Treatment Of Atopic Dermatitis

The following guidelines is a 5-year update of the International Committee on Allergic Diseases of Animals, ICADA guidelines for the treatment of atopic dermatitis (AD) in dogs. The treatment of flares of AD usually involves the elimination of the cause of the flares, bathing with mild shampoos, and controlling itching and skin lesions with glucocorticoids or oclacitinib (Apoquel—Zoetis). For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic itching and skin lesions are glucocorticoids, oral ciclosporin, oral oclacitinib, and interferons. Treatment plans vary between dogs and, for the same dog, between times when the disease is at different stages.

Treatment Of Acute Flares Of Atopic Dermatitis

  1. Recognizing allergenic causes of acute flares of canine allergic dermatitis (house dust mites, fleas and pollens) is important to prevent further worsening or recurrences of the flares. House dust mites are the most important source of allergens for canine AD, worldwide.
  2. Treatment of bacterial and yeast skin and ear infections infections (common causes of flares in dogs with AD) with systemic antimicrobials. Veterinarians and pet owners should watch for a drying or irritating effect of topical antimicrobials, especially shampoos, that might cause a flare of AD.
  3. Bathing with a non-irritating shampoo such as Allermyl shampoo or a Douxo Calm shampoo and foam combination.
  4. Using sprays (Cortavance, Genesis) for the treatment of acute flares.
  5. Using short course of oral glucocorticoids or oclacitinib in dogs with severe or extensive allergic dermatitis.
  6. Oral type 1 antihistamines might provide a small and limited benefit in some dogs with AD.
  7. Oral essential fatty acids are not useful to treat acute flares of AD due to the length of time needed for any possible beneficial effect to occur.
  8. Topical tacrolimus is unsuitable for managing acute flares of AD because of the slow onset of action.
  9. Evidence supporting the use of oral probiotics for prevention or treatment of canine AD is insufficient.
  10. Dog owners are encouraged to avoid storing dry dog foods in humid and warm areas and to store foods in clean containers to avoid hypersensitive to storage mites. The containers must be sealed as the concentration of storage mite allergens on the floor next to stored dog food bags is much higher than in the food itself.
Atopic dermatitis affecting a dog's paw

The update showed that the best clinical benefit normally requires the combination of multiple treatments.

References

  1. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA).