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Living with an atopic dog

by
01 July 2014, at 1:00am

Lucy Rivett describes her experience of looking after her own dog which has shown signs of atopic dermatitis for nearly seven years and how it has helped her treat other cases.

MY dog Fido is an eight-year-old Labrador cross Springer Spaniel. She first showed signs of atopic dermatitis when she was 15 months old and has been on treatment ever since.

Although I wish for Fido’s sake she wasn’t atopic, living with her and medicating her has given me an insight as a vet into the condition that I otherwise wouldn’t have had. This enables me to empathise with owners, understanding that nothing is more distressing and frustrating then living with a persistently pruritic dog.

My experience with Fido has improved the way I work up cases and because I’ve personally tried practically all the available treatments, I can advise owners more comprehensively of the options available to them.

Distressing and difficult

Living with an atopic dog can be extremely distressing; it is so difficult to see your pet in such discomfort and in some cases cause real damage to their skin from scratching and nibbling. Fido’s clinical signs started out fairly mild with her itching and scratching around her face. As her condition progressed, her clinical signs worsened; she became restless and was chewing at her feet until she nearly bled. Fido was obviously very uncomfortable and it became clear that we needed to find an appropriate management strategy to make her itch-free.

Diagnosing atopic dermatitis can be a difficult process, not helped by the fact that clinical presentation can vary quite markedly between individuals, as shown by some of the other case studies detailed here.

Good compliance can also be really difficult to achieve when performing diet trials and other diagnostic processes and many dogs experience episodes of are-ups which seem to have no clear underlying cause. This can make the process of identifying the allergen(s) responsible full of hurdles and frustrations, for the owner and for the vet.

How I worked Fido up wasn’t exactly textbook, but following my experience with her, I would always stress the importance of following a clear diagnostic pathway. Fido had responded very well to steroids but, unsurprisingly, once treatment was stopped the pruritus would return.

Initially my diagnostic work-up was relatively short, with coat brushings and tape strips, from which I was able to rule out surface parasites and Malessezia. I ran a general health profile including t4, which was unremarkable. I didn’t do skin scrapes as I felt with no obvious lesions, demodex and sarcoptes were unlikely. I have subsequently seen a dog on treatment for atopy which was actually suffering from demodicosis, so I now try to never skip this step.

Logically it would have made sense to do a food trial at this point; however, I rationalised that she was more likely to be allergic to something in her environment than food, so I concentrated on trying to identify what the allergen might be.

Care with medication

I wanted to run allergy blood tests at this point but couldn’t stop her steroids without her becoming puritic again, so it was at this stage I started her on ciclosporin.

I needed a medication which would keep her comfortable without interfering with the blood test.

The allergy blood tests showed a strong positive result for house dust mites and storage mites, so there were a few management controls that I was able to introduce to help minimise her exposure whilst her immunotherapy was prepared.

At this stage, I did a six-week food trial in case a food allergy was a component of her condition; however, I felt there was no obvious difference in her during the trial and there was no are-up in her symptoms when we re- challenged her with the original diet.

The situation today

Atopic dermatitis is such a big topic that it can be daunting for us vets, let alone for owners. One of the hardest points to get across to owners is that atopic dermatitis is a lifelong condition that requires lifelong and often multimodal treatment. In Fido’s case, alongside her immunotherapy and ciclosporin, she also receives anti-histamines, medicated shampoos and spot-on treatments to keep her comfortable.

At present Fido is itch-free 95% of the time, with any are-ups treated with a short course of steroids.

People always comment on her shiny coat and she has a good quality of life which I believe has been achieved by not assuming that one solution is going to act as a “cure all”. 

Sadly, however good your communication is, there will always be non-compliance amongst owners who stop their dog’s medication once they are itch-free, causing a recurrence of their clinical signs. Finances also play a massive role

in what diagnostics you can perform and what treatment can be afforded. It is vital, however, to communicate to owners the benefits of these treatments and the value of having an itch-free pet. With lots of treatment options available, the world of atopic dermatitis is always a rewarding challenge!

For more information and educational resources about diagnosing and treating atopic dermatitis, visit http://dog.atopica.co.uk.