WELCOME…

CiTiVET

ITCHY PETS?SCRATCHING BENEATH

THE SURFACE

CiTiVET

Presented by : Dr. Peter van der Merwe

WHAT IS ITCHINESS?• The desire to scratch, lick, rub, chew and

nibble at skin surface in response to chemical stimulus.

• Itchiness causes discomfort and decreases pet’s quality of life.

Usually living with a frustrated owner

“An itchy pet is an unhappy pet”

THE MOST COMMON CAUSESOF ITCHING:

External parasites :•

Fleas• Mange mites• Lice

Common causes of itching• Allergies:

• Atopy (hayfever)• Caused by interaction of abnormal

• Skin barrier genes• Immune function genes• Exposure to allergens & pathogens• Allergens incl house dust, dust & storage mites, pollens, moulds• Characterised by initial seasonal occurrence & “flare ups”

• Flea bite allergy• Abnormal response to flea saliva• Often worse in atopic individuals

• Food • Itchy skin sometimes with digestive upsets• Usually non seasonal -> ears, rears, paws

• Contact allergies• Very rare,

Skin infections

• Staphylococcus

• Streptococcus

• Yeast (Malessia)

Bacteria

WHAT HAPPENS TO THE SKIN?NORMAL SKIN

NORMAL SKIN

Inflamed skin

TreatmentFlea control• Adulticides on pet e.g Frontline,

Advantage, Practic• Capstar• Enviromental control pyrethroids and

methoprene• Sprays -> Flego, Ultrum Duration

Treatment of mange mites• Revolution• Advocate• Amitraz dips such as Amitrax, Triatix

Control skin infections• Bacteria – Anti bacterial shampoos and

wipes• Antibiotics

• Yeast – Shampoos• Anti Fungals (eg Ketazol)

• Allergic skin disease– Atopy

• Can’t be cured, only controlled• Multimodal approach is essential• First control parasite & microorganism infections• High quality diet especially fish based -> hypoallergenic

formulations are best• Omega 3 supplementation• Barrier treatments

– Allerderm – decreases secondary infections, less effect on itchiness– Shampoo – best is Allermyl but physical action of washing is most

important, bath 1-2x weekly

• Topical -> new cortisone spray Cortavance

Treatment

• Corticosteroids • Best given as short acting tablets eg lenisilone• Many side effects including weight gain, urinary tract

infections, increase risk of skin infections, decrease in bone and muscle strengths• Safe annual dose calculated as 30x dog’s body weight

in milligrams of steroid i.e. 10 kg dog can take 300 mg of steroid over a year

Treatment

• Cyclosporin• New drug being launched today• Long term control not for use in controlling acute flare

ups• Side effects

– Very Expensive– Vomiting in approximately 30% of patients– Hriutism, gingival hyperplasia, urinary tract infections– Rare s/e unmasking systemic infections e.g. fungal infections

and Toxoplasmosis– In humans may increase risk for lymphoma (cancer) – not

proven in dogs

Treatment

• Antihistamines– Only work in 10% of patients– Generally safe and used with other treatments

especially cortisone.– Main side effect is sedation but should be used

with caution in animals with glaucoma, heart disease, urinary bladder problems

Treatment

Treatment• Immunotherapy– Based on blood tests of IgE levels– Problem ->approximately 30% of atopic dogs do not have

raised IgE levels– Test does not indicate if raised IgE is causing symptoms,

merely that IgE level is high– HOWEVER immunotherapy is the only treatment that

allows us to reverse part of the pathology, works for majority of patients, reasonable cost

Treatment• If all else fails– Gabbapentin -> acts on nerve endings– Maropitant (Cerenia) -> substance P– Pentoxfyline

– Prayer

• Diet trail essential for diagnosis, blood tests are inaccurate• Diagnosis confirmed by provocative exposure• List of common food allergens include– Beef, lamb, chicken– Soya– Maize, rice, wheat

• avoid all protein treats, faeces (cat poop!!)• Commercial diet trail foods are superior to home cooked

diets• Treatment -> avoid offending foods

Food Allergies

• Thanks once again to all our client who continue to support us

• Genna van der Merwe • Tamsen Maritz• Royal Canin• Afrivet• Citivet staff

Acknowledgements

• Itching to get answers??

Questions??