Reasons Your Dog is Itching Despite Medication

There are a few reasons that could be why your dog is itching — different “flare factors” can increase your dog’s itching despite being on previously-effective medication. A flare factor is a condition that causes dramatic worsening of itching or skin inflammation that was previously under control. These factors include fleas or mites, Staph (bacteria) or yeast (fungal) infections, and food allergies. If you’re noticing an increase in your dog’s scratching, they may have developed one or more of these flare factors that are pushing them over their “itch threshold” despite being on anti-itch medication.

Fleas

Flea control is crucial for managing allergic itch. If you only use flea preventative when you see fleas or just during summer months, your dog is at higher risk for developing flea allergy.1 Aggressive flea treatment helps keep your dog below their allergic itch threshold, making it easier to control chronic itch.

Staph or Yeast Infections

Dogs with environmental allergies (atopic dermatitis) have increased Staph and yeast on their skin compared to normal dogs, due to a breakdown in their protective skin barrier. This can lead to skin and ear infections. Your veterinarian can prescribe oral, injectable and topical medications to treat these conditions.

Food Allergies

The most common food allergens are animal proteins, but grain-free diets are not likely to be helpful. The best way to determine what food allergies your dog might have is an eight-week elimination diet followed by food challenge trials. Mislabeling of over-the-counter dog food is common, even with hypoallergenic ingredients, so a prescription or veterinarian-supervised home-cooked diet is often best.

Seasonal Allergies

Seasonal spikes in pollen levels can also cause a flare.

The reason for the flare-up in your dog’s scratching needs to be addressed – whether it’s getting back on track with a flea preventative, a prescription treatment for a bacterial or fungal skin infection, or a vet-monitored food trial to determine any food allergies that your dog might have developed. Your dog’s immune system can only handle so much, and a combination of these factors can push your dog over their “itch limit” and can make them uncomfortable.

Flare Factors & Their Signs

Flare Factor	Typical Signs	Diagnostic Steps	Treatment Options
Fleas/Mites	Scratching, hair loss, flea dirt	Flea comb, skin scraping	Year-round flea control
Staph/Yeast	Redness, odor, greasy skin, ear issues	Skin cytology, culture	Antibiotics, antifungals, medicated baths
Food Allergies	Persistent itch, GI upset, ear infections	Elimination diet, food trial	Prescription diet, vet-supervised home cooking
Seasonal Allergies	Flare-ups in spring/summer, face/paw itch	History, allergy testing	Immunotherapy, anti-itch meds

Proactive Treatment for Dogs with Environmental Allergies

Dogs with environmental allergies can benefit greatly from the following proactive treatments and management^[2,3]:

Control their itch and inflammation with effective and safe prescription medication.
Work with your veterinarian to find the underlying cause of your dog’s itch.
Make sure your dog is on year-round flea control — your veterinarian can recommend the best option for your dog. An oral treatment versus a topical solution may be best because you’ll likely be bathing your dog regularly.
Bathe your dog weekly with a medicated or hypoallergenic shampoo and use anti-itch sprays and/or mousse as recommended by your vet. This will help prevent Staph and yeast infections, which are major flare factors as they weaken your dog’s natural skin barrier and make them more susceptible to allergens.
Keep your dog on a high-quality dog food, preferably with a high fatty acid content that will support their skin barrier.
Consider asking your vet about allergen immunotherapy — either injections under the skin or allergy drops given orally to normalize your dog’s immune response to allergens.
Work closely with and stay in touch with your vet (or even a board-certified veterinary dermatologist) to keep flares and other skin problems to a minimum.

By taking some steps to prevent flare factors, your dog’s regular anti-itch medication should work more effectively, and your dog will be more comfortable.

Dr. Michele Rosenbaum, VMD, DACVD

Born in North-Central NJ, Dr. Rosenbaum received her VMD with honors from the University of Pennsylvania. After 4 years of private small animal practice in northern NJ, she returned to the University of Pennsylvania and completed her residency in Dermatology and Allergy, obtaining board certification from the American College of Veterinary Dermatology, then continued as a Lecturer in dermatology at Penn. She then joined a multi-specialty referral practice in Rochester, New York where she practiced for 10 years before joining Zoetis. Dr. Rosenbaum has lectured extensively and has published articles on a wide variety of dermatology topics. Her areas of particular interest include canine and feline allergic dermatitis and management of recurrent and resistant pyoderma.

Brought to you by Zoetis

IMPORTANT SAFETY INFORMATION: See full Prescribing Information. Do not use Apoquel or Apoquel Chewable in dogs less than 12 months of age or those with serious infections. Apoquel and Apoquel Chewable may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. Consider the risks and benefits of treatment in dogs with a history of recurrence of these conditions. New neoplastic conditions (benign and malignant) were observed in clinical studies and post-approval. Apoquel and Apoquel Chewable have not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. Apoquel and Apoquel Chewable have been used safely with many common medications including parasiticides, antibiotics and vaccines.
INDICATIONS: Control of pruritus (itching) associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age.

References:
1. Wilkerson MJ et al. The immunopathogenesis of flea allergy dermatitis in dogs. Vet Immunol Immunopathol 2004; 99:179-19
2. Olivry T, et al. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol. 2010;21:233-248.
3. Olivry T et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Veterinary Research 2015; 11:210.