Let’s start from square one… Who out there has an itchy dog??
DISCLAIMER: I am not a veterinary dermatologist. If you would like more information on immunotherapy for your itchy dog, please ask for a referral from your primary care veterinarian.
Atopic dermatitis (also known as allergies) is one of the most frequent diseases that veterinarians treat, especially down here in the South! Almost everyone I know has an itchy dog to some extent. So let’s get into a treatment option that many people are unfamiliar with: Immunotherapy.
Today on dermatology, I got to see Champion for a recheck examination of his chronic allergies. I have known this doggo since before veterinary school. I worked with his momma when we were just baby veterinary assistants. Champion has struggled with allergies for as long as I have known him. When Apoquel, Cytopoint, and hydrolyzed diets weren’t cutting it, his owners brought him to UGA Dermatology for treatment. Two years ago, he received an intradermal skin test and was subsequently started on immunotherapy.
So, what is immunotherapy?
Immunotherapy uses certain parts of a pet’s immune system to fight various types of diseases, including atopic dermatitis. The treatment is uniquely formulated based on the results of your pet’s response to intradermal skin testing. Intradermal skin testing involves injecting individual allergens under the skin (e.g., mold, dust mites, etc.) and analyzing the skin’s response. If the pet is allergic, the site will react.
There are different ways of giving immunotherapy injections, most commonly subcutaneous, sublingual, or intra-lymphatic. Owners can give the subcutaneous injections at home, while intra-lymphatic treatment will typically be done by a veterinary dermatologist.
This treatment takes a while to work but the results can be amazing. Immunotherapy actually BUILDS up the immune system. It encourages the body to respond by creating antibodies against small doses of allergens that steadily increase over the length of the treatment. Pretty cool, huh?
Types of immunotherapy
There are many types of immunotherapy out there, so for now I will only talk about what UGA offers. Today we discussed the use of non-adjuvanted vs. adjuvanted immunotherapy serums. There are a few differences between the two formulations. Adjuvanted serums include aluminum hydroxide, which basically acts like a huge beacon telling the immune system to respond. It also can be administered less frequently than non-adjuvanted serums. This ultimately makes adjuvanted immunotherapy often more cost-effective for owners.
The decision to use adjuvanted vs. non-adjuvanted immunotherapy is up to the veterinary dermatologist and the owner’s preference. For more information, please contact your primary care veterinarian and ask if they think your pet would benefit from immunotherapy.
Back to champion…
Although Champion is overall MUCH improved since his initial dermatology appointment, Champion is still an itchy dog. Today, the owner reported a 5/10 on the pruritus (itchiness) scale. Ideally, dermatologists would like to see dogs at a 3/10 or lower. Last year, he was managed on immunotherapy alone; however, the family moved into a different house over the summer and he had another “flare” episode. To treat this, Champion started taking Apoquel again in combination with immunotherapy. Since then, the owner has tried to wean him off of Apoquel with no luck. Each time, he seems to have another “flare”. Therefore, we decided to switch Champion from non-adjuvanted to adjuvanted immunotherapy to see if we could improve his clinical response even more!
We will have to wait and see how Champion responds to his new immunotherapy regimen. Atopic dermatitis and itchiness can negatively impact both you and your pet’s lives. The hard part about this disease is that there is nothing that will cure it 100%. However, veterinary dermatologists are incredible resources to help manage clinical signs when the typical treatments fail. I loved experiencing Champion’s case and seeing his clinical improvement first- hand today. It makes me even more excited to get out there and start practicing medicine!
If you have an itchy dog, contact your primary care veterinarian about a dermatology referral.