Treatment Simplified:
A Guide to Comfort for
the Itchy Dog
Treatment Simplified:
A guide to comfort for the itchy dog
Atopic dermatitis, a pruritic and
inflammatory disease, has no cure. One
estimate indicates that one in 10 dogs in
the United States has atopic dermatitis,
which makes it one of the most common
chronic conditions that veterinarians
encounter.1 Although practitioners are
growing more adept at diagnosing
atopic dermatitis, the real challenge
comes with providing immediate relief of
patients’ clinical signs while addressing
their underlying allergic disease. This
article illustrates how managing atopic
dermatitis in dogs may be simplified
and will help you provide comfort
for these pruritic canine patients.
Treatment Simplified: Start early, address flares, and assess progress
Atopic dermatitis can start with acute,
seasonal flare-ups and if the underlying
disease process is not managed, it
progresses, over several months to years,
to a nonseasonal, chronic condition.2
Thus, managing the disease earlier
should be beneficial. Every dog that
suffers from atopic dermatitis has its
individual allergic threshold — the
point at which the environmental
allergen load triggers the dog’s immune
system to react. Once the allergic
threshold is exceeded, the dog develops
inflammation, pruritus, and pain, which
usually results in skin damage. Therefore,
treatment of the clinical signs and longterm management are always aimed
at returning to a point below the dog’s
allergic threshold. This, in turn, reduces
the number and severity of allergy flareups that the patient experiences.
Even in well-managed patients,
occasional flare-ups are inevitable and
should not be deemed a long-term
treatment failure. Jerry Wilson, DVM,
owner of Animal Hospital of Collin
County in Allen, Texas, says, “Having a
plan that will decrease the frequency and
severity of these flare-ups is in the best
interest of the patient and client. Longterm success is achievable with the correct
diagnosis and medication regimen.”
Once atopic dermatitis has been
diagnosed, this three-month “Treatment
Simplified” protocol (Figure 1) may be
implemented to help control patients’
clinical signs and monitor their response.
Treatment Simplified:
Month One — Long-term
solution, immediate relief
Start long-term therapy early
Since atopic dermatitis is progressive,
beginning a long-term management
plan as early as possible should make
it easier to control the disease. In the
first month of treatment, ATOPICA®
(Cyclosporine capsules, USP) MODIFIED
“In many of my earlier cases, atopic
patients receiving corticosteroids,
shampoos, fatty acid supplements,
you name it, were the norm before
I prescribed ATOPICA. Now ATOPICA
has climbed to the top of my treatment
recommendation list.” —Steve Milden, VMD
should be initiated at a dose of 5 mg/
kg/day (range 3.3 to 6.7 mg/kg/day).
ATOPICA is the first and only approved
nonsteroidal prescription medication for
the control of atopic dermatitis in dogs.
Dr. Wilson agrees, saying, “Having had
success with ATOPICA, I now make the
recommendation much earlier in the
course of therapy.” As with all drugs,
side effects may occur. In a field study,
the most common side effects were
gastrointestinal signs. Gingival hyperplasia
and papillomas may also occur during
the initial dosing phase. ATOPICA is a
systemic immunosuppressant that may
increase the susceptibility to infection.
ATOPICA is not for use in reproducing
dogs or dogs with a history of neoplasia.
Please see the included product insert
on page 7 for more information.
Treat secondary infections
Patients with allergic skin disease have
alterations to the normal protective
Treatment Simplified
Figure 1
function of the skin, which increases
the likelihood of infection. Secondary
bacterial and yeast infections of the skin
and ears, caused by Staphylococcus
and Malassezia species, commonly
exacerbate a dog’s clinical signs, such
as pruritus. In dogs with clinical signs
of atopic dermatitis, positive cytologic
examination results indicate the need
for antimicrobial agents.3 Antimicrobial
therapy should be continued for four
to six weeks and be discontinued only
when cytologic examination results
are negative. More chronic infections
may require prolonged antimicrobial
therapy. If fungal infections are present,
antifungal treatment (e.g., ketoconazole)
may be indicated. Simultaneous
administration of ATOPICA and drugs that
suppress the P-450 enzyme system, such
as ketoconazole, may lead to increased
plasma levels of cyclosporine. ATOPICA
should be used with caution with drugs
that affect the P-450 enzyme system.
