Diagnosing the cause of itching can be challenging and requires a disciplined and systematic approach.
Itching can be caused by an infection, infestation or hypersensitivity (e.g., an allergy).
Infections can be the primary cause of itching or can be secondary to an underlying allergic condition.
Allergic dermatoses, including flea allergy, cutaneous adverse food reactions and atopic dermatitis are the most common causes of allergic skin disease.
The diagnosis of atopic dermatitis is a diagnosis of exclusion. Simply stated, it is a steroid-responsive itch that isn’t caused by:
- Anything with legs (fleas, Sarcoptes, Cheyletiella)
- Anything that can be grown in a laboratory (Staphylococci, Malassezia)
- Anything eaten (food, medications)
Once the cause of itching is identified, an appropriate course of treatment can be designed. Treating the signs of itch while making a diagnosis is critical to improving the quality of life of the pet and owner.
Recent scientific discoveries highlight the role of direct neuronal stimulation as a major cause of the itch response seen in allergic and inflammatory diseases.
A key therapeutic challenge for clinicians is finding a way to stop the neuronal itch stimulation and inhibit all aspects of the cycle – halting the inflammatory process, without causing systemic side effects.
The most common treatment prescribed, corticosteroids, stop the inflammation and related itching but also have systemic side effects that negatively impact the quality of life of the dog and its owner, and, when used in excessive amounts, can have serious medical consequences. To avoid this, practitioners often rely on a multimodal approach.
In recent years, newer therapies designed to target specific biochemical aspects of the itch cycle have begun emerged. These modalities may offer veterinarians additional approaches to treating canine pruritus.
Click here to learn more about two innovative treatments that interrupt the itch cycle – one by inhibiting JAK and one by blocking an itch-promoting cytokine with a monoclonal antibody (mAb).
BMC Vet Res. 2015 Aug 16;11:210. doi: 10.1186/s12917-015-0514-6. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). Olivry T1, DeBoer DJ2, Favrot C3, Jackson HA4, Mueller RS5, Nuttall T6, Prélaud P7
Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prélaud P, for the International Task Force on Canine Atopic Dermatitis. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol. 2010:21:223–248.
Lessons About Itch From Recent Advances in Human Therapeutics
An interview with Martin Steinhoff, MD, PhD about his research and insights into the science of itch at the 7th WCVD, 2012.
PowerPoint® deck for educational purposes
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