November 2023 17 administered to cats. Imepitoin is approved in the veterinary market for use in dogs. Levetiracetam should be administered as an adjunct to other antiepileptic drugs. Gabapentin and pregabalin are poor anti-epileptic drugs but used for the treatment of painful conditions including neuropathic pain and to decrease stress during patient transportation. ONCOLOGY (The relapsed disease using rescue protocols or cases of toxicity with a specific drug cannot always be treated with this essential list of drugs). Core List 1) Alkylating agents (cyclophosphamide and chlorambucil) Cyclophosphamide is available in oral and iv forms and it is used commonly to treat canine and feline lymphoma in conjunction with other medications as part of a multi-drug protocol. Chlorambucil is orally administered and it is used to treat chronic lymphocytic leukaemias, mast cell tumours and transitional cell carcinomas. 2) Anti-tumour antibiotics (doxorubicin) Used alone or in combined protocols to treat lymphoma, hemangiosarcoma, osteosarcoma, mammary carcinomas, feline injection site sarcomas and most epithelial and mesenchymal tumours in dogs and cats. 3) Corticosteroids (prednisolone) Prednisolone is the most routinely used corticosteroid for the treatment of almost all round cell tumours. 4) Platinum agents (carboplatin) Carboplatin is widely used to treat a variety of sarcomas and carcinomas, including osteosarcoma, transitional cell carcinomas, prostatic carcinomas, head and neck carcinomas, pulmonary carcinomas and others. 5) Vinca alkaloids (vincristine, vinblastine) Vincristine is a first-line chemotherapeutic agent used in many lymphoma and leukaemia protocols and for the treatment of transmissible venereal tumour (TVT). It is used in a multiagent protocol for treatment of hemangiosarcoma. Vinblastine is commonly used for the treatment of mast cell tumours and transitional cell carcinomas. Complementary List 1) Antimetabolite (hydroxyurea) Mostly used to treat polycythaemia vera and can be considered for certain forms of leukaemia. 2) Nitrosureas (lomustine and melphalan) Lomustine is a drug for oral use in the treatment of canine cutaneous lymphoma, mastocytoma and lymphoma, histiocytic sarcoma or relapsing lymphomas. Lomustine crosses the blood-brain barrier, and it is widely used for tumours of the central nervous system. Melphalan is orally administered and used to treat multiple myeloma. 3) Tyrosine kinase inhibitors (toceranib, masitinib and imatinib) These drugs are targeted therapies that can block specific receptors that are frequently aberrantly expressed in certain tumours, especially mast cell tumours. The use of toceranib has been expanded to treat apocrine gland adenocarcinomas of the anal sac, GIST, pulmonary neoplasia, oral squamous cell carcinomas and most endocrine neoplasia such as insulinomas, thyroid carcinomas, pancreatic and adrenal carcinomas (anecdotal evidence). OPHTHALMOLOGY Core list 1) Carbonic anhydrase inhibitors (dorzolamide) Topical carbonic anhydrase inhibitors should be considered to decrease intraocular pressure by decreasing aqueous humour production in cases of glaucoma. 2) Glucocorticoids Topical steroids that are potent (dexamethasone phosphate) and/or have good penetration through the cornea (prednisolone acetate) are often required to treat ocular surface disorders and intraocular disorders. 3) Hyperosmotic agents (mannitol) Drugs that increase osmolality of the blood can be used iv to help decrease intraocular pressure during glaucoma crisis (see anaesthetic, analgesics, sedative and emergency drugs). 4) Immunosuppressive/immunomodulatory drugs Cyclosporine and tacrolimus are immunosuppressive/ immunomodulatory drugs that are routinely used in immunemediated disorders (e.g. keratoconjunctivitis sicca). These drugs are used topically (e.g. cyclosporine, tacrolimus) (see immunosuppressive drugs). 5) Local anaesthetics Local anaesthesia can be administered topically (e.g. proparacaine, tetracaine) or during loco-regional anaesthesia for enucleation, for example (see anaesthetics, analgesics, sedative and emergency drugs). 6) Mydriatics and cycloplegics Topical administration of antagonists of cholinergic receptors (tropicamide and atropine) is commonly used to allow visualisation of the lens, vitreous and retina and as an adjunctive treatment for uveitis. Mydriatics and cycloplegics can be used topically. 7) Non-steroidal anti-inflammatory drugs (NSAID) Topical NSAIDs (e.g. flurbiprofen, diclofenac, ketorolac) are routinely used to treat ocular surface or intraocular disorders. Leading Article
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