The diagnostic approach to the pruritic dog is summarised in figure 4. In treating atopic dermatitis it is imperative to consider the situation as a whole. Bacterial infections will make the animal far more itchy and may even contribute to worsening the allergy through damaging the skins' protective mechanisms. Corticosteroid medication is best withdrawn throughout the period of treatment as steroids can interfere with the dogs ability to fight infection. Spots are not seen in this disease, but instead the organism causes redness, geasiness and a mousy odour.
Dogs can be quite depressed when infected and can be extremely itchy.
Treatment is usually with baths containing enilconazole, or miconazole in combination with chlorhexidine. Tablet therapy is also available, but as a surface infection Malassezia is best treated using baths. Similarly, fleas and other ectoparasites will make an atopic dog far more itchy. All allergic animals should have regular and efficient flea therapy using veterinary preparations to treat both the dog and the environment. With bacterial, yeast and parasitic problems under control most dogs will be very much more comfortable and some may only need minimal therapy using the least potent of the drugs available.