Clinical and experimental data have demonstrated that corticosteroids administered orally or by injection to animals may induce the first stage of parturition if used during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta and metritis. Additionally, corticosteroids administered to dogs, rabbits, and rodents during pregnancy have resulted in cleft palate in the offspring. In dogs, other congenital anomalies have resulted; deformed forelegs, phocomelia, and anasarca.
Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not intended for the treatment of deep abscesses or deep-seated infections such as inflammation of the lymphatic vessels. Parenteral antibiotic therapy is indicated in these infections.
Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment has been extremely well tolerated. Cutaneous reactions attributable to its use have been extremely rare. The occurrence of systemic reactions is rarely a problem with topical administration.
There is some evidence that corticosteroids can be absorbed after topical application and cause systemic effects. Therefore, an animal receiving nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment therapy should be observed closely for signs such as polydipsia, polyuria, and increased weight gain. Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not generally recommended for the treatment of deep or puncture wounds or serious burns.
Sensitivity to neomycin may occur. If redness, irritation or swelling persists or increases, discontinue use. Do not use if pus is present since the drug may allow the infection to spread. Keep this and all medications out of the reach of children.
Avoid ingestion. Oral or parenteral use of corticosteroids (depending on dose, duration of use, and specific steroid) may result in inhibition of endogenous steroid production following drug withdrawal.
SAP and SGPT (ALT) enzyme elevations, polydipsia/polyuria, vomiting, and diarrhea (occasionally bloody) have been observed following parenteral or systemic use of synthetic corticosteroids in dogs. Cushing’s syndrome has been reported in association with prolonged or repeated steroid therapy in dogs. Temporary hearing loss has been reported in conjunction with treatment of otitis with products containing corticosteroids. However, regression usually occurred following withdrawal of the drug. If hearing dysfunction is noted during the course of treatment with nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment, discontinue its use.
Before instilling any medication into the ear, examine the external ear canal thoroughly to be certain the tympanic membrane is not ruptured in order to avoid the possibility of transmitting infection to the middle ear as well as damaging the cochlea or vestibular apparatus from prolonged contact. If hearing or vestibular dysfunction is noted during the course of treatment, discontinue the use of nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment.