Atopic Dermatitis (Allergic Skin Disease)
Atopic dermatitis is a pruritic (itchy) skin disease of dogs and cats. In atopic dermatitis, an allergic reaction occurs when an animal inhales airborne substances (pollen, house dust) or ingests (eats) a substance to which they are sensitive. The allergic reaction causes the animal to rub, lick bite, or scratch. Unlike man, animals with atopic dermatitis only occasionally cough, sneeze or get asthma. Instead, they itch. The itching may be localized to certain areas or may be over their entire body. Usually the feet, face, ears, armpits and front legs are affected. This is in contrast to flea allergy where the rump, tail, groin and thighs are affected. About 1/2 the pets with atopy will also be allergic to fleas and so will have symptoms of both diseases.
Atopic dermatitis due to food reactions can be cured, while those due to airborne substances can't be cured, but in most cases it can be controlled. Usually, cortisone-type drugs (steroids) are used. They are very effective anti-inflammatory, anti-itch medications. The problem with steroids is that they have more side effects (excessive drinking, urinating and eating along with increased susceptibility to infection) than other treatments. If used long term without supervision, it may decrease your pet's longevity. Unfortunately, it may be the only treatment that will control your pet's symptoms.
If you do not want your pet on long-term steroids, or if he cannot tolerate them, there are alternatives.
Antihistamines in conjunction w/essential fatty acids (EFA's) will control 10-25% of animals with atopic dermatitis due to airborne allergens. They have far fewer side effects (only grogginess) than steroids. EFA's work better in combination w/antihistamines than either product by themselves. There are no side effects to EFA's, but they may take up to 60 days to be effective. These products, however, do not help pyodermas (bacterial skin infections), Malassezia infections (yeast infections), otitis externa (ear infections), cutaneous adverse food reactions or flea allergies.
Cyclosporine is another alternative to steroids. It works by suppressing the immune system, but in a safer manner than steroids. It is effective 40-50% but must be given life long and like antihistamines is not effective for a pet with pyodermas (bacterial skin infections), Malassezia infections (yeast infections), otitis externa (ear infections), cutaneous adverse food reactions or flea allergies.
Apoquel (chemical name oclacitinib) is an oral medication licensed for the treatment of both acute allergies and chronic atopy in dogs >12 months of age. It can be used instead of steroids to treat dogs with occasional seasonal pollen or flea allergy flares, and to control itch in allergic dogs while the underlying cause of the itch is addressed (ie. while a hypoallergenic diet trial is started in food allergic dogs, or to control itch in atopic dogs while allergy desensitization therapy has time for effect). This drug is a janus kinase inhibitor, similar to the human rheumatoid arthritis medication Xeljanz. Apoquel acts to reduce production of inflammatory allergic proteins and also to reduce the sensation of itch transmitted by nerves, which no other drug does. It is intermediate in cost between steroids and cyclosporine, and acts very rapidly (within hours) to reduce itching. It is given twice daily for 2 weeks, then once daily, and in both short term and longer term (2-3 year) studies appears so far to have very few side effects (occasional GI upset). Since this is a relatively new drug, and it does affect the immune system, regular examinations and lab work are still recommended.
Canine Atopic Dermatitis Immunotherapeutic is our newest therapy that helps reduce clinical signs of atopic dermatitis so that your dog can stop scratching. This is a new type of medication called an antibody therapy, designed to target the itch at its source. It mimics the natural immune system of your dog to help neutralize the main cause of itch in atopic dermatitis. Canine Atopic Dermatitis Immunotherapeutic is an injection given every 4-6 weeks by your veterinarian.
Allergen-specific immunotherapy (ASIT) is the ONLY method that is currently available to help IMPROVE the health of the immune system (vs MASKING symptoms). ASIT involves giving a series of injections containing specific airborne (not food) antigens to which your pet is sensitive. In order to determine YOUR pet's SPECIFIC airborne allergy, intradermal testing is performed. Intradermal testing is a technique in which a small amount of airborne allergens are injected into the skin. The skin is then evaluated for any reactions to determine which airborne allergens affect your pet. Once we identify the allergens, you can try avoiding them. However, in the vast majority of the cases (99%) avoidance does not work. Allergen-specific immunotherapy makes it possible to desensitize your pet to these airborne allergens.
At the Allergy, Skin and Ear Clinic for Pets, 60-70% of the cases of atopic dermatitis due to airborne allergens respond to allergen-specific immunotherapy (either needing no other medication or less potent medication than previously). Allergen-specific immunotherapy stimulates your pet's own protective mechanism (immune system), which stops the allergic reaction from occurring. You will need to give an injection every 7-21 days for the LIFETIME OF YOUR PET. Because we must depend on the immune system for allergen-specific immunotherapy to work, it may take 6-12 months for them to be effective. Pets with atopic dermatitis are prone to secondary skin infections, ear infections, and Malassezia (yeast) infections and frequently have sensitive skin. Any skin infection, irritating substance, or fleas will aggravate the allergic condition.