Atopic Dermatitis (AD) is also referred to as inhalant allergic dermatitis or atopy.  The disease occurs when a dog is allergic to environmental allergens (e.g. Pollens of trees/grasses/weeds, house dust mites, molds, epidermals, etc.)  It is very similar to hay fever and asthma in humans, except dogs develop skin disease and uncommonly develop respiratory symptoms.  Dogs with AD are itchy and frequently have secondary bacterial or yeast infections of the skin and ears.  Unfortunately, dogs with AD rarely grow out of their disease.  Many dogs with AD also have flea allergy, and it is essential that flea control be maintained, no matter what therapy is being pursued for the AD.

Treatment:

There are 4 basic ways to treat AD:

1. Avoidance- it is very difficult to prevent exposure to specific allergens.  House dust mite and mold allergen levels in the home can often be reduced- see handouts from our service.
   
   
2. Symptomatic treatment- includes corticosteroids, essential fatty acid supplements, topical shampoos and conditioners with anti-itch contents, and antihistamines.  These treatments relieve the itching for a short period of time, but the disease tends to continue and progress.
   
   
3. Allergen-specific immunotherapy
   
   
4. Atopica (Cyclosporine) – A drug that slows the immune system response to allergens thus preventing the inflammation that causes allergic itching.

Allergen-specific immunotherapy (ASIT) (also referred to as desensitization or hyposensitisation) is the administration, by injection, of a vaccine that contains the specific allergens to which the dog is allergic.  In this manner, we are often able to manipulate the immune system to be tolerant of these allergens rather than excessively reactive.  If this can be achieved, then the skin inflammation decreases and the dog is less itchy and less likely to develop secondary bacterial or yeast infections.
Some important points regarding immunotherapy:

1. Generally, the expected results are as follows
1. 1/3rd of dogs have an excellent response (75%  better)
2. 1/3rd of dogs are significantly better (still some symptoms and need for treatment)
3. 1/3rd of dogs do not respond (an unfortunate fact and impossible to predict!)

2. Therapy must be given for 1 year before we are able to definitively assess response.
   
   
3. Many dogs that do respond to immunotherapy will do so in the 1st 6 months of treatment.
   
   
4. Itching and/or secondary infections may continue to occur and require treatment for a number of months whilst we are waiting for the dog to respond to the vaccine.  Consequently, symptomatic therapy is commonly necessary during the initial months of immunotherapy and will not affect the outcome of immunotherapy.
   
   
5. Side effects of immunotherapy are uncommon, but may occur.  Most often there maybe and increase in itching (the dose of vaccine is then adjusted or symptomatic treatment is given at the time of injection).  More severe side effects like anaphylaxis and shock (e.g. Hives, heavy breathing, and collapse) are rare.
   
   
6. It is very important that your dog is seen for rechecks after 3 months and 12 months of ASIT, and that you keep in contact with us if we are to optimize the chances for success.