Canine Atopic Dermatitis - Treatments to finally stop all the itching

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At first, your dog just seemed itchy. It wouldn’t bother you, and you thought it didn’t bother him. But now, the itch just won’t stop. Any time the house gets quiet, its filled with the thumps persistent scratching, and the sounds of rhythmic licking lulls you to sleep.

This is about the time when owners bring their dogs in for a veterinary visit. More often than not, owners won’t notice the underlying skin or yeast infections, but they will notice the strange behaviors associated with the intense itchy sensations. At this point, veterinarians give several options for treatments, and owners will try them one-by-one until they find a solution that works for their pup.

It sounds simple enough– but it rarely ever is. In fact, several of these cases are repetitive, and the culprit is frustratingly unavoidable: air.

Several dogs suffer from atopic dermatitis. It may seem like an intimidating condition, but it is relatively simple when you break it down: atopic– genetically predisposed allergic response to inhaled allergens– and dermatitis– skin infection. So, for many dogs, their nonstop itching is due to simply breathing in their local environment.

In order to confirm that atopy is to blame for all the itch, it’s best to get allergy testing done to see exactly what is at the root of the problem. Some of the common allergens that dogs with atopy react to include grass pollens, tree pollens, fungus spores, and dust mites. If the results come back that your pup has inappropriate reactions to specific, inhaled allergens in addition to constantly being itchy, it’s time to start considering treatments to help your dog deal with its atopic dermatitis.

On the other hand, sometimes itchy dogs get negative results on these allergy tests, meaning the itchiness isn’t caused by atopy. In this case, it’s usually a food allergy causing all the problems which can easily be solved by changing diets. If so, hydrolyzed diets tend to be the cure-all: the protein source is chemically broken down (hydrolyzed) before it is even swallowed, so your dog’s immune system doesn’t get a chance to react to it

But, if it is atopic dermatitis, the first thing you need to figure out is how your dog’s body responds to the allergy. While chronic itchiness is the primary symptom, atopic dermatitis can also manifest as chronic ear and paw yeast infections, underbelly rashes, or as patchy hair loss. It all depends on the dog and what they are more susceptible to. When symptoms flare up, various medications can be used to keep those local infections under control.

Next, you’ll want to get that itch under control! While there are several options out there, ranging from soothing shampoos to topical anti-inflammatory sprays, there are two drugs that your veterinarian can prescribe that block IL-31 cytokines– the official way of saying “the stuff that makes you itchy.”

Oatmeal-based baths may offer soothing skin relief.

The first is called Apoquel, an oral tablet that you’d need to administer once or twice daily. If you know that daily pilling is something you or your dog will not be able to follow, then your dog is better off getting the other option, a Cytopoint injection, at their next vet visit instead. Like the oral tablet, the injection rapidly blocks the itch response and will continue to block the response for 4-8 weeks after the initial injection. So, if you’d rather make the trek to the vet once a month than give the pills yourself, Cytopoint is the way to go.

However, I must warn you: these IL-31 interceptors can be deceiving. Some patients will see an immediate, fantastic response and then assume that since their dog is no longer itching, the infection is gone and all problems are solved. Unfortunately, it’s not that easy– it’s pretty common that the infection is still there, but now the dog just isn’t paying attention to it. So, another treatment should be given to control bacteria and fungus causing the underlying infection.

For example, some dogs may develop severe yeast infections in between their toes resulting from atopic dermatitis. These infections are usually caused by the dog constantly licking their itchy toes, and the trapped moisture between paw’s inner folds creates the perfect environment for yeast to grow. A drug like Atopica or Cytopoint will not be able to cure the yeast infection, but it will stop the itching. So, your vet may recommend a topical antifungal cream, spray, or soap that will eliminate the infection so that the actual root of the problem goes away– and not just the itch.

In other dogs, the underlying dermatitis can be much more widespread (and hard to see if you don’t know what you’re looking for). Some key signs that show there’s still a bacterial problem even though the itch is gone is flakey skin patches, hair loss, and red bumps or pimples. If these symptoms are present, especially when paired with infections in targeted areas like the ears and feet, it is best to give an oral drug that stops the infection early in the allergic reaction response.

Atopica, a cyclosporine, does exactly that: it inhibits the first step in the chain reaction causing the allergic response (the infections and the itch) rather than just blocking the end byproduct (the itch) . Some patients may be able to use Atopica without anything like Apoquel or Cytopoint supplementing it, but the downside to using Atopica alone is that it takes a long time (up to 8 weeks!) for the drug to start being effective. So, it’s recommended to pair Atopica with a temporary anti-itch treatment at least in the beginning to make sure your pet is comfortable as soon as possible.

Having so many options available to cure your dog’s atopic dermatitis can seem overwhelming. However, just because there are so many drugs out there, it doesn’t mean it’s going to be an easy path to figure out what works for your dog. What works for Sally the Schnauzer might not work for Buddy the Bulldog, and unfortunately the only way to figure out what works for your special pup is trial and error. A few lucky dogs out there might be able to tame their atopic dermatitis flare ups with steroids alone, but others may require chronic Atopica administration with Cytopoint to support any breakthrough itching. It all comes down to what your dog’s body chemistry needs and a supportive owner listening to help along the way.

By working together with your veterinarian, allergies can be put to rest, something you and your dog will both appreciate!

Cave, N. (2006). Hydrolyzed Protein Diets for Dogs and Cats. Veterinary Clinics Small Animal Practice, 36, 1251-1268. Dell, D. (2018). It's not magic: The skinny on treating canine atopic dermatitis. Animal Dermatology Clinic. Retrieved from https://animaldermatology.com/news/110727/It-s-Not-Magic-The-Skinny-On-Treating-Canine-Atopic-Dermatitis Guaguère, E., Steffan, J., & Olivry, T. (2004). Cyclosporin A: a new drug in the field of canine dermatology. Veterinary Dermatology, 15(2), 61-74.