CAD & Itch Drugs

Question 1

canine atopic dermatitis is

Answer 1

an inflammatory and itchy disease with clinical signs associated with IgE production directed most commonly against enviromental allergens

Question 2

some risk factors for canine atopic dermatitis include

Answer 2

urban environment, male, neutered, allowed on furnature, receving flea control, exposure to smoke, regular bathing, being raised in a shed, others but im too lazy

Question 3

the most commone allergen for CAD is

Answer 3

dust mites–>shown to worsen the skin barrier in atopic dogs

can also be: dust, mould, grass, dander

Question 4

where are lesions of CAD usually?

Answer 4

periocular, muzzle, paws, ventral metacarpal and metatarsal regions, perianal, inguinal, axillary, cubital fold

Question 5

3 components to diagnosing canine atopic dermatitis?

Answer 5

rule out other diseases that look similar (pyoderma, yeast, ringworm, rule out parasites, and do diet trial)

detailed analysis of history and C/S

demonstration of IgE/identify allergens

Question 6

what are some favrots criteria

Answer 6

Age at onset <3 years
Mostly indoor
Corticosteroid-responsive pruritus
Chronic or recurrent yeast infections
Affected front feet
Affected ear pinnae
Non-affected ear margins
Non-affected dorso-lumbar area

Question 7

true or false There is no test to definitively diagnose atopic dermatitis

Answer 7

true

Question 8

what allergy testing is available for CAD?

Answer 8

intradermal allergy testing (IDAT) : This test requires specific drug withdrawals, the preferred test

serum IgE testing: major advantage is its convenience and widespread availability

allergy tests do not diagnose a patient as
having AD!!!!!!! and not useful for identifying food
allergens !!!!

Question 9

why do we allergy test

Answer 9

• to identify any allergens that can be avoided. Examples include wool, house dust mites (highest in
  beds and bedrooms), and grass. Avoidance is rarely sufficient for a satisfactory reduction in signs, so:
• more often allergy testing allows the formulation of a prescription for allergen-specific
  immunotherapy (ASIT)
  Intradermal skin test showing many strong positive reactions

Question 10

________is the only way to diagnose food allergy (or
rule out food allergy in dogs with non-seasonal allergic signs)

Answer 10

A well-executed diet trial and challenge

Question 11

there are 4 main medical therapies for the treatment
of itch which are

Answer 11

glucocorticoids, Modified Cyclosporine (Atopica), Oclacitinib (Apoquel), and Lokivetmab (Cytopoint)

Question 12

describe how Oclacitinib (Apoquel) works

Answer 12

Janus kinase (JAK) inhibitor, rapid onset of action, has targeted activity against JAK1-dependent cytokines (including the one that causes itch IL-31)

Question 13

describe how Lokivetmab (Cytopoint) works

Answer 13

caninized anti-IL-31 monoclonal antibody , gets rid of the itch! rapid onset of action, not the same as apoquel!

Question 14

describe how Cyclosporine (Atopica) works

Answer 14

calcineurin inhibitor , SLOW ONSET (not for acute flareups), can take 4 weeks or longer to see effects, given to both dogs and cats, dont use it in dogs with cancer

Question 15

describe how Corticosteroids work for allergic conditions

Answer 15

they are anti inflammatory and reduce itching, useful for flare ups and short term treatment

Question 16

what are soft steroids

Answer 16

potent steroids that are metabolized to much
weaker steroids in the skin before entering systemic circulation. Soft steroids are less
likely to cause cutaneous and systemic side effects and may be appropriate for long-term use at 2-3
times weekly dosing with careful monitoring for adverse cutaneous effects

in my words: a topical steroid that is very potent on the skin but then metabolized to a very weak steroid once it is absorbed

2 examples: hydrocortisone aceponate (Cortavance) and mometasone

Question 17

_____ is the only treatment that can modify or reverse this disease, rather than just alleviating
clinical signs

Answer 17

ASIT: allergen specific immunotherapy

Question 18

describe how allergen specific immunotherapy works

Answer 18

ASIT: administering gradually increasing quantities of an allergen extract to an allergic
subject to ameliorate the signs associated with subsequent exposure to the causative allergen.

can take 3-9 months and it can take 12 months or even longer to see the full benefit. If ASIT is
effective, it should be given for life because permanent remissions are uncommon.

Question 19

There are 4 goals of topical therapy in allergic dogs which are

Answer 19

1. Remove allergens from the skin: the physical act of bathing removes substances, including
   allergens from the skin
2. Treat and prevent secondary infections
3. Restore skin barrier
4. Deliver anti-itch ingredients

remember DRRT (dirt)

Question 20

what are the 2 kinds of allergen specific immunotherapy? compare and contrast them

Answer 20

subcutaneous immunotherapy

sublingual immunotherapy

Question 21

what causes CAD flares?

Answer 21

food allergens, ectoparasites, seasonal exposure, change in medication, infections like staph or yeast

Question 22

proper way to do a food trial?

Answer 22

use itch meds beforehand to control clinical signs

stop these 1-2 weeks before beginning food trial

over 8 weeks

if no improve: no food allergy

if improvement: rechallenge

Question 23

what are some reasons why a pet could improve during a feed trial that are NOT food allergy related?

Answer 23

seasonal change, placebo, nutracuticals, infections have resolved, strict flea control is now in place

Question 24

Answer 24

flea allergy

Question 25

Answer 25

pediculosois (lice)

Question 26

Answer 26

scabies

Question 27

Answer 27

demodex

Question 28

Answer 28

malassizia