According to Keith Hnilica, DVM, MS,
DACVD, of the Allergy and Dermatology
Clinic of the Pet Wellness Center in
Louisville, Tenn., “Bacterial and yeast
infections and the accompanying
pruritus are the most common
reasons for apparent failure of most
allergy treatments.” It is imperative
to resolve any secondary infections
to successfully manage patients with
atopic dermatitis in the long term.
Provide immediate relief
Short-term concurrent topical or systemic
corticosteroid therapy may be indicated
for immediate relief in a dog that is
suffering from pruritus and pain. As
Steven Milden, VMD, of Delaware Valley
Veterinary Hospital in Mullica Hill, N.J.,
explains, “All atopic pets have some
degree of discomfort. While ATOPICA®
(Cyclosporine capsules, USP) MODIFIED is the
long-term solution to treat the underlying
disease to minimize and prevent flare-ups,
corticosteroids may be needed in the
most severe cases to bring the pet relief.”
“With the vast majority of cases,
corticosteroids are not needed past
14 to 21 days because most of the
patient’s inflammation and itching
has subsided and the effects of
ATOPICA® (Cyclosporine capsules,
USP) MODIFIED are becoming clinically
evident.” —Jerry Wilson, DVM
Unlike ATOPICA, corticosteroids do not
treat the underlying atopic disease and
should be used only in the short term to
treat the clinical signs. Anti-inflammatory
doses of corticosteroids provide quick
relief, but also can cause numerous side
effects, especially with long-term use.
There have been reports of convulsions in
human adult and pediatric patients receiving
cyclosporine, particularly in combination
with high-dose methylprednisolone. (See
the Animal Safety section of the product
insert — “Methylprednisolone combination:
Twenty-four dogs were administered
1 mg/kg/day methylprednisolone alone
for 14 days followed by 20 mg/kg/day
cyclosporine either alone or in combination
with methylprednisolone, or placebo for 14
days. There was no evidence of seizures/
convulsions or neurological signs.”)
Treatment Simplified:
Month Two — The
turning point
After four weeks of treating secondary
infections, initiating ATOPICA, and
managing the patient’s clinical signs, a
progress examination should be performed
to assess the patient’s response to therapy.
If the patient shows a 50% reduction
in skin lesions and pruritus, the ATOPICA
dose can be tapered to once every other
day.4 Conversely, if a dog is only showing
slight improvement, the patient’s ATOPICA
dose should be evaluated to ensure it
falls within the dose range (3.3 to 6.7
mg/kg/day). If the patient’s dose is at the
lower end of the range, it may need to
be increased or once-daily treatment may
need to continue. If no improvement in
skin lesions or pruritus has occurred, a
thorough re-evaluation of the patient may
be warranted, and referral to a veterinary
dermatologist should be considered.
A cytologic examination should also
be included, as failure to adequately
address infections may lead practitioners
and owners to declare ATOPICA a
failure. If the cytologic examination
results are negative, antimicrobials
can be discontinued. If the secondary
infections are chronic, a longer course
of antimicrobials may be indicated.
By this point in treatment, cortico
steroids may no longer be indicated. Dr.
Milden offers this perspective based on his
clinical experience: “I try to discontinue
corticosteroids before the second month
A guide to comfort for the itchy dog.
MONTH 1*
Initial Exam
MONTH 2*
30-Day Progress Check
MONTH 3*
2
60-Day Progress Check
Diagnose atopic dermatitis
Treat any infections
with antimicrobials.
Initiate long-term management with ATOPICA®
(Cyclosporine capsules, USP) MODIFIED therapy for long-term relief.
YES
Significant improvement
Consider
tapering dose.
Continue long-term
management with
ATOPICA.
NO
Re-evaluate and consider
concurrent disease.
