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

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Drug Name	Acute Flare	Long-term Management	Advantage/Disadvantage
Oclacitinib	✓	✓	Very rapid onset of action (hours) Does not interfere with intradermal allergy testing and immunotherapy Antipruritic and anti-inflammatory
Oclacitinib	✓	✓	Not for use in dogs <1 yr of age Do not use in the presence of deep skin or systemic infection, neoplasia, or history of neoplasia Has not been tested in dogs receiving other long-term allergy medications such as corticosteroids and cyclosporine
Lokivetmab	✓	✓	Safe for use in puppies and dogs with comorbidities (neoplasia, infection, systemic disease) Does not interfere with intradermal allergy testing and immunotherapy Biologic compound Safe to use in combination with other medications
Lokivetmab	✓	✓	Must be administered at veterinary clinic Variable onset of action (hours to 3 days)
Corticosteroids	✓	✓	Rapid onset of action Antipruritic and anti-inflammatory
Corticosteroids	✓	✓	Side effects common
Allergen-specific immunotherapy	X	✓	Safe to use in combination with other medications Only management strategy that induces change in the immune response Biologic compound
Allergen-specific immunotherapy	X	✓	Slow onset of action (months to 1 yr) Requires intradermal or serum allergy testing
Cyclosporine	X	✓	Does not interfere with intradermal allergy testing
Cyclosporine	X	✓	Slow onset of action (weeks) Side effects common (gastrointestinal, hirsutism, gingival hyperplasia, papilloma) Requires periodic monitoring of hepatic enzymes and blood cell counts
EFAs	X	✓	May have steroid-sparing benefits
EFAs	X	✓	Slow onset of action (weeks to months)
Antihistamines	X	✓	Side effects uncommon
Antihistamines	X	✓	Questionable efficacy—may only be effective in mildly pruritic animals

EFAs, essential fatty acids.

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Guidelines Contributors

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.