MY ALLERGIC PATIENT IS A “WRECK”: MANAGING ALLERGIC FLARES IN DOGS
DR. ANDREW HILLIER BVSC, MANZCVS (CANINE MEDICINE), DACVD Medical Lead Dermatology, Veterinary Specialty Operations, Zoetis Petcare
In the complimentary VETgirl-Zoetis webinar “My allergic patient is a “wreck” - managing allergic flares in dogs,” Dr. Andrew Hillier BVSc, MANZCVS (Canine Medicine), DACVD reviewed atopic dermatitis and best ways to achieve success with management.
KEY HIGHLIGHTS
KEYS TO SUCCESS IN DOGS WITH ATOPIC DERMATITIS 1 Atopic dermatitis (AD) is a common disease . In some areas, it is the #1 cause of pruritus in dogs. And it is becoming more common as the popularity of predisposed breeds increases (think French Bulldogs for example, or the still ever-popular Labrador and Golden Retrievers). 2 Making the diagnosis of AD can appear challenging and may be time- consuming – here are a few key points to remember: • Regard the problem of itch as urgent. Let the owner know that your 1st priority today and throughout the process will be to stop the itch and make their pet comfortable as quickly and safely as possible. Do not mess with therapies that don’t work, like antihistamines. This will give the owner peace of mind and some trust and confidence ; they are far more likely to listen to and accept the offer of a workup. • Keep the description of the diagnostic workup streamlined and simple ; rule out parasites, treat infections and perform an elimination
diet trial if necessary. If the dog is still itching, then it has atopic dermatitis. • Make sure that you share the value of a workup e.g. “We may find that your dog has a curable disease (like a mite infestation) or a condition that that can be managed without long- term pharmacotherapy, (like a diet adjustment in the case of food allergy)”. These possibilities will help get buy-in. • It is a diagnosis of elimination and may take only take a few weeks, or it may take several months – but we will always prioritize keeping the dog comfortable no matter how long it takes to work it out. 3 We now have options for treatment of atopic dermatitis – but how do I decide which to use? • It is a great time to be a veterinarian and seeing dogs with AD because we have new innovative options that allow us to tailor treatment according to the specific needs of each owner and each pet. • Consider trying to find an anchor treatment (a single therapy that provides satisfactory control and is sustainable for both pet and owner)
– examples would be oclacitinib, Cytopoint, cyclosporine and allergen- specific immunotherapy. Multimodal therapy may be necessary but probably only in a minority of dogs – it is very difficult for owners to continue several treatments long-term. Consider referring to your local dermatologist if
this occurs. (continued)
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