An inflammatory, pruritic, chronic, relapsing, and non-contagious disease involving immunoglobulin E (IgE) antibody reactions to various allergens
Hypersensitivity occurs to common substances, such as pollens, dust mites, feathers, molds, insects, and other environmental allergens
A complex, multifactorial skin disease with a genetic predisposition
Clinical signs can be highly variable; otitis externa may be noted
Skin lesions may be localized or appear more extensively involving the feet, ears, lip folds, axilla, or inguinal regions
Initial signs are often noted between 1 and 3 years of age
May occur seasonally, related to environmental factors such as temperature and humidity; these factors also affect severity and duration of clinical signs
Severity worsens with age (e.g., symptoms may progress from seasonal to year-round)
Estimated prevalence is 3% to 15%
Diagnosis is based on a combination of history, clinical signs, physical exam, exclusion of other potential diagnoses, and supportive testing (Intradermal allergen testing or allergen-specific IgE serological testing)
Treatment approaches vary for acute versus chronic disease
Successful management may be anticipated in the majority of cases; not life-threatening
Causes and Risk Factors
Causes
A heritable disease
Pollens, such as trees, weeds, and grass
Indoor and outdoor mold spores
Yeast (Malassezia pachydermatis)
Animal dander
Dust mites
Cytokine dysregulation
Risk Factors
Temperate regions with longer allergy seasons, high levels of pollen, and high levels of mold spores
Mean age of onset is 1 to 3 years; most show first clinical signs by 3 years of age
Predilection noted in the following breeds: Labrador Retriever, Golden Retriever, Soft-Coated Wheaten Terrier, West Highland White Terrier, Jack Russell Terrier, Bulldog, Boston Terrier, Boxer, Pit Bull Terrier, Shar-Pei, Shih Tzu, and Weimaraner
Diagnosis is based on a combination of history, clinical signs, physical exam, exclusion of other potential diagnoses, and supportive testing (Intradermal allergen testing or allergen-specific IgE serological testing)
Use of any approach in isolation may lead to misdiagnosis
Signs and History
Pruritus, initially without lesions and often symmetrical; typically involves the feet (interdigital), ears, face (lips, chin, muzzle, and periocular areas)
Self-induced cutaneous trauma from scratching, itching, and licking leads to hair loss and observable cutaneous signs
Progressively worsens over time
May initially appear seasonally
May present with history of recurring skin or ear infections
Diagnostic criteria for atopic dermatitis have sensitivity and specificity of approximately 80% when five criteria are met; similar diseases in differential diagnosis must also be ruled out
Diagnostic criteria for atopic dermatitis have sensitivity and specificity of approximately 80% when five criteria are met; similar diseases in differential diagnosis must also be ruled out
Age at onset < 3 years
Mostly indoor living
Pruritus sine materia at onset (pruritus with no lesions)
Affected front feet
Affected ear pinnae
Non-affected ear margins
Non-affected dorsolumbar area
Physical Exam
Lesions may include:
Broken hairs
Salivary discoloration/ staining
Hyperpigmentation
Erythema
Crusts
Alopecia
Papules
Lichenification
Seborrhea; dry or oily
Hyperhidrosis
Cutaneous lesions most frequently appear in carpal and tarsal areas, interdigital spaces, ear pinnae, periocular area, muzzle, axillae, groin/genitalia, and abdomen
Eosinophilia is rare unless there is a flea infestation
Allergen-specific IgE serological tests
Presence and quantity of allergen-specific IgE may indicate allergy; should be interpreted in light of clinical findings and when other causes of pruritus have been eliminated
May allow identification of appropriate allergens for immunotherapy and allergen avoidance
Limited number of allergens can be tested
False-positive and false-negative tests are possible