A long-term treatment plan
will help you achieve success
sooner rather than later.
NEGATIVE
Provide short-term relief
with corticosteroids.
Cytologic exam
Discontinue
treatment.
POSITIVE
Continue treatment
until infection is resolved.
Discontinue
short-term relief.
*The timing of progress may vary from case to case.
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re-evaluation so I can assess the dog’s
true level of pruritus. If the dog is still
receiving corticosteroids at the end of the
first month, veterinarians may prematurely
reduce the ATOPICA dose and then see a
rapid return of pruritus, leading them
(and the owners) to believe (and rightly
so) that ATOPICA wasn’t responsible for
the decrease in pruritis and that ‘only
steroids will help this dog.’”
Treatment Simplified: Month Three — Entering the comfort zone
The dog’s clinical signs and response to
treatment and the results of physical
and cytologic examinations should be
assessed at this evaluation. ATOPICA®
(Cyclosporine capsules, USP) MODIFIED
dosage adjustments may be made if
needed. By this point, ATOPICA may
be indicated as the sole therapeutic
“Consistency in our recommendations
establishes credibility and confidence in
our clients, which helps with compliance
and eventually success in treating
the clinical signs of this complicated
disease.” —Jerry Wilson, DVM
agent for long-term management of
atopic dermatitis. However, according to
many dermatologists, even in the most
well-managed patients, practitioners
and owners should expect occasional
flare-ups, and clients must be prepared
to address these. Possible flare factors
include an increased allergen load,
secondary infections, fleas, and
concurrent disease (e.g., food allergy).
Some options for managing the shortterm flares include increasing the
frequency of ATOPICA administration
(e.g., back to once-daily dosing),
controlling secondary infections, and
adding a topical corticosteroid.
Conclusion
Once atopic dermatitis is confirmed,
practitioners need a reliable, repeatable,
and customizable treatment protocol
providing both long-term comfort and
short-term relief for the atopic patient.
Utilizing the “Treatment Simplified”
approach may help practitioners achieve
success in atopic dermatitis patients
sooner rather than later. According to
Dr. Milden, “Many clients come to me
frustrated. Either the dog has been
keeping them awake or they have
been dealing with chronic disease.
When ATOPICA prevents the return
of their dog’s clinical signs, they bring
Initiating treatment with ATOPICA as the
first-line medication for the primary
disease can result in successful, longterm management of atopic patients.
me presents!” In addition, Dr. Wilson
points out, “Through long-term use of
ATOPICA and control of clinical signs
and flare-ups, we are able to integrate
the pet back into the family — the
pet and the people all benefit.”
Initiating treatment with ATOPICA as
the first-line medication for the primary
disease can result in successful, longterm management of atopic patients.
The following two case summaries for
Prissy and Matty will demonstrate how
the “Treatment Simplified” protocol
has helped Drs. Jerry Wilson and Steven
Milden manage their canine atopic
dermatitis patients, describe what they’ve
learned along the way, and illustrate how
the protocol can help in your practice.
REFERENCES
1. Hillier A. Definitively diagnosing atopic dermatitis in dogs.
Vet Med 2002;97(3):198-208.
2. Griffin CE, DeBoer DJ. The ACVD task force on canine atopic
dermatitis (XIV); clinical manifestations of canine atopic
dermatitis. Vet Immunol 2001; 81:255-269.
3. Olivry T, DeBoer DJ, Favrot C, et al. Treatment of canine
atopic dermatitis. 2010 clinical practice guidelines from
the International Task Force on Canine Atopic Dermatitis.
Vet Derm 2010:21(3);233-248. doi: 10.1111/j.13653164.2010.00889.x.
4. ATOPICA Freedom of Information Summary. NADA
141-218, 2003.
CLIENT COMMUNICATION SIMPLIFIED
Month One
4
Month Two
Month Three
Long-term solution, immediate relief
The turning point
Entering the comfort zone
1. Explain the progressive, lifelong nature
of atopic dermatitis.
