A Summary of the 2023 AAHA Management of Allergic Skin Disorders in Dogs and Cats Guidelines
Pruritus is one of the most frequent complaints that leads to small animals presenting to the vet. A dog or cat with an allergic disorder causes not only stress to the animal itself but also to its owners, since diagnosis is frequently difficult and can include multiple trips to the vet until a definitive diagnosis is achieved. The AAHA recently released their guidelines for the management of allergic skin diseases, so we thought we’d summarise them for our busy veterinary colleagues in practice!
With these guidelines, the goal is to offer guidance on how to approach allergic dermatitis cases and how to adequately choose the best treatment option.
Important notes on diagnosing the allergic dog
- A detailed history is very important – it should include pruritus level, seasonality, external parasite prevention and response to previous therapeutics
- A minimum dermatologic exam database should be included – cytology, combing to look for fleas, skin scrapings and eventually ear cytology if there is ear involvement
- Atopy is diagnosed by exclusion – allergic test should only be performed if immunotherapy is part of the treatment plan
Important notes on treatment of the allergic dog
- Treatment is not always the same and it is frequently multimodal
- Owner education is imperative for treatment to be successful
- If all previous treatment protocols were not successful, start from the beginning and get all the information needed on the dog’s history and perform new dermatologic exams to determine if anything has changed
Important notes on diagnosing the allergic cat
- Cats can present several forms of allergic dermatitis such as overgrooming, scratching and several different cutaneous inflammatory patterns
- Flea and tick treatment and prevention is not only important therapeutically but also when it comes to diagnostics
- Environmental allergy in cats is only diagnosed by exclusion
Important takeaways on treating the allergic cat
- Parasitic causes should be excluded before treatment of any other allergy
- Flea allergy dermatitis is the most frequent cause; a strict antiparasitic regime in a cat with pruritus is essential because it can be a complicating factor
Client communication in allergic skin disease
- Be clear and manage owner expectations – sometimes, diagnostics and treatment can take up to 2-4 months or even more in some cases
- Discuss any possible restraints to diagnosis and treatment – owner work schedule, environment at home, financial constraints, etc.
- Prepare the owner for possible flare-ups even in well managed cases
At the end of the day, all cases of allergic dermatitis can be frustrating to deal with. Despite being one of the most common conditions we come across as vets, it’s easy to feel disheartened and unconfident when allergic cases don’t go to plan. If this sounds like you, have you considered doing some small animal dermatology CPD? Our Veterinary Dermatology Certificate is an online course, with successful candidates getting the GPCert. You can even convert it into a PgC and apply for RCVS Advanced Practitioner status.