Should only be ordered if there is strong clinical evidence for allergy, and after all other possible diagnoses have been ruled out
Should not be used as a screening test in animals presenting with pruritus
Other Diagnostic Tests
Intradermal allergen testing
Involves intradermal injection of small amounts of allergens, with evaluation and measurement of wheal formation
May allow identification of appropriate allergens for immunotherapy and allergen avoidance
False-positive and false-negative tests are possible
Should only be ordered if there is strong clinical evidence for allergy, and after all other possible diagnoses have been ruled out
Should not be used as a screening test in animals presenting with pruritus
Some anti-allergic drugs should be withdrawn prior to testing:
Antihistamines: 10 to 14 days before test
Oral glucocorticoids: 4 weeks before test
Topical/otic glucocorticoids: 14 days before test
Injectable glucocorticoids: 4 to 6 weeks; longer if depot formulations are used
Cyclosporine and oclacitinib do not require withdrawal times
Skin biopsy for histopathologic analysis
May be useful in ruling out other conditions in the differential diagnosis; concurrent skin infections should be treated prior to biopsy
Typically, results will not provide a definitive diagnosis of atopic dermatitis; histopathology may support a diagnosis of allergic dermatitis but will not differentiate among allergic etiologies
Should not be used as a screening test in animals presenting with pruritus
Prevention
General Points
Once causative allergens have been identified through allergy testing (serological and/or intradermal), owners should attempt to avoid or reduce those exposures for their pet
Other causes of pruritus should also be avoided or reduced, such as food allergies and flea infestations
Surgical Interventions
Dogs with stenotic ear canals or excessive skin folds may benefit from surgical intervention
Treatment
General Points
Acute exacerbations or flares
Eliminate or reduce exposure to allergenic flare factors, such as food allergens and environmental allergens
Treat bacterial or yeast infections
Encourage bathing with a non-irritating shampoo
Treat with a topical corticosteroid formulation (short-term) or with anti-IL 31 monoclonal antibody therapy to alleviate pruritus
Treat severe pruritus with a short course of systemic corticosteroids; also consider for patients with stenotic otitis externa
Alternatively, treat severe pruritus with a short course of oclacitinib; however, this is ineffective at reducing inflammation associated with otitis externa and should not be combined with corticosteroids in this setting
Oral type 1 antihistamines might offer a small, limited benefit in some dogs, likely with mild disease; should preferably be given before a flare occurs
Unlikely to be of benefit for acute flares: essential fatty acids, cyclosporine, topical tacrolimus
Chronic disease
Eliminate or reduce exposure to allergenic flare factors, such as food allergens and environmental allergens
Allergen-specific immunotherapy is a preferred treatment, due to potential for lifelong benefits
Treat localized pruritus with topical corticosteroids or tacrolimus
Use anti-IL 31 monoclonal antibody therapy, oclacitinib, or cyclosporine for control of non-localized pruritus
Systemic corticosteroids are recommended for treatment of chronic disease, particularly non-localized disease, when flare factors have been eliminated, and non-steroidal therapies are ineffective
Oral type 1 antihistamines might offer a modest, variable benefit in some dogs; should preferably be given before a flare occurs
Restriction-provocation dietary trials (elimination diets) should be performed in any dogs with non-seasonal allergic dermatitis
Diet supplementation with essential fatty acids may improve coat quality and gloss
Weekly baths in lukewarm water, with nonirritating, antipruritic shampoos may provide relief
