Allergic skin disease (atopic dermatitis) is one of the most common and most expensive chronic conditions in dogs, affecting an estimated 10–15% of the UK dog population. It is also increasingly recognised in cats. Here is a complete guide to diagnosis, treatment, and the ongoing costs involved.

Types of Pet Allergies

Environmental allergies (atopy): The most common type. Caused by pollen, dust mites, mould spores, and other airborne allergens. Usually appears between ages 1 and 3 and is lifelong.

Food allergies: Less common than many owners think — only about 10–15% of allergic dogs have a true food allergy. Common culprits include beef, chicken, dairy, and wheat.

Flea allergy dermatitis (FAD): An allergic reaction to flea saliva. Even a single flea bite can trigger intense itching in allergic pets. The cheapest allergy to manage — rigorous flea control is the treatment.

Diagnosis Costs

Diagnosing allergies is a process of elimination, and it can be expensive:

  • Initial consultation: £30–£65
  • Skin scrapes and cytology (to rule out infection/mites): £40–£80
  • Elimination diet trial (to rule out food allergy): £40–£80/month for prescription hydrolysed or novel protein diet, lasting 8–12 weeks
  • Intradermal allergy testing (gold standard): £200–£350. Performed by a veterinary dermatologist, usually under sedation.
  • Blood allergy testing (serology): £150–£250. Less accurate than intradermal testing but more widely available.
  • Dermatology specialist referral: £150–£300 for the initial consultation

Total diagnostic costs: £200–£500 or more, depending on how many investigations are needed.

Treatment Options and Annual Costs

Apoquel (oclacitinib):

  • Daily tablet, £1–£2.50 per day depending on dog size
  • Annual cost: £365–£910
  • Blood monitoring recommended every 6–12 months: £60–£120 per test

Cytopoint (lokivetmab):

  • Injection every 4–8 weeks at your vet: £60–£120 per injection
  • Annual cost: £390–£1,560 depending on frequency
  • No blood monitoring needed

Allergen-specific immunotherapy (desensitisation):

  • Custom vaccine based on allergy test results
  • Initial course: £200–£400
  • Ongoing injections or sublingual drops: £30–£60/month
  • Annual cost: £360–£720
  • Takes 6–12 months to see benefit. Effective in about 60–70% of cases.

Steroids (prednisolone):

  • Very cheap: £5–£15/month
  • But significant long-term side effects (increased thirst, weight gain, diabetes risk, skin thinning)
  • Best used short-term for flare-ups, not as ongoing management

Secondary Infections

Allergic pets frequently develop secondary skin and ear infections that require additional treatment:

  • Skin infection treatment (antibiotics + medicated shampoo): £50–£150 per episode
  • Ear infection treatment: £50–£120 per episode
  • Many allergic dogs have 2–4 infection episodes per year

Total Annual Cost

For a dog with moderate atopic dermatitis managed with Apoquel, including secondary infections:

  • Apoquel: £365–£910
  • Blood monitoring: £60–£120
  • 2–3 infection episodes: £100–£450
  • Medicated shampoo: £30–£60
  • Total: £555–£1,540 per year

This makes allergies one of the most expensive chronic conditions to manage. Pet insurance that covers ongoing conditions is invaluable for allergic pets — but remember that pre-existing conditions are excluded, so insuring early is critical.

Last updated: March 2026. Sources: BSAVA dermatology guidelines, VetCost pricing data. Always work with your vet to find the best treatment plan for your pet.