg/kg | IM |
Indications
- Treatment of selected inflammatory or immune-mediated skin disease in dogs and cats, including some pemphigus, allergic dermatitis or focal inflammatory lesions.
- Local treatment of selected noninfectious synovitis or osteoarthritis-associated joint inflammation with an appropriate intra-articular product.
- Intralesional treatment of selected focal inflammatory lesions.
- Treatment of selected equine airway inflammation, including asthma, with a supported formulation and regimen.
Contraindications
- Never administer injectable suspension IV.
- Corneal ulcers exclude ocular use.
- Use caution with infection, GI ulcers, diabetes, renal disease, pregnancy and impaired healing.
Interactions
- NSAIDs compound GI injury.
Adverse effects
- HPA suppression, hyperglycemia, polyuria/polydipsia, appetite changes, infection and GI injury; local granuloma risk with ocular injection.
Toxicity
Repeated glucocorticoid excess causes adrenal suppression, infection, metabolic disturbance and impaired healing; acute symptoms are managed supportively.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Triamcinolone acetonide tablet 0.5 mg | Tablet | 0.5 mg / tablet | PO |
| Triamcinolone acetonide tablet 1.5 mg | Tablet | 1.5 mg / tablet | PO |
| Triamcinolone acetonide suspension 2 mg/mL Not for IV use. Local joint/lesion administration requires a suitable product and procedure. | Injection | 2 mg / mL | IM, SC |
| Triamcinolone acetonide suspension 6 mg/mL Not for IV use. Local joint/lesion administration requires a suitable product and procedure. | Injection | 6 mg / mL | IM, SC |
| Triamcinolone acetonide suspension 10 mg/mL Not for IV use. Local joint/lesion administration requires a suitable product and procedure. | Injection | 10 mg / mL | IM, SC |
| Triamcinolone acetonide suspension 40 mg/mL Not for IV use. Local joint/lesion administration requires a suitable product and procedure. | Injection | 40 mg / mL | IM, SC |
Monitoring and Administration
Monitor glucose, hepatic and renal indices, infection and adrenal function. Shake suspensions; do not freeze. Do not substitute acetonide, diacetate and hexacetonide products without confirming basis.
Local procedures: dogs/cats intralesional 1.2-1.8 mg, or 1 mg per centimeter lesion diameter, repeated every 2 weeks or longer; large joints 5-15 mg/joint, small joints and tendon sheaths 2.5-5 mg. Horses 6-18 mg/joint, commonly 9-12 mg, repeated after 4-13 days if needed. These routes are not available in the calculator. Cattle have no established dose; the reported guidance suggests equine extrapolation rather than a validated cattle regimen.
Other preparations include triamcinolone diacetate 25 mg/mL and hexacetonide 5 or 20 mg/mL. These distinct esters lack a product-specific route and dose basis here and are not normalized as acetonide preparations.
Intralesional treatment has a specific 0.6-mg/site and 6-mg total procedure ceiling, despite usual 1.2-1.8 mg treatment amounts. Esophageal re-stricture procedure uses 0.5-1 mL of 2 mg/mL injected submucosally at four circumferential points during dilation; the report is unclear whether stated volume is total or per point, so no 4-fold conversion is made. Equine joint calendars and cattle 6-18 mg intra-articular amounts are local procedures.