Steroid refractory

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Steroid-induced osteoporosis (SIOP) is osteoporosis arising due to use of glucocorticoids (steroid hormones) - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Bisphosphonates are beneficial in reducing the risk of vertebral fractures. [1] Some professional guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take the equivalent of more than 30 mg hydrocortisone ( mg of prednisolone), especially when this is in excess of three months. [2] [3] The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases. [4] Alternate day use may not prevent this complication. [5]

Webster and Walker (2006) examined the safety and effectiveness of prolonged low-dose, continuous intravenous (IV) or subcutaneous ketamine infusions in non-cancer outpatients.  A total of 13 outpatients with neuropathic pain were administered low-dose IV or subcutaneous ketamine infusions for up to 8 weeks under close supervision by home health care personnel.  Using the 10-point VAS, 11 of 13 patients (85 %) reported a decrease in pain from the start of infusion treatment to the end.  Side effects were minimal and not severe enough to deter treatment.  Prolonged analgesic doses of ketamine infusions were safe for the small sample studied.  The authors concluded that these findings demonstrate that ketamine may provide a reasonable alternative treatment for non-responsive neuropathic pain in ambulatory outpatients.  Moreover, the authors stated that additional studies should follow to ascertain optimal dose and duration for specific pain disorders and to minimize side effects.  They also noted that questions regarding which patients would be most susceptible to this type of therapy and when treatment should be instituted remain unanswered. 

Steroid Responsive Meningitis - Samantha Goldberg BVSc MRCVS

Neck Pain and Fever in a Boxer--NAVA Clinician's Brief, November 2009
The Five Minute Veterinary Consult Page 388,
J AM Vet Med Assoc 201[10]:1553-8 Nov 15'92--Systemic Necrotizing Vasculitis in Nine Young Beagles.
J Vet Inter Med 4[2]:112 Mar/Apr'90 ACVIM 8th Annual Forum--Systemic Vasculitis {Canine Pain Syndrome} in young beagles
J Vet Intern Med 2[1]:26-35 Jan/Mar'88 123 Refs--Canine Meningitis:A Changing Emphasis
The Veterinary Record, June 17, 1978--Polyarteritis in a colony of beagles.
The Veterinary Record, April 7th 1973--Polyarteritis in the Dog: A Case Report   Dr. Roughie’s Questions and Answers- Steroid Responsive Meningitis-Vasculitis: The Disease With Many Names   Kasmin D. Bittle DVM   /images/Health/Dr-Roughie-ST-Column/
Neck Pain By Dr. J. E. Dillberger,  /images/Health/Dr-Roughie-ST-Column/

Steroid refractory

steroid refractory

Steroid Responsive Meningitis - Samantha Goldberg BVSc MRCVS

Neck Pain and Fever in a Boxer--NAVA Clinician's Brief, November 2009
The Five Minute Veterinary Consult Page 388,
J AM Vet Med Assoc 201[10]:1553-8 Nov 15'92--Systemic Necrotizing Vasculitis in Nine Young Beagles.
J Vet Inter Med 4[2]:112 Mar/Apr'90 ACVIM 8th Annual Forum--Systemic Vasculitis {Canine Pain Syndrome} in young beagles
J Vet Intern Med 2[1]:26-35 Jan/Mar'88 123 Refs--Canine Meningitis:A Changing Emphasis
The Veterinary Record, June 17, 1978--Polyarteritis in a colony of beagles.
The Veterinary Record, April 7th 1973--Polyarteritis in the Dog: A Case Report   Dr. Roughie’s Questions and Answers- Steroid Responsive Meningitis-Vasculitis: The Disease With Many Names   Kasmin D. Bittle DVM   /images/Health/Dr-Roughie-ST-Column/
Neck Pain By Dr. J. E. Dillberger,  /images/Health/Dr-Roughie-ST-Column/

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