Journal watch18 February 2024
Author(s): Miller, J., Simpson, A., Bloom, P., Diesel, A., Friedeck, A., Paterson, T., Wisecup, M. and Yu, C-M.
Published in: Journal of the American Animal Hospital Association
Date: November 2023
DOI: https://doi.org/10.5326/JAAHA-MS-7396
Type of access: Free access
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Our summary
Miller, J. et al. (2023) 2023 AAHA Management of allergic skin diseases in dogs and cats guidelines. Journal of the American Animal Hospital Association, 59 (6), pp. 255–284.
The aim of these consensus guidelines, prepared by a task force of experts convened by the American Animal Hospital Association, was to provide a step-by-step approach to the diagnosis and management of flea allergy, food allergy and atopy in dogs and cats. The production of the guidelines was supported by Hill’s Pet Nutrition, Merck Animal Health, and Zoetis.
The guidelines are structured in sections which cover diagnosing and treating the allergic canine patient; diagnosing and managing the allergic feline patient; Otitis Externa; the spectrum of care considerations in managing allergic skin diseases; technician utilisation in managing allergic skin diseases, and client communication. Detailed diagnostic and treatment plans for flea allergy, food allergy and atopy in dogs and for feline atopic skin syndrome in cats are given.
There is emphasis on a multimodal approach that is tailored to the individual patient with frequent, and ongoing communication with the client which should include discussions of the possible spectrum of care. Top three takeaways are given in each section and recommendations are made throughout, these are classified as technician, spectrum of care or referral recommendations.
Key recommendations include that in all cases a detailed history should be taken; a physical examination must be performed with particular attention paid to ears, skin folds, and paws; a minimum dermatologic database should be collected, including cytology of skin and ears and that clients should be prepared for the fact that these cases require lifelong maintenance and treatment, and that an occasional flare up should be expected.
There is no explicit statement of the methodology used to develop the guidelines.
Take home
These guidelines provide a practical guide to best practice when managing allergic skin diseases in dogs and cats. The use of graphics and flowcharts makes the information easily accessible and the discussions on the role of veterinary technicians (nurses) and on managing cases withing existing resource constraints are particularly useful.
The following may also be of interest
Evidence collection: Quality of life assessment tools: disease specific assessment tools: other conditions: skin disease [RCVS Knowledge] [online] Available from: https://www.rcvsknowledge.org/resource/quality-of-life-assessment-tools/ [Accessed 16 February 2024]
Evidence collection: Caregiver burden and the client perspective on veterinary care: client perspective and caregiver burden in specific conditions: skin disease [RCVS Knowledge] [online] Available from: https://www.rcvsknowledge.org/resource/caregiver-burden-and-the-client-perspective-on-veterinary-care/ [Accessed 16 February 2024]
Journal watch: A randomised controlled trial testing the rebound-preventing benefit of four days of prednisolone during the induction of oclacitinib therapy in dogs with atopic dermatitis [RCVS Knowledge] [online] Available from: https://www.rcvsknowledge.org/resource/a-randomised-controlled-trial-testing-the-rebound-preventing-benefit-of-four-days-of-prednisolone-during-the-induction-of-oclacitinib-therapy-in-dogs-with-atopic-dermatitis/ [Accessed 16 February 2024]
Journal watch: Treatment of the feline atopic syndrome – a systematic review [RCVS Knowledge] [online] Available from: https://www.rcvsknowledge.org/resource/treatment-of-the-feline-atopic-syndrome-a-systematic-review/ [Accessed 16 February 2024]
Long, S. (2020) Managing atopic dermatitis in dogs: are antihistamines as effective as glucocorticoids? Veterinary Evidence, 5 (4). https://doi.org/10.18849/ve.v5i4.335
Cheung, B.Y.T (2022) In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the score of a recognised scoring system? Veterinary Evidence, 7 (2). https://doi.org/10.18849/ve.v7i2.569
Spectrum of Care
The Spectrum of Care Initiative [AAVMC] [online] Available from: https://www.aavmc.org/the-spectrum-of-care-initiative/ [Accessed 16 February 2024]
Brown, C.R. et al. (2021) Spectrum of care: more than treatment options. Journal of the American Veterinary Medical Association, 259 (7), pp. 712-717. https://doi.org/10.2460/javma.259.7.712
Conversation guide for delivering contextualised care [RCVS Knowledge] [online] Available from: https://www.rcvsknowledge.org/resource/conversation-guide-for-delivering-contextualised-care/ [Accessed 16 February 2024]
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