Shiba Inu Skin Allergies – Ultimate Resource and Guide

Phew, this website is a labor of love and largely a one-woman show so unless indicated, all articles written by J.Tsukamoto

One of the most common and perplexing health problems of Shiba Inus are allergies - specifically skin allergies.

And unlike other ‘good’ diseases which are easy to diagnose and therefore easy to treat - diagnosing skin allergies is complex and time consuming.

Is it an environmental allergy, food allergy, or flea allergy??

While treating a flea allergy (F.A.D) is straightforward - environmental allergies usually require various therapies to successfully manage the condition.

Needless to say, a skin allergy is a DIFFICULT and frustrating disease to tackle.

This article is dedicated to helping you understand skin allergies so that you may choose an appropriate treatment path with guidance from your trusted veterinarian.

We’ve done a ton of research - going through dozens of clinical studies to bring forth information that is scientifically backed (links provided throughout) - and not just your typical “Internet” advice.

No corners were cut in bringing our readers the most up-to-date information on canine atopic dermatitis.

We’ve  got the opportunity to correspond with Nathalie Abutaha, founder of Pawsitively Primal about their Shiba Inu allergy program that has so far experienced an *almost 100% cure rate. (*One Shiba in the allergy program recently succumbed to cancer)

At Pawsitively Primal, Nathalie and her extensive team of volunteers focuses on healing and strengthening their Shiba Inu's body and immune functions versus "covering up" symptoms with medications that can cause severe long term side effects. 

Her input on canine gut health, microbiomes, the "Hygiene Hypothesis", and a species-appropriate diet has been invaluable in helping to shape the content of this post.

And what's impressive about Pawsitively Primal's allergy program is that they DO NOT use harsh prescription medications (steroids, Apoquel, antibiotics, etc. unless medically necessary) to treat their allergy dogs.

If that's not enough on her plate, Nathalie also heads DC Shiba Inu Rescue (DCSIR). There she and her large team of volunteers care for, rehabilitate, and find Shiba Inus loving homes. 

Links to Nathalie's organization and clinical studies will be posted at the end of the article. ***Please note that Pawsitively Primal and DCSIR are completely separate organizations so all inquiries relating Shiba Inu health topics should be sent to Pawsitively Primal. 

DCSIR Shiba rescue is solely for Shiba rescue, fostering, and rehoming.

Note : This article is comprehensive and will go over most conventional treatments (prescription medications, immune therapy, etc) for canine allergies.

Please note that this information is provided to give you a basic understanding of some of the most options available.

It is critical that you consult with your veterinarian to discuss the best options for your dog.t

It does necessarily mean that any of these options are recommended or endorsed by Pawsitively Primal or My First Shiba. 

Any methods or recommendations that ARE endorsed by Pawsitively Primal or My First Shiba will be explicitly stated.

First, let’s start easy with a summary of the basics (symptoms and causes):

Symptoms of Canine Skin Allergies 

Canine skin allergies is commonly referred to as canine atopic dermatitis, or C.A.D.

Atopy is a genetic disposition to develop allergies and is associated with heightened immune reactions to common allergens. 

While allergies in humans commonly cause nasal symptoms - allergies in dogs commonly cause skin / and or G.I. Problems.

That’s because dogs have a higher proportion of histamine-releasing mast cells in their skin.

Allergy symptoms usually start appearing between the ages of one and three in most dogs.

The most commonly affected areas on the dog’s body include their paws, armpits, between folds of skin, stomach, groin, and ears.

Atopic dogs will engage in constant licking, chewing, and biting of the affected area leading to hair loss and open wounds.

And because atopic dogs usually have skin barrier dysfunction - secondary infections are common.

List of symptoms of canine atopic dermatitis:

• Itchy skin
• Oily skin
• Scabs
• Loss of fur
• Dry skin / dandruff
• Red / inflamed skin
• Scratching, licking, gnawing
• Incessant paw chewing
• Itchy / red eyes / eye discharge
• Face rubbing
• Recurrent skin and ear infections
  

Causes of Canine Atopic Dermatitis 

- Environmental Allergy - Contact / Inhalant

Environmental allergies also known as inhalant, contact allergies, are caused by substances found in the environment that trigger an allergic reaction. 

It’s also the most common cause of C.A.D.

Common environmental allergens include pollen, dust mites, and mold. 

If your dog only experiences allergies during certain times of the year, there’s a high probability that an environmental allergy is the culprit.

Environmental allergies are not only the most common - but also the most difficult allergy to treat.

