There are several effective treatments to control itch in dogs that have allergic skin disease (atopic dermatitis). Among the most commonly prescribed are Apoquel, Cytopoint, Atopica, and prednisone. Each of these are effective in controlling itch and inflammation to varying degrees. Response rates can vary by individual and with the presence of concurrent infections, which are common in these patients. The downsides of these treatments can range from adverse reactions to financial concerns, depending on individual responses and pet size.
Many concerned pet owners and veterinarians seek out a treatment that can address the underlying causes (allergy triggers) for atopic dermatitis. Cats and dogs with atopic dermatitis usually have some combination of pollen allergens, dust mites, and mold spores triggering their allergic skin disease. Their immune system is over-reacting to these normally encountered allergens, resulting in a cascade of inflammation. The end result is itch, more inflammation, self-trauma, and often skin and ear infections.
In an ideal world, we would perform an allergy test to identify a pet’s allergy triggers, then avoid them. In reality, it is rare that a dog or cat’s environment can be changed enough to avoid allergy triggers (with the exciton of food allergens). A more realistic course is to desensitize pets to the environmental allergens with a treatment called allergen immunotherapy, desensitization, hyposensitization, or “allergy shots.” Allergens are introduced to the pet orally or by injection to re-train the immune system so that it doesn’t over-react. Although a slow process, this is the only treatment for atopic dermatitis that addresses the underlying causes.
Selection of allergens to include in the pet’s extract should be based on intradermal testing performed by a veterinary dermatologist or using regionally-specific immunotherapy (a standardized mixture of allergens corresponding to a geographic region). Allergy testing using blood, hair, and/or saliva have been found to be unreliable in dogs.