Dogs with this condition should be treated with flea adulticides, year-round, for prevention of pruritic flares and to avoid development of fleabite hypersensitivity
Triamcinolone acetonide 0.015% spray, apply to affected areas 1 to 2 times each day until pruritus controlled, OR
Hydrocortisone aceponate 0.0584% solution, apply to affected areas 1 to 2 times each day until pruritus controlled; not available in the United States
Tailor frequency and duration of application based on severity of clinical signs
Avoid long-term use due to adverse effects such as skin thinning (cutaneous atrophy), comedones, and superficial follicular cysts
Anti-IL 31 monoclonal antibody therapy
Lokivetmab (Cytopoint™) 2 mg/kg SC (minimum dose) every 4 to 8 weeks
Available in 4 concentrations; round up to the nearest strength and draw entire vial contents into a syringe to administer as a single injection
Can be considered in lieu of corticosteroids to alleviate pruritus
Can be used in conjunction with other therapies including corticosteroids, antihistamines, cyclosporine, or oclacitinib
Injection site reactions and lethargy are possible side effects; long-term studies are lacking
Oclacitinib
Oclacitinib (Apoquel ®) 0.4 to 0.6 mg/kg PO (with or without food) twice daily for 14 days, then once daily
Approved for the treatment of atopic dermatitis in dogs
Not approved for use in dogs less than 12 months of age
Level 1 and Level 3 studies have found oclacitinib to be a safe and effective alternative therapy for dogs with atopy; long-term safety and efficacy studies are lacking
Oral corticosteroids
Prednisone, OR prednisolone, OR methylprednisolone tablets, 0.5 to 1 mg/kg IM or PO daily (0.25 to 0.5 mg/kg PO for methylprednisolone), in one or divided into two doses initially; then taper to 0.3 to 0.5 mg/kg every 48 hours
Trimeprazine tartrate with prednisolone (Temaril-P®),
One-half tablet for dogs weighing less than 4.5 kg; one tablet for dogs weighing 5 to 9 kg; two tablets for dogs weighing 10 to 18 kg; and three tablets for dogs weighing more than 20 kg. All doses start with every 12 hours, and eventually taper to once daily and once every other day
Once clinical signs are controlled, taper to lowest dose and frequency of administration that allows control of signs, good quality of life, and minimal side effects
If rapid improvement does not occur within the first few days, or in cases of very severe signs, a longer course may be needed; use lowest dose and frequency of administration that provides control
Do not use if concurrent widespread bacterial infections present
Antimicrobial therapy
Underlying skin or ear infections (bacterial or yeast) should be identified and treated appropriately
A combination of skin and/or ear cytology and culture can be used to identify pathogens
Use of topical therapies may be sufficient; however, systemic agents may be needed based on severity
A preferred treatment, due to potential for lifelong benefits
Sublingual and injectable options available
Treatment schedule is dependent on manufacturer; procedures and protocols are not standardized
May be used in combination with anti-IL 31 monoclonal antibody therapy, oclacitinib, cyclosporine or anti-inflammatory doses of glucocorticoid therapy
Frequency of therapy is gradually tapered with clinical response
Injections involve 1 mL syringes and fine-gauge needles
With instruction, pet owners should be able to give the injections at home
Choice of allergens to include depends on results of allergy testing and patient history
Response may require 3 months to 1 year for full effect
If no improvement occurs after 1 year of therapy, treatment should be stopped
If effective, treatment should continue for at least 2 to 3 years. Some patients may experience long-term benefits after treatment is stopped; others may require lifelong maintenance therapy
Anti-IL 31 monoclonal antibody therapy
