Allergies in Our Pets
Just as in people, allergies can be a frustrating, hard to manage problem that requires treatments year-round in some cases. We have a diagnostic approach to allergies in our pets that we want to walk you through and explain why sometimes we have to try multiple different treatment regimens before we find one that works well for your patient.
What types of allergies do pets get?
The two main types of allergies in pets are environmental (termed atopy) and food allergies. Both cause similar clinical signs but are treated very differently. Atopy is usually seasonal and food allergies are typically year-round.
Clinical signs of allergies
Pets usually begin to develop symptoms of allergies between 2-5 years of age, but symptoms can develop at any time during your pet's life. Symptoms common to both food and environmental allergies are:
*DID YOU KNOW?*
The number one most common cause of recurrent allergies in dogs and cats is FLEAS! If your pet is not on a monthly flea and tick preventative, then even if you are not seeing active fleas you may have a problem in your home. We have an in-clinic test for flea allergies that can be run before extensive treatment or diagnostics for allergies. Flea allergy dermatitis is actually a curable allergy so we always treat for it first!
Diagnosis: Food vs. Environmental
The first time we see your pet for allergies, we will usually ask the following questions about the allergy symptoms:
Treatment
Initial
For allergies, we usually recommend a trial with an antihistamine to see if that can resolve your pet's symptoms. We will also often use a steroid injection to treat allergies. If your pet's symptoms go away on antihistamine or steroid treatment, then allergies are likely the culprit. With food allergies, the symptoms do not usually completely resolve on steroids, so we can actually use a single steroid injection as part of our diagnostic testing to help distinguish between atopy and food allergies.
Secondary problems
We will use antibiotics, antifungals, medicated ear cleaners, and medicated shampoos to treat the skin and ear infections that come from underlying allergies. A nail trim is also important if sharp nails are scratching the skin raw! Flea prevention for all dogs and cats is recommended, but even more important for those with flea allergies.
Long Term Treatment
There are many different possible ways to treat allergies - it all depends on how your pet responds. Below is a list of possible treatments.
Seeing the dermatologist
We will always recommend taking your pet to the dermatologist if we determine there may be environmental allergies. The dermatologist performs an allergy test and can mix up serum for injections to give your pet to treat allergy symptoms (this is exactly the same process that occurs in people!). With immunotherapy, over time your pet should require fewer treatments for allergies as their own immune systems take over. Initial visits to the dermatologist can be expensive (average $400-500) but the cost over time is actually cheaper if you consider monthly steroid injections, shampoos, antibiotics for skin and ear infections, and the antihistamines most of our allergy patients are on. There is also no risk of side effects from long term medication use, and some pets will be able to discontinue allergy injections after a year or two of treatment. It can take 6 months for allergy injections to work, so please be patient while waiting to see improvement.
Monitoring
For patients on either Atopica or long-term steroids, we recommend bloodwork once a year (or sometimes more often when starting a new therapy or changing dosages) to make sure the medication is being well tolerated. If liver disease is present we may recommend a liver protectant in addition to trying to find an alternative to steroids.
Food trials
With suspect food allergies, one diagnostic tool as well as a treatment option is a food trial. We will place your pet on a hypoallergenic food for a minimum of 3 months to see if symptoms improve. There are several prescription foods that are strict hypoallergenic diets. These diets will be slightly more expensive than pet store foods, but the benefits of eliminating food allergy symptoms usually outweigh the cost of the food. We do have one pet store brand that we consider okay as a diet for food trials, but if your pet still has symptoms on this diet then we will recommend the prescription diet before ruling out a food allergy. There are some important points to remember when doing a food trial:
Allergies can be frustrating to treat, but if the time and money is invested in getting a diagnosis quickly and effectively when symptoms first start, you will be more pleased with the result and have a happier and healthier pet!