That’s  because unless your dog resides in a “bubble” - it’s almost impossible to avoid allergens such as dust mites, pollen, etc.

Instead, a more long term solution would be to focus on strengthening your Shiba's immunity through lifestyle changes and possibly, immunotherapy.

- Parasites

Parasites, especially fleas are another common cause of C.A.D. 

Dogs that are specifically allergic to the bites of fleas have a condition referred to as flea allergy dermatitis or F.A.D.

Dogs who suffer from F.A.D. are also more prone to general C.A.D. caused by environmental allergies, food allergies, etc.

Shiba Inus in particular, seem to be especially susceptible to the miserable effects of F.A.D.

A single flea bite is usually enough to cause extreme itching and ripping of the fur that could last up to a week

Fortunately, F.A.D. is the easiest cause of C.A.D. to treat - you get rid of the flea issue and you'll get rid of the F.A.D. issue.

- Food Allergies

Dogs with C.A.D. caused by food allergens show the same type of common C.A.D. symptoms (itching, hair loss) along with gastrointestinal symptoms such as diarrhea and vomiting.

However true food allergies are not common - affecting roughly 5 -10% of dogs.

Food sensitivities / intolerances on the other hand, are much more common - and it’s important to understand the difference.

Although the symptoms between the two are very similar a true food allergy involves an immunological response whereas a food intolerance does not.

One negative aspect caused by the suspicion of a food allergy is the dog’s diet may get more restricted than it needs to be. 

A diverse diet is critical for maintaining good overall health.

Since the majority of dogs suffer from food sensitivities versus true food allergies, it’d be totally reasonable to maintain a diverse diet while slowly reintroducing the foods that your dog is sensitive to into their diet.

Some owners may not suspect food allergies / sensitivities as the cause of C.A.D. because their dog has been eating the same type of food for an extended period of time.

However, food allergies usually take time to develop and can show up later on in a dog’s life.

Diagnosing true food allergies is a time consuming process that takes a significant amount of commitment from the dog’s owner.

Food allergy testing requires stringent compliance to an elimination diet. The strict diet aims to find which types of foods trigger and immunological response.

This involves the use of novel proteins and starches that your dog has never consumed before.

If the dog shows improvement with the new foods, then more foods are slowly added until your dog shows an allergic response.

Only then will you have a clue as to what’s causing the food allergy. This process can sometimes take 10 - 12 weeks.

Blood tests are available but have been labeled as unreliable due to reports of multiple false positives.

- Allergy To Normal Bacterial Flora (Staph)

Bacterial hypersensitivity is caused by your dog’s immune system overreacting to the normal Staphylococcus bacterial found on your dog’s skin.

And it’s more common when other issues such inhalant / flea allergies and  hypothyroidism are also present.

Diagnosis is confirmed via bacterial cultures and biopsies.

Short / Long Term C.A.D. Effects:

• Intense itching
• Hair loss
• Inflamed wounds
• Scabbing, scarring, scaling
• Risk of infection
• Discomfort / low well-being
• Chronic ear infections
• Behavioral problems

Allergy tests are available for certain types of allergies - mainly seasonal and environmental allergies. 

The two commonly used tests are blood testing and intradermal skin prick testing

Allergy testing may be justified if you plan on having your dog undergo immunotherapy treatment in the future.

Intradermal Skin Prick Testing -

Intradermal allergy testing is considered “the gold standard” for diagnosing canine atopic dermatitis.

Testing involves shaving off a portion of the dog’s hair and injecting small quantities of allergens directly into the skin.

Typically around 50 injections of various antigens are injected into one area of the dog’s body (abdomen / lateral thorax).

The veterinarian then waits and observes for visible swelling at the injection sites which is a sign that the dog is reacting to the specific allergen.

While intradermal skin prick testing is highly accurate, there’s a few negatives / cons that come with this particular type of testing.

First off, it’s more expensive than blood testing.

It’s also contraindicated for a various conditions / reasons such as:

• Pregnant dogs / dogs in heat
• Dogs that are on topical steroids in the past 14 day
• Dogs on oral steroids within the past 30 days
• Dogs on long-acting steroids within the past 90 days
• Dogs who took antihistamines within the past past 7 days
• Dogs who consumed essential fatty acids within the past 7 days

These contraindications affect a lot of dogs that are typically already taking the various medications indicated to control their allergies.

Because of the number of injections necessary, sedation and or anesthesia is needed to perform the test. This rules out dogs who have underlying medical conditions that can be negatively affected by anesthesia. 

Many pet owners are also wary of putting their dog’s “under” for non life-threatening reasons.

