Prevention of canine Atopic Dermatitis, cutaneous Adverse Food Reactions and Feline Atopic Skin Syndrome

Given what we know about the pathogenesis of cAD, is prevention possible?

cAD is a syndrome with a genetic predisposition involving an altered skin barrier that allows contact between allergens and the immune system. Prevention can therefore focus on supporting the skin’s inherent weakness with specific diets or topical treatments, reducing allergen exposure on the skin, or moderating immune responses with medications such as corticosteroids.

What role does nutrition play in terms of prevention in dogs?

Despite the genetic skin alterations, nutrition is fundamental to skin strength. By supporting skin quality with key nutrients such as zinc, EPA/DHA, and vitamins, skin permeability - and consequently allergen exposure - can be reduced. This approach also applies to skin inflammation, as compounds like polyphenols can help mitigate underlying chronic inflammation.

What are your main recommendations on how to use nutrition in terms of prevention in dogs?

In terms of prevention, the inherited skin defect itself cannot be avoided, so no intervention can prevent cAD entirely. However, nutrients that strengthen skin health can limit transepidermal allergen entry and nutrients that reduce skin inflammation can help prevent severe acute flare-ups. While nutrition cannot prevent cAD, it can help reduce the severity of dermatitis.

How often is atopy diagnosed in the feline population?

Cutaneous lesions associated with feline allergy were characterized quite recently, in late 2021, and designated as Feline Atopic Skin Syndrome (FASS). Compared to cAD, there is limited research on FASS, and its epidemiology is less well understood than in dogs. However, it is believed that the prevalence of FASS is similar to that of cAD. As for CAFR, it appears to be rare in cats, with a prevalence ranging from 0.2% in the general cat population to up to 21% in cats with pruritus.

Are there specific nutritional recommendations for Feline Atopic Skin Syndrome at this point?

Although the etiopathogenesis in cats is not yet well understood, the syndrome is considered to have enough similarities with human atopy, which also shares similarities with canine atopy. Therefore, the recommendations for enhancing skin health remain valuable.

What are your top tips for the long-term management of Feline Atopic Skin Syndrome?

FASS is a complex and multifactorial condition, and more randomized controlled trials are needed to understand its pathogenesis and properly assess therapeutic options. The therapeutic arsenal for the long-term management of FASS includes validated solutions such as systemic glucocorticoids, cyclosporine, and others. There is limited evidence for the efficacy of topical glucocorticoids, while antihistamines and fatty acids show low to moderate efficacy. Additionally, supporting skin health through diets, shampoos, and moisturizers is also important to consider.

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