From the Guidelines
Treatment for atopic dermatitis in German Shorthaired Pointers (GSPs) should prioritize a multimodal approach, starting with medications like Apoquel (oclacitinib) or Cytopoint injections (lokivetmab), alongside regular bathing with medicated shampoos and supplementation with omega-3 fatty acids. When considering treatment options, it's essential to weigh the severity of the condition, its impact on the patient, and the efficacy, safety, and accessibility of available interventions, as suggested by the American Academy of Dermatology guidelines 1. The guidelines highlight the importance of shared decision-making between patients and clinicians, taking into account the severity of atopic dermatitis and its impact on the patient 1. Key considerations in managing atopic dermatitis include:
- Identifying and eliminating environmental triggers when possible
- Considering allergen-specific immunotherapy for long-term management if allergen testing identifies specific triggers
- Addressing secondary bacterial or yeast infections with targeted antibiotics or antifungals
- Using oral steroids like prednisone for short-term flare management, while being mindful of their potential side effects and the need to taper to the lowest effective dose Regular bathing with medicated shampoos containing chlorhexidine or miconazole helps remove allergens and treat secondary infections, with an initial frequency of weekly bathing, then every 2-4 weeks for maintenance. Supplementation with omega-3 fatty acids, approximately 20 mg/kg daily, can help reduce inflammation. It's crucial to monitor the long-term safety of systemic medications for atopic dermatitis, as emphasized by the guidelines 1. By adopting a comprehensive approach that addresses both symptom relief and underlying causes, clinicians can effectively manage atopic dermatitis in GSPs, a condition resulting from an abnormal immune response to environmental allergens in genetically predisposed dogs.
From the Research
Treatment Options for GSP Dog Atopic Dermatitis
- The treatment of canine atopic dermatitis involves a multi-faceted approach, including the identification and avoidance of flare factors, skin and coat hygiene and care, and the use of medications to reduce pruritus and skin lesions 2, 3.
- Topical and oral glucocorticoids, calcineurin inhibitors such as oral ciclosporin and topical tacrolimus, and antimicrobial therapy are commonly used to treat acute flares and chronic canine atopic dermatitis 2, 3, 4.
- Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are recommended to prevent or delay the recurrence of flares of atopic dermatitis 2, 3.
- Newer medications, such as oclacitinib and injectable recombinant interferons, have also been shown to be effective in reducing chronic pruritus and skin lesions in dogs with atopic dermatitis 3, 5.
- The use of nonirritating baths, essential fatty acid supplementation, and skin and coat hygiene and care are also important components of the treatment plan for canine atopic dermatitis 2, 3.
Medication Efficacy
- Topical cyclosporine A has been shown to be effective in reducing the severity of skin lesions and pruritus in dogs with moderate to severe atopic dermatitis 4.
- Oral glucocorticoids and calcineurin inhibitors, such as ciclosporin, have been found to be effective in reducing pruritus and skin lesions in dogs with chronic atopic dermatitis 2, 3.
- The efficacy of these medications can vary depending on the individual dog and the severity of the disease, and treatment plans may need to be tailored to each patient 2, 3.
Treatment Considerations
- The treatment of canine atopic dermatitis should be individualized to each patient, taking into account the severity of the disease, the presence of flare factors, and the patient's and owner's needs 2, 3, 5.
- A combination of interventions, including medications, skin and coat hygiene and care, and allergen-specific immunotherapy, may be necessary to achieve optimal results 2, 3.