Refractory atopic dermatitis therapy

摘要

Wayne Rosenkrantz (USA) opened the workshop with general comments and an introduction to the topic. He emphasized that this was to be an interactive discussion. Each attendee received a 'clicker' for the Turning Point Technology interactive system generously provided by Pfizer Animal Health. This technology allows for immediate polling of the audience and records the results to stimulate further discussion and for data response collection.The discussion started with a presentation of a sample case of refractory atopic dermatitis in a 5.5 kg 12-year-old male castrate bichon frise. Overall, Wayne Rosenkrantz had noted that this breed has a tendency to have a higher incidence of refractory canine atopic dermatitis. This patient had a many year history of intense, self-mutilating pruritus. Numerous medications had been tried. The dog had a history of a partial response to glucocorticoids, but had failed two rounds of allergen-specific immunotherapy (ASIT) of adequate duration, and had had numerous elimination diet trials with no response. In the month prior to the referral, he had had a selamectin treatment trial. At presentation, the patient was receiving oral gabapentin 100 mg every 12 hours, phenobarbital 15 mg every 12 hours, and dexamethasone 2 mg twice weekly. The phenobarbital was prescribed by the primary veterinarian in an attempt to deal with what he felt to be a severe psychogenic component. The patient had subsequently been examined by an American College of Veterinary Dermatology (ACVD) diplomate, and gabapentin and dexamethasone were prescribed.