Changes

Several factors exist that in normal dogs may by insufficient to cause pruritus. However, when these occur at the same time as allergen exposure in atopic dogs, there can be an additive effect that breaks the threshold for pruritus. These "flare factors" include ectoparasites, microbial infections, stress and environmental effects. When treating for atopic dermatitis it is therefore critical to keep these factors to a minimum. Atopic dogs should be regularly treated with an ectoparasiticide against fleas and mites, and secondary bacterial or ''Malassezia'' infections should be identified and treated promptly. Stress should be avoided and products that may be irritant, such as cleaning materials, should not be used in the environment. This requires a certain amount of vigilance on the part of the owners.

Several factors exist that in normal dogs may by insufficient to cause pruritus. However, when these occur at the same time as allergen exposure in atopic dogs, there can be an additive effect that breaks the threshold for pruritus. These "flare factors" include ectoparasites, microbial infections, stress and environmental effects. When treating for atopic dermatitis it is therefore critical to keep these factors to a minimum. Atopic dogs should be regularly treated with an ectoparasiticide against fleas and mites, and secondary bacterial or ''Malassezia'' infections should be identified and treated promptly. Stress should be avoided and products that may be irritant, such as cleaning materials, should not be used in the environment. This requires a certain amount of vigilance on the part of the owners.

===Improving Barrier Function==

===Improving Cutaneous Barrier Function===

In normal animals, the skin has an important barrier function. The integrity of the epithelium may be impaired in atopic animals, facilitating further exposure to allergens. Finding ways to help improve the barrier function of the epidermis can contribute towards the effective management of atopy. Food trials are often used during the course of a work-up for atopic dermatitis to eliminate food allergy as a cause of pruritus. Many atopic animals non-specifically improve during food trials on prescription hypoallergenic diets, which may be attributable to several of their components. The inclusion of zinc and long-chain omega essential fatty acids is thought to reduce inflammation, and substances such as inositol, choline, histidine, pantothenate and nicotinamide may help improve epidermal lipid barrier⁴. The use of topical shampoos and emollients can also be beneficial. As well as physically removing allergens from the skin and coat, moisturising shampoos can hydrate the skin and improve the lipid barrier. Colloidal oatmeal may also have a direct antipruritic action⁴. Anti-microbial or anti-scaling shampoos, and ear cleaners can prove useful in certain cases depending on presentation. The effects of essential fatty acids in atopic dermatitis have been subjected to numerous clinical trials. EFA supplementation alters incorporation into cell membranes, which may reduce production of pro-inflammatory leukotrienes and prostaglandins⁴. The cutaneous lipid barrier may also be improved. However, there is some conflicting informtation, and high levels of supplementation may be neccessary to give beneficial effects.

In normal animals, the skin has an important barrier function. The integrity of the epithelium may be impaired in atopic animals, facilitating further exposure to allergens. Finding ways to help improve the barrier function of the epidermis can contribute towards the effective management of atopy. Food trials are often used during the course of a work-up for atopic dermatitis to eliminate food allergy as a cause of pruritus. Many atopic animals non-specifically improve during food trials on prescription hypoallergenic diets, which may be attributable to several of their components. The inclusion of zinc and long-chain omega essential fatty acids is thought to reduce inflammation, and substances such as inositol, choline, histidine, pantothenate and nicotinamide may help improve epidermal lipid barrier⁴. The use of topical shampoos and emollients can also be beneficial. As well as physically removing allergens from the skin and coat, moisturising shampoos can hydrate the skin and improve the lipid barrier. Colloidal oatmeal may also have a direct antipruritic action⁴. Anti-microbial or anti-scaling shampoos, and ear cleaners can prove useful in certain cases depending on presentation. The effects of essential fatty acids in atopic dermatitis have been subjected to numerous clinical trials. EFA supplementation alters incorporation into cell membranes, which may reduce production of pro-inflammatory leukotrienes and prostaglandins⁴. The cutaneous lipid barrier may also be improved. However, there is some conflicting informtation, and high levels of supplementation may be neccessary to give beneficial effects.