Lokivetmab (Cytopoint™) 2 mg/kg SC (minimum dose) every 4 to 8 weeks
One study (Level 2) suggested a dose of 1 mg/kg SC every 4 weeks is also effective
Available in 4 concentrations; round up to the nearest strength and draw entire vial contents into a syringe to administer as a single injection
Can be considered in lieu of corticosteroids to alleviate pruritus
Can be used in conjunction with other therapies including corticosteroids, antihistamines, cyclosporine, or oclacitinib
Injection site reactions and lethargy are possible side effects; long-term studies are lacking
Oclacitinib
Oclacitinib (Apoquel ®) 0.4 to 0.6 mg/kg PO (with or without food) twice daily for 14 days, then once daily
Approved for the treatment of atopic dermatitis in dogs
Not approved for use in dogs less than 12 months of age
Can be combined with ASIT therapy
Level 1 and Level 3 studies have found oclacitinib to be a safe and effective alternative therapy for dogs with atopy; long-term safety and efficacy studies are lacking
Topical corticosteroids
Triamcinolone acetonide 0.015% spray, apply to affected areas 2 times each day until pruritus controlled, then taper dose, OR
Hydrocortisone aceponate 0.0584% solution, apply to affected areas 1 time each day until pruritus controlled, then taper dose; not available in the United States
Tailor frequency and duration of application based on severity of clinical signs
Best suited for focal or multifocal lesions and for short durations (< 2 months)
Avoid long-term use due to adverse effects such as skin thinning (cutaneous atrophy), comedones, and superficial follicular cysts
Contraindicated during pregnancy
A randomized, controlled study (Level 1) reported that proactive, long-term treatment with hydrocortisone aceponate 0.0584% spray was efficacious and well-tolerated when applied on 2 consecutive days each week; time to relapse, after remission, was significantly longer than with placebo
Tacrolimus topical ointment
For treatment of chronic focal or multifocal disease
Tacrolimus 0.1% ointment, apply 2 times each day x 1 week, then reduce frequency of application as needed to control signs
A calcineurin inhibitor that may be used as an alternative to topical glucocorticoids in dogs with chronic, localized disease; particularly those with visible skin atrophy
Mild irritation may occur after application
A black box warning from the U.S. Food and Drug Administration suggests a potential risk of neoplasia; clients should be advised to apply product with gloves
Systemic corticosteroids
For the treatment of chronic disease, particularly non-localized disease and when flare factors have been eliminated
Prednisone, OR prednisolone, OR methylprednisolone tablets, 0.5 to 1 mg/kg IM or PO daily (0.25 to 0.5 mg/kg PO for methylprednisolone), in one or divided into two doses initially; then taper to 0.3 to 0.5 mg/kg every 48 hours, OR;
Trimeprazine tartrate with prednisolone (Temaril-P®),
One-half tablet for dogs weighing less than 4.5 kg; one tablet for dogs weighing 5 to 9 kg; two tablets for dogs weighing 10 to 18 kg; and three tablets for dogs weighing more than 20 kg. All doses start with every 12 hours, and eventually taper to once daily and once every other day
Once clinical signs controlled, taper to lowest dose and frequency of administration that allows control of signs, good quality of life, and minimal side effects
Adverse effects may include polyuria, polydipsia, polyphagia, urinary tract infections, calcinosis cutis, demodicosis
Contraindicated during pregnancy
Cyclosporine
Approved for the treatment of atopic dermatitis in dogs
Cyclosporine (modified) 5 mg/kg PO per day
Continue initial dose until adequate reduction in clinical signs; then, reduce dose by increasing dosing intervals (every other day to every third day) or reducing daily dose by half
If clinical signs improve 75% or more, increase dosing interval to twice per week or reduce dose to 25% of original dose
