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Treating canine atopic dermatitis
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The atopic dog is an all-too-often presentation in first opinion clinics; this paper reviews the options for treatment and emphasizes the need for a multi-modal approach.
Annette van der Lee
DVM, PhD, Dip. ECVD
After graduating in 2004 Dr. van der Lee followed a clinical rotation and dermatology residency at Utrecht University, achieving her ECVD Diploma in 2009. She has worked in various referral hospitals within the Netherlands since then, but alongside her clinical work she also participates in clinical dermatological research programs and she completed her Doctorate with a thesis on “T cells and immunomodulation in canine atopic dermatitis” in 2014. She joined the IVC Evidensia group in 2017, where she is currently Head of Dermatology for the Netherlands.
Key points
- Canine atopic dermatitis is a common, chronic disease which affects the quality of life for many dogs and their owners.
- The various factors that influence the pruritus threshold should be addressed simultaneously in order to achieve successful treatment, especially when flares are present.
- Symptomatic immunosuppressive treatment and allergen-specific immunotherapy both play an important role in controlling canine atopic dermatitis, and may be used simultaneously.
- Treatment should always be individualized and adjusted for flares, seasonality and the general health of the patient.
Introduction
Canine atopic dermatitis (CAD) is a common allergic skin disorder that develops from predominantly environmental allergens, such as house dust mites and pollens of grasses, trees and weeds. The etiology is considered multifactorial, whereby an epidermal barrier dysfunction, combined with dysregulation of the immune system, leads to the development of clinical disease in dogs with a suggested genetic background of CAD. In most cases the problem starts at a young age, but causes discomfort by dermatitis and pruritus throughout life.
Several therapies have been developed for CAD, but each has its pros and cons regarding effectiveness and health interference. This article offers a logical approach to the daunting question “where do we start?” The challenge is not only to treat the patient successfully, but also to avoid severe flares. For this reason, the treatment of CAD requires multifaceted management (Figure 1). Successful remission can only be achieved with a combination of approaches in order to control the clinical signs and prevent flares, and the options will depend on a patient’s individual needs and the severity of disease over time. [...]
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