The prevention and treatment of pruritus and skin lesions require a personalized patient plan
The management of atopic dermatitis (AD) in dogs begins with finding the allergen responsible for the outbreak and ends with the administration of the best treatment. Darren Berger, DVM, DACVD, associate professor at Iowa State University College of Veterinary Medicine, discussed the correlation between allergens and Alzheimer’s disease, and disease management at the Fetch dvm360® 2022 conference in Kansas City, Mo.
“Allergy management is allergy control,” he said during his presentation sponsored by Virbac. And if customers think they “will never go [see a] flare is an inappropriate expectation,” he added. The “realistic goals” are to reduce the severity of Alzheimer’s disease, space out attacks and make long-term treatment less expensive.
An inflammatory condition, AD is the second most common allergic skin disease in dogs, behind flea allergy dermatitis,2 and can be caused by food, parasite and environmental allergens.1,2
“These are microscopic fleas and mites,” Berger said, but flea preventatives can discourage the onset of signs and symptoms of Alzheimer’s disease.
“We have to stop talking about expensive diets…[and] fancy foods [and]…start talking about diagnostic testing,” Berger added, emphasizing the benefits of an elimination diet as a diagnostic tool to determine what food, if any, is causing a dog to itch or is showing signs of itchiness. other signs of Alzheimer’s disease.
Pollen and dust mites are among the environmental allergens that can cause a skin reaction in dogs.
Because atopic dermatitis is multifaceted, treatments should be individualized for each patient and combination interventions should be used to improve outcomes. The stage and severity of the condition as well as the distribution of lesions should be considered when creating a treatment plan.3 Once the cause of a flare is established, subsequent treatments can be explored.
One way to prevent or manage flare-ups 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 may relieve mild signs and symptoms.3 The International Committee on Allergic Diseases of Animals (ICADA) recommends formulations containing complex sugars and antiseptics (Allermyl; Virbac), phytosphingosine, raspberry oil or lipids (Douxo Calm; Ceva).3 “It should be soothing,” Berger said, noting that clients who don’t see relief in pets after bathing often use warm water and 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 pruritus and skin lesions, while topical glucocorticoids and immunotherapy that target specific allergens can prevent or delay recurrence of AD.3 Antihistamines are also an option when environmental allergens are the trigger: they “don’t stop the itch; they prevent it,” Berger said.
Communication is essential. “I don’t tell customers what to do. I involve them in the decision-making process,” Berger said, to help them understand why they’re doing what they’re doing and ensure adherence to treatment and better long-term outcomes.
Customer feedback 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 may be dismissed as the cause. Similarly, the cost must be discussed: if the treatments are unaffordable, the dogs will do without them. “It’s our job to educate [clients]to give them options,” concluded Berger.
- Berger D. Canine atopic dermatitis: how a dermatologist discusses atopy with pet parents. 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: update of the 2015 guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Veterinary Res. Published online August 16, 2015. doi:10.1186/s12917-015-0514-6