Oclacitinib for the Treatment of Nasal Alar Arteriopathy in Two Dogs

Nasal alar arteriopathy (NAA) is a rare dermatologic condition in dogs characterized by ulcerative and potentially severe hemorrhagic lesions of the nasal alar fold. This condition has only previously been reported in German Shepherd Dogs. Achieving clinical remission can be challenging and typically involves a combination of surgical resection of the diseased tissue and immunosuppressive therapies. This report is the first to describe two cases of NAA in which clinical remission was initially achieved with oclacitinib alone. Both cases were presented to the Internal Medicine service with a complaint of unilateral recurrent epistaxis. The first case involved a 7-year-old German Shepherd dog. Clinical remission was first achieved with oclacitinib monotherapy. Relapse occurred following dose tapering, and remission was ultimately regained with dose reescalation of oclacitinib and the addition of cyclosporine. The second case involved a 3-year-old Poodle mix that achieved and maintained clinical remission with oclacitinib alone. These cases suggest that oclacitinib may be an effective and well-tolerated treatment option for NAA, offering an alternative to traditional systemic immunosuppressive therapies. However, additional treatment may be required in severe cases or during oclacitinib dose reduction. Further studies are needed to evaluate long-term outcomes and broader applicability.