Other immunosuppressive agents including chlorambucil, cyclophosphamide, or azathioprine may also be utilized if the inflammatory reaction cannot be adequately controlled with corticosteroids or cyclosporine. Jennings and Tessler46 described favorable results with various combinations of cyclophosphamide, azathioprine, and chlorambucil with or without steroids. Mycophenolate has also been recommended for the treatment of refractory panuveitis or posterior uveitis unresponsive to high-dose maintenance steroids (>15 mg/day) or other immunosuppressive agents or where toxicity concerns exist.47 Dosage is 2 g orally and blood count monitoring is necessary. Tacrolimus has also been shown to be effective; however, renal dysfunction and glucose intolerance should be monitored.48 Given the more powerful nature and less favorable side-effect profile of these agents, collaborative management with experienced immunology specialists is advisable.
Dogs can be affected by numerous internal and external parasites which can have direct deleterious effects on their hosts and potentially transmit disease agents to dogs and humans [1, 2]. Of the most common parasites, fleas frequently infest dogs worldwide  with the cat flea (Ctenocephalides felis felis) being the most common species followed by the dog flea (Ctenocephalides canis). Flea infestations are very common in dogs but often go unnoticed by pet owners  unless the dog develops pruritus or the flea infestation becomes severe, in which case newly emerged fleas may also jump on and bite the owner. Fleas cause irritation due to their direct blood-feeding activity and heavy flea infestations may lead to anemia, especially in immature animals . Dogs and cats can be highly sensitive to flea bites and the development of flea allergy dermatitis (FAD) is common [6, 7]. Fleas can transmit zoonotic pathogens such as Rickettsia felis , Rickettsia typhi  and Bartonella henselae [10, 11], and are the intermediate hosts for the tapeworm Dipylidium caninum . Due to the ubiquitous nature of fleas, their ability to potentially induce clinical signs such as pruritus, and the possibility of transmitting diseases to the dog including zoonotic disease agents, efficacious treatment and control of flea infestations is a significant concern for pet owners and veterinarians . To alleviate the direct negative impact of fleas and to reduce the risks of disease transmission, year-round flea control should therefore be considered for pets in most geographical areas [3, 13].
The dogs were infested with fleas on Days-1, 5, 12, 19, 26 and 33. The fleas originated from a C. felis colony that had been initiated with fleas caught from naturally infested animals in California, USA. The colony was periodically enriched with locally-sourced wild fleas, with the last introduction occurring approximately 4 months prior to the study. 2b1af7f3a8