Atopic dermatitis is a prevalent skin condition in dogs, characterized by intense itchiness, medically known as pruritus. It is estimated that between 10-15% of the canine population is affected by this lifelong disease. While there is no definitive cure, effective management strategies can significantly improve a dog’s quality of life. This condition is triggered by environmental allergens, leading to a chronic inflammatory response.
Atopy dermatitis is believed to have a genetic predisposition, as certain breeds and family lines of dogs are more susceptible. The outer layer of the skin (epidermis) in atopic dogs is often compromised, making them more vulnerable. When allergens come into contact with the skin, the dog’s immune system overreacts, causing inflammation and the characteristic itchiness. Common culprits include various pollens, molds, dust mites, dander, and other airborne substances.
The most prominent sign of atopy is excessive itching, which can fluctuate in severity and change over time. Often, the itchiness has a seasonal pattern, correlating with the presence of specific allergens in the environment, though it can evolve into a year-round issue. Dogs typically exhibit this by scratching behind their elbows, persistently licking and chewing their paws, rubbing their faces, and scooting. Initially, the skin may appear normal, but with persistent scratching and licking, hair loss can occur. The affected skin areas may become red, and the hair in these spots can develop a brown discoloration due to saliva staining. As the condition progresses, the skin may darken and thicken. Secondary infections can manifest as skin rashes, commonly appearing on the belly, behind the front legs, and around the base of the tail.
Dogs usually begin showing signs of atopy between six months and three years of age. Numerous breeds are prone to this condition, including Labrador Retrievers, Golden Retrievers, Soft-coated Wheaton Terriers, West Highland White Terriers, Jack Russell Terriers, Bulldogs, Boston Terriers, Boxers, Pit Bulls, Shar-Peis, Shih Tzus, and Weimaraners, as well as mixed-breed dogs. Atopy is more common in dogs with atopic parents and affects males and females equally.
Diagnosing atopy involves a process of elimination and observation, as there isn’t a single definitive test. A presumptive diagnosis is made based on several criteria: the presence of classic itching signs, findings from a physical examination, a positive response to treatments for atopy, and the exclusion of other conditions with similar symptoms. These rule-out conditions include parasitic infestations like fleas and sarcoptic mange, as well as bacterial and fungal infections of the skin and ears.
Treatment Approaches for Atopic Dogs
Treatment for atopic dermatitis is highly individualized and may need to be adjusted seasonally and over time. A multimodal approach, combining several therapies, is often most successful. The process may involve trial and error to identify the most effective options for each dog.
Initially, your veterinarian will thoroughly examine your dog for secondary infections on the skin and in the ears and recommend appropriate treatments. Dogs with atopy may also suffer from flea allergies and food allergies. Your veterinarian will likely prescribe an effective flea and tick preventive. If itching persists despite flea and atopy treatments, a food allergy will be considered.
Topical Therapies
Topical treatments, including shampoos, rinses, mousses, and medicated wipes, can help remove allergens, moisturize the skin, and manage secondary bacterial and yeast infections. Some formulations also contain antihistamines and corticosteroids to reduce inflammation.
Allergen-Specific Immunotherapy (ASIT)
ASIT involves identifying specific allergens triggering your dog’s reaction. This can be done through intradermal skin testing or by analyzing a blood sample for IgE antibodies against a panel of allergens. While reducing environmental allergen exposure is sometimes possible, it’s often impractical due to their prevalence. Based on test results, immunotherapy can be administered via subcutaneous injections or sublingual drops.
Oral Medications
Several oral medications can help control inflammation and reduce itching.
- Corticosteroids (e.g., prednisone, prednisolone) are highly effective for acute flare-ups. However, due to potential side effects, they should be used at the lowest effective dose for the shortest duration possible, with a transition to other medications.
- Cyclosporine is effective in reducing itchiness and generally has fewer side effects than corticosteroids.
- Oclacitinib (Apoquel) is a newer medication that provides significant relief from itching with fewer side effects compared to corticosteroids.
- Antihistamines (e.g., hydroxyzine, diphenhydramine, cetirizine) may help with mild itchiness but are less effective once severe itching has already set in.
- Essential fatty acid (EFA) supplements can be used as an adjunct therapy.
Injectable Medications
- Lokivetmab (Cytopoint) is a monoclonal antibody administered via subcutaneous injection, typically every 4-8 weeks, to reduce itching.
Managing Atopy for a Better Quality of Life
Atopic dermatitis can significantly diminish a dog’s quality of life and present a continuous challenge for owners in terms of time and cost. Fortunately, most dogs with atopy can be managed successfully through close collaboration with a veterinarian to prevent and control flare-ups. For more complex cases, consulting a veterinary dermatologist may be beneficial. Your veterinarian can provide a referral, or you can find a specialist through the American College of Veterinary Dermatology or the European College of Veterinary Dermatology. Consistent management and veterinary guidance are key to helping your canine companion live a comfortable life.