And finally, intradermal allergy testing must be done by an experienced dermatologist.

Analyzing the results of skin prick reactions can be subjective thus requiring expertise and experience in interpreting results.

Blood Testing

Blood testing is the most common and convenient type of testing that involves checking the blood for allergen-specific antibodies. 

Depending on the laboratory, different techniques are utilized to perform the test which makes the outcomes of these tests variable in terms of accuracy and clinical relevance.

Although blood testing is much more convenient than skin prick testing - the results are less accurate.

However, reports do show that blood testing often produces positive outcomes in terms of clinical improvement.

Treating C.A.D. takes patience, persistence, and good record keeping.

C.A.D. caused by flea allergy dermatitis can be easily resolved with flea management - whereas treating C.A.D. due to environmental allergies is much harder and sometimes may never be fully resolved.

Successful treatment usually involves a multi-pronged approach that combines various forms of therapies. 

Certain methods will work better than others, so it’s important to take notes for later reference.

Basically, you'll likely to be doing a lot of trialing and erroring before you find a suitable therapy.

The most important advice we’d like to get across is the need to fully understand the implications of your chosen treatment path.

You, as your dog’s sole guardian and advocate, must take initiative to understand every single treatment option so you can engage in productive discourse with your vet.

Considering the serious implications of relying on strong pharmaceuticals, we believe it’s worth the extra time, effort, and expense to focus on the most natural and conservative forms of therapy as a first line of therapy.

If the therapy doesn’t work, move on to the next tiers of therapy until you can find a treatment plan that best suits your dog's needs for now while at the same time, considering your dog’s long-term health.

Medications such as antibiotics, steroids, and immunosuppressing drugs all have an important role and place in mediating the health of both dogs and humans.

But using these medications comes at the price of increasing antibiotic resistant bacteria, immune system damage, and other serious side effects - therefore judicious and responsible use is critical.

Improve Immune Response 

Improving your Shibas immunity and overall health should be started as soon as possible.

Consider this the foundation therapy that will complement and support future therapeutic interventions - that may or may not include the use of medications, allergy therapy, etc. 

BUT.

It must be reiterated that a visit to your veterinarian first is a must.

This especially applies to severe cases that may need medications to provide immediate relief to your dog and help get the issue under control.

The main components of improving your dog’s immunity and health are:

• Fresh Diet
• Supplements
• Strengthening microbiome
• Exposure To Environment / Exercise

Addressing these four elements can improve both C.A.D. as well as your dog’s overall health.

However it’s not an overnight fix. 

Doing it right takes commitment, time, and a tad bit of a bigger budget.

But the benefits make it all worth it if you truly want to improve your Shibas quality of life as well longevity.

In this section, Nathalie Abutaha or Pawsitively Primal shares her knowledge about nutrition, the microbiome, and the hygiene theory to positively improve our Shiba Inu's health.

Other advanced modalities that Pawsitively Primal incorporates include they use include:

•  Heliotherapy/Photobiomodulation
• Hydrotherapy: with Nanobubbles, Oxygen, and Anions for advanced hydrotherapy
• Mycology
• Zoopharmacognasy 
  

Be on the lookout for a future write up on their incredible organization.

Fresh / "Fresher" Diet 

Healthy, fresh foods with bioavailable nutrients will play a huge role in getting your dog healthier and happier -  especially if you are currently only feeding “kibble”.

While kibble is formulated to be nutritionally balanced via natural and synthetic vitamins / minerals -is it the best choice of nutrition for your dog?

Is it hard to deduce that a dry, lifeless diet full of preservatives, synthetics, and "left-over" waste ingredients would not be equivalent to a fresh, diverse, and balanced species appropriate diet?

Fortunately, many dog owners are finally figuring this out and are now looking for healthier options to offer their furry family members.

[TIDBIT] - Did you know that “kibble” was invented because the “fresher” dog food packed in cans could not be packed due to the shortage of canning material during World War 2?

Breakdown of not so great facts about “kibble”:

• Made of ‘left-over’ low quality byproducts
• made out of “roadkill”, euthanized pets (very common in the past / less so now that pet owners are more aware of commercial pet food industry practices)
• Dehydrated and drying
• Anything but fresh
• Chalk full of preservatives, synthetic ingredients, low quality imported vitamins / minerals (mainly China)
• Responsible for numerous pet deaths due to unsafe / toxic ingredients (melamine, 
• Mostly devoid of bioavailable nutrients
• Not something dogs / wolves ate for almost the entirety of their evolution

Offering your canine family member fresher food options will help build the crucial foundation of dog’s health and natural immunity.