Initial benefits will not occur for 4 to 8 weeks after treatment initiation; failure to improve at appropriate dose after > 8 weeks of therapy indicates treatment failure
Addition of a short course of oral glucocorticoids during the first 1 to 3 weeks of therapy with cyclosporine may result in quicker improvement
Minor and temporary adverse effects may include vomiting and diarrhea; monitor for weight loss
Gingival hyperplasia and papillomatosis have been reported
Opportunistic infections may be more likely
Caution if concurrent administration of ketoconazole; reduce cyclosporine dose
A topical cyclosporine A formulation has been reported to reduce skin lesion severity and pruritus in dogs, in a randomized, controlled trial
Antihistamines
There is no conclusive evidence that oral type I antihistamines are effective for treatment of active atopic dermatitis; might offer a modest, variable benefit in some dogs
If used, should be given daily as a preventive therapy; should preferably be given before a flare occurs
For example, hydroxyzine 2 mg/kg PO or IM every 8 to12 hours
Adverse effects may include drowsiness, anorexia, vomiting, and diarrhea; caution with cardiac arrhythmias
Other topical formulations
Overall, there is insufficient evidence to support use of topical formulations containing essential fatty acids, essential oils, or complex lipid mixtures
A randomized, double-blinded, placebo controlled study (Level 1) has reported results suggesting that a topical preparation with polyunsaturated fatty acids and essential oils was effective and safe in treating clinical signs of canine atopic dermatitis
Other Therapies
Weekly baths
Use lukewarm to cool water and nonirritating, antipruritic shampoos; leave on for 10 to 15 minutes before rinsing
May be soothing, remove allergens, and increase skin hydration
Antiseborrheic shampoos (for greasy, scaly skin) or antiseptic shampoos (for skin infections) may be considered
Bathe from head to tail to avoid traumatic folliculitis (especially in short coated breeds)
Diet
Restriction-provocation dietary trials (elimination diets) should be performed in any dogs with non-seasonal allergic dermatitis
Essential fatty acid (EFA) supplementation (mainly omega-3) or EFA-rich diets can improve coat quality and gloss; may require 2 months of treatment before improvement noted
There is no evidence to recommend a specific EFA combination, dosage, ratio, or formulation
Follow-up
General Points
Evaluate patients every 2 to 8 weeks after new therapy started, and then every 3 to 12 months, once the condition is adequately controlled
Therapeutic Follow-up
When a new therapy is started, evaluate patient every 2 to 8 weeks; monitor cutaneous lesions, degree of pruritus, secondary skin infections, and any adverse drug reactions
Once condition is adequately controlled, evaluate patient every 3 to 12 months
For patients receiving chronic corticosteroid or cyclosporine treatment, monitor complete blood count, serum chemistry, and urinalysis every 3 to 12 months; with chronic corticosteroids, urine cultures should also be monitored
Prognosis
Successful management may be anticipated in the majority of cases; not life-threatening
If untreated, pruritus will worsen and clinical signs will present with a longer duration each year; some cases may resolve spontaneously
Unremitting pruritus could lead to euthanasia in certain cases
Evidence
Guidelines and Consensus Statements
Olivry T, DeBoer DJ, Favrot C, et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res. 2015 Aug 16;11:210. Level B (IND) Article
Hensel P, Santoro D, Favrot C, et al. Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification. BMC Vet Res. 2015 Aug 11;11:196. Level BArticle
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;21:233-48. Amendment made June 28, 2011. Level B (IND) Article
