Atopic Dermatitis in Dogs

Atopic Dermatitis in Dogs: Everything You Need to Know

Atopic dermatitis, or allergic dermatitis, is an inherited condition that is common in dogs. It causes dogs to develop allergy symptoms in their skin as a result of repeated exposure to allergens. These allergens may be relatively harmless substances, such as the bacteria and yeast that exist in the skin, fleas, different foods, and contact with objects such as cement floors. Allergens may also be environmental, such as dust mites, mold spores, and grass. As a hereditary disease, atopic dermatitis is especially prevalent in certain breeds, such as the majority of terriers, poodles, cocker spaniels, golden retrievers, dalmatians, bulldogs, Lhasa apsos, pugs, and shih tzus. However, other breeds, including crossbred dogs, may also develop this disease.

While people who are allergic often break out in hives or develop symptoms in their nasal passage, dogs tend to react with problems in their gastrointestinal tract, ears, or skin. This is a result of dogs having a higher proportion of mast cells in those areas. These cells release histamines and other chemicals when confronted by an allergy, causing the dog to develop an array of problems, including chronic itching, poor coat, gastrointestinal pain, flatulence, and diarrhea. The discomfort may cause the dog to lick, chew, and self-mutilate. In addition, allergies may contribute to the development of chronic ear infections as well as thyroid disease, making the treatment of atopic dermatitis that much more difficult.

Dogs that have developed atopic dermatitis will lick, chew, and bite the affected area due to persistent itchiness. They may also rub and scratch it. The paws, ears, underbelly, armpits, and groin are some of the parts of the dog’s body that are commonly affected. Atopic dermatitis may also occur around the eyes, the base of the tail, and between the toes. The skin may become red and thick while the fur will become patchy as a result of the dog constantly licking and chewing it. The dog’s ears may also become red and inflamed as a result of the dog constantly rubbing its face on the ground. The allergic reaction may cause a wax buildup in the ear, resulting in yeast infection.

Atopic dermatitis is not only unattractive to look at, but will affect your dog’s quality of life as it will cause constant itching and discomfort. In the long term, it may change the dog’s personality, making it aggressive when it is touched. Ear allergies can even lead to permanent deafness. As atopic dermatitis is a lifelong condition, it is important to take a methodical and thorough approach to the problem. Work with your veterinarian to put in place a long-term plan that will cure your dog’s dermatitis and prevent it from recurring.

Identifying atopic dermatitis

The defining characteristic of atopic dermatitis is itchiness. This can also lead to skin lesions, inflammation, and other complications. Since these symptoms are shared with a number of other conditions, a correct diagnosis of atopic dermatitis will involve ruling out other possible diseases.

The itchiness could well be the result of fleas and other ectoparasites, such as sarcoptic mange, pediculosis, and otoacariasis. Although these parasites favor different areas of the dog’s body, identifying the correct one can be challenging. Skin scraping, ear swabs, and hair combing can be utilized to collect samples to be examined microscopically. Serology testing of blood serum may also help identify the parasites.

Dogs with atopic dermatitis often suffer from bacterial skin infections caused by Staphylococcus pseudintermedius (SP). While the skin lesions caused by this infection are usually identifiable visually, sample testing should be carried out to confirm this diagnosis. Staphylococcal pyoderma is often a secondary condition brought about by atopic dermatitis and some other diseases. It is necessary to eliminate the pyoderma in order to establish the nature of the primary disease as well as its distribution and severity. The dog could well be unresponsive to anti-allergy medication due to the involvement of other bacterial infections. Consequently, thorough testing must be done to establish whether bacteria are responsible for the dog’s skin condition.

Identifying the allergy

In order to successfully treat your dog, you must first identify the cause of the allergy that results in the dermatitis. This is complicated by the fact that dogs can develop an allergy to something over time, so it could have recently become allergic to a substance that it used to live with quite happily.

For example, the dog could have developed a food allergy to an ingredient that it previously had no adverse reaction to. Consequently, it is unwise to discount the food that it used to consume quite happily. Any ingredient in its food could be setting off the allergy. Many people believe that their dogs can develop an allergic reaction to poor-quality food. However, even expensive dog food can cause an allergic reaction as the dog could well be allergic to one of its ingredients. It is, however, true that pricier dog foods avoid the ingredients that most commonly cause allergies.

While your dog could well be suffering from atopic dermatitis that was caused by a food allergy, food intolerance can also lead to similar symptoms, making it hard to distinguish between the two conditions. In general, diarrhea, flatulence, vomiting, soft stools, and increased defecation are generally a sign of atopic dermatitis brought about by a food allergy.

