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Veterinary Dermatology: Dealing with Itchy Patients

The following article is excerpted from a feature by contributing editor Jessica Tremayne-Farkas for the Veterinary Practice News.

Clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis have gotten a lot of interest from primary care veterinarians.

These guidelines, created by veterinary dermatologists, offer recommendations to help primary care practitioners identify and treat chronic atopic dermatitis (AD).

Last June, the World Small Animal Veterinary Association endorsed the amended guidelines, which have since been translated from English into 18 additional languages.

Thierry Olivry, DrVet, Ph.D., Dipl. ECVD, Dipl. ACVD, led the international task force and was the lead author of the practice guidelines for atopic dermatitis. He is with the Department of Clinical Sciences and the Center for Comparative Medicine and Translational Research in the College of Veterinary Medicine at North Carolina State University in Raleigh. Dr. Olivry says the team concluded that treatment of canine atopic dermatitis must be individualized for each patient.

“Treatment regimens depend on the canine patient, if acute flares or chronic skin lesions of AD are presented and whether signs are localized or generalized,” Olivry says. “Chronic canine AD is a challenge and known flare factors, including food, flea and environmental allergens, Staphylococcus bacteria and Malassezia yeast, should be investigated before moving forward with a treatment plan.

dog itching“In addition, optimization of skin care, reduction of skin lesions and pruritus and prevention of recurrence of signs after remission are a treatment goal,” Olivry adds.

Evidence-based medicine principles were highlighted in the guidelines, Olivry says, but consideration for owners’ finances and convenience must be considered in efforts to have a substantial compliance rate.

The task force defines canine atopic dermatitis as a genetically predisposed inflammatory and pruritic skin disease with characteristic clinical features associated with IgE antibodies, most commonly directed against environmental allergens. However, experts also include information on a parallel condition—atopic-like dermatitis (ALD), which must be differentiated from AD.

“Patients with ALD have the same clinical signs as those with AD, but in ALD, an IgE response to environmental or other allergens cannot be documented by usual methods,” Olivry says. “Dermatological issues, especially ones proven to be chronic, can be very frustrating to figure out and there is a point when vets will want to refer to a specialist.”

Olivry says that while the most prevalent skin conditions and contributing factors tend to differ from one region to another, they can be vastly different between practices in the same state.

April 3, 2012