Allergic Dermatitis in Dogs and Cats

From the Field shares insights from Banfield Pet Hospital veterinary team members. Drawing from the nationwide practice’s extensive research, as well as findings from its electronic veterinary medical records database and more than 8 million annual pet visits, this column is intended to explore topics and spark conversations relevant to veterinary practices that ultimately help create a better world for pets.

The itchy pet. These 3 words probably bring at least 1 pet patient immediately to mind. Given that these cases can be misunderstood by pet owners, we focused Banfield Pet Hospital’s 2018 State of Pet Health^® Report on the 3 common allergic dermatitis conditions: food, flea and atopy. The largest of its kind, our eighth State of Pet Health Report was generated using the electronic medical data from the more than 3 million dogs and cats cared for at our hospitals in 2017.

It likely won’t surprise you that approximately 7% of canine and 4% of feline visits to Banfield hospitals in 2017 resulted in a skin-related diagnosis. Some of these cases are relatively easy to diagnose and manage—fleas, seborrhea, skin trauma. As veterinary professionals, we know all too well that others can be more complex and challenging, for both the owner and the veterinary team.

Among these cases are allergic dermatitis cases. Unfortunately, allergic dermatitis can clinically present like other skin conditions, such as ectoparasites and bacterial, yeast, or fungal infections. With the plethora of information available these days through venues such as the internet, many pet owners turn to online resources for information on pet itching and what’s considered “normal” for a breed, and to purchase off-the-shelf products, only consulting with their veterinary team when the problem persists or worsens. It can be difficult for pet owners to discern what sources are reputable and which information is substantiated. This year’s State of Pet Health Report focused on the allergic dermatitis conditions to provide owners some clarity, including myth-busting common misinformation pet owners may have read or heard.

Many people are increasingly aware of food allergies in humans. Understandably so, this is causing increased concern about food allergies in pets. As veterinary professionals, it’s not uncommon to encounter the pet owner who is convinced their pet has food allergies and has already tried several over-the-counter or homemade diets to relieve their pet’s condition. However, we found food allergies to be very uncommon, with less than 1% of dogs and cats diagnosed with them (TABLE 1), which emphasizes the importance of ruling out other conditions that can have similar clinical presentation before exploring diet trials.

In addition, it is recognized in veterinary medicine that pets with allergic dermatitis conditions are more likely to have pyoderma or other skin conditions as a comorbid condition. Banfield data revealed that, of those with food allergies, dogs are 6 times and cats are 15 times more likely to also be diagnosed with pyoderma (FIGURE 1). While there is increased risk, don’t assume all allergic dermatitis pets require antibiotic therapy. This is only indicated when diagnostic testing demonstrates an active skin infection.

Pets diagnosed with flea allergic dermatitis, on the other hand, are common (TABLE 1). Fleas remain the most commonly found ectoparasite in pets, with cats twice as likely to have them as dogs. Given the prevalence of fleas in the feline population was 9.3% (versus 4.5% in dogs)¹ and the number of effective flea control products available, this suggests further client education on the use of 1 of these products is needed. There are several reasons for this increased prevalence of fleas in cats, including some pet owners not recognizing that fleas can be a year-round problem in their homes and that indoor cats can still be exposed to fleas by other pets, their owners or visitors. And given cats are fastidious creatures, many owners may not see fleas on their cat, and therefore not realize their cat has been exposed to fleas until the clinical signs manifest, and treatment with a flea control product is underway.

Similar to flea allergy, atopy is more common, particularly in dogs (TABLE 1). Its prevalence represents 30% and 11% increases of atopy in dogs and cats, respectively, over the last 10 years (FIGURE 1). Although the reasons remain unknown, this could be due to a number of factors, including increased awareness due to new, effective therapies brought to market in recent years. Our 2018 report provides educational information for pet owners to help them better understand that the inciting agents are similar to the common environmental allergens for humans. And that, just like humans, identification of the environmental allergens can help owners reduce exposure when possible and pursue more specific treatment, such as immunotherapy.

Treating itchy pets can be resource- and time-consuming, frustrating both pet owners and veterinary teams. Proper diagnosis of the pet’s skin condition is key to ensuring that the pet is receiving appropriate treatment. Equally important is clearly setting pet owner expectations about the management of these conditions, which can range from relatively easy to quite complex, with some diagnostic tests (and treatments) being repeated and possibly referral to a veterinary dermatologist. The entire veterinary team plays an important role in managing these cases and especially in educating pet owners. Management of allergic dermatitis is a lifelong commitment, and as veterinary professionals, we need to partner with pet owners by remaining alert to the onset of clinical signs that indicate a flare-up. As we all know, the earlier these are detected and brought to us for treatment, the better for the pet’s wellbeing.

Banfield’s State of Pet Health Report’s primary goal is to raise awareness among pet owners of the need for regular preventive care and emphasize the role of the veterinary care. This year’s report focused on client education to better understand these skin conditions, debunk common myths about itchy pets, and lay the groundwork for conversations with their veterinary teams about how to approach the diagnosis and treatment. As veterinary professionals, we recognize that client education and communication are the key components to pets receiving the best care and, therefore, the best outcomes. Thus, it is important that we remain up-to-date on the latest recommendations and treatment options, present a thorough diagnostic plan to ensure that treatment is addressing the right condition(s), set aside the time to get a thorough history, including what has already been tried, to perform the needed diagnostic tests. We need to discuss with the owners the diagnosis and treatment plan, as well as set clear expectations for the immediate issue and for the lifetime of the pet. These are the building blocks of a partnership in managing the pet’s itchy condition, leading to a win-win-win solution for the client, the pet, and the veterinary team.

Visit StateofPetHealth.com for more information on Banfield’s State of Pet Health Report and to learn more about our allergic dermatitis conditions findings, as well as find client education tools.