My pet is itchy…what do I do?
This is an excellent question as each pet is individual as to what they will respond to. Additionally, we need to determine what type of allergy we dealing with (environmental, food, parasite or combination). At your consult with us, we will obtain a thorough history to determine the best approach to work up to determine which treatment we should pursue. If your pet has more of a nonseasonal (year-round) history of symptoms (itching, infections (including ear infections)), we are likely going to want to rule out a food allergy and/or parasite problem first.
If we determine environmental allergies are contributing to your pet’s symptoms, there are numerous treatment options to consider. We now have so many options for treating pets with environmental allergies. Treatment options vary depending on the severity of the symptoms. Some will respond to frequent bathing, fatty acids and antihistamines. However, so many more need additional help with either medications or allergy testing and desensitization therapy. The decision for medications versus allergy testing is individual, but new medication options are becoming available every few years.
For many years, the only medication available was steroids, however, steroids can have some serious adverse side effects, including liver disease and diabetes. Atopica®/cyclosporine and Apoquel® have become available as good medication alternatives to steroids. Both of these medications are metabolized by the liver, and so blood work monitoring is recommended if remaining on these medications long term. Although Apoquel is FDA approved for use in dogs, use in cats is off-label. In dogs, a biotherapeutic has become available in the past few years called Cytopoint (also known as Canine Atopic Dermatitis Immunotherapeutic, or CADI). This is a caninized (dog-only) monoclonal antibody that specifically targets an inflammatory mediator within the body called interleukin-31 (IL-31) which is one of the principle inflammatory mediators that drives itching in dogs. There is not any metabolization through any organs nor any negative effects on the immune system.
A good, long term option for treating environmental allergies is to desensitize with tailored allergy shots or allergy drops (sublingual therapy) based on an allergy test. The gold standard test is an intradermal test, or skin test. If this is recommended, your pet will be lightly sedated for the procedure as we test to over 70 different environmental allergens (that is, 70 individual injections into the skin!). Based on the reactions, we will formulate a recipe for a serum to be administered either by injection or by sublingual drops, both of which we teach you how to perform at home. Response to treatment does take time; improvement may take anywhere from 2-5 months on average to up to a year (occasionally longer). If improvement is noted, therapy is generally continued lifelong. In many cases, we have to “piggyback” another therapy to keep your pet comfy while we await for improvement. Another option for environmental allergy testing is blood allergy testing. This testing may not be as accurate as skin testing but may be recommended if there is a reason to avoid sedation. For either test, certain medications may need to be withdrawn.
Lastly, skin infections can greatly contribute to your pet’s itching! It is important that we work with you to help resolve the infections. This will likely be addressed with a combination of topical and systemic therapies. In some cases, cultures are needed to determine if we are dealing with resistant infections and to help guide us to the appropriate drug choice for treatment.
Did you know that Richmond is one of the #1 areas of the country for the worst cases of environmental allergies? Working together, we can make a difference in the quality of life for your pet!