2. Set client expectations. Record the
client’s opinion, a pre-treatment pruritus
score, from 0 to 10; 0 being normal
skin and 10 being severe pruritus.
Using a pruritus scale at the baseline
examination and at every recheck
helps gauge the success of the therapy
and monitor the progress of the pet’s
condition.
3. Educate the client that ATOPICA®
(Cyclosporine capsules, USP) MODIFIED will
target the allergic response to provide
long-term relief and management of the
underlying disease process.
4. Eliminate secondary infections. Discuss
with the client that these infections are
common with atopic dermatitis and can
exacerbate pruritus.
5. Provide short-term relief of clinical signs
with corticosteroids.
6. Schedule the next progress examination.
1. Discuss the patient’s progress, including
cytologic examination results and
pruritus score.
2. Continue ATOPICA® (Cyclosporine
capsules, USP) MODIFIED therapy;
continue with the daily dose if the
patient shows moderate improvement,
taper the dose if the patient shows
significant improvement.
3. Eliminate corticosteroids. Review with
the client that corticosteroids were
administered to provide short-term
relief of clinical signs and that the
targeted therapy of ATOPICA will
provide long-term comfort.
4. Celebrate the patient’s improvement
with the client. Acknowledge the
frustration that comes with atopic
dermatitis and talk about a future with
a more comfortable, less itchy dog.
5. Schedule the next progress
examination.
1. Discuss the patient’s progress and
celebrate improvement with the
client.
2. Customize the ATOPICA®
(Cyclosporine capsules, USP) MODIFIED
dosing frequency based on clinical
assessment.
3. Educate the client about the
likelihood of an occasional flare-up
and discuss how it will be handled.
To address flares, the frequency of
ATOPICA administration can be
temporarily increased (in dogs not
receiving daily dosing) and other
short-term therapies may be used.
PRISSY
Breed: Maltese-poodle cross
Age: 6 years
Sex: Spayed female
Weight: 12.3 lb (5.6 kg)
First Prescribed Atopica® (Cyclosporine capsules, USP) MODIFIED: 5 years of age
Veterinarian: Jerry Wilson, DVM
“Educating clients about the long-term approach of controlling clinical signs of atopic
dermatitis with ATOPICA® (Cyclosporine capsules, USP) MODIFIED is the best solution for
most atopic canine patients. By avoiding long-term glucocorticoid use, we reduce a dog’s
risk of complications and achieve better results in controlling the signs of atopy.”
Before “Treatment Simplified”
Patient history and presenting problems
to provide immediate relief of the
pruritus and treat the yeast dermatitis.
• Yeast and bacterial otitis externa two
years previously
“TREATMENT SIMPLIFIED”
• Two-year history of recurring seasonal
allergic skin disease, which was
treated three times at another clinic
• Administer one ATOPICA 25-mg
capsule (4.46 mg/kg) once daily for
30 days.
• Pruritus involving front limbs and
ventral abdomen
• Administer an intramuscular
dexamethasone sodium phosphate
injection (0.66 mg/kg).
• Pustules on ventral abdomen and
front legs; flaky skin on front legs
Month One
• Malassezia dermatitis
• Prescribe oral ketoconazole (5 mg/kg)
once daily.
Previous therapies
Month Two
• Ear flushing with an otic cleansing
solution
• Antibiotic/antifungal/corticosteroid
otic medication
• Oral trimeprazine with prednisolone
The owner reported that Prissy’s
pruritus was greatly improved. Prissy
had a few pustules, and cytologic
examination revealed that low
numbers of yeast were still present.
• Oral clindamycin
• Continue ATOPICA 25 mg; reduce
dosing frequency to every other day.
Patient response and treatment plan
• Continue ketoconazole; reduce dosing
frequency to every other day.
Prissy’s otitis resolved with the
otic treatments. Her pruritus
decreased while she was receiving
trimeprazine/prednisolone and
clindamycin, but recurred when the
medications were discontinued.
