ATOPIC DERMATITIS.

ATOPIC DERMATITIS.The arsenal of treatment options for dogs with atopic dermatitis is expanding. It includes corticosteroids, which have been around the longest, as well as Cytopoint, which gained FDA approval at the end of 2016. It is extremely important to note that not all drugs are created equal, and you should not use the same treatment option for each patient. This article reviews the major systemic drugs for atopic dermatitis used in everyday practice. Corticosteroids have been used for decades and have withstood the test of time. Corticosteroids are non-specific in their mechanism of action, since corticosteroid receptors are in every cell. Side effects of corticosteroids are well known. They can be great at decreasing the inflammation associated with atopic dermatitis, but long-term treatment is not recommended. I use them regularly for short courses to battle flare ups in patients that were well-controlled otherwise. My steroid of choice is commonly Temaril-P due to the anti-inflammatory effects, while using less than half the amount of steroids in an anti-inflammatory dose. The side effects can be less significant with Temaril-P. Atopica is the veterinary microemulsified formulation of cyclosporine, which has been available for about 16 years. Atopica mainly affects T cells. The most significant side effect observed is gastrointestinal, with up to 40 percent of patients experiencing this side effect in some studies. I advise owners to give it with a meal instead of on an empty stomach, which brings the prevalence of gastrointestinal upset among my patients to about 5 percent. continue