However it’s important to note that feeding fresh requires quite a bit of commitment. 

It takes time, research, effort - and it’s not cheap.

But oh, the benefits. 

Once you start realizing the benefits of a fresh diet, you’ll likely question your reasoning for providing only dry, preserved kibble to such a beloved member of your family for so long.

Nathalie Abutaha of DSCIR quickly realized the benefits of feeding both her own dogs and her allergy dogs a species-appropriate raw diet.

The results to the dog's health was so dramatic, that in 2013 Nathalie switched DCSIR to an all raw fed Shiba rescue.

Understandably, not everyone has the time and or budget to go completely fresh, raw, etc.

Additionally, learning how to properly feed your Shiba a balanced raw diet is not easy.

Only those who are dedicated to learn the ins and outs of fresh feeding should attempt to feed raw / homemade. 

It'd also be highly recommended that a consult with a vetererinary nutritionist is done first.

Otherwise, you could be doing more harm than good by feeding your Shiba an unbalanced diet deficient if critical vitamins and minerals.

But we all can defintely do our best to feed our Shiba Inus better.

The following list provides various “fresher” feeding options to consider:

• Raw, species appropriate diet (made at home, properly balanced) (Only with the proper know-how)
• Raw, balanced, frozen diet (purchased from reputable source) 
• Home lightly cooked diet (properly balanced, supplemented, occasional raw proteins)
• Home cooked purchased diet (from reputable source)
• Freeze-dried raw, with additional veggies (purchased from reputable source)
• Uber high quality kibble rotated with above four options (60% kibble / 40% fresh / raw)
• Average quality kibble rotated with above four options (40% kibble / 60% fresh / raw)

If you have never prepared raw, home cooked balanced meals for your dogs, the most critical thing you should know is that achieving balance without supplementation is extremely difficult.

Don’t think that home cooking for dogs means throwing some chicken, starch, and vegetable into a doggy bowl and calling it a day is all it takes.

Not enough close.

In fact, feeding your dog an unbalanced fresh meal is dangerous to your dog’s health - basically defeating the whole purpose of you trying to improve your dog’s health.

So until you’ve taken the time to learn what it takes to prepare a fresh diet for your dog - start with purchased fresh options mentioned in the above list.

Also it’s beneficial to feed your dog a diverse diet which means rotating menus on a regular basis.

Instead of sticking to only a few feeding options, be sure to change it up periodically.

Feed what’s fresh and in season. And on sale. 

Your Shiba’s health, taste buds, and your wallet - will thank you for it.

Supplements

Supplements are all the rage for us humans.

So it makes total sense that it’s likely beneficial for our dogs as well.

Supplementing your dog’s diet with appropriate and safe supplements will add extra nutrition ammunition as well as diversity.

Just remember that not all human foods are safe for dogs.

Always check that the human foods you provide your dog is safe before feeding. 

There’s been some studies that show that omega-3 supplementation is helpful for dog skin conditions as well as having a "steroid-sparing" effect. 

[TIDBIT] - Steroid Sparing means the ability to use less steroids by incorporating other agents. (for example a study found that using omega-3's and a antihistamine initiated a "steroid sparing effect.")

As with all supplements, do your research to ensure you’re getting a high quality supplement.

 Supplements to Consider:

• Fermented foods like: Natto, 
• Fermented pumpkin seeds
• Fresh broccoli sprouts
• Bitter vegetables (mustard greens, bitter melon)
  
• High quality Omega-3 supplementation
• Spirulina (fresh powder)
• Astaxanthin

Exercise and Exposure To the Natural Environment

It’s a no-brainer that sufficient exercise is beneficial to your Shiba’s health.

Exercise preserves muscle, controls weight, improves digestion, mood, well-being… The list goes on.

 Just be sure you’re doing it safely by taking into consideration your dog’s age and abilities.

Get Your Dog Dirty With The “Hygiene Hypothesis” (H.H.).

I first learned of the Hygiene Hypothesis from Nathalie of Pawsitively Primal.

The information she shared me about this topic was truly fascinating. Her Facebook and YouTube page has tons of awesome content about this subject.

The hygiene hypothesis is in a nutshell is this:

With humans - children specifically - numerous studies have shown that exposure to various types of bacteria may be beneficial.

This early exposure to various commensal microbiota strengthens the child’s immune system and increases the diversity of the child's microbiome environments. 

Clinical studies show that early life microbial exposure can reduce a child’s chance of developing allergies, asthma, rhinitis, eczema, and food allergies. 

Currently, there’s not many companion animal clinical studies showing these same correlations.

