Aseptic injection techniques should be practised. Depo-Medrone V must not be given intravenously. The technique of aspiration should be employed, as appropriate, to avoid intravascular injection. Due to the potential for local cosmetic effects, the subcutaneous use of this product in show animals is not recommended. Intrasynovial, intratendinous or other injections of corticosteroids for local effect are contra-indicated in the presence of acute infectious conditions.
It is recommended that Depo-Medrone V is not mixed with any other product for injection at the same site. Exacerbation of pain, further loss of joint motion, with fever and malaise following intrasynovial injection may indicate that the condition has become septic and appropriate antibacterial therapy should be instituted immediately. Animals receiving corticosteroids should be monitored for signs of infection and, where necessary, appropriate antimicrobial therapy instigated.
As with any corticosteroid, treatment of working or racing animals should be followed by a period of rest to allow resolution of the clinical condition.
It is recommended that, where joint therapy is indicated, a radiologic examination is undertaken prior to treatment to evaluate the presence of fractures. If fractures are present, corticosteroid therapy should only be used with utmost caution if permanent damage is to be avoided.
Anti-inflammatory corticosteroids, such as methylprednisolone, are known to exert a wide range of side-effects. Whilst single high doses are generally well tolerated, they may induce severe side-effects in long term use and when esters possessing a long duration of action are administered. Dosage in medium to long term use should therefore generally be kept to the minimum necessary to control clinical signs. The continued or prolonged use of this product is not generally recommended.
Steroids themselves, during treatment, may cause Cushingoid symptoms involving significant alteration of fat, carbohydrate, protein and mineral metabolism, e.g. redistribution of body fat, muscle weakness and wastage and osteoporosis may result. During therapy effective doses suppress the Hypothalamo-Pituitary-Adrenal axis. Following cessation of treatment, signs of adrenal insufficiency extending to adrenocorticol atrophy can arise and this may render the animal unable to deal adequately with stressful situations. Consideration should therefore be given to means of minimising problems of adrenal insufficiency following the withdrawal of treatment, e.g. a gradual reduction of dosage (for further discussion see standard texts).
Systemically administered corticosteroids may cause polyuria, polydipsia and polyphagia, particularly during the early stages of therapy. Some corticosteroids may cause sodium and water retention and hypokalaemia in long term use. Locally applied steroids may cause thinning of the skin and systemic corticosteroids have caused deposition of calcium in the skin (calcinosis cutis).
There are risks associated with the use, especially systemically, of corticosteroids during pregnancy. The safety of methylprednisolone in canine, feline and equine pregnancy has not been established. Systemic activity of corticosteroids in early pregnancy is known to have caused foetal abnormalities in laboratory animals and in late pregnancy may cause early parturition or abortion.
Corticosteroids may delay wound healing and the immunosuppressant actions may weaken resistance to or exacerbate existing infections. In the presence of bacterial infection, anti-bacterial drug cover is usually required when steroids are used. In the presence of viral infections, steroids may worsen or hasten the progress of the disease.
Systemic corticosteroid therapy is generally contra-indicated in patients with renal diseases and diabetes mellitus. Gastrointestinal ulceration has been reported in animals treated with corticosteroids and g.i.t. ulceration may be exacerbated by steroids in patients given non-steroidal anti-inflammatory drugs and in corticosteroid treated animals with spinal cord trauma. Steroids may cause enlargement of the liver (hepatomegaly) with increased serum hepatic enzymes.
The product is contra-indicated for the treatment of laminitis in horses. Additionally it should be noted that use of the product in horses for other conditions could induce laminitis and careful observations during the treatment period should be made.
During a course of treatment the clinical condition of the animal should be reviewed regularly by close veterinary supervision.
Withdrawal periods
Not to be used in horses intended for human consumption.
Treated horses may never be slaughtered for human consumption.
The horse passport must have been declared as not intended for human consumption under national horse passport legislation.
Operator warnings
Wear protective gloves when using this product. Care must be taken to avoid accidental self-injection. Accidental spillage onto the skin should be washed off immediately with soap and water.