Successful management of refractory cough with the leukotriene receptor antagonist zafirlukast in a dog with chronic bronchitis: a case report

https://doi.org/10.17221/162/2017-VETMEDCitation:Yoon IH, Han HJ, Kim JH (2018): Successful management of refractory cough with the leukotriene receptor antagonist zafirlukast in a dog with chronic bronchitis: a case report. Veterinarni Medicina, 63: 181-186.
download PDF

A 7-year-old spayed female Pomeranian dog was evaluated for a 6-month history of intractable coughing and dyspnoea. The cough was unresponsive to antibiotics and a bronchodilator medication prescribed by the previous animal hospital. No abnormalities were identified on the blood work, echocardiography and radiography. However, computed tomography revealed mild bronchiectasia. Based on the history, physical examination and non-specific diagnostic imaging findings, the dog was diagnosed with chronic bronchitis. The cough failed to resolve, despite an attempt to manage it with prednisolone, theophylline, codeine and N-acetylcysteine. With the owner’s consent, we stopped all previous medications and finally tried the leukotriene receptor antagonist zafirlukast. The cough progressively improved and had mostly resolved four weeks after starting the administration of zafirlukast. The dog remained in complete remission without recurrence for seven months. This case report is the first to describe the successful long-term management of chronic cough with zafirlukast in a dog.

References:
Barnes PJ, Adcock IM (2003): How do corticosteroids work in asthma? Annals of Internal Medicine 139, 359–370.
 
Becker A. B., Black C., Lilley M. K., Bajwa K., Ford-Hutchinson A. W., Simons F. E., Tagari P. (1995): Antiasthmatic effects of a leukotriene biosynthesis inhibitor (MK-0591) in allergic dogs. Journal of Applied Physiology, 78, 615-622 https://doi.org/10.1152/jappl.1995.78.2.615
 
Brownlie S. E. (1990): A retrospective study of diagnosis in 109 cases of canine lower respiratory disease. Journal of Small Animal Practice, 31, 371-376 https://doi.org/10.1111/j.1748-5827.1990.tb00482.x
 
Byers CG (2005): Feline bronchial asthma: treatment. Compendium 27, 426–431.
 
Cai Chuang, He Mu-zhi, Zhong Shu-qing, Tang Yan, Sun Bao-qing, Chen Qiao-li, Zhong Nan-shan (2012): Add-on montelukast vs double-dose budesonide in nonasthmatic eosinophilic bronchitis: A pilot study. Respiratory Medicine, 106, 1369-1375 https://doi.org/10.1016/j.rmed.2012.06.009
 
CALHOUN WILLIAM J., LAVINS BERNARD J., MINKWITZ MARGARET C., EVANS RHOBERT, GLEICH GERALD J., COHN JUDITH (1998): Effect of Zafirlukast (Accolate) on Cellular Mediators of Inflammation. American Journal of Respiratory and Critical Care Medicine, 157, 1381-1389 https://doi.org/10.1164/ajrccm.157.5.9609014
 
Wood Alastair J.J., Drazen Jeffrey M., Israel Elliot, O'Byrne Paul M. (1999): Treatment of Asthma with Drugs Modifying the Leukotriene Pathway. New England Journal of Medicine, 340, 197-206 https://doi.org/10.1056/NEJM199901213400306
 
Finkel Terri H., Hunter Deborah J., Paisley Jan E., Finkel Richard S., Larsen Gary L. (1999): Drug-induced lupus in a child after treatment with zafirlukast (Accolate). Journal of Allergy and Clinical Immunology, 103, 533-534 https://doi.org/10.1016/S0091-6749(99)70482-3
 
GOODMAN L., COLES T. B., BUDSBERG S. (2008): Leukotriene inhibition in small animal medicine. Journal of Veterinary Pharmacology and Therapeutics, 31, 387-398 https://doi.org/10.1111/j.1365-2885.2008.00963.x
 
Jeffery P K (2001): The roles of leukotrienes and the effects of leukotriene receptor antagonists in the inflammatory response and remodelling of allergic asthma. Clinical <html_ent glyph="@amp;" ascii="&amp;"/> Experimental Allergy Reviews, 1, 148-153 https://doi.org/10.1046/j.1472-9725.2001.00028.x
 
Kelloway Judy Shepard (2017): Zafirlukast: The First Leukotreene-Receptor Antagonist Approved for the Treatment of Asthma. Annals of Pharmacotherapy, 31, 1012-1021 https://doi.org/10.1177/106002809703100912
 