Additionally, the term "hygiene hypothesis" may be flawed in a sense that it correlates low hygiene to better health - which is far off from reality.

Several proponents of the hygiene hypothesis theory believe that the term "microbial deprivation hypothesis" is a more fitting and useful term. 

[CAVEAT] - It's important to realize that most theories and hypotheses have flaws and are not 100% accurate. With the H.H., it would be dangerous to think that it's beneficial to be exposed to just any types of "germs" - because it's not. Certain bacteria can actually induce and or exacerbate asthma and other serious diseases.  So in this case, it's critical to differentiate between proper hygiene and beneficial microbiota. [ Translation: Exposure to diverse microbiota = Good! Exposure to antibiotic resistant superbugs = NOT SO GOOD! ]

So while there’s no definite proof the hygiene hypothesis also applies to dogs - it’s still something worth thinking about.

Improving your dog’s microbiome via exposure to microbes, and beneficial bacteria is not exactly an easy "mainstream" therapy to recommend. 

But it’s seriously something to learn more about and consider.

It simply means stop over sanitizing - especially the use of antibacterial products.

It also means getting your Shiba out more - on hikes, walks, etc - and not caring if dirt is involved at times.

At Pawsitively Primal, Nathalie lets exposes her dogs to the RSP, or the local / regional species pool in order to strengthen their microbiome. 

A regional species pool is basically the natural environment surrounding the dog including the soil, water, animals, and vegetation.

(Be sure to avoid areas that are chemically treated (Round-Up, etc)

Letting your dog get up and personal with the natural environment has numerous benefits - provided you take heed to common sense. (Stay away from poison ivy, skunks, and questionable bodies of water) 

Improving Your Dog's Microbiome

Nathalie of Paswitively Primal shares excellent content about the importance of a healthy microbiome for your Shiba's overall health.

A microbiome is a community of microorganisms coexisting together in a particular habitat such as your dog’s gut or skin.

A balanced and flourishing microbiome is one of the top indicators of good health and immunity.

A healthy microbiome:

• Protects against pathogens
• Strengthens the immune system, thereby increasing resistance to disease
• Aids digestion

 Improving Your Dog’s Microbiome:

All of the therapies mentioned earlier (diet, supplementation, exercise, exposure to the natural environment) will improve your dog’s gut microbiome.

Additionally, Nathalie explains the importance of keeping your Shiba away from toxins that are detrimental to microbiome functioning.

Toxins such as:

• Chlorine / harsh chemical cleaners
• Yard chemicals / fertilizers
• Aerosols
• Pesticides
• Coat / skin products with potentially toxic ingredients
• Volatile sprays / air fresheners

Probiotics

Probiotics are another potentially effective way to promote a healthy and flourishing microbiome.

Nathalie of Pawsitively Primal has worked closely with the creators of Animal Biome and can vouch for their knowledge and products. 

Studies have shown that probiotics can improve immunity, intestinal microbiota, and weight gain - especially in elderly dogs. 

However, probiotic supplementation must be done carefully using the right type of probiotics at the right time and amount. (Certain immune comprised dogs may be contraindicated for probiotic usage) 

It’s important to introduce probiotics in a very gradual manner. Too much too soon can cause discomfort and actually increase the risk of gut imbalance.

Though probiotics are generally deemed safe, FDA approval is not needed as probiotics are labeled as supplements.

Therefore it’s important to buy probiotics from trusted sources.  Even better is to find probiotics that have been used in clinical studies.

Fecal microbial transplants (F.M.T.)

Fecal microbial transplants is the process of transferring healthy stool containing beneficial bacteria to a recipient with the goal of the bacteria colonizing inside the recipient's gut.

Multiple studies have shown F.M.T to be effective in improving intestinal diseases in dogs while at the same time promoting a healthier gut microbiome.

However, these studies also show that F.M.T. will not work in all cases.

Nathalie has used FMT for some of her allergy dogs with mixed success. 

Some allergy dogs improved quickly while others showed no response.

Therefore dogs with C.A.D. along with gastrointestinal issues may possibly benefit from F.M.T. (either from improved C.A.D. symptoms or G.I. functioning) - though dogs without g.i. Issues might find less success.

Need Specific, Targeted Bathing - 

In certain cases of C.A.D. - simply the act of giving your dog a bath a bit more often can have astounding effects.

This is because bathing helps remove allergens as well yeast in yeasty dogs.

Unfortunately, too many dog owners are under the impression that frequent bathing is bad for their dog’s skin health. This stems from the fact that a very long time ago, dog shampoos were made out of harsh materials such as lye. 

