Treatment of canine atopic dermatitis in 2021 – what options, in what order?

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: Atopic dermatitis is a very common condition that severely compromises quality of life for affected dogs and their owners. It is a lifelong disease that requires ongoing treatment to maintain remission and prevent flares. Atopic dermatitis is a complex disease that involves a poor skin barrier, abnormal skin inflammation, allergies (in most but not all dogs) to environmental and/or food allergens, and secondary skin and ear infections. It is important to identify the triggers for each dog and then use a multimodal treatment programme to address these. Treatment options include topical emollients, essential fatty acid (EFA) supplements or enriched diets, palmitoylethanolamide (PEA), allergen specific immunotherapy (ASIT), antihistamines, and anti-inflammatory medication. Anti-inflammatory treatments with good evidence of high efficacy include systemic and topical steroids, ciclosporin, oclacitinib and lokivetmab. It is essential that these treatment options are understood so that they can be used effectively in the management of canine atopic dermatitis.

: Canine atopic dermatitis is a common skin disease in dogs. Affected patients and their owners can have severely reduced quality of life. Different treatment modalities need to be combined strategically for each patient to formulate a treatment plan that suits the given patient and carer. This may involve treatment of flare factors, symptomatic anti-pruritic therapy, immunotherapy and treatments to strengthen the skin barrier function. Optimal therapy depends on the patient, breed, temperament, body areas affected, severity of the skin disease, financial considerations and owner attitude and ability all come in the equation. Different scenarios are discussed in this presentation.

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