Intradermal allergy testing | serum allergen evaluation | Bouzer the Saint Bernard
Name: Bouzer | Age: 2 years | Breed: St Bernard
IDT test
History: Bouzer presented to Animal Dermatology Clinic-Perth for further investigation of seasonal atopic dermatitis. His history included recurrent episodes of bilateral otitis externa since 12 months of age and multiple courses of topical ear medications. Bouzer’s owners complained about his severe, constant pedal pruritus. He had received several courses of oral glucocorticoids but his owners were reluctant to continue this strategy because of the potential for adverse effects.
Test /Procedure: Intradermal allergy skin testing and serum allergen evaluation were performed after the initial dermatology consultation. External ear cytology and skin surface cytology on the paws determined whether there was an underlying secondary infection contributing to his pruritus.
Results: Bouzer’s intradermal skin test demonstrated very positive reactions to a wide range of grass and tree pollens (see below) This cutaneous reaction pattern is known as pollinosis. A bilateral mixed bacterial and yeast overgrowth was identified in both ears.
Diagnosis:
Atopic dermatitis and chronic bilateral allergic otitis externa.
Treatment:
A treatment plan to manage the acute problems was carefully formulated. Bouzer will commence oclacitinib (Apoquel®) twice a day to reduce his pruritus and inflammation. Topical antibacterial drops for the otitis externa as well as medicated shampoos to reduce the surface microbial burden are indicated. A combination of therapies are commonly recommended in veterinary dermatology. When used together, they are often much more effective than a single treatment.
Prevention or Follow up:
Bouzer will commence immunotherapy in order to desensitise him to the environmental airborne pollens he is allergic to. The desensitisation process aims to induce a tolerance to allergens when the dog is exposed to them. Avoidance is very difficult as most environmental allergens are airborne and the source of the allergen is often some distance from the patient. Immunotherapy is the safest long term allergy treatment for atopic dogs and cats. Immunotherapy can be highly effective in managing pruritus and chronic skin and ear infections and reducing reliance on drugs.