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adjusted during the induction period and this is where the “art of therapy” rather than using a “cookbook formula” comes in.
Recently, sublingual immunotherapy, used for years
in people for the treatment of allergic rhinitis, has been tried in small groups of dogs in pilot studies with success similar to standard subcutaneous immunotherapy. Several companies, including Heska, Bio-Medical services, RESPIT and Nelco are offering sublingual formulations of their immunotherapy vaccines. Vaccines are glycerin-based and administered by the owner twice daily using a special oral applicator. Dogs may respond in 1-3 months in some cases and seem to have fewer side- effects than with subcutaneous vaccines. In one study, 50% of dogs who failed the standard subcutaneous vaccine improved with the sublingual formulation. In people, the vaccine often can be discontinued after
3-5 years with long-lasting remission of clinical signs.
It remains to be seen if this is the case in dogs. More studies are needed to determine the optimal dosing frequency and protocol, and how long-term efficacy compares with subcutaneous immunotherapy. This is an option for owners who cannot give injections to their pets, but requires continuous twice daily dosing.
The most recent therapy for the treatment of canine
AD is the monoclonal antibody Cytopoint. This is an injectable caninized anti-cIL-31 monoclonal antibody (mAb)specifically designed to target the cytokine IL-31,
a key cytokine involved in sending the itch signal to the brain. It removes the cytokine from the circulation. It begins working within 1 day and delivers relief from itch and inflammation for 4-8 weeks. Cytopoint is safe for dogs of all ages and can be used in combination with many common medications, including parasiticides, antibiotics, antifungals, corticosteroids, vaccines, immunotherapy, antihistamines, and other antipruritics, such as oclacitinib and cyclosporine. It does not interfere with serum or intradermal allergy testing.
References
Marsella R, Sousa CA, Gonzales AG, Fadok VA. Current understanding of the pathophysiologic mechanisms of canine atopic dermatitis. JAVMA 241:194-207, 2012.
Miller WH, Griffin CE, Campbell KL, et al. Muller and Kirk’s Small Animal Dermatology 7th ed. Hypersensitivity Disorders; Elsevier, 2013 p.383.
Olivry T, et al. Evidence-based Veterinary Dermatology: a systematic review of the pharmacotherapy of canine atopic dermatitis. Vet Dermatol 14:121-146, 2003.
Olivry T, et al. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 21:233-248, 2010.
Olivry T, Bizikova P. A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs:2008–2011 update. Vet Dermatol 24: 97–e26, 2013.
Olivry 2015, et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res 11:210, 2015.
Sousa C. Glucocorticoids in Veterinary Medicine. In: Kirk’s Veterinary Therapy XIV, Saunders-Elsevier, 2009, pp. 400-405.
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