Diagnostic Steps:
Allergic dermatitis is a diagnosis of exclusion
- Rule out presence of fleas and flea allergies
- Evaluate skin tests where needed
- Cytology - to identify bacteria and yeast
- Skin scrapes - to identify mites
- Fungal cultures - to identify ringworm and other fungal disease
- Food Trials - elimination food trials for food allergies if symptoms persist
- Referral to dermatologist for further evaluation
Treatment:
- Keep the pet on year-round flea and tick control
- Treat any present bacterial or fungal infection
- Treat for other external parasites
- Provide relief for itchiness
If symptoms persist after treating other causes of skin problems, allergic dermatitis may be diagnosed. A long-term maintenance protocol is implemented to treat allergies seasonally or year-round based on symptoms.
Allergy Treatment Options:
- Antihistamines (given 2-3x per day)
- Only appropriate for mild symptoms
- Can be used along with other treatments
- Monoclonal antibody injections (Cytopoint, etc.) [Dogs only]
- long lasting injections that control itch
- JAK inhibitors (given daily or twice daily) [Dogs only]
- Daily treatment that blocks itch receptors
- Can help with inflammation
- Requires regular bloodwork
- Cyclosporine (given in decreasing doses over time)
- Suppresses immune response to allergens
- Decrease dose to least effective dose over time
- Requires regular bloodwork
- Immune therapy
- Requires bloodwork to initiate
- Injections desensitize the body to allergens
- Can result in remission for current allergies but does not affect new ones
- Requires living in one location for a minimum of 12 months
- Other treatments as deemed necessary by the veterinarian
Supportive Care Options:
Supportive care is often added to allergy treatments to help add additional support, strengthen skin barriers, and relieve symptoms. It is not usually enough to treat allergic symptoms alone.
- Fatty acid supplements
- Skin barriers
- Skin support diets
- Soothing shampoos, conditioners, and other topical products
What To Expect Longterm:
- The primary treatment should control symptoms most of the time.
- It may take several months to establish which treatment your pet responds to best
- Flares will happen when there are changes to the weather or environment where more allergens may become present or if there are changes in stress levels. Flares need to be addressed as soon as they occur to prevent secondary problems affecting the ability of the allergy medication to work.
- Re-evaluation or referral to a dermatologist may be required if symptoms persist.