If your dog is showing clinical signs all year, a strict elimination diet trial may have to be performed. This diet trial should consist of ingredients that the dog has never had before. Unfortunately, most premade diets and elimination diets have been contaminated by a variety of food components, so finding an appropriate diet is not easy. A diet incorporating novel proteins such as venison, rabbit, horse, kangaroo, or hydrolyzed protein can be used. The dog should be fed for at least eight weeks. If it is not responding to a commercial elimination diet, a home-cooked one should be used. In fact, done properly, home-cooked diets are the most effective elimination diets.

If the dog’s skin condition improves, it is an indication that a food allergy is the cause. This can be confirmed by reintroducing the original diet. If the skin condition and other symptoms return, it confirms that the original diet is the cause of the skin condition. A proper diagnosis is complicated by the fact that the dog consuming table food, treats, flavored toothpaste, flavored drugs, and other items that the owner is unaware of can disrupt the result of the elimination diet.

Like people, many dogs are allergic to pollen, molds, and dust. Do you have mold in your home? Many molds cause allergic reactions and could well be the cause of your pet’s discomfort. Similarly, the pollen from nearby trees, plants, and weeds may be affecting the dog. If allergic reactions happen seasonally, it could be a clue that the problem is pollen. On the other hand, if your dog develops allergies throughout the year, it is a sign that the allergy-causing agent could be dust mites or mold. Shampoos, soaps, and cleaning products are known to cause allergies. Fire and cigarette smoke, along with substances such as perfume, can also trigger a reaction.

Flea allergies also commonly affect dogs. This is because the proteins in the flea’s saliva can set off a reaction when the flea bites the dog. A single bite can cause a reaction that lasts for a week, so it takes only a few fleas to make your dog’s life absolutely miserable. Strangely, flea-ridden dogs are generally not affected. It is the relatively well looked after dogs that have only a few fleas that most often develop allergic reactions.

Another common allergy in dogs is a result of the dog’s immune system becoming hypersensitive to the Staph bacteria that exists normally on its skin. This reaction of the immune system is especially likely to happen if the dog already suffers from some other allergy or hypothyroidism.

In the event of serious allergies, your vet will use allergy testing to determine the cause of the allergy and the best course of treatment that can be prescribed. The most common testing method is to examine a sample of blood for the antibodies caused by the antigen. An alternative method involves testing the intradermal skin of the canine. Here, a small amount of antigen is injected according to a predetermined pattern into a shaved area of the skin and left for a couple of hours. The shaved skin is subsequently examined for any reaction.

Treatment

Topical and internal treatments are used to deal with atopic dermatitis. In order to treat the inflamed and irritated skin, the vet will prescribe a medicated shampoo. These shampoos will usually have antifungal and antibacterial agents as well as ingredients that prevent the skin from becoming dry as a result of constant bathing. High-quality shampoos often incorporate chlorhexidine, which will remove harmful bacteria that may accumulate on the dog’s skin. Besides their medicinal value, shampoos will also remove allergens from the dog, aiding in the treatment. To ensure that the dog’s coat doesn’t get too dry, you may want to apply a rinse after bathing.

In many cases, fleas are the cause of atopic dermatitis. A strong flea powder will have to be used to get rid of the fleas. Alternatively, an anti-flea lotion can be used. Even once you get rid of the fleas, you will have to use anti-flea medication as a preventive measure.

Allergen-specific immunotherapy (ASIT) is an extremely effective and safe way to deal with atopic dermatitis. Once the allergens that are responsible for the dog’s condition are identified, a suitable immunotherapy can be manufactured for that particular dog. This will take the form of a hyposensitization injection that contains a mixture of the antigens. It can also be administered orally.

While immunotherapy has enjoyed great success, it can take a long time to show improvements, with results taking up to a year to appear. These injections will have to be given over a period of several weeks, sometimes months, until your dog develops immunity. A booster shot may also have to be given periodically. If the ASIT is administered via injection, the frequency of maintenance doses will vary according to the protocol. The dog should be observed, and adjustments of a couple of days to several weeks may be made to the frequency of the booster injection depending on the dog’s response. If the ASIT is administered orally, the maintenance dose should be given once or twice a day.

