Just Ask the Expert: When clients decline immunotherapy for atopy - Veterinary Medicine
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Just Ask the Expert: When clients decline immunotherapy for atopy



In addition to the aforementioned oral medication options and injectable immunotherapy, topical treatments are helpful. Some topical antimicrobials target the secondary infections. More recently, products are available that help maintain better barrier function (e.g. Allerderm Spot-On Skin Lipid Complex—Virbac Animal Health; DOUXO—Sogeval), which is often compromised in allergic patients. There are also numerous topical anti-inflammatory and antipruritic options (e.g. corticosteroid sprays or analgesic sprays containing pramoxine). Topical treatments often compliment the other options mentioned above. In some cases, topical treatments are all that is indicated.


More recently, tyrosine kinase inhibitors such as masitinib (Kinavet-CA1—AB Science), which are used to treat mast cell tumors in dogs, have been considered as an option for managing allergies in dogs. Treatment with tyrosine kinase inhibitors is in the early stages, and more time will be necessary to determine how effective and safe these medications are in allergic patients.


Many management options are available for atopic patients that are not receiving allergen-specific immunotherapy. Every patient is different, and every client situation is unique. This is where the art of managing the allergic patient, and trying different options, comes into play.

And new options for treating atopic dermatitis are on the horizon. Researchers are currently investigating oral immunotherapy (sublingual) as well as regionally specific immunotherapy (formulating immunotherapy based on the most common allergens in a specific region rather than based on allergy test results).


Numerous other options are beyond the scope of this overview, but I strongly recommend reading Olivry T, DeBoer DJ, Favrot C, et al. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 2010;21(3):233-248.

Ian B. Spiegel, VMD, MHS, DACVD
Veterinary Specialty and Emergency Center (VSEC)
24 hr Emergency and Referral Hospital
301 Veterans Hwy, Levittown, PA 19056

Animerge 24/7 Animal Emergency and Specialty Care
21 U.S. Hwy. 206
Raritan, NJ 08869

Jersey Shore Veterinary Emergency Service (JSVES)
Dermatology and Allergy Service
1000 Route 70 East
Lakewood, NJ 08701


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