Post-vaccinal side effects comprising dogs have previously been reported within various studies^5-8. Adverse reactions to distemper, infectious hepatitis and parvovirus vaccines^8, and leishmune vaccine against canine leishmaniasis⁹ included angioedema confined to the nose, ears and eyes⁸ and face⁹.

The purpose of this study was to investigate the clinical formation of angioedema and the efficacy of therapy with cetirizine and dexamethasone in controlling the clinical sings in a German shepherd puppy dog affected with angioedema.

Complete physical examination including rectal temperature, heart rate and evaluation of gastrointestinal, respiratory and dermatologic system did not reveal any abnormalities other than the swelling on the head. Based on the admittedly informative history and physical examination and excluding some of the presumed causes the dog was diagnosed to have acute angioedema. At clinical evaluation and laboratory examinations including complete blood counts, serum biochemical analysis (urea, creatinine, ALT, AST) and urinalysis no pathological condition was detected to cause angioedema attack other than vaccination.

Therapy included cetirizine (Hitrizin 10 mg. tablet, Deva Holding A.S.) 1 mg/kg once a day perorally and dexhamethasone (Deksavet %0.4 inj. sol., Interhas A.S.) 0.15 mg/kg intravenously q 12 hours for 2 consequetive days. After 5 hours of starting treatment angioedema regressed. On hour 9 of starting treatment oedema on periorbital area and face was subsided at 75% and 24 hours later angioedema was succesfully controlled and disappeared. After 6 months of therapy, the owner of the dog was interviewed in an atttempt to get information about any remaining or new complaints related to this condition, who informed that the dog was healthy.

Adverse reactions in association with animal vaccination has been studied over the past years. Suspected adverse reactions against vaccines have been recognized as inflammatoric, allergic, autoimmune or neoplastic diseases¹¹. Vaccine related side effects including angioedema in dogs have previously been discussed by several studies^5-8. Adverse toxic reactions to parvovirus vaccines⁸ included angioedema of the nose, ears and eyes⁸. Allergic reactions occuring against vaccines frequently constitutes the skin, and systemic symptoms such as urticaria/ angioedema, serum sickness and eczema or localized site reactions may be noticed¹². In a previous case series angioedema and urticaria was reported in two Great dane dogs following inactive vaccination against M. canis¹³. In line with previous reports the present puppy was diagnosed to have an angioedema attack following parvoviral vaccination, by possible excluding of all other unremarkable differentials.

Adverse reactions in association with animal vaccination has been studied over the past years. Suspected adverse reactions against vaccines have been recognized as inflammatoric, allergic, autoimmune or neoplastic diseases¹¹. Vaccine related side effects including angioedema in dogs have previously been discussed by several studies^5-8. Adverse toxic reactions to parvovirus vaccines⁸ included angioedema of the nose, ears and eyes⁸. Allergic reactions occuring against vaccines frequently constitutes the skin, and systemic symptoms such as urticaria/ angioedema, serum sickness and eczema or localized site reactions may be noticed¹². In a previous case series angioedema and urticaria was reported in two Great dane dogs following inactive vaccination against M. canis¹³. In line with previous reports the present puppy was diagnosed to have an angioedema attack following parvoviral vaccination, by possible excluding of all other unremarkable differentials.

In allergic reactions including urticaria and angioedema, histamines play an important role as by causing vasodilatation and increased vascular permeability⁴. Therefore the primary indication for antihistamine therapy in angioedema must be the treatment of dermal edema, that is clinically presented as swelling^4,14. In addition due to the risk and side effects of prolonged use of glucocorticoid therapy, antihistamines are preferred by veterinarians in an attempt to avoid or reduce the necessary doses of glucocorticoids¹⁵. The development of a group of second generation antihistamines, with non-sedative effects, has aroused interest in the application of those drugs for treatment of various human disorders¹⁶ and for dogs with atopic dermatitis¹⁷. Cetirizine has been effectively used in a human angioedema case¹⁸. In aggreement with previous reports, in the present case cetirizine was effective and clinical remisison was achieved with a short term usage. Although only 1 case was presented in this article and it is unwise to draw conclusions, the present authors suggest that cetirizine in conjunction with dexamethasone was completely effective for releiving acute angioedema.

1) Anonymous http://www.vetmedpub.com//vetmed/article/ articleDetail.jsp? id=336416.Accessed January 2008.

2) Kaplan AP, Greaves MW. “Angioedema,” J Am Acad Dermatol 2005; 53(3): 373–388.

3) Shaw DH, Ihle SL. 1997 Gastrointestinal Disease. Small Animal Internal Medicine. Philadelphia: Wolters K.

4) Çalışkaner Z, Karaayvaz M. Akut Ürtiker ve Anjioödem. http://www.gata.edu.tr/dahilibilimler/ichastaliklari/files/kitaplar/8.pdf. Accessed:September 2007.

5) Schultz RD. Theoritical and practical aspects of an immunization program for dogs and cats. JAVMA 1982;81:1141-1149.

6) Tizard I. Risks associated with use of live vaccines. JAVMA 1990;196:1851-1858.

7) Brooks R. Adverse reactions to canine and feline vaccines. Aust Vet J 1991;68:342-344.

8) Tjälve H. Adverse reactions to veterinary drugs reported in Sweden during 1991-1995. J Vet Pharmacol Therapeut 1997;20 (2):105–110.

9) Parra LE, Borja-Cabrera GP, Santos FN, Souza LO, Palatnik-de-Sousa CB, Menz I. Safety trial using the Leishmune vaccine against canine visceral leishmaniasis in Brazil. Vaccine. 2007;25(12):2180-2186.

10) Anonymous. Allergic Vaccination Reaction in Dogs. By: Dr. Mark Thompson http://www.petplace.com/dogs/allergic-vaccination-reaction-in-dogs/page1.aspx. Accessed: January 2008.

11) Day J. Vaccine side effects: Fact and fiction Vet Microbiol 2006;117 (1): 51-58.

12) Ponvert C, Pierre S. Vaccine allergy and pseudo-allergy. EJD. Eur J Dermatol 2003; 13(1):10-15.

13) Ural K, Cıngı CC, Uzlu E. Acut urticaria and anjioedema in two great dane dogs medicated with inactive Microsporum canis vaccine. Kafkas Univ Vet Fak Derg 2006;12 (1):109-110.

14) Haas N, Hermes B, Henz BM. Adhesion Molecules and Cellular Infiltrate: Histology of Urticaria. J Invest Dermatol Symp Proceed 2001;6:137-138.

15) Scott DW, Miller WH Jr, Griffin CE. Muller & Kirk's Small Animal Dermatology VI. Philadelphia: WB Saunders, 2001:543–666.

16) Slater JW, Zechnich AD, Hasby DG. Second-generation antihistamines: A comparative review. Drugs 1999;57:31–47.

17) Cook CP, Scott DW, Miller WH. Jr, Kirker JE, Cobb S. MTreatment of canine atopic dermatitis with cetirizine, a second generation antihistamine: A single-blinded, placebo-controlled study. Can Vet J 2004;45:414-417.

18) Radhakrishna P, Abdul Rahman AD. Angioedema - a rare cause of acute episodic dysuria: Case report and review of literature. Indian J Dermatol 2007; 52 (2):106-108.