My own success story:
My lab/great pyrenees mix Bentley kept having recurrent left sided ear infections. After treating him 3 times in the span of 2 or 3 months for an ear infection, I took him to see the dermatologist for allergy testing. In addition to the many molds and pollens Bentley is allergic to, he had a pretty high allergy to Malassezia yeast, the common type of yeast in ear infections. This is why he kept having such severe ear infections! I started him on allergy injections and within 1 month his ear infections cleared up. Bentley has not had an ear infection since, and his other milder symptoms have improved as well (chewing on his feet). I am an advocate of the veterinary dermatologists because Bentley has benefited so well from his immunotherapy!
What types of allergies do pets get?
The two main types of allergies in pets are environmental (termed atopy) and food allergies. Both cause similar clinical signs but are treated very differently. Atopy is usually seasonal and food allergies are typically year-round.
Clinical signs of allergies
Pets usually begin to develop symptoms of allergies between 2-5 years of age, but symptoms can develop at any time during your pet's life. Symptoms common to both food and environmental allergies are:
- Itching - this can be mild, moderate or severe
- Chewing on feet
- Brown staining on the hair and skin in between the toes
- Chronic or recurrent skin infections
- Chronic or recurrent ear infections
- Dry, flaky sin and rough coats
- Hair loss
- Wheezing, snoring, and other upper respiratory signs
- Red, teary eyes
- Wheals and hives
*DID YOU KNOW?*
The number one most common cause of recurrent allergies in dogs and cats is FLEAS! If your pet is not on a monthly flea and tick preventative, then even if you are not seeing active fleas you may have a problem in your home. We have an in-clinic test for flea allergies that can be run before extensive treatment or diagnostics for allergies. Flea allergy dermatitis is actually a curable allergy so we always treat for it first!
Diagnosis: Food vs. Environmental
The first time we see your pet for allergies, we will usually ask the following questions about the allergy symptoms:
- When did the symptoms start and have they gotten worse or stayed the same?
- Is this a seasonal problem or a year-round problem?
- Are you using a topical flea and tick preventative?
- Have you purchased any new collars or harnesses, bedding or clothing for your pet?
- Have you tried any home remedies to fix your pet's itching?
- What do you bathe your pet with at home? How often?
- What type of diet do you feed your pet?
Treatment
Initial
For allergies, we usually recommend a trial with an antihistamine to see if that can resolve your pet's symptoms. We will also often use a steroid injection to treat allergies. If your pet's symptoms go away on antihistamine or steroid treatment, then allergies are likely the culprit. With food allergies, the symptoms do not usually completely resolve on steroids, so we can actually use a single steroid injection as part of our diagnostic testing to help distinguish between atopy and food allergies.
Secondary problems
We will use antibiotics, antifungals, medicated ear cleaners, and medicated shampoos to treat the skin and ear infections that come from underlying allergies. A nail trim is also important if sharp nails are scratching the skin raw! Flea prevention for all dogs and cats is recommended, but even more important for those with flea allergies.
Long Term Treatment
There are many different possible ways to treat allergies - it all depends on how your pet responds. Below is a list of possible treatments.
- Antihistamines(Benadryl, Chlorpheniramine, etc.) - there are many different types of antihistamines we can use in our patients. Sometimes they work well, and other times there is no effect. Some pets will respond better to one antihistamine over another, and some pets will develop a tolerance to an antihistamine if they have to take it all the time. There are no negative side effects to chronic antihistamine use, though, which is why we use them as primary treatment whenever possible. The dosage for dogs and cats is different than the human dosage so please consult a veterinarian before starting any new medication!
- Steroids - we have injectable, oral and topical steroids we can use. These usually work better than antihistamines for moderate to severe allergies, but there are side effects with steroids that make long term use undesirable. These include immune suppression (and therefore an increased risk for urinary tract, dental and skin infections), an increased risk for diabetes because steroids inhibit insulin, and steroids also have a negative effect on the liver with long term use so liver disease is a common side effect.
- Non-steroidal immunosuppressives - We have a medication called Atopica which modulates the immune system in a similar way to steroids without causing the bad side effects that come with long term steroid use. About 80% of patients will improve with Atopica.
