Preventing and treating itching and skin lesions requires a personalized patient plan
Management of atopic dermatitis (AD) in dogs begins with finding the allergen causing the outbreak and ends with administering the best treatment. Darren Berger, DVM, DACVD, associate professor, Iowa State University College of Veterinary Medicine, discussed the correlation between allergens and AD, and managing the condition at the Fetch dvm360® 2022 Conference in Kansas City, Missouri .
“Allergy management is allergy control,” he said during his presentation, sponsored by Virbac. And if customers think “they are never going to [see a] flare, that’s an inappropriate expectation,” he added. The “realistic goals” are to decrease the severity of AD, space out flare-ups, and make long-term treatment less expensive.
An inflammatory condition, AD is the second most common allergic skin disease in dogs, after flea allergy dermatitis,2 and can be caused by food, parasitic, and environmental allergens.1,2
“It’s microscopic fleas and mites,” Berger said, but flea preventatives can prevent the signs and symptoms of AD from appearing.
“We have to stop talking about expensive diets…[and] fancy meals [and]…start talking about diagnostic testing,” Berger added, noting the benefits of an elimination diet as a diagnostic tool to determine which food, if any, is causing a dog to itch or show other signs of AD .
Pollen and dust mites are among the environmental allergens that can cause a skin reaction in dogs.
Because atopic dermatitis is multifaceted, treatments must be tailored to the individual patient and combined interventions used to improve outcomes. When creating a treatment plan, the stage and severity of the condition should be considered, as well as the distribution of the lesion.3 Once the cause of a flare has been established, the following treatments can be explored.
One way to prevent or control outbreaks is to eliminate a known allergen from a dog’s diet. Increasing fatty acids in the diet can help prevent flare-ups, Berger said, although the practice isn’t as helpful in managing signs and symptoms.
Bathing with a non-irritating shampoo can relieve mild signs and symptoms.3 The International Committee for Allergic Diseases of Animals (ICADA) recommends formulations containing complex sugars and antiseptics (Allermyl; Virbac), phytosphingosine, raspberry oil, or lipids (Douxo Calm; Ceva) .3 “It has to be calming,” Berger said, noting that clients who don’t see relief in pets after bathing often use lukewarm water and do see a change after switching to cold water.
According to ICADA, topical and oral glucocorticoids, oral cyclosporine, oral oclacitinib, and injectable recombinant interferons effectively reduce itching and skin lesions, whereas topical glucocorticoids and allergen-targeted immunotherapy can prevent or delay the recurrence of itching. EA.3 Antihistamines are also an option when the surrounding allergens are the trigger: “they don’t stop the itching; they prevent it,” Berger said.
Communication is essential. “I don’t tell clients what to do. I involve them in the decision-making process,” said Berger, to help them understand why they are doing what they are doing and ensure adherence to treatment and better long-term outcomes.
The client’s opinion is also important because not all dogs respond to treatments in the same way. If the condition appears to be seasonal, for example, food allergens can be ruled out as a cause. Similarly, cost should be discussed: if treatments are not affordable, dogs will be left without them. “It is our job to educate [clients]to give them options,” concluded Berger.
- Berger D. Canine atopic dermatitis: how a dermatologist talks about atopy with pet owners. Presented at: Fetch dvm360® Conference, August 26-29, 2022; Kansas City, MO.
- Atopic dermatitis in dogs: causes, symptoms and treatments. PetMD. February 13, 2020. Accessed September 21, 2022. https://www.petmd.com/dog/conditions/skin/c_dg_atopic_dermatitis
- Olivry T, DeBoer DJ, Favrot C, et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee for Allergic Diseases of Animals (ICADA). BMC Vet Res. Published online August 16, 2015. doi:10.1186/s12917-015-0514-6