Now, good quality dog shampoos are p.h. balanced and gentle enough on a dog’s skin to use on a frequent basis if necessary.

Medicated dog shampoos containing antimicrobials, ceramides, and free fatty acids go even further in repairing a dogs compromised skin.

These products also contain ingredients that reduce itching and the chance for secondary infections as well as emollients to improve skin health and texture.

The key is using the right type of product and bathing at the right frequency intervals.

Choosing the wrong product for your dog's condition will at best - do nothing, and at the worst - make your dog’s skin health deteriorate further.

Treat Secondary Infections - (Bacterial / Yeast)

Canines with atopic dermatitis are at higher risk for bacterial and yeast infections that affect both the skin and ears.

 This is referred to as secondary infected C.A.D.

Therefore, if your dog has visible skin lesions, it’s important that your veterinarian checks for Staphylococcus (bacteria) and Malassezia (yeast) via impressions, smears, and / or tape.

Secondary infected C.A.D related to bacteria is typically treated with topical antimicrobial shampoos, ear cleansers, and if necessary - systemic oral antimicrobials.

An emergence of multidrug-resistant bacteria strains has increased interest in the use of targeted topical antimicrobial therapy with chlorhexidine shampoos and sprays.

Secondary infected C.A.D. related to yeast is typically treated with topical therapies such miconazole/chlorhexidine shampoos and conditioners. 

Severe cases may need to be treated with systemic antifungal drugs such as ketoconazole.

The use of systemic antibiotics and antifungals are usually the last resort saved for the most severe cases. 

Overuse and incorrect use of these modalities increases the prevalence of drug resistance in addition to the associated side effects that come with the use of these types of drugs.

Improve Epidermal Barrier Function

First off, what exactly is an epidermal barrier?

It's basically skin - more specifically, the most superficial layer of skin referred to as the stratum corneum.

And just as with humans, a dog’s skin is one of the most important organs of their body.

It’s their first line of defense from the external environment and plays a large role in a dog’s overall immunity.

It supports the healthy functioning of a dog’s internal environment as well as helping to maintain hydration levels and thermoregulation functioning. 

A healthy epidermal barrier protects from dehydration due to water loss, poisoning via noxious substances penetrating the skin, and infection caused by invading surface microorganisms.

Mounting evidence shows that dogs with C.A.D. also have epidermal barrier dysfunction. Which results in:

• Dry skin caused by transepidermal water loss
• Weakened skin barrier, allowing for increased allergen penetration
• Increases susceptibility to infections and irritants  

It’s not yet clear if C.A.D. contributes to a compromised skin barrier OR if a compromised skin barrier contributes to C.A.D.

Understanding the critical importance of a healthy epidermal barrier is crucial.

Before opting for medications that may have severe side effect risks, it’s reasonable to first take proactive measures to improve, heal, and protect your dog’s epidermal barrier. (Unless your dog’s condition requires immediate intervention - your vet will help you determine this). 

Improving Your Dog’s Epidermal Barrier - 

Improving a dog's skin barrier involves addressing several issues such as diet and skin care.

A clinical study has shown that feeding dogs a raw, fresh diet instead of dry kibble improved immune markers and reduced oxidative stress.

Essential Fatty Acid Supplementation

Research has shown that essential fatty acid supplementation can improve C.A.D. 

The International Task Force on Canine Atopic Dermatitis iterates that essential fatty acid supplementation and topical therapy are two ways to build up a healthier epidermal barrier.

Products such as nonirritating shampoos, keratolytic agents, medicated shampoos, moisturizers, emollients, and topical antimicrobials can be included in your topical epidermal defense arsenal. 

Essential Fatty acid supplementation may also improve skin barrier functioning though the time frame to see results can take up to two months or longer. 

Additionally, not all supplements are the same and research must be done to ensure the quality and efficacy of the supplement before using. 

Control Manage Fleas / Parasites

Dogs with CAD are more likely to also be affected by F.A.D. (flea allergy dermatitis).

Fortunately, many vets refer to diseases like F.A.D. as “good diseases” as these types of diseases are easy to diagnose as well as treat.

Addressing F.A.D. is one the first steps you must take when trying to determine the cause of your dog’s allergies. 

Dog’s with F.A.D. are typically dogs with low past exposure to fleas. Additionally, these dogs can get severe symptoms (intense itching / scratching / wounding) from just a few flea bites.

A dog with F.A.D. will experience hair loss, wounding, and scabbing at areas of the body where fleas are usually found - back, base of tail, butt region (sometimes referred to as the “flea triangle”.

