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Atopic Dermatitis (view source)

Revision as of 17:31, 26 August 2010

1,464 bytes removed ,  17:31, 26 August 2010
→‎Allergen specific immunotherapy (ASIT)
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best results seem to occur with early treatment,
 
best results seem to occur with early treatment,
 
although a 9-12 month trial is necessary to assess
 
although a 9-12 month trial is necessary to assess
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the response in each case. Animals on ASIT
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the response in each case.  
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require careful supervision to control microbial
+
 
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infections and other flare factors, to administer
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anti-inflammatory treatment as required and to
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adjust the dose and/or frequency according
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to the clinical response (Figure 1).
   
The exact protocol varies widely but usually
 
The exact protocol varies widely but usually
 
involves repeated injections a few days to 1-2
 
involves repeated injections a few days to 1-2
 
weeks apart. Once the full dose is reached, the
 
weeks apart. Once the full dose is reached, the
 
interval between injections can be extended.
 
interval between injections can be extended.
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A rush protocol, where the initial loading course
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is given within a single day, was recently shown
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to be as effective as conventional ASIT in a small
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number of dogs (7). Recent reports also described
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starting with a full dose (monodose therapy).
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No adverse effects were seen in either case
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although the dogs were pre-medicated with
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an anti-histamine.
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Alum precipitated vaccines have a depot effect
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and require less frequent administration. Alum
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adjuvants potentiate IgE responses in experimental
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animals but no differences in efficacy between
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alum-precipitated and aqueous vaccines have been
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demonstrated in dogs. There are anecdotal reports
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of improved efficacy with low dose ASIT, but a
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controlled study, however, found no difference in
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efficacy between low dose and conventional
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alum-precipitated ASIT (8).
   
If ASIT proves successful, the interval between
 
If ASIT proves successful, the interval between
 
injections can be extended. Increased pruritus
 
injections can be extended. Increased pruritus
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but most require maintenance injections every
 
but most require maintenance injections every
 
1-2 months.
 
1-2 months.
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Re-testing may reveal new sensitivities in dogs
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with initially negative tests, dogs <12 months
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old at the time of the original test, if there has
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been a poor response to ASIT or where a good
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response is not maintained. Re-formulating ASIT
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can be beneficial in these dogs.
   
Adverse effects are uncommon. Injection site
 
Adverse effects are uncommon. Injection site
 
reactions and anaphylactic shock are very rare,
 
reactions and anaphylactic shock are very rare,
 
although many dermatologists advise giving the
 
although many dermatologists advise giving the
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first 5-6 doses in a veterinary clinic. Increased
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first 5-6 doses in a veterinary clinic.
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pruritus after an injection indicates that the dose is
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too high although mild reactions can sometimes be
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managed with antihistamines.
      
===Anti-inflammatory therapy===
 
===Anti-inflammatory therapy===
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