Few problems can be as frustrating for pet owners (and veterinarians) to deal with as allergies. For dogs and cats the itchy feeling can cause severe irritation and self-mutilation. Treating allergies can be as simple as an effective flea control. However, in severe cases obtaining complete control of allergies can be elusive and necessitate multiple treatments. It is almost always a lifelong problem and can be expensive to control.
It is felt that if a dog or cat has an allergy to one thing then to some degree they are allergic to many things. The primary causes for allergies are fleas, environmental and food.
- Flea allergies are a reaction to flea saliva.
- Environmental allergies include dust mites, grasses, weeds and trees.
- Food allergies can be due to many different dietary ingredients.
Sorting out which allergy or combination of causes is responsible for a pet’s itchy feeling is best done in a strict, systematic approach. The location of biting, chewing, rubbing, etc. can be helpful as well as the breed, age and if it is a seasonal problem. The possibility of mites cannot be overlooked and at least a cursory evaluation for mites needs to be done first. Bacterial and malassezial (a yeast) infections can mimic allergies and are a frequent complication of the biting and chewing associated with allergies. These infections need to be controlled and kept under control when dealing with allergies.
The easiest allergy to control is an allergic reaction to flea saliva. Even the bite of one flea can cause an allergic reaction. Effective flea control on all dogs and cats in the household will control this allergy. Unfortunately, many products claim to be effective but are not. Consult with your veterinarian.
Environmental allergies (Atopy) and food allergy symptoms are similar and distinguishing between the two can be difficult. In dogs both can cause rubbing or scratching at the face, chewing the paws and recurrent ear infections. While food allergies generally start at less than 1 year of age or older than 5 years, Atopy generally starts between 6 to 3 years of age. Atopy can be seasonal at least at first while food allergy symptoms are usually year round. In cats Atopy and food allergies are much less common than flea allergy and occur with equal frequency and without an unique pattern.
Corticosteroids generally control Atopy but long-term use is associated with undesirable side effects. Newer immune system modulating drugs such as Apoquel® (oclacitinib) and Atopica® (cyclosporine) can also be effective with Apoquel generally effective in reducing the itch resulting from Atopy and/or food allergy. Both medications can also have long-term side-effects which need to be monitored for. For Atopic dogs an injectable monoclonal antibody (Cytopoint ™) that blocks the protein Interleukin-3/ that results in the itch is highly effective and safe. Long-term therapy is best done with multiple therapies including immunotherapy based on blood or skin allergy testing, antimicrobial therapy with shampoos and other topical products and skin barrier therapy with topical products and essential fatty acid supplementation.
Food allergies are treated by avoiding the offending food allergens. While beef, poultry, chicken and wheat are commonly implicated, the adverse reaction can be to any food or food additive. There is no accurate blood test. To make a definitive diagnosis, one must feed a dietary trial for 3 months and if improvement is seen, then feed the former diet to see an adverse response. While a home-prepared diet is best, prescription veterinary diets are easier but no single one will work all the time. Usually improvement will be seen in 4-5 weeks but if no improvement is seen in 12 weeks, then try another. 100% compliance is essential and this means no treats, table food and flavored medications. All skin infections need to also be eliminated by the end of the trial, as a common complication with any allergy is skin infections.Allergies are a lifelong problem and tend not to just go away. When dealing with allergies a systematic and disciplined approach is key. Trying a little of this or that generally is ineffective and leaves one frustrated and having to start all over again. Patience is needed. While “flare ups” will likely occur, allergies can be controlled by a systematic approach and close monitoring by your veterinarian.