Olivry T, Saridomichelakis M. Evidence-based guidelines for anti-allergic drug withdrawal times before allergen-specific intradermal and IgE serological tests in dogs. Vet Dermatol. 2013 Apr;2:225-e49. Level BArticle
Systematic Reviews/Meta-analyses
Olivry T, Bizikova P. A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008-2011 update. Vet Dermatol. 2013;24:97-e26. Level 1 (IND) Abstract
Steffan J, Favrot C, Mueller R. A systematic review and meta-analysis of the efficacy and safety of cyclosporine for the treatment of atopic dermatitis in dogs. Vet Dermatol. 2006 Feb;17(1):3-16. Level 2 (IND) Abstract
Randomized, Controlled Trials (RCTs)
Lourenco AM, Schmidt V, São Braz B, et al. Efficacy of proactive long-term maintenance therapy of canine atopic dermatitis with 0.0584% hydrocortisone aceponate spray: a double-blind placebo controlled pilot study. Vet Dermatol. 2016 Apr;27(2):88-e25. Epub 2016 Jan 25. Level 1 (IND) Abstract
Blaskovic M, Rosenkrantz W, Neuber A, et al. The effect of a spot-on formulation containing polyunsaturated fatty acids and essential oils on dogs with atopic dermatitis. Vet J. 2014 Jan;199:39–43. Level 1 (IND) Abstract
Cosgrove SB, Wren JA, Cleaver DM, et al. A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel®) in client-owned dogs with atopic dermatitis. Vet Dermatol. 2013 Dec;24(6):587-97. Level 1 (IND) Article
Van Brussel L, Moyaert H, Escalada M, et al. A masked, randomised clinical trial evaluating the efficacy and safety of lokivetmab compared to saline control in client-owned dogs with allergic dermatitis. Vet Dermatol. 2021 Oct;32(5):477-e131. Level 2 (IND) Article
Moyaert H, Van Brussel L, Borowski S, et al. A blinded, randomized clinical trial evaluating the efficacy and safety of lokivetmab compared to ciclosporin in client-owned dogs with atopic dermatitis. Vet Dermatol. 2017 Dec;28(6):593-e145. Epub 2017 Sep 14. Level 2 (IND) Article
Michels GM, Walsh KF, Kryda KA, et al. A blinded, randomized, placebo-controlled trial of the safety of lokivetmab (ZTS-00103289), a caninized anti-canine IL-31 monoclonal antibody in client-owned dogs with atopic dermatitis. Vet Dermatol. 2016 Dec;27(6):505-e136. doi: 10.1111/vde.12364. Epub 2016 Sep 19. Level 2 (IND) Abstract
Michels GM, Ramsey DS, Walsh KF, et al. A blinded, randomized, placebo-controlled, dose determination trial of lokivetmab (ZTS-00103289), a caninized, anti-canine IL-31 monoclonal antibody in client owned dogs with atopic dermatitis. Vet Dermatol. 2016 Dec;27(6):478-e129. doi: 10.1111/vde.12376. Epub 2016 Sep 19. Level 2 (IND) Abstract
Dip R, Carmichael J, Letellier I, et al. Concurrent short-term use of prednisolone with cyclosporine A accelerates pruritus reduction and improvement in clinical scoring in dogs with atopic dermatitis. BMC Vet Res. 2013 Sep 3;9:173. Level 2 (IND) Article
Eichenseer M, Johansen C, Mueller RS. Efficacy of dimetinden and hydroxyzine/chlorpheniramine in atopic dogs: a randomised, controlled, double-blinded trial. Vet Rec. 2013 Nov 2;173:423-6. Level 2Article
Puigdemont A, Brazis P, Ordeix L, et al. Efficacy of a new topical cyclosporine A formulation in the treatment of atopic dermatitis in dogs. Vet J. 2013 Aug;197(2):280-5. Level 2Abstract
Cadot P, Hensel P, Bensignor E, et al. Masitinib decreases signs of canine atopic dermatitis: a multicentre, randomized, double-blind, placebo-controlled phase 3 trial. Vet Dermatol. 2011 Dec;22(6):554-64. Level 2 (IND) Abstract
Ahlstrom LA, Mason KV, Mills PC. Barazone decreases skin lesions and pruritus and increases quality of life in dogs with atopic dermatitis: a randomized, blinded, placebo-controlled trial. J Vet Pharmacol Ther. 2010 Dec;33(6):573-82. Level 2 (IND) Abstract
Other Studies or Reviews
Santoro D, Marsella R, Hernandez J. Investigation on the association between atopic dermatitis and the development of mycosis fungoides in dogs: a retrospective case-control study. Vet Dermatol. 2007 Apr;18(2):101-6. Level 2Abstract