The great advantage of ASIT is that side effects are rare. Increased itchiness in the canine is the only complaint that has been commonly encountered. Other side effects that are very occasionally reported include lethargy, pain at the injection site, and hives. Very rarely, the dog may suffer from anaphylaxis. For this reason, you should monitor your dog for 30 minutes after the ASIT injection has been given. As the treatment must be given for at least a year before the results can be evaluated, you must discuss the pros and cons before opting for this treatment. Approximately two-thirds of all dogs that receive ASIT respond positively to the treatment. You may have to support the treatment regime by giving your dog regular baths, antihistamines, and essential fatty acids.

Antihistamines are regularly used to treat atopic dermatitis as they are cheap and have few side effects. Consequently, dogs can be safely treated with them. However, results are variable, with some dogs quickly responding to treatment while other dogs have little or no improvement. In general, antihistamine treatment is successful in around one-third of the cases. Atarax, Benadryl, Chlor-Trimeton, Claritin, and Zyrtec are examples of antihistamines that have proven effective with canines. It is advisable to try different types of this medication as responsiveness often depends on the dog.

Corticosteroids are effective in reducing inflammation, helping to ease the itching that may arise from these skin allergies. They have the advantage of being inexpensive, making them a cost-effective way to manage atopic dermatitis. Dexamethasone, prednisolone, and prednisone are some of the cortisone treatments that may be prescribed. Prednisolone acts within four hours of being administered and is credited with having a high rate of efficacy in reducing itching and skin lesions. Dogs are usually given a dose of prednisolone/methylprednisolone of between 0.5mg and 1 mg per kg of body weight to begin with.

However, they also have side effects and must consequently be used sparingly. These side effects can include behavioral changes, increased appetite, greater thirst, and increased urination. In the longer term, the dog may develop diabetes and become more susceptible to infection. Therefore, this drug must be used only if strictly necessary, especially in the long term. In cases where corticosteroids are the only alternative to controlling atopic dermatitis, a low dose protocol that is administered on alternate days may be adapted. However, this should strictly be a last resort as the pet may face complications from taking the medication long-term.

In the event of an acute flare-up of atopic dermatitis, drugs such as oclacitinib, lokivetmab, and glucocorticoids can be used. These drugs are fast acting, not only reducing itchiness and inflammation but also preventing the disease from progressing to the chronic level.

Oclacitinib is efficacious in rapidly reducing itchiness in the event of a rapid flare-up, often working within 12 hours. This helps prevent the dog from damaging its skin by scratching and biting, in turn reducing the chance of the canine developing other infections and the dermatitis spreading to other parts of the body. While oclacitinib is a very useful medication, a small minority of dogs are affected by adverse side effects, such as urinary tract infections, stomach upsets, ear infections, and skin conditions. These side effects need to be considered as most dogs need lifelong management of atopic dermatitis.

In biological medicine, monoclonal antibodies are used to target proteins, such as cellular receptors. These antibodies bind to the same antigen, helping to control the immune response. Recently, lokivetmab, a monoclonal antibody that is capable of acting on a cytokine that plays a part in causing itching in dogs, was developed. Unlike oclacitinib, lokivetmab does not have significant side effects and acts within days of administration. Usually, after an injection, itching decreases within three days. Its effect lasts for an extended duration and it is generally given in four-week intervals. Lokivetmab is effective in reducing itchiness, skin rash, and inflammation.

In cases where the atopic dermatitis is localized to a particular area of the dog’s body, a glucocorticoid spray that contains hydrocortisone aceponate can be used and has proven to be very effective. Also efficacious in these situations are creams and gels containing betamethasone.

Oral medication may have to be given in situations where the atopic dermatitis has spread throughout the dog’s body. In such cases, ciclosporin could be given daily until the disease has been controlled. The dosage varies depending on the size of the dog, with 5 mg being given per 1 kg of body weight. This usually takes up to four weeks after which, depending on the dog’s response, the treatment can be tapered to alternate days. Side effects associated with ciclosporin include gastrointestinal complaints, muscle cramps, reduced appetite, skin lesions, and coat changes.

Due to the slow-acting nature of the drug, dogs with acute itchiness may require an additional dose of prednisolone, usually 1 mg per kilogram of body weight. Clinical tests have shown that combining a glucocorticoid with ciclosporin in this manner is effective in reducing itchiness and controlling skin rashes.

The itchiness caused by atopic dermatitis can cause the dog to bite and scratch the affected skin, damaging the epidermal barrier. The correct diet can help restore the barrier function of the damaged skin. Seek out high-quality diets that include fatty acids and have vitamins that can restore the skin barrier and reduce itchiness.

Recent scientific studies have revealed a relationship between atopic dermatitis and imbalanced gut microbiomes. Consequently, giving the dog probiotic supplements could play a positive role in controlling its dermatitis. Gut microbiome manipulation could be another method of controlling atopic dermatitis.