After two years of unsuccessful
treatment of Prissy’s atopic dermatitis at
another clinic, Dr. Wilson implemented
a treatment simplified plan using
ATOPICA® (Cyclosporine capsules, USP)
MODIFIED to control the underlying allergic
condition. A short-acting corticosteroid
and an antifungal were also prescribed
Month Three
The pruritus was decreased. Prissy
exhibited minimal scratching and
chewing on the every-other-day
ATOPICA dosing schedule. The pustules
and yeast dermatitis had resolved.
• Continue ATOPICA 25 mg; reduce
dosing frequency to every third day.
• Discontinue ketoconazole.
PATIENT FOLLOW-UP AND OUTCOME
• Prissy became mildly pruritic again
when ATOPICA was given every three
days, but the pruritus rapidly resolved
after every-other-day ATOPICA dosing
was reinstituted.
• Prissy is doing well and the owner is
very pleased.
• The owner was advised that allergy
flares may occur occasionally, and that
Prissy’s pruritus can be managed with
short-term medications to alleviate
the clinical signs at those times.
DR. WILSON’S CASE
COMMENTARY
”Prissy’s atopic dermatitis is being
successfully managed because the
owner agreed with implementing a
long- and short-term plan to address
Prissy’s underlying allergic disease.
As the short-term, anti-inflammatory
effect of the glucocorticoid
diminished, the ATOPICA®
(Cyclosporine capsules, USP) MODIFIED
targeted suppression of cells that
cause the allergic reaction began to
help control Prissy’s clinical signs, all
while the antifungal helped resolve
her secondary yeast infection.
Prissy’s owner is aware that atopic
dermatitis can be controlled but
not cured, that allergy flares will
occur occasionally, and that Prissy’s
treatment will be lifelong.”
Jerry Wilson, dvm
In 1982, Jerry W. Wilson, DVM, opened the Animal Hospital of Collin County in Allen, Texas, a suburb
of Dallas. He also helps manage the Emergency Animal Hospital of Collin County, an after-hours
emergency and specialty practice he helped form in 1985 along with 26 other practitioners in an area
north of Dallas.
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MaTTY
Breed: Bichon Frise age: 7 years Sex: Neutered male weight: 14.5 lb (6.6 kg)
First Prescribed aToPiCa® (Cyclosporine capsules, USP) ModiFied: 2.5 years of age
veterinarian: Steven Milden, VMD
“Matty’s case is a reminder that atopic dermatitis should be
considered in young dogs with appropriate clinical signs.”
BeFoRe “TReaTMenT SiMPLiFied”
PATIENT HISTOry AND
PrESENTING PrOBlEMS
• Presented at 5 months of age for
evaluation of pruritus and alopecia
• Persistent pruritus, chewing at feet,
and discomfort
• Alopecia, scaly skin, epidermal
collarettes involving the hip regions
bilaterally, saliva-staining on feet,
possible nail bed infection
• Episode of acute moist dermatitis and
pyoderma
PrEVIOUS THErAPIES
• Topical corticosteroid spray
• Topical corticosteroid lotion
signs indicated nonseasonal allergic
dermatitis with secondary self-induced
trauma and infection. ATOPICA was
prescribed to better control Matty’s
underlying allergic condition.
“TReaTMenT SiMPLiFied”
MONTH ONE
• Administer one ATOPICA
(Cyclosporine capsules, USP) MODIFIED
25-mg capsule (3.79 mg/kg) once
daily for 30 days.
®
At this point, Matty was doing great;
he exhibited obvious hair regrowth and
had no sores or areas of erythema.
• Weekly oatmeal/corticosteroid
shampoo
• Monthly flea preventive
MONTH THrEE
• Oral diphenhydramine
PATIENT rESPONSE AND
TrEATMENT PlAN
results of a skin scraping and cytologic
examination revealed no mites. A
complete blood cell count and total T4
concentration revealed no abnormalities.
A serum chemistry profile revealed
neutrophilia, eosinopenia, and
lymphopenia, which were attributed
to the corticosteroid treatment.
Matty’s pruritus decreased while he
was receiving the oral antibiotics and
topical treatments but recurred when
the medications were discontinued.
