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Antipruritic and anti-inflammatory medications

Treatment of the pruritic dog with antipruritic and anti-inflammatory medications brings comfort and is an important aspect of treatment for atopic dermatitis. Treatment will depend on the severity of inflammation.

There are 2 phases of treatment for atopic dermatitis:

Phase I

To aim for induction of remission, consider rapid-acting and broad-targeting drugs:

  • Consider transition from glucocorticoids to oclacitinib or ilunocitinib once cutaneous inflammation subsides from severe to mild inflammation.
  • Consider combining oclacitinib or ilunocitinib with topical glucocorticoid if lesions are mild.

Phase II

The aim is to prevent recurrence of flare-up.

  • Topical Medications:
  • Proactive topical glucocorticoid treatment of previously affected areas twice weekly can help prevent allergic flares
  • Proactive use of antiseptic (e.g. chlorhexidine) shampoos, mousses, and wipes can help prevent yeast and bacterial overgrowths
  • Oral Medications:
  • In patients with allergies with severe inflammation and skin thickening:
  • Consider cyclosporine or short courses of oral glucocorticoids
  • In patients with allergies with minimal inflammation and skin thickening:
  • Consider lokivetmab, oclacitinib, or ilunocitinib
  • Immunotherapy is the only treatment to retrain the immune system and reduce the amount of medication needed long term
  • Allergy avoidance can be attempted
  • Treatment strategies can be reassessed periodically

Was treatment for pruritus successful?

Complete Response
Partial or No Response