Veterinary Allergy Treatment Strategies

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a primary strategy in treating a pruritic pet?

Using a single treatment modality

Focusing solely on food allergies

Ignoring secondary infections

Ruling out ectoparasites (correct)

Which of the following statements about treatment for life-long conditions is true?

Only medication needs to be considered

Multimodal approaches are beneficial (correct)

Treatment can be discontinued once symptoms improve

Focusing only on infection is sufficient

What is NOT a recommended component of long-term management for a pruritic pet?

Breaking the itch cycle

Regularly ignoring pet allergies (correct)

Tailoring therapy to the individual

Environmental allergy testing

Which of the following is an important step in managing itch and inflammation?

Identifying and treating secondary infections Signup and view all the answers

What should be incorporated in the treatment plan for pets with nonseasonal allergies?

A food trial Signup and view all the answers

What is the primary treatment for anaphylaxis?

Epinephrine Signup and view all the answers

Which therapy is NOT typically used for asthma management?

Antihistamines Signup and view all the answers

Why are many therapeutic interventions for allergies considered imperfect?

No treatment works effectively for all patients. Signup and view all the answers

In treating pruritus and inflammation, which approach is emphasized?

Targeted treatment Signup and view all the answers

What additional problems should be addressed when treating allergies?

Secondary infections and ectoparasites Signup and view all the answers

What is the primary mineralocorticoid side effect associated with long-term use of glucocorticoids?

Pot-bellied appearance Signup and view all the answers

Which glucocorticoid has the most potent anti-inflammatory effect as indicated by its dosing frequency?

Dexamethasone Signup and view all the answers

Which effect is commonly observed in animals that are on short-term glucocorticoid therapy?

Increased thirst and urination (PU/PD) Signup and view all the answers

What is a potential side effect of cyclosporine therapy?

Gingival hyperplasia Signup and view all the answers

What is the labeled dose of cyclosporine for cats?

7mg/kg SID Signup and view all the answers

In what instances should cyclosporine not be used according to the content?

With renal insufficiency Signup and view all the answers

Which glucocorticoid typically has the longest duration of action?

Dexamethasone Signup and view all the answers

What is an important consideration when administering Methylprednisolone acetate (Dep-Medrol®)?

Once injected, it cannot be reversed Signup and view all the answers

Which response is primarily encouraged by Allergen-Specific Immunotherapy (ASIT)?

Th1 response Signup and view all the answers

What is a critical factor for the success of Allergen-Specific Immunotherapy (ASIT)?

Allergen selection Signup and view all the answers

Which of the following cytokines is decreased by Allergen-Specific Immunotherapy (ASIT)?

IL-4 Signup and view all the answers

What is one mechanism by which glucocorticoids exert their effects?

Stabilize cell membranes Signup and view all the answers

Which of the following conditions is a contraindication for glucocorticoids?

Previous demodicosis Signup and view all the answers

What common side effect might patients experience when taking glucocorticoids?

Heightened infection risk Signup and view all the answers

What is an important aspect of administering ASIT?

Requires patient compliance Signup and view all the answers

How long can it typically take for Allergen-Specific Immunotherapy (ASIT) to begin showing effects?

About a year Signup and view all the answers

What is the mechanism of action of Oclacitinib (APOQUEL)?

JAK inhibitor Signup and view all the answers

Which cytokine associated with pruritus in dogs does Oclacitinib inhibit?

IL-31 Signup and view all the answers

What is a contraindication for the use of Lokivetmab (CYTOPOINT)?

Pregnancy/lactation Signup and view all the answers

Which of the following is a potential side effect of antihistamines?

Hyperexcitability Signup and view all the answers

What is the labeled dose of Oclacitinib for dogs?

0.4-0.6 mg/kg BID Signup and view all the answers

Which treatment modifies prostaglandin and leukotriene synthesis?

Fatty acids Signup and view all the answers

What is a common side effect of Pentoxifylline?

GI upset Signup and view all the answers

Why are antihistamines not ideal for treating severe pruritus?

They do not provide rapid relief Signup and view all the answers

What is one of the learning objectives regarding pruritic dogs or cats?

To list the diagnostic steps needed in working up a pruritic dog or cat Signup and view all the answers

Which drug class is commonly associated with antipruritic effects in animals?

Antihistamines Signup and view all the answers

What percentage of veterinary care costs in 2023 was attributed to skin conditions?

32% Signup and view all the answers

Which of the following is NOT a common clinical sign of allergic dermatitis?

Angioedema Signup and view all the answers

Which of the following signs can vary by species when assessing allergic dermatitis?

Allergic reactions such as anaphylaxis Signup and view all the answers

Which two side effects might be associated with antipruritic drugs?

Vomiting and diarrhea Signup and view all the answers

Given a scenario, what must be evaluated to choose an appropriate antipruritic drug?

The seasonality of itch and the signalment of the pet Signup and view all the answers

What is the most likely cause of bilateral symmetric pruritus in pets?

Allergic dermatitis Signup and view all the answers

Study Notes

Treatments for Allergy

Diagnostic steps for a pruritic (itchy) dog or cat need to be determined.
Matching antipruritic drug mechanisms of action to their respective drugs is required.
Two side effects for each discussed antipruritic drug/drug class should be listed.
Choosing an appropriate antipruritic drug for a patient based on factors like animal characteristics, itch season, and client finances is crucial, along with justifying the choice.

Cost of Veterinary Care in 2023

Skin conditions make up 32% of veterinary care costs.
Gastritis accounts for 19%.
Ear infections represent 11%.
Eye conditions total 7.8%.
Heart conditions represent 6%.
Growths and tumors make up 5.5%.
Seizures account for 5.3%.
Infections comprise 4.6%.
Urinary tract infections (UTIs). are 4.6%.
Liver disease accounts for 3.8%.

