Environmental (Atopic) Allergies:
Environmental allergies are the most common cause of itchiness in pets – far exceeding food allergies and parasites in this area of the country. Dogs manifest allergies through itchy skin (most notably by chewing the paws), hot-spots, and infections of the ears, skin and/or feet. Some dogs also develop mucoid ocular discharge and red eyes (lymphoid follicular conjunctivitis), but dogs rarely will have congestion, coughing or sneezing as is seen in humans. Environmental allergies can be year round due to things like dust and storage mites, but often they will flare in the early spring and fall, while improving in the winter.
There is a blood test that can help determine the cause of your pets environmental allergies. If negative, this test can help rule out environmental allergies as well. To determine if secondary infections are present, skin cytology is commonly performed (evaluating the surface of a lesion under the microscope to know if bacteria or yeast are present and need to be treated along with the allergen).
- Immunotherapy: This is the only treatment that can eventually train your dogs immune system to stop reacting to the allergens. This therapy is based on your dog specific allergy test and involves giving them very small amounts of the allergen in a controlled fashion to teach the immune system not to react. Immunotherapy can be given by injections at home or as a liquid by mouth twice a day. Immunotherapy must be given for a minimum of 12 months to determine effectiveness and would be continued life long. There is roughly 50% efficacy of immunotherapy and the goal is to be able to stop all other medications and avoid future infections of the skin, ears and paws.
- Anti-itch medications: Medications are used to suppress the itchiness caused by allergies and, by reducing skin inflammation, they commonly result in less infections.
- CADI (Cytopoint) Injections – a safe and effective, but expensive, option for reducing itchiness and inflammation of the skin. Injections are typically given monthly during the allergy season.
- Apoquel – a safe and effective, but expensive, oral medication used to reduce itchiness and infection with less suppression of the immune system than is seen with other options.
- Steroids – an effective and inexpensive option coming in several forms (sometimes combined with an anti-histimine) to be used for short term allergy relief. Long term or high dose use of steroids tends to result in unwanted side effects and generally suppresses the immune system.
- Antihistamines – over the counter anti-histimines are effective for only a small percentage of dogs. However, because they are inexpensive, safe and readily available, many owners chose to try antihistamines as part of their dogs therapy.
- Cylosporine – an expensive immune suppressant that poses higher risk, but is generally effective. Used typically as a last resort because of expense and risk of side effects.
- Topical medications: These include sprays, shampoos, soaks, mousses, and ointments. Many dogs will benefit from a topical regiment targeted to their most sensitive allergen areas. For example, dogs that suffer from recurrent ear infections may benefit from a topical ointment used in the ears regularly to reduce risk of infection. Another example would include certain anti-itch baths or foot soaks designed to sooth the skin, reduce itchiness and lower the risk of infection. We will help determine if your pet would benefit from topical therapy.
- Supplements: Dogs with atopic allergies are known to benefit from high doses of fish oil supplements and/or probiotics. We will help you determine what, if any supplements, may help your pet. Further, many foods designed for sensitive skin will have supplements built into the diet.