Thank you to everyone who attended the Canine Atopic Dermatitis webinar. The questions which were not answered during the webinar have been answered below by Professor R. Halliwell and Dr. K. Pantenburg
Q. What do you class as aggressive flea and tick control?
A. Good flea & tick products for the patient + all in-contact animals + ongoing environmental control using and adulticide and an insect growth regulator. Bear in mind efficacy of topical products may be limited with very frequent use of shampoos! Better to consider oral products in this case.
Q. How long do you use systemic anti-fungals typically for? Thank you both for an excellent talk.
A. Three to five weeks in the first instance if supplemented by shampoo therapy. Evaluate the clinical response and check the microbiological response using cytology, and continue for another course if needed.
Q. Can you use apoquel for moist dermatitis ?
A. Moist dermatitis (‘hot spots’) are often localised and therefore I would consider topical products rather than systemic medication.
Apoquel is a good anti-pruritic drug, with no anti-inflammatories properties, therefore not a good choice for moist dermatitis. If the hot spot has developed from a perforating folliculitis, which can be recognized by careful palpation of the edge of the lesions, the systemic antibiotics are necessary.
Q. What would be the financial constraint therapeutic approach?
A. Since the therapeutic approach very much depends on each individual patient this is a difficult question to answer.
Flea control, topical therapy (some type of shampoo, or ear cleaner) and essential fatty acids are almost a must for good management.
Although the initial outlay of undertaking serology may seem high, it then enables the use of ASIT which over the long-term is very cost effective. In the event of an incomplete response it can be supplemented with low-dose alternate day corticosteroids
Q. Have you seen improvement in cases what did not improve on a hypoallergenic diet, when changed to a raw diet, so not processed, and with a marked reduction(elimination) of storage mites?
A. It is true that commercial diets may contain varying amounts of storage mites which have the potential to be allergenic. However, the truth is I have never changed a patient from a hydrolysed diet to a raw diet.
I usually try to work out during the history taking and having regard to the results of serology – if undertaken – which diet would be the most appropriate for the patient and client – with which diet will I get the best compliance?
Some clients are very motivated and pro-home prepared diets, some clients are very busy with work, family, general life-style and better off with a commercial diet.
Q. Do you avoid oral EFA supplementation during a diet trial if it contains fish oil?
A. Yes, I do. I think the opinions vary between dermatologists and there is still not much evidence supporting either. I normally use topical formulations while performing a diet trial.