Drugs for allergic dermatitis in dogs

 During her talk at WVC 2025, Brittany Lancellotti, DVM, DACVD, explained the various methods of treating canine allergy dermatitis, including singing.

Many factors, including the dog's environment, genes, immunological response, skin barrier function, and cutaneous microbiome, can contribute to the complicated illness known as canine allergic dermatitis. Given the intricacy of this illness, what are the potential therapy options and strategies for these dogs? In her lecture titled "Anti-Hero: A Variety of Inflammatory and Antipruritic Medications for Canine Allergic Dermatitis," Brittany Lancellotti, DVM, DACVD, reviewed the many therapeutic choices for managing inflammations and pruritus. Using slides and her own karaoke version (the "Dermatology Version"), Lancellotti discussed several drugs that veterinarians can prescribe.

Glucocorticoids

After interacting to glucocorticoid receptors in the cytoplasm, glucocorticoids (GCs) go to the nucleus and influence gene transcription through binding to glucocorticoid response elements. In doing so, it increases expression of proteins that reduce inflammation and decreases expression of genes that promote it. Acute and chronic inflammation and pruritus treatments are also affected by this process. Some frequent short-term side effects include changes in behavior, diarrhea, panting, increased urination, increased thirst, increased hunger, and more.

If GCs are to be used long-term, veterinary specialists giving them to patients should prioritize reducing the frequency and dose to the lowest effective level while monitoring the patient's tolerance, as the adverse effects of GCs might progress with time. These effects can include cardiovascular workload, immunosuppression, muscle and ligament atrophy, risk of diabetes and pancreatitis, and more. Lancellotti noted that these medications are delivered to patients via liquid or pill at 0.5–1.0 mg/kg prednisone/prednisolone equivalent every 24 hours at first. The dose can then be adjusted to lowest effective dose and frequency that is maintaining remission of clinical symptoms in the pet. 2,3 Lancellotti also mentioned that these drugs are not suggested for long term. For the benefits of GCs, Lancellotti noted that it is rapid acting, effective against edema, can be an economical option for clients, and offers that diversity of administration methods. However, she highlighted some negatives for GCs is more frequent changes were found during monitoring and it interferes with allergy and hormonal testing.

Modified cyclosporine

Cyclosporine inhibitors (Atopica; Elanco) leads to a decrease in activation of T cells, and a decrease in proinflammatory cytokines such interferon-α and is used in canines with atopic dermatitis who weigh at least 4lbs. This therefore leads to a decrease in pruritus and edema in treatment in chronic allergic dermatitis, not acute. When it comes to this medication, the most prevalent of the short-term adverse effects are gastrointestinal, with less common long-term concerns include gingival hyperplasia, opportunistic fungal infections (which are less common at 5 mg/kg dose), and papillomas. This type of drug is provided by liquid or capsule at 5 mg/kg once daily for the first 4-6 weeks to see if clinical symptoms improve, then the dosing frequency of delivery can be lowered to either every other day or twice daily, and the daily dose itself can be decreased. Lancellotti reminded guests that when providing cyclosporine concurrently with drugs that can alter the cytochrome p450 enzyme system in the liver, it would in turn affect the concentration of cyclosporine circulation.

In conclusion

Lancellotti used her keyboard and voice to engage the room till the very end. As she performed 'We Will Block You' and other remixed classics, she communicated to the crowd that itchy dogs will be in the clinic, much like music in our life. It would be easy to assist these people in recovering if you are aware of the many treatment options.

References

1. Lancelloti B Anti-Hero: A Variety of Inflammatory and Antipruritic Medications for Canine Allergic Dermatitis. Presented at: WVC; Las Vegas, Nevada. March 2-5, 2025.

2. Van den Broek A. Muller & Kirk’s Small Animal Dermatology. William Miller Jr, Craig Griffin, Karen Campbell. Saunders-Elsevier, St Louis; 7th Edition, 2013, 938 p; IBSN: 978-1-4160-0028-0, £113. Veterinary Dermatology. 2013;24(5):559-559. doi:https://doi.org/10.1111/vde.12055

3. Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med. 2014;28(1):1-20. doi:10.1111/jvim.12265