Canine Atopic Dermatitis

Question 1

What factors may you consider under identification and avoidance of flare factors?

Answer 1

• allergenic causes: environmental, food, insect

- bacterial/yeast infections

Question 2

What are two ways you can improve skin and coat hygiene and care?

Answer 2

• bathing with a non-irritating shampoo

- short coarse of oral glucocorticoids or oclacitinib

Question 3

What is a starting dose of prednisolone to tx. acute flares of atopic dermatitis?

Answer 3

0.5mg-1mg/kg SID

Question 4

What is the active ingredient of apoquel?

Answer 4

Oclacitinib

Question 5

What is the dose regime of apoquel?

Answer 5

0.4-0.6mg/kg PO BID up to 14d

Question 6

ID a concern in concurrent administration of oclacitinib and glucocorticoids

Answer 6

theoretical possibility of immunosuppression

Question 7

Discuss the efficacy of EFAs in controlling AD

Answer 7

Not useful in acute flare ups dt slow onset of action. Benefit takes >2m w/ PO supplementation –> improves coat quality and gloss.

Question 8

Name a topical and an oral calcineurin inhibitor

Answer 8

Topical - tacrolimus

Oral - ciclosporin

Question 9

What stages of investigation are required in the ID and avoidance of flare factors in a dog with chronic AD?

Answer 9

1. Performance of dietary restriction-provocation trials in dogs w/ nonseasonal AD
2. Implementation of flea control regimen (spinosad)
3. Performance of allergen-specific intradermal and/or IgE serological tests to ID possible allergenic flare factors
4. Implementation of house dust mite control measures (benzyl benzoate acaricidal spray)
5. Evaluation of use of antimicrobial tx (Itraconazole 5mg/kg SID 3-4wks vs. pulse tx)
6. Investigation of the relevance of other flare factors: O education

Question 10

List 4 strategies you could implement to prevent recurrence of signs of AD

Answer 10

1. Avoidance of flare factors
2. Proactive topical pharmacotherapy
3. Allergen-specific immunotherapy (ASIT)
4. Nonspecific immunotherapy - probiotics - Lactobacillus rhamnosus PO

Question 11

What is the preferred preventative antihistamine in dogs to tx. potential flare ups of AD?

Answer 11

Hydroxyzine and its metabolite cetirizine.

Question 12

Ciclosporin dose

Answer 12

5mg/kg PO SID ~4-6wks (at resolution of CS)

Question 13

What medication can you combine with oral prednisolone to achieve a faster reduction in CS?

Answer 13

Ciclosporin for the first 3wks of tx.

Question 14

Why would you want to do periodic UAs in dogs on longterm glucocorticoids?

Answer 14

higher risk of developing a UTI

Question 15

What drug is contraindicated in dogs <12mo?

Answer 15

Oclacitinib (Apoquel)

Question 16

Discuss the efficacy of oral fluoxeline in managing AD.

Answer 16

it has little/no benefit

Question 17

Contrast the use of tacrolimus vs. topical glucocorticoids on skin lesions

Answer 17

Topical glucocorticoids are cheaper and have similar effectiveness as tacrolimus but can cause skin atrophy - so if skin atrophy is present tacrolimus may be the more prudent choice.