LAVIOLETTE MICHEL, MALMSTROM KERSTIN, LU SUSAN, CHERVINSKY PAUL, PUJET JEAN-CLAUDE, PESZEK IZABELLA, ZHANG JI, REISS THEODORE F. (1999): Montelukast Added to Inhaled Beclomethasone in Treatment of Asthma. American Journal of Respiratory and Critical Care Medicine, 160, 1862-1868 https://doi.org/10.1164/ajrccm.160.6.9803042
 
Liu Min, Yokomizo Takehiko (2015): The role of leukotrienes in allergic diseases. Allergology International, 64, 17-26 https://doi.org/10.1016/j.alit.2014.09.001
 
Mantis P., Lamb C. R., Boswood A. (1998): Assessment of the accuracy of thoracic radiography in the diagnosis of canine chronic bronchitis. Journal of Small Animal Practice, 39, 518-520 https://doi.org/10.1111/j.1748-5827.1998.tb03697.x
 
McKiernan Brendan C. (2000): Diagnosis and Treatment of Canine Chronic Bronchitis. Veterinary Clinics of North America: Small Animal Practice, 30, 1267-1278 https://doi.org/10.1016/S0195-5616(00)06006-X
 
Nafe Laura A., DeClue Amy E., Lee-Fowler Tekla M., Eberhardt Jason M., Reinero Carol R. (2010): Evaluation of biomarkers in bronchoalveolar lavage fluid for discrimination between asthma and chronic bronchitis in cats. American Journal of Veterinary Research, 71, 583-591 https://doi.org/10.2460/ajvr.71.5.583
 
Padrid P (1992): Chronic lower airway disease in the dog and cat. Problems in Veterinary Medicine 4, 320–344.
 
Piatti G (2003): Effects of zafirlukast on bronchial asthma and allergic rhinitis. Pharmacological Research, 47, 541-547 https://doi.org/10.1016/S1043-6618(03)00017-3
 
Ramsay C.F., Sullivan P., Gizycki M., Wang D., Swern A.S., Barnes N.C., Reiss T.F., Jeffery P.K. (2009): Montelukast and bronchial inflammation in asthma: A randomised, double-blind placebo-controlled trial. Respiratory Medicine, 103, 995-1003 https://doi.org/10.1016/j.rmed.2009.01.019
 
Reinero Carol R. (2011): Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. The Veterinary Journal, 190, 28-33 https://doi.org/10.1016/j.tvjl.2010.09.022
 
Reinero Carol R., Decile Kendra C., Byerly Jenni R., Berghaus Roy D., Walby William F., Berghaus Londa J., Hyde Dallas M., Schelegle Edward S., Gershwin Laurel J. (2005): Effects of drug treatment on inflammation and hyperreactivity of airways and on immune variables in cats with experimentally induced asthma. American Journal of Veterinary Research, 66, 1121-1127 https://doi.org/10.2460/ajvr.2005.66.1121
 
Reiss Theodore F. (1998): Montelukast, a Once-Daily Leukotriene Receptor Antagonist, in the Treatment of Chronic Asthma<subtitle>A Multicenter, Randomized, Double-blind Trial</subtitle>. Archives of Internal Medicine, 158, 1213- https://doi.org/10.1001/archinte.158.11.1213
 
Rozanski Elizabeth (2014): Canine Chronic Bronchitis. Veterinary Clinics of North America: Small Animal Practice, 44, 107-116 https://doi.org/10.1016/j.cvsm.2013.09.005
 
Senter DA, Scott DW, Miller Jr WH (2002): Treatment of canine atopic dermatitis with zafirlukast, a leukotriene-receptor antagonist: a single-blinded, placebo-controlled study. The Canadian Veterinary Journal 43, 203–206.
 
Sharma JN, Mohammed LA (2006): The role of leukotrienes in the pathophysiology of inflammatory disorders: is there a case for revisiting leukotrienes as therapeutic targets? Inflammopharmacology 14, 10–16.
 
Wenzel S E, Trudeau J B, Kaminsky D A, Cohn J, Martin R J, Westcott J Y (1995): Effect of 5-lipoxygenase inhibition on bronchoconstriction and airway inflammation in nocturnal asthma.. American Journal of Respiratory and Critical Care Medicine, 152, 897-905 https://doi.org/10.1164/ajrccm.152.3.7663802
 
download PDF

© 2018 Czech Academy of Agricultural Sciences