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For dogs that don’t respond adequately to corticosteroids or cannot tolerate their side effects, second-line immunosuppressants include: Cyclosporine: Targets T-cell function Azathioprine: Broad immunosuppressive action Chlorambucil: Primarily used for lymphocytic-plasmacytic IBD Mycophenolate mofetil: Newer option with potentially fewer side effects Antibiotics: Antibiotics like metronidazole and tylosin are frequently prescribed for IBD, operating through both antimicrobial and immunomodulatory mechanisms