Veterinarians who need assistance with managing pruritic pets have a free resource from the American Animal Hospital Association. The organization’s newly released guidelines, “2023 Management of Allergic Skin Diseases in Dogs and Cats,” provide diagnosis and treatment plans in cases of flea allergy dermatitis, food allergies, canine atopy and feline atopic skin syndrome.
“[The guidelines] give concrete recommendations and step-by-step workups for allergic patients, so practitioners can feel confident they are not missing something,” said Dr. Julia Miller, who co-chaired the task force behind the guidelines.
Key takeaways include:
- A medical history is necessary in every allergic dermatitis case. It should detail seasonality, pruritus level, ectoparasite prevention, age of onset, progression and the response to previous therapies.
- Atopy is a diagnosis of exclusion, and allergy testing should be performed only if immunotherapy is planned.
- Treating allergic patients is not one-size-fits-all, and a multimodal approach often yields the best results.
- Client communication must be efficient and effective to manage expectations.
- Recognizing when referral is necessary is vital.
- Veterinary technicians should be trained to conduct diagnostic tests and explain the procedures and treatments to clients.
“Technicians are so important when it comes to client communication, which is a huge aspect of being successful with allergic pets,” Dr. Miller said. “You can use a veterinary technician to reiterate things you recommend. If they hear it from multiple people, it drives it home for them.”
The guidelines recommend a step-by-step approach when working up an allergic skin patient, including:
- Step 1: Take a clinical history and perform a dermatological physical examination.
- Step 2: Collect a minimum dermatological database that includes skin and ear cytology, skin scraping and potentially, dermatophyte testing.
- Step 3: Treat pruritus.
- Step 4: Treat secondary infections and ectoparasites.
- Step 5: Recheck, verify medication, and assess treatment response.
- Step 6: Perform a diet trial.
Desperate pet owners might consider mail-order blood or saliva allergy tests, but the guidelines stress that those diagnostic tools aren’t conclusive.
“Being purposeful in your choice of diagnostics and treatments will end up saving money in the long term,” said Dr. Jessica Vogelsang, AAHA’s chief medical officer.
Highlights are at bit.ly/4a3jQme and the full guidelines at bit.ly/3uJt9Yp.