The actual cause of F.A.D. is from the saliva of the fleas. One bite can affect a dog for up to 5 - 7 days.

Naturally addressing the flea problem  is the first step in resolving F.A.D.

There are a variety of prescription medications available to control fleas. (We do not recommend over-the-counter flea medications due to safety concerns).

However, even prescription flea medications are not without side effects - some being very serious. ( V E R Y SERIOUS ).

We recommend having a discussion with your veterinarian on which type of flea medications would have the best safety profile for your dog. Doing your own research is also highly recommended.

Natural therapies to control fleas are available, however the efficacy of these therapies are usually low. 

Because F.A.D. causes severe discomfort to dogs, natural therapies should not be the sole type of therapy used - stronger intervention is usually necessary.

Important: The following content below is for informational purposes ONLY. - The information provided below is not endorsed by Pawsitively Primal.

Immunotherapy 

Subcutaneous Injection

 Allergen immunotherapy (AIT) is the only casual medical treatment for environment-induced CAD.

It is also the only one of the ONLY medical interventions likely to prevent or delay the recurrence of flares of CAD.

Also called hypo-sensitization or desensitization, AIT involves administering offending allergies to the dog in increasing quantities in hopes that the dog’s allergy response will lessen with repeated exposure.

AIT can be administered subcutaneously (by injection) or sublingually (orally). However, subcutaneous administration is the most common route.

AIT therapy can improve clinical signs of CAD as well as decrease the need for systemic medications in 50-80% (respectively) of dogs treated.

However, a transdermal skin prick allergy test is needed to first identify the offending allergens.

In terms of safety, AIT has been done for decades with low rates of systemic adverse events.

Although immunotherapy takes an appreciable amount of time and effort -  the benefits of successful immunotherapy is vast. 

First off immunotherapy is not a drug thus there are no reported serious adverse side effects associated with the therapy. 

Second immunotherapy is the only type of treatment capable of changing the natural course of the disease versus simply blunting out the symptoms.

And finally immunotherapy is especially beneficial for younger dogs who would otherwise have to face a lifetime of likely drug intervention as well as the worsening of clinical signs due to aging.

The positives outweigh the negatives by so much that the International Task Force on Atopic Dermatitis recommends that when possible, immunotherapy should be offered to prevent recurrence of the clinical signs of C.A.D.

Since AIT therapy takes an extended time to complete (6 - 12 months), dogs would still need to have their immediate C.A.D. symptoms addressed to ensure comfort. 

Regionally Specific Immunotherapy (RESPIT)

Although immunotherapy has shown to be safe and efficacious in treating C.A.D, a limiting factor that may prevent owners from seeking this therapy is the need for intradermal allergy testing. 

Enter Respit - a relatively new and so far promising immunotherapy modality that does not require allergy testing.

Intradermal (needle injections) allergy testing can be expensive and contraindicated in dogs with certain conditions.

Additionally, the quality of the test results heavily rely on the veterinarians ability to interpret the test results. 

Regionally-specific immunotherapy is basically the same as standard immunotherapy with one key difference.

Instead of taking an allergy test to determine target allergens - Respit is pre-formulated with the most common allergens in your specific area of the United States (including Hawaii, and Alaska). 

Is Respit Effective as Traditional Targeted Immunotherapy?

So far, a few studies seem to indicate that standardized immunotherapy is not significantly different than targeted immunotherapy
. 

However it’s important to note that the author of the above referenced study, Dr. Jon Plant does have competing interests in the study.  He's the dermatological veterinarian who developed Respit.

Regardless of this fact, Respit should be seen as a potentially valuable tool in the area of C.A.D. - especially if allergy testing is a limiting factor.

Respit is available as an oromucosal spray or by an injectable needle.

Monoclonal Antibodies (Cytopoint)

Medications

While drugs such as antibiotics and steroids play an important role in disease management -  the over reliance on these types of drugs can inevitably cause more harm than good in the long term.

 Overuse of antibiotics results in antibiotic resistant strains of bacteria as well as the decimation of the dog's gut flora.

Strong steroids such as Prednisone / Prednisolone given to canines over a long period can cause: (link)

• Increased risk of infection
• Diabetes / worsening of diabetes
• Digestive tract ulcers
• Cushing's Disease 
• Stunted growth in puppies
• Altered behavior (aggression)
• Vomiting / diarrhea
• Lethargy
• Urinary tract infection
• Thinning of skin / coat
• Muscle weakness secondary to protein catabolism
• Calcinosis cutis
• Fungal infections (especially in the nasal cavity)
• Adult onset demodectic mange

Other non-steroidal drugs such as Apoquel -  sometimes referred to as the “wonder drug” - may be immunosuppressive.

