Long-term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions.

BACKGROUND: Allergic pruritus and urticaria in the horse are challenging for veterinarians and owners; little is known about their long-term management.

OBJECTIVES: To summarize intradermal allergen test results (IDT), and to assess owners' perceptions of skin disease and the effects of medical treatment and management changes in their atopic horses over time.

ANIMALS: Eighty two horses with atopic dermatitis in southeastern England between 2006 and 2011.

METHODS AND MATERIALS: The IDT results were reviewed retrospectively. Owners completed telephone questionnaires on skin changes, medication, effect of allergen-specific immunotherapy (ASIT) and management.

RESULTS: Sixty one owners (74.4%) could be contacted, an average of 5.9 years (range 28-88 months) after IDT; of those, three could not be enrolled. Of the 58 remaining horses, eleven (19%) were deceased at the time of owner interview, including four (6.9%) euthanized due to uncontrollable skin disease. The remaining 47 owners reported that the signs of skin disease had not been seen for at least two years in 18 horses (38.3%), including two that only flared with known triggers. Twenty nine horses (61.7%) still required medication to control skin disease although 25 (53.2%) required less since testing. Owners reported benefit from ASIT in nine of 14 horses (64.3%) from glucocorticoids in 33 of 35 (94.3%) and from antihistamines in 17 of 28 (60.7%). Specific management changes were implemented for 22 horses and reported as beneficial in nine of 22 (40.9%).

CONCLUSIONS: Equine atopic dermatitis may not always be chronic, but severe cases appear difficult to control. IDT may help to formulate ASIT and can help to guide management changes.