His history, clinical signs, and response
to treatment to alleviate the clinical
At this point, Matty was doing
well, and the owners reported
that they reinstituted a once-daily
ATOPICA dosing schedule.
• Continue administering one ATOPICA
25-mg capsule once daily for 30 days,
then decrease to every other day.
PaTienT FoLLow-UP
and oUTCoMe
• Over the next several months, Matty
had one recurrence of pruritus
that was associated with reducing
the ATOPICA dosing frequency.
reinstituting once-daily ATOPICA
treatment for 30 days controlled
Matty’s pruritus.
STeven MiLden, vMd
Steven Milden, VMD, opened Delaware Valley Veterinary
Hospital in Mullica Hill, N.J., a semirural/suburban area of
southern New Jersey in 1994. He works at his small-animal
practice with seven veterinarians and a staff of nearly 50
employees.
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• Three years later, Matty is receiving
ATOPICA every other day and has not
had any recurrence of pruritus.
• The duration of Matty’s relief with
ATOPICA treatment alone: 4.5 years.
MONTH TWO
• Continue administering one ATOPICA
25-mg capsule once daily for two
weeks, then every other day.
• Oral cefpodoxime proxetil
• Two years later, Matty was receiving
ATOPICA every third day, but had
episodes of pruritus a couple of times
a year. When these mild allergy flares
occurred, the owner was able to
control them by temporarily returning
to once-daily therapy.
dR. MiLden’S CaSe
CoMMenTaRY
“Matty was one of my early
ATOPICA® (Cyclosporine capsules,
USP) MODIFIED treatment cases. In
retrospect, his case helped me
recognize that I could probably
relieve atopic patients’ discomfort
sooner by prescribing ATOPICA
concurrently with treatment
for secondary infections, rather
than waiting until the infections
resolved to start ATOPICA.
Matty’s case also demonstrates
that different dogs may require
different ATOPICA dosing schedules,
and owner communication is
key to identifying what schedule
works best. We can modify Matty’s
ATOPICA dosing schedule to
manage his allergy flares — which
are likely the result of increased
environmental allergen exposure
— rather than use multiple
medications to relieve the clinical
signs. For Matty’s atopic dermatitis,
one drug does it all, and his
case made me a true believer in
ATOPICA’s efficacy for long-term
control of atopic dermatitis.”
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Simplify allergy treatment by starting earlier
Keith A. Hnilica, DVM, MS, MBA, DACVD
The earlier an allergic patient is started on
a management program designed with
aggressive allergen avoidance practices
and targeted treatment of the underlying
disease, the easier the allergic condition
will be to control. Patients with chronic
allergic disease or recurrent skin or ear
infections have immune system changes
as well as alteration in normal skin
function, which can make it more difficult
to treat dermatitis. By starting targeted
allergy treatment early in the disease
course, simpler, less expensive adjunct
therapies are likely to help improve the
patient’s condition.
The most common allergens in the
home environment are house dust
mites, molds, and cigarette smoke.
These, as well as other allergens (e.g.,
wool, fleas, certain foods), can often be
reduced or avoided with several simple
techniques. Bathing the pet with a mild
antimicrobial shampoo every three to
seven days removes allergens and helps
resolve and prevent secondary bacterial
or yeast infections. Administering a
monthly insect growth regulator and a
flea adulticide is the best combination
for flea control and prevention. In my
experience, feeding a diet without beef
or dairy ingredients but with high levels
of essential fatty acids is beneficial.
Allergic disease changes the normal
protective function of the skin, which
increases susceptibility to skin infections.
These infections can cause severe pruritus
and further inflammation. In my clinical
experience, up to 80% of allergic patients
develop secondary infections, and typically
any dog that has a pruritus score above
5 on a scale of 0 to 10 has a secondary
bacterial or yeast infection. Additionally,
bacterial and yeast infections and the
accompanying pruritus are the most
common reasons for apparent failure of
most allergy treatments.
