All About The Itch: Atopy

Before we start, a small side note: Hey guys! I want to apologize for missing Thursday’s blog update. Since I’ve started actively blogging, meeting a twice-weekly schedule has been one of my top priorities. I hope to deliver relevant, informative content on a timeline that my readers can expect and rely on. Thursday, I failed to do that- I was sick with the stomach bug. In the future, I hope to have each post written a few days in advance so that I can be a more reliable blogger for my audience. Thanks for sticking with me!

Today, we’re going to be talking about something called atopy.

Atopy (also known as atopic dermatitis) is a condition that results in chronic dermatitis (skin inflammation), and is associated with allergies, usually from the environment. Atopy is in full bloom here around the tristate. I’ve been seeing itchy dogs (and even itchy cats) left and right. Unfortunately, atopy can be a very difficult problem to diagnose, and can be even more difficult to manage.

Here are 5 things you should know about atopy in dogs and cats;

1. Allergens invade your pet’s immune system through the skin- not the respiratory system. It was once thought that, much like humans, dogs inhaled their allergens, which then caused a skin reaction. We now know that the allergens that cause skin inflammation break directly through the skin barrier. Because of this, keeping your pet’s coat healthy with topical shampoos and essential fatty acids is extremely important in treating this disease.
2. Atopy can only be ‘definitively diagnosed’ when all other causes of itching and skin inflammation are ruled out. Atopic dermatitis is what veterinarians call a “diagnosis of exclusion.” That means that we cannot say for certain that skin disease is caused by environmental allergies unless we rule out all other causes of skin inflammation. These causes include mites and other topical parasites, food allergy, bacterial infection, ringworm- the list keeps going. If your vet is suggesting diagnostic tests, don’t get frustrated! Remember that your vet is just trying to make sure that a different problem isn’t going undetected.
3. A wide variety of allergens can play a role in atopic dermatitis. Dogs can be allergic to seemingly ridiculous things- even cat dander! Common allergens associated with atopy include animal dander, dust and dust mites, feathers, fleas, grains, cleaners, insects, mold spores, plants, pollen, and wool. Because many of these allergens are ubiquitous in the environment (meaning: everywhere, no matter what), eliminating them from the atopic pet’s environment is often not possible. However, if you can find out what the cause of the reaction is- eliminating or reducing exposure to the allergen is a good place to start.
4. There is no cure for atopic dermatitis. But it can be managed. Usually, long term management involves allergy testing and immunotherapy (small doses of the allergen that are given to desensitize the pet to its effects). In the last few years, products such as apoquel and atopica have been developed to act as immune suppressants, which decrease a pet’s immune response to an allergen. Recently, a product called Cytopoint has launched that is a biologic aimed at preventing the itch signal from being released in dogs. These products are impressive and have very few side effects compared to traditional treatments (such as steroids), but they can be expensive, and patients usually require them at least periodically for life.
5. Symptomatic treatment can help some pets. Some pets may benefit from using anti-histamines, topical anti-itch medications, and short courses of steroids (long-term steroid use is no longer advised due to the high risk of dangerous side effects). However, these treatments may not be enough in severe cases of atopy. Some pets may do well for most of the year on antihistamines, and only need apoquel (or the other products listed above) during flare ups. Which treatment is best for your pet depends on many factors, and your veterinarian is the best person to ask for advice!

If you think that your pet may be having signs of atopic dermatitis (such as inflamed ears, head shaking, licking the paws, gnawing the legs or forearms, scooting his back on furniture, and otherwise itching excessively), talk to your vet about the short and long-term options for treatment. Remember that atopy is a complicated disease and that there is no permanent cure. However, you can substantially improve your pet’s comfort level and quality of life by communicating well with your veterinarian and by being dedicated to life-long management.

Question for readers: Has your pet ever been diagnosed with atopy or “allergies?” What steps did you and your vet take to improve his or her quality of life?