- Medicated shampoos - we commonly use oatmeal based shampoos or shampoos medicated with antimicrobials or steroids to aid in relief from allergies.
- Fatty acid supplements - Omega 3 and 6 fatty acids as well as increased fish oils in the diet can improve coat quality and skin condition, and sometimes help resolve some of the allergy symptoms.
- Diet - for food allergies, changing to a hypoallergenic diet is key to improving the symptoms. The most common allergens in dogs and cats are: chicken, beef, pork, lamb, egg, milk/cheese, corn, wheat, soy, fish, rice and potato. See below for a brief discussion on food trials.
Seeing the dermatologist
We will always recommend taking your pet to the dermatologist if we determine there may be environmental allergies. The dermatologist performs an allergy test and can mix up serum for injections to give your pet to treat allergy symptoms (this is exactly the same process that occurs in people!). With immunotherapy, over time your pet should require fewer treatments for allergies as their own immune systems take over. Initial visits to the dermatologist can be expensive (average $400-500) but the cost over time is actually cheaper if you consider monthly steroid injections, shampoos, antibiotics for skin and ear infections, and the antihistamines most of our allergy patients are on. There is also no risk of side effects from long term medication use, and some pets will be able to discontinue allergy injections after a year or two of treatment. It can take 6 months for allergy injections to work, so please be patient while waiting to see improvement.
Monitoring
For patients on either Atopica or long-term steroids, we recommend bloodwork once a year (or sometimes more often when starting a new therapy or changing dosages) to make sure the medication is being well tolerated. If liver disease is present we may recommend a liver protectant in addition to trying to find an alternative to steroids.
Food trials
With suspect food allergies, one diagnostic tool as well as a treatment option is a food trial. We will place your pet on a hypoallergenic food for a minimum of 3 months to see if symptoms improve. There are several prescription foods that are strict hypoallergenic diets. These diets will be slightly more expensive than pet store foods, but the benefits of eliminating food allergy symptoms usually outweigh the cost of the food. We do have one pet store brand that we consider okay as a diet for food trials, but if your pet still has symptoms on this diet then we will recommend the prescription diet before ruling out a food allergy. There are some important points to remember when doing a food trial:
- Most pets do not respond fully until they have been on a hypoallergenic diet for 2-3 months.
- Pets can suddenly develop allergies to foods that they have been eating for years with no previous problems.
- Food allergies usually manifest as skin conditions and itching rather than diarrhea or vomiting, but both of the latter can occur as well.
- Nothing else that is flavored can be given by mouth during the period of the food trial unless it is hypoallergenic. This includes treats, table scraps, medication (including oral heartworm prevention - we have to use a topical form) or supplements, or flavored toys (rawhides, basted chew toys). You will be spending more money on any hypoallergenic diet so you wouldn't want to ruin it by offering these items! When we place your pet on a food trial, we will go through some options for hypoallergenic treats. If your pet responds well to a food trial, we can start adding in food items one at a time to see if your pet is allergic to a specific ingredient.
- Sometimes pets can have both environmental and food allergies, so if your pet's symptoms have improved on a hypoallergenic diet but do not go away completely, this may be one reason why.
Allergies can be frustrating to treat, but if the time and money is invested in getting a diagnosis quickly and effectively when symptoms first start, you will be more pleased with the result and have a happier and healthier pet!
My own success story:
My lab/great pyrenees mix Bentley kept having recurrent left sided ear infections. After treating him 3 times in the span of 2 or 3 months for an ear infection, I took him to see the dermatologist for allergy testing. In addition to the many molds and pollens Bentley is allergic to, he had a pretty high allergy to Malassezia yeast, the common type of yeast in ear infections. This is why he kept having such severe ear infections! I started him on allergy injections and within 1 month his ear infections cleared up. Bentley has not had an ear infection since, and his other milder symptoms have improved as well (chewing on his feet). I am an advocate of the veterinary dermatologists because Bentley has benefited so well from his immunotherapy!