Clinical Signs of Allergic Dermatitis

Common: Bilaterally symmetric, initially lesion-less pruritus, erythema
Rare: Angioedema, urticaria, anaphylaxis
Variable presentation across species

Distribution of Lesions

Images/examples of lesion distribution in animals.
This includes various forms and areas of skin involvement

Treating Allergic Conditions

Identify the specific allergic disease(s) present.
Lifelong conditions require long-term treatment strategies.
A multimodal treatment approach is often necessary
Secondary infections need to be addressed.
Itching and inflammation need to be managed.
Treatments must be tailored to individual animal.

Clinical Approach to the Pruritic Pet

Rule out ectoparasites (external parasites)
Treat secondary infections.
Break the itch cycle.
Food trials (if not seasonal triggers).
Environmental allergy testing/allergy immunotherapy (if needed)
Antipruritic therapy for long-term management

Treatment

Long-term conditions require long-term therapies
Use a multimodal approach.
Treatments should be customized to each individual animal.
Threshold of pruritus (itching) needs to be considered.

Allergen-Specific Immunotherapy (ASIT)

Encourages a Th1 response and increases IFN-γ.
Promotes IgG to act as a blocking antibody.
Increases Treg cells to suppress Th2 polarization.
Decreases Th2 cytokines (like IL-4 and IL-5).
Decreases inflammatory cells (neutrophils, eosinophils, basophils, mast cells).
Allergen selection is crucial.
Subcutaneous or sublingual (under-the-tongue) approaches are used.
Owner education and compliance are essential.

Glucocorticoids

Act by stabilizing cell membranes, inhibiting pro-inflammatory cytokines, inhibiting T cell function, decreasing eicosanoids.
Suppress myeloid cell activities.
Many potential side effects.
Contraindicated in patients with previous demodicosis, liver disease, diabetes mellitus, hyperadrenocorticism, cardiac disease, current NSAID use, pregnancy, and lactation.
Once-daily dosing and tapering protocols are sometimes possible.
Different formulations of glucocorticoids vary in potency, duration of action, and mineralocorticoid side effects.

Glucocorticoids (Specific Formulations)

Methylprednisolone acetate (Dep-Medrol®) dosages and/or administration methods are unique (20mg/dog sc).

Side Effects of Glucocorticoids

Short-term: polyuria/polydipsia (PU/PD) and polyphagia (excessive eating).
Long-term: muscle wasting, pot-belly, alopecia (hair loss), and diabetes mellitus.

Cyclosporine (Atopica™ / Cyclavance™)

Inhibits T cell function by blocking IL-2 transcription.
Side effects include vomiting/diarrhea and gingival hyperplasia.
Caution when administering with other drugs.
Contraindicated in animals with a history of neoplasia or renal insufficiency.
Also contraindicated in pregnant animals, females that are lactating, and animals younger than 6 months of age.

Oclacitinib (APOQUEL®)

Acts as a JAK inhibitor, influencing IL-2, IL-4, IL-6, IL-13, and IL-31.
Side effects include vomiting, diarrhea, lethargy, anorexia, and polydipsia.
Not intended for use in dogs younger than 12 months or those with certain conditions.
Note caution when use with demodicosis, pregnancy, and lactation.

Lokivetmab (CYTOPOINT®)

It's a monoclonal antibody neutralizing IL-31.
Not recommended for use in cats.

Antihistamines

Mechanism of action: Block H1 receptors.
Side effects: sedation, hyperexcitability (2nd generation are generally less sedating).
Caution in cases of liver disease, urinary abnormalities, and digestive issues..
Not ideal for rapid relief or severe pruritus.
Potential to reduce the need for corticosteroids.

Others

Fatty acids help with barrier function, modifying prostaglandins and leukotrienes
Pentoxifylline a phosphodiesterase inhibitor has multiple anti-inflammatory and immunomodulatory effects.

Outside-In vs. Inside-Out Treatment

Defective epidermal barriers play a role in allergic conditions and are addressable by topical therapies
Including topical therapies for skin barrier restoration.

Topical Antipruritics

Ingredients like hydrocortisone and pramoxine may be beneficial for treating itchiness.
Short-acting relief; frequent use can be problematic with topical steroids
- It's key to use topical steroids carefully for the best results.

Topical Barrier Restoration

Ceramides, fatty acids, and phytosphingosine can help restore skin barriers
Barrier restoration therapies are generally helpful as adjunctive therapy

Species-Specific Considerations

Different responses to treatments like Cytopoint and Apoquel may vary between species (dogs vs. cats).
Antihistamines may be more effective on some species.
Some treatments aren't suitable for certain species (ie: cats can’t use cytopoint)

Non-Derm Allergic Therapies

Addressing anaphylaxis with epinephrine, promoting vasodilation or vasoconstriction of vessels.
Managing allergic respiratory issues and possibly treating other conditions requiring antihistamines or corticosteroids.

Summary

Allergies are a significant reason for bringing pets to veterinarians.
Diverse treatment approaches exist; not one is perfect for everyone; however, some are better suited for certain species., so consideration is key.
Secondary problems like infection and ectoparasites often need treatment, too.

Questions?

Some general questions relate to allergy protocols and best practices are asked.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the primary strategies for treating pruritic pets and managing allergies effectively. This quiz covers essential treatment components, important management steps, and common therapeutic interventions for conditions such as anaphylaxis and asthma. Enhance your understanding of veterinary care for allergies in pets.