There is growing evidence that fecal microbiota transplants (FMT) can treat gastrointestinal diseases such as atopic dermatitis. In this procedure, stool from a healthy donor is transplanted into the gut of the dog. Nasogastric tubes, enemas, oral capsules, and skin transplants can be used to conduct the transplant. This adds a complete set of microbes into the dog’s imbalanced gut.

Ensuring that your pet has a balanced gut microbiome will not only help manage its atopic dermatitis but also promote its long-term health. Since atopic dermatitis is a long-term disease, conventional treatment will typically cause its microbiome to become unbalanced. In such a situation, FMT and similar therapies that promote gut microbiome health may well become the therapy of choice to manage the health of the affected dog without having to deal with adverse side effects.

Atopic dermatitis can lead to yeast infection. If that happens, antifungal medicine and topical products will have to be included in the treatment regime. If the yeast infection is mild, the application of ointment and bathing with shampoos may be sufficient to deal with the problem. If the infection is more severe or spread throughout the body, it may be necessary to go in for oral medication or use a combination of the two.

The yeast infection may have spread to the dog’s ears. You will have to use a medicated ear wash to get rid of the yeast. Once the liquid has been put into the dog’s ears, massage the base of the ears to help the medicine travel down the ear canal. In the case of topical medication, an antifungal shampoo must be massaged thoroughly into the dog’s skin. Leave for ten minutes before washing it off. If your dog’s fur is exceptionally oily or waxy, you may have to use a degreasing shampoo first to remove the grease that has coated the dog’s skin. An antifungal ointment or cream such as clotrimazole, ketoconazole, or miconazole may be prescribed to be applied to the affected patches of skin. Oral medicine such as fluconazole, itraconazole, and terbinafine may be given in more serious cases or where the dog refuses to be bathed. However, they do have side effects, including liver problems and stomach upsets. If your dog is getting long-term treatment, it may be advisable to test its blood regularly.

Antibiotics may also be prescribed to deal with any other infections that arise as a result of the dermatitis. Cephalexin, clindamycin, erythromycin, and amoxicillin are some of the antibiotics that are commonly prescribed to deal with the Staph bacteria. Doxycycline, chloramphenicol, and amikacin are examples of stronger antibiotics that are used to deal with other bacteria. Antibiotic therapy will have to be continued for at least three weeks to see results. If the correct antibiotic has been used, symptoms should subside in a week.

Prevention

Even when the dog has been successfully treated, exposure to the cause of the allergic reaction can cause atopic dermatitis to recur. Consequently, it is important to limit the dog’s exposure to the allergen. Even in cases where the dog has been desensitized with allergy shots, it is better to avoid exposing the dog to the substance that is triggering the allergy. Consider investing in an air filter, preferably with a HEPA filter, to control pollen, dust, and airborne pathogens if these are the issue. Molds are another common cause of allergy that can be removed by the use of a dehumidifier. If your house has a lot of mold, you may have to get a professional to control it. You can also limit the airborne allergens circulating in your house by opting for air-conditioning, which will allow you to keep the doors and windows closed.

Hypoallergenic diets are another measure that you can adopt if your pet suffers from a food allergy. Diagnostic testing is the best way to determine which foods your dog is allergic to, but as dogs may develop allergies over time, avoiding these particular goods is no guarantee that the dog will not develop a food allergy. As food with gluten and wheat ingredients, along with beef, chicken, and turkey, are responsible for the majority of food allergies, it is best to avoid these items. Hypoallergenic diets will include carbohydrates and proteins that the dog has not eaten before. The diet may incorporate special proteins, such as different varieties of fish not typically included in pet food, egg, duck, venison, and lamb. Carbohydrates such as peas, yam, potatoes, and sweet potatoes should feature in the diet. While most dogs respond well to a hypoallergenic diet that has been purchased from a pet store, occasionally a pet may suffer an adverse reaction. In such cases, you will have to switch to a home-based diet in consultation with your vet.

You could also try a hydrolyzed protein diet where the protein sources have been broken down into tiny fragments. The idea is that the protein in the food should be reduced to particles small enough that they will not be noticed by the dog’s hypersensitive immune system and trigger an immune response. Making the protein in the dog’s food harmless will allow your allergic pet to consume it without suffering any adverse side effects.

