Veterinary surgeons are very fortunate to have some outstanding medicines available to treat the aetiology and clinical signs of atopy, potentially giving both the pet and the owner relief from the angst of allergic skin disease. However, it is easy to overlook the value of topical therapies and simple environmental management routines, which can also play an important role in managing the condition while helping to cultivate relationships with clients.
From adequate flea control to the use of shampoos, owners can make a real difference when it comes to improving the quality of life for their pets; it just takes a conversation to improve that bond between the vet and the owner.
Encouraging flea control
Every vet has experienced a client vehemently denying that their pet has fleas and refusing to believe that fleas have caused the pet to scratch. In this situation, maintaining a good relationship with the client and taking time to discuss the benefits of flea control is crucial, especially in dogs with underlying allergic skin disease.
Flea infestations are a well-known flare factor for canine atopic dermatitis. Atopy will predispose dogs to develop hypersensitivity to flea saliva antigens which, if exposed repeatedly to flea bites, will eventually lead to flea allergic dermatitis (Sousa and Halliwell, 2001; Olivry et al., 2010). This is why it is so important to convey to pet owners the importance of a strict anti-flea treatment strategy for atopic dogs.
Environmental control against the developmental flea life stages should go hand in hand with the discussion of topical flea treatment, as it is well known that infested environments often account for more than 95 percent of the total flea population.
Regular washing of covers on which dogs rest and the daily vacuuming of resting sites should be performed to reduce the number of flea stages. The use of adulticides in combination with IGRs can also be utilised and some of the available products have persistent activity over several months.
As house dust mite glycoproteins are the most common canine allergens worldwide, their environmental control would seem an appropriate measure to take.
Studies have shown a statistically significant reduction in levels of mite allergens collected from carpets in the homes with atopic dogs when the environmental flea control was used in the preceding year. Dust mite control needs to be sustained due to the persistence of mite allergens in the environment.
The importance of shampoos
The pathogenesis of allergic dermatitis is still being unravelled but there is increasing evidence to suggest that defects within the epidermal barrier are likely to contribute to disease by facilitating contact with environmental allergens.
For this reason, maintaining and improving skin barrier function remains a vital component in control of allergic dermatitis. The simple act of bathing dogs at least weekly with a non-irritating shampoo will help to aid skin barrier function by physically removing surface allergens and increasing the levels of skin hydration. A direct soothing effect from the shampoo and through the process of bathing can also relieve some of the clinical signs.
Topical lipid formulations
A sometimes forgotten therapy for the management of allergic dermatitis is a topical formulation containing biomimetic lipid complexes, which comes in a pet owner-friendly spot-on applicator.
The aim of topical lipid formulations is to improve epidermal barrier function. Studies have proven that complex lipids applied as a spot-on help to restore lipid anomalies within the stratum corneum of dogs suffering from allergic dermatitis (Piekutowska et al., 2008). Another suggests therapeutic and clinical benefits in dogs with the condition (Fujimara et al., 2011).
Remembering some simple options before moving on to more arduous tasks like food trials and advanced therapies like allergen-specific immunotherapy could provide a way of keeping both the pet and the owner happy in managing this frustrating condition.
A full reference list is available on request