Spring is Coming – What You Need to Know About Your Pet’s Allergies!

Updated February 20th, 2018

FREE Client Education Event: 4/14/18 @ 1pm
“Allergic Pets – What to feed them and why”
Join veterinary dermatologist Dr. Darcie Kunder to discuss dermatologic problems (and solutions) caused by what you’re feeding your pet.  Bring your dog or cat and stick around to taste test recommended treats and diets.
Kindly RSVP for this free event: rsvp@friendshiphospital.com

What is atopy?

Atopy is a medical term for a predisposition to developing allergies. There can be a genetic component, but even in humans, there are continuing studies to find other factors. Because atopy is such a broad term, for owners, we will often use the term environmental allergies to describe a more specific subcategory of disease. Environmental allergens can include things both indoors (ex. dust mites, molds, wool) and outdoors (ex. pollens, weeds, trees, grasses). Depending on what the patient is allergic to, there may or may not be seasonality to the symptoms.

What are the signs of environmental allergies?

The most common symptom of environmental allergies is itch (licking, biting, scratching, chewing, rubbing).  This can sometimes be followed by or associated with a secondary infection (bacteria, yeast).  The damage done to the skin surface from itching allows the normal bacteria and yeast on the surface of the skin to affect the abnormal skin barrier.  Some of the typical affected locations on the body include: paws, belly, armpits, groin, around the eyes, and sometimes ears. Treating infection and itch is important, but without controlling the underlying allergy there will be recurrence of signs.

What animals are more likely to develop environmental allergies?

Most pets begin to show signs between the ages of 1 to 3-years-old. Veterinary patients tend to have signs that get worse with each successive year/season; and they do not tend to “grow out” of their allergies like some humans do.

Although any pet can be allergic, there are some dog breeds that are more likely to develop environmental allergies: golden retrievers, bulldogs (French, English, American), terriers (Pit, West Highland, soft-coated Wheaten, etc.), Boxers, and German Shepherds.

For all allergic patients, we strongly recommend early management of allergies as chronic changes to the skin and ears after years of itch and inflammation can lead to resistant infections, less effective treatments, and/or other associated diseases. Recommendations for each patient would differ, but in general our preferred way of treating allergies is with patient-specific immunotherapy (allergy shots or allergy drops).  This formulation is based on allergy testing and is individually formulated for a patient.

How do we diagnose environmental allergies?

Diagnosis is purely through exclusion of other diseases. This means that all other causes of itch need to be ruled out first, including secondary infections, flea allergy, food allergy, systemic disease, and parasitic infections. There is no definitive one-time test that can be used for diagnosis. This can be frustrating but we also make sure to help individual patients with the itch and discomfort of allergies before, during, and after allergy testing. We want owners to understand the value as well as the limitations of allergy testing. If a non-allergic patient had allergy testing performed, he/she may also have positive reactions on the test since we are injecting or measuring the response to irritating substances. However, for truly allergic patients the reactions are specific and obvious, making them more significant.

What is the purpose of environmental allergy testing?

The only purpose of environmental allergy testing is to use the results to create an individualized set of immunotherapy (i.e. allergy vaccines or drops) for an individual patient.  Unfortunately, allergy avoidance is very difficult so simply removing carpets, air purifiers, or frequent cleaning are rarely enough to prevent exposure to these microscopic environmental irritants.

What types of skin testing are available?

The gold standard test is skin testing. Often available only through veterinary dermatologists. This procedure requires brief sedation, injection of multiple allergens, and assessment of the reactions after 15-20 minutes.  This is very similar to the pinprick test that is performed on human patients.

Blood testing for environmental allergies is an alternative or additional option for some patients. If sedation is high-risk, then we may recommend only performing blood testing. In cats, we often need to rely on both skin and blood testing since reactions are less obvious with intradermal (skin) testing. We do not recommend blood testing for food allergies (see Dermatology FAQs).

What does my pet need prior to skin testing?

There are some medications (steroids, antihistamines, fish oils, vitamin E) that need to be discontinued for varying amounts of time prior to testing, under the guidance of a veterinarian. Skin infections should also be relatively well controlled, especially in the expected site of testing on the side of the body. Patients are fasted for about 12 hours prior to skin testing because of sedation. Not every patient is ready to be skin tested at the first appointment, but we will work with you and your primary care veterinarian to prepare.

What types of immunotherapy are available?

Allergy shots are the classic type of treatment given to introduce the body to small amounts of allergens over time. Immunotherapy attempts to “retrain” the immune system so that it stops having an over-reactive response. Shots are initially every-other-day during the induction period when more dilute concentrations of allergens are used. These shots can be given at home with owners instructed how to administer injections. This therapy is very safe and is usually well tolerated by most patients. Side effects are uncommon to rare, but owners are taught to monitor for an increase in itch (hives, swelling), gastrointestinal signs (vomiting, diarrhea), or respiratory signs. After a few weeks, the shots are only given once weekly at the maintenance concentration, but the concentration, volume, and frequency may need to be tailored more specifically for each individual patient.

Allergy drops are a newer method of administering allergens over time. The drops are given once daily using a special pump device in the mouth. The success rate is similar to allergy shots, and we often allow owners to choose based on their preferred schedule, comfort level for administration, and patient compliance (most cats prefer weekly shots over daily drops). There are special situations in which we may recommend drops or shots for a specific patient.

What other treatments may be needed?

Immunotherapy can work in 60-70% of pets, but it can take 12-18 months to have maximal effect. During that time, some pets need additional treatments for infection and comfort. This may include antimicrobials, topicals, and/or anti-itch drugs, but hope to decrease the frequency of other therapy as the immunotherapy begins to take effect. If immunotherapy is helpful, then it is continued lifelong. Allergies are for life since there is no definitive “cure,” but the goal of veterinary dermatologists is to help patients and owners have an excellent quality-of-life with long-term management.

Now through April 30th, 2018, schedule a complimentary allergy consult with Friendship Dermatology Specialists.  Call 202.363.7300 or email dermatology@friendshiphospital.com.

Friendship Dermatology Specialists, led by Dr. Darcie Kunder and Dr. Fiona Lee, is the only board-certified veterinary dermatology group in the District.  Specially trained to treat a wide variety of conditions affecting the skin, hair and nails, Friendship Dermatology Specialists see appointments Monday through Friday.

*Featured image courtesy of U.S. Canine.