Many dogs respond positively to supplements. Omega-3 and Omega-6 are fatty acid supplements that are anti-oxidative and anti-inflammatory. As they also work to improve the health of the skin, they are a useful addition to your pet’s diet. Omega-3 is found in fish oils while omega-6 is derived from plants that contain gamma-linolenic acid. Both are harmless, with little or no side effects, and many supplements combine both to be conveniently given to the dig in a single dose.

Home remedies

If your dog has a mild case of atopic dermatitis, you can try some natural home remedies to deal with the situation. In many cases, these home remedies could well solve your pet’s condition. If it worsens, however, make sure to take the dog to a vet. Natural remedies have the advantage of having no side effects, unlike many drugs that are given to deal with the allergic reaction.

Oatmeal baths

Dogs suffering from atopic dermatitis are apt to have itchy, inflamed skin. You can reduce the inflammation and soothe the skin by bathing your pet in a colloidal oatmeal bath. This will cool the dog’s inflamed skin, reducing the redness, itching, and swelling that is caused by inflammation. It will also wash away the allergens trapped in the dog’s fur. As oatmeal is completely safe, your dog can lick it off without suffering any negative effects. You can grind the oatmeal into a powder yourself or buy premade colloidal oatmeal from the pet store.

Coconut oil

Coconut oil is also capable of soothing the inflammation associated with atopic dermatitis. Massage it into the dog’s skin and fur to reduce the itchiness and discomfort it is feeling. Make sure that the oil is solidified and chilled. Purchase the best quality coconut oil that you can find. Oil that is described as “organic” or “virgin” is better suited for this purpose.

Apple cider vinegar

A powerful antifungal and antibacterial liquid, apple cider vinegar is an excellent treatment for a dog that is suffering from dermatitis. To apply, dilute the apple cider vinegar in an equal quantity of water and spray it on the affected spots on the dog’s body. You can also soak your dog’s paws in the mixture for five minutes if necessary. It is very important to remember that apple cider can be very painful to a dog that has open cuts or raw skin and could also worsen symptoms. It should consequently never be used in those circumstances.

Jojoba oil

This oil works as an anti-inflammatory agent that adds moisture to the irritated skin and boosts its natural barrier. Apply it directly to the affected area to soothe the skin.

Aloe vera

Aloe vera is well known as a healing agent that can greatly mitigate the discomfort of sunburn, soothing the inflamed heat and reducing the redness. It is equally effective on dogs, soothing the affected skin and greatly enhancing the dog’s comfort. Directly apply all-natural aloe vera to the irritated areas on the dog’s body. If you are buying a gel, make sure it doesn’t contain alcohol that can burn the dog’s skin.

Chamomile and green tea soaks

Just as in humans, soaking in chamomile and green tea can have a calming, anti-inflammatory effect on your dog’s skin, helping to soothe the hot, irritable areas that are causing discomfort. To use it, let several tea bags steep in a basin of lukewarm water for several minutes. After removing the tea bags, soak your dog in the mixture for five or more minutes. You can also directly apply the tea to an affected spot. Steep the tea bag and let it cool completely before daubing it on the inflamed patch.

Baking soda

Baking soda may be a mainstay in the kitchen, but it’s also great at reducing itching, drying out rashes, and curbing inflammation. Mix equal parts of water and baking soda and apply the paste to the affected patches on the dog’s skin. Wash it off completely after 20 minutes. If your dog has irritated or red skin all over its body, add some baking soda to its bath. You can also add a little coconut oil to the paste if your dog’s skin needs a little extra moisturizing.

CBD oil

CBD or cannabidiol oil is derived from the leaves, flowers, and stems of the hemp plant. It works by interacting with the dog’s endocannabinoid system. This system regulates several important functions in your dog’s body, including sleep cycles, blood sugar, appetite, and immune system. Since atopic dermatitis is the result of the immune system overreacting, it is thought that CBD oil may help control the overactive allergy response, reducing the dermatitis. As it is nontoxic, you can safely try it out without jeopardizing your dog’s health. It is also nonintoxicating, so you don’t have to worry about your dog getting stoned!

Since CBD oil is not FDA-approved, there are no mandated doses for different dog ailments. If you do decide to try CBD oil on your pet, it is advisable to go with reputed, highly rated companies that have been tested by third parties. This way, you can be confident in the product that you are getting. CBD oil is commonly available as capsules and tinctures. You can even give it to your dog as a treat as it can be conveniently given as a capsule by wrapping it in some food. Tinctures should be given directly to the dog’s mouth in a dropper. They should be administered under the tongue so that CBD can be absorbed quickly. Treats are especially useful as you can reinforce positive behaviors while feeding your dog the required supplements.

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