Table 1: Antipruritic and Anti-inflammatory Medications for Dogs

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Drug Name	Oclacitinib¹	Lokivetmab²	Cyclosporine³	Glucocorticoids⁴
Mode of action	JAK-STAT inhibitor that blocks signaling from proinflammatory and pruritogenic cytokines	Caninized monoclonal antibody that neutralizes the pruritogenic cytokine IL-31	Calcineurin inhibitor that modulates T-cell function	Influences gene expression of proinflammatory cytokines
Administration	PO q 12 hr up to 14 days, then reduce to q 24 hr	SC injection at veterinary office q 4-8 wk	PO q 24 hr	PO q 12-24 hr with taper Injectable not recommended
Time to onset	Hours	Hours to 3 days	4-6 wk	Hours
Age	>1yr	Any	>6 mo	Any
Weight	>3 kg	Any	>1.8 kg	Any
Health restrictions	History of demodicosis History of neoplasia Serious infection	None	History of neoplasia Renal insufficiency	Congestive heart failure Diabetes mellitus Hyperadrenocorticism Hypertension
Adverse reactions	Vomiting Diarrhea Nonspecific dermal masses Demodicosis Pyoderma	Vomiting Diarrhea Lethargy Pain at injection site Rare: Hypersensitivity effects (urticaria, facial edema, anaphylaxis)	Vomiting Diarrhea Gingival hyperplasia Hirsutism Cutaneous papillomatosis Drug interactions	Polyuria/ polydipsia Polyphagia Panting Obesity Muscle wasting Iatrogenic hyperadrenocorticism Congestive heart failure

JAK-STAT, Janus kinase signal transducers and activators of transcription; PO, orally; SC, subcutaneously.

Apoquel (oclacitinib tablet). Package insert. Zoetis, 2020.
Cytopoint. Package insert. Zoetis, 2015.
Atopica (cyclosporine capsules). Package insert. Elanco, 2020.
Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. The Vet Jour. 2016;207:29–37.

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Introduction

Figure 1: Diagnosing Allergic Skin Disease in the Canine Patient

Table 1: Antipruritic and Anti-inflammatory Medications for Dogs

Table 2: Acute Flare and Long-term Management Therapies in Dogs

Table 3: Oral Antihistamine Doses for Dogs

Figure 4: Assessing Diet Trial Results

Table 4: Antimicrobials for Skin Infections in Dogs

Table 5: Oral Antifungal Medication Doses for Dogs

Figure 5: Clinical Presentation of the Feline Patient

Figure 6: Diagnosing Allergic Skin Disease in the Feline Patient

Table 6: Antipruritic and Anti-inflammatory Medications for Cats

Table 7: Acute Flare and Long-term Management Therapies in Cats

Table 8: Oral Antihistamine Doses for Cats

Reformulated Topical Medications for Management of Allergic Otitis Externa

Figure 7: Flowchart of Technician Utilization for Allergic Skin Diseases

Figure 8: Client Communication Flow Chart for Treatment Plans

10 Key Messaging Points When Talking to Clients

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Developing the Guidelines

The 2023 AAHA Management of Allergic Skin Diseases in Dogs and Cats Guidelines are generously supported by Hill’s Pet Nutrition, Merck Animal Health, and Zoetis.