Additionally there are no long term clinical studies on the safety of the continued use of Apoquel over a long term period.

Concerning letter to Zoetis (makers of Apoquel) from the FDA.

These are serious things to consider when deciding on various treatment options for your dog.

Unfortunately, many veterinarians are more inclined to prescribe these medications over other options - simply because that’s what they are trained to do.

Topical Glucocorticoids

Topical Glucocorticoid (steroid) treatment is the mainstay treatment for  localized CAD skin lesions.

Glucocorticoid sprays such as triamcinolone acetonide and a diester hydrocortisone aceponate have shown high efficacy in CAD dogs. Unfortunately, these two sprays are currently not available in the United States.

However another potent diester steroid, mometasone furoate in cream form is available in the United States. 

Oral Glucocorticoids 

Oral Glucocorticoids are effective / fast-acting steroid medications that reduce inflammation by deactivating inflammatory cells.  

These types of medications are used to rapidly induce remission in C.A.D dogs - though at a potentially high cost to your dog's long term health.

Just as in humans, the use of steroids is not recommended for long term use due to the many adverse side effects associated with these types of drugs.

Typically veterinarians will prescribe oral glucocorticoids for severe cases of C.A.D that do do not respond to topical glucocorticoid therapy.

Oclactinib (Apoquel)

Oclactinib (Apoquel, zoetis.com) is a Janus kinase inhibitor and is the first of its kind to be approved in the U.S. and Canada for the treatment of C.A.D. in dogs. 

Apoquel works by blocking the effects of inflammatory cytokines including IL-3` which is a cytokine that is directly involved with the itching sensations that drives dogs crazy.

The benefits of Apoquel is that it works rapidly, rarely causes g.i. distress and can be used in conjunction with other drugs such as cytopoint.

However the negatives of Apoquel may possibly be as severe as the negatives of oral steroids due to Apoquel's immune suppressing effects.

There just hasn't been enough time to complete studies on long term side effects.

So at present, the  long term side effects of Apoquel are currently unknown. 

Studies have shown that bone marrow suppression has been observed so monitoring for that issue should be considered.

Apoquel is not approved for use in dogs under 12 months of age due to clinical findings of demodicosis and pneumonia.

Because it’s a non-specific immunosuppressive drug, long term use is not recommended.

Cyclosporine (Atopica)

Cyclosporine (Atopica) is a cytokine inhibitor that has anti-pruritic as well as immunosuppressive properties 

Atopica shows similar efficacy as glucocorticoids / oclactinib in the treatment of C.A.D. - though clinical improvement takes longer than both drugs.

Atopica is usually considered a “later choice drug" by veterinarians due its immunosuppressive nature as well as side effects and interactions with other drugs. 

The cost of Atopica is high as well - especially affecting larger dogs

Atopica is usually indicated for dogs with severe forms of C.A.D that would otherwise need glucocorticoid therapy.

Antihistamines 

Antihistamines work by blocking the inflammatory effects of histamine.

However the efficacy of antihistamines vary widely. It may help some dogs, but have little to no effect on others.

It has been estimated that only 20 % of atopic dogs will respond well to the use of antihistamines or other non-steroidal medications alone. 

The major downsides of antihistamine use is low chance of effectiveness and sedation. Higher dosages may also induce nervousness and or tremors though not common.

Some veterinarians may prescribe it due to low side effects risks - while others won't simply because of it's low efficacy. 

However according to the International Task Force on Canine Atopic Dermatitis there is no conclusive evidence of the efficacy of antihistamines for treatment of active / chronic CAD skin lesions.

Sometimes antihistamines are used in conjunction with essential fatty acids as a steroid sparing agent.  Basically facilitating the use of a lower dose of oral glucocorticoids such as prednisolone 

Final Thoughts 

Hopefully this article has helped you better understand your options to address your Shiba's skin allergies.

By being proactive in your role as your Shiba's guardian / advocate, you'll likely find that the most important thing you can do is self-educate and be critical on what type of therapies you ultimately choose.

Remember, C.A.D. is a difficult disease to manage and often requires multiple avenues of treatments, therapies, and lifestyle changes. 

By understanding the detrimental effects of certain therapies and medications, it undoubtedly makes sense to start by improving your dog's foundational health and immune functions.

Especially since going this route presents no dire long term consequences to your dog's health -  and instead provides a path to prolonged wellness and vitality.

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