Antibiotic administration is needed
for at least 21 days for each pyoderma
episode. Yeast infections require topical
or systemic antifungal treatment for at
least one month. Ear infections usually
require ear cleaning every three to seven
days and daily administration of a topical
antibacterial or antifungal. Often a topical
corticosteroid is used to decrease the
associated inflammation. Pododermatitis
is often treated with topical antimicrobial
wipes, shampoos, or rinses used
frequently.
For patients with atopic dermatitis, the
only targeted treatments that modulate
the immune system are ATOPICA®
(Cyclosporine capsules, USP) MODIFIED and
allergy desensitization vaccination. Skin
Simplify allergy treatment by addressing flare-ups
Ian Brett Spiegel, VMD, MHS, DACVD
A multimodal approach is often required
when initially treating atopic dermatitis
in dogs. Secondary bacterial and yeast
(Malassezia species) infections must
be identified and managed in order
to successfully treat these patients.
Preventing flea infestations, ruling out
mite infestations, and addressing potential
adverse food reactions are important
components as well.
Corticosteroids are often indicated
at some point in allergy management,
but ideally they are used infrequently
and administered orally and only when
necessary. If injectable corticosteroids are
used, consider short-acting options such
as dexamethasone sodium phosphate. In
my opinion, injectable corticosteroids are
rarely indicated. The modified formulation
of cyclosporine (ATOPICA®) is an
excellent option for managing canine
atopic dermatitis. This drug lacks the
adverse effects frequently associated with
corticosteroids. A corticosteroid may be
needed in conjunction with ATOPICA when
therapy is initiated, and even in a wellmanaged atopic patient, the therapeutic
plan will need to be adapted to address
occasional flare-ups of clinical signs.
Intermittent application of topical
treatments may also be effective in
helping manage flare-ups of atopic
dermatitis. Topical antimicrobials may
target the secondary infections, and
some topicals may help maintain barrier
function. Many topical anti-inflammatory
and antipruritic preparations (e.g.,
corticosteroid sprays or analgesic sprays
containing pramoxine) are also available.
Keep in mind that every patient is
Dr. Hnilica is the author of
Small Animal Dermatology:
A Color Atlas and
Therapeutic Guide, 3rd ed.
He is the founder of the
Allergy and Dermatology
Clinic of the Pet Wellness
Center in Louisville, Tenn.
or serum allergy testing can be used to
identify the offending allergens, and the
results can be used to formulate an allergy
vaccine that may desensitize the immune
system to those allergens. Desensitization
therapy has few side effects and various
authors have rated response as good
to excellent in 60% to 70% of atopic
dogs.1,2 ATOPICA is an oral capsule that is
administered every day until the patient’s
clinical signs markedly improve. Then the
dosing frequency can usually be reduced
to every other day. In clinical trials,
ATOPICA was proven to be effective in
74% of dogs with atopic dermatitis.3
References
1. Griffin CE, Hillier A. The ACVD task force on canine
atopic dermatitis (XXIV): Allergen-specific immunotherapy.
Vet Immunol Immunopathol 2001;81:363-383.
2. Nuttall TJ, Thoday KI, van den Broek AH, et al.
Retrospective survey of allergen immunotherapy in canine
atopy. Vet Rec 1998;143(5):139-142.
3. ATOPICA Freedom of Information Summary. NADA
141-218, 2003.
Dr. Spiegel is affiliated
with the following clinics:
Veterinary Specialty
and Emergency Center,
Levittown, Pa.; Animerge
24/7 Animal Emergency
and Specialty Care,
Raritan, N.J.; and Garden
State Veterinary Specialists,
Tinton Falls, N.J.
different, and every client’s situation is
unique. It is important to remember that,
even in the most well-managed cases,
flare-ups are inevitable. Flare-ups can be
caused by anything from a flea infestation
or a change in season to the development
of a concurrent disease, such as a food
allergy. The art of managing the allergic
patient requires good communication
with the client as well as patience and
perseverance on the part of both the
clinician and the client.
Sponsored by
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© 2012 Novartis Animal Health US, Inc.