Papich MG. Papich Handbook of Veterinary Drugs, 5th Edition. St Louis, MO: Elsevier; 2021. Level 3
Santoro D. Therapies in canine atopic dermatitis: an update. Vet Clin North Am Small Anim Pract. 2019 Jan;49(1):9-26. Level 3
Mueller RS. Update on allergen immunotherapy. Vet Clin North Am Small Anim Pract. 2019 Jan;49(1):1-7. Level 3
Souza CP, Rosychuk RAW, Contreras ET, et al. A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Vet Dermatol. 2018 Dec;29(6):489-e164. Epub 2018 Aug 23. Level 3
Muller MR, Linek M, Lowenstein C, et al. Evaluation of cyclosporine-sparing effects of polyunsaturated fatty acids in the treatment of canine atopic dermatitis. Vet J. 2016 Apr;210:77-81. Level 3 (IND)
Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Vet J. 2016 Jan;207:29-37. Level 3
Bizikova P, Pucheu-Haston CM, Eisenchenk MN, et al. Review: Role of genetics and the environment in the pathogenesis of canine atopic dermatitis. Vet Dermatol. 2015 Apr;26(2):95-e26. Epub 2015 Feb 22. Level 3 (IND)
Little PR, King VL, Davis KR, et al. A blinded, randomized clinical trial comparing the efficacy and safety of oclacitinib and ciclosporin for the control of atopic dermatitis in client-owned dogs. Vet Dermatol. 2015 Feb;26(1):23-e8. Level 3
Favrot C. Diagnostic criteria for canine atopic dermatitis. In: Bonagura JD, Twedt DC, ed.’s. Kirk’s Current Veterinary Therapy. 15th ed. St. Louis: Elsevier Saunders; 2014:403-4. Level 3
Olivry T, Prelaud P. Treatment guidelines for canine atopic dermatitis. In: Bonagura JD, Twedt DC, ed.’s. Kirk’s Current Veterinary Therapy. 15th ed. St. Louis: Elsevier Saunders; 2014:405-7. Level 3
Hillier A. Cyclosporine use in dermatology. In: Bonagura JD, Twedt DC, ed.’s. Kirk’s Current Veterinary Therapy. 15th ed. St. Louis: Elsevier Saunders; 2014:407-10. Level 3
Rosenkrantz WS. Topical therapy for pruritus. In: Bonagura JD, Twedt DC, ed.’s. Kirk’s Current Veterinary Therapy. 15th ed. St. Louis: Elsevier Saunders; 2014:419-21. Level 3
Jung JY, Nam EH, Park SH, et al. Clinical use of a ceramide-based moisturizer for treating dogs with atopic dermatitis. J Vet Sci. 2013;14(2):199-205. Level 3
Ganz EC, Griffin CE, Keys DA, et al. Evaluation of methylprednisolone and triamcinolone for the induction and maintenance treatment of pruritus in allergic cats: a double-blinded, randomized, prospective study. Vet Dermatol. 2012;23:387-e72. Level 3 (IND)
Favrot C, Steffan J, Seewald W, et al. A prospective study on the clinical features of chronic canine atopic dermatitis and its diagnosis. Vet Dermatol. 2010 Feb;21(1):23-31. Level 3 (IND)
DeBoer DJ, Hillier A. The ACVD task force on canine atopic dermatitis (XV): fundamental concepts in clinical diagnosis. Veterinary Immunology and Immunopathology. 2001;81:271-6. Level 3
DeBoer DJ, Griffin CE. The ACVD task force on canine atopic dermatitis (XXI): antihistamine pharmacotherapy. Veterinary Immunology and Immunopathology. 2001;81:323-9. Level 3
Additional Reading
Takahashi J, Kanda S, Imanishi I, et al. Efficacy and safety of 0.0584% hydrocortisone aceponate topical spray and systemic oclacitinib combination therapy in dogs with atopic dermatitis: a randomized, double-blinded, placebo-controlled trial. Vet Dermatol. 2021 Apr;32(2):119-e25. Epub 2020 Nov 13.
Timm K, Mueller RS, Nett-Mettler CS. Long-term effects of intralymphatic immunotherapy (ILIT) on canine atopic dermatitis. Vet Dermatol. 2018 Apr;29(2):123-e49. Epub 2018 Jan 12.
Klinger CJ, Hobi S, Johansen C, et al. Vitamin D shows in vivo efficacy in a placebo-controlled, double-blinded, randomised clinical trial on canine atopic dermatitis. Vet Rec. 2018 Apr 7;182(14):406. Epub 2018 Feb 1.
DeBoer DJ. The future of immunotherapy for canine atopic dermatitis: a review. Vet Dermatol. 2017 Feb;28(1):25-e6. doi: 10.1111/vde.12416.
Plant JD, Neradilek MB. Effectiveness of regionally-specific immunotherapy for the management of canine atopic dermatitis. BMC Vet Res. 2017 Jan 5;13(1):4. doi: 10.1186/s12917-016-0917-z.