In today's VETgirl online veterinary CE blog, we interview Dr. Andrew Hillier, BVSc, MANZCVS, DACVD, Medical Lead for Dermatology at Zoetis on the diagnostic approach for itchy dogs (particularly those with atopic dermatitis!). What are some keys to success in treating dogs with atopic dermatitis? Tune in to learn how we should be communicating with our pet owners, what mistakes we want to avoid with the atopic dog, and the diagnostic and therapeutic approach to atopy.
Thanks to Zoetis for sponsoring this blog. Please note the opinions in this blog are the expressed opinion of the author, and not directly endorsed by VETgirl, LLC.
KEYS TO SUCCESS IN DOGS WITH ATOPIC DERMATITIS
Dr. Andy Hillier, Medical Lead Dermatology, Veterinary Specialty Operations, Zoetis Petcare
- Atopic dermatitis (AD) is a common disease. In some areas of the country, like more northern states and mountain states, it is the most common cause of itch in dogs. And it is becoming more common as the popularity of predisposed breeds increases (think French Bulldogs for example, or the still ever-popular Labrador and Golden Retrievers).
- Making the diagnosis of AD can seem difficult and time-consuming – here are a few key points to remember:
- It is a diagnosis of elimination and may take anything from a few days to several months – this is not particularly attractive to owners.
- Let the owner know that your 1st priority today and throughout the process will be to stop the itch and make their pet comfortable. This will give the owner peace of mind and some trust and confidence; they are far more likely to accept the offer of a workup.
- Keep the description of the diagnostic workup streamlined and simple; rule out parasites, treat infections and perform an elimination diet trial if necessary. If the dog is still itching, then it has atopic dermatitis.
- There are so many options for treatment of atopic dermatitis – how do I decide which to use?
- It is a great time to be a veterinarian and seeing dogs with AD because we have new innovative options that allow us to tailor treatment according to owner and pet needs.
- Consider trying to find an anchor treatment (a single therapy that provides satisfactory control and is sustainable for both pet and owner) – examples would be oclacitinib, Cytopoint, cyclosporine and allergen-specific immunotherapy. Multimodal therapy may be necessary but probably only in a minority of dogs – it is very difficult for owners to continue several treatments long-term. Consider referring to your local dermatologist if this occurs.
- What else is important in finding long term solutions?
- How we communicate and interact with today’s pet owner is crucial. They want to be educated (keep it high level), they want to hear the options (a brief description of the main options, maybe 30 seconds maximum), they want to partner with us and be part of the process instead of just being told what to do. I always like to finish any conversation with an open-ended question (“do you have any questions?” or “how do you feel about that?”) to be sure that they are comfortable with the situation and feel included.
Important Safety Information
Do not use APOQUEL® (oclacitinib tablet) in dogs less than 12 months of age or those with serious infections. APOQUEL may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. APOQUEL has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporine. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. APOQUEL has been used safely with many common medications including parasiticides, antibiotics and vaccines. For more information, please see the full Prescribing Information available at apoquel.com.