Atopic Dermatitis in Dogs and Cats

Atopic dermatitis is the most common reason for dog and cat owners to visit their local veterinary clinic. Several breeds are prone to this condition but there also may be an underlying genetic predisposition. As a compounding pharmacist, we often get pet owners to visit us regarding this before going to their veterinarian.

Common Treatment Options
Appropriately resolving pruritus and elimination of causative agents are the first priority. This includes evaluation of diet, environmental allergens, etc.  The common treatment, Apoquel is effective but poses a few problems. This medication tends to have availability issues, inability to tolerate and dosing may not fit your particular client since it is an oral tablet. This could be remedied by compounding into a flavored fixed oil suspension for dosing accuracy with the help of Pharmacy Solutions. Other formulations to consider are Naltrexone and Tranilast. Naltrexone for acral lick granulomas due to atopy has been shown effective. The theorized mechanism of action is that the naltrexone blocks the release of endogenous opioids, which increased the perception of pain and lessened the licking behavior.² The mast-cell stabilizer tranilast can be used topically or orally. In cases of compromised skin with possible infection other anti-infectives and antipruritics can be combined for comprehensive therapy.

• Naltrexone HCl 1%/Pramoxine 1% in Pracasil Base

• Naltrexone HCl 2.2mg/kg by mouth daily

• Tranilast 1%/Diphenhydramine 2% in Pracasil Base

References
1.    Moriello, K. A. (n.d.). Overview of atopic dermatitis. Merck Veterinary Manual. Retrieved from http://www.merckvetmanual.com/integumentary-system/atopic-dermatitis/overview-of-atopic-dermatitis 
2.    White, S. D. (1990). Naltrexone for treatment of acral lick dermatitis in dogs. Journal of the American Veterinary Medical Association, 196(7), 1073-1138.