Most allergic dogs and cats respond well to a holistic or integrative treatment approach, but some don’t. In these cases, allergy testing and hyposensitization may be the answer.
Q: My dog has allergies and keeps itching and scratching even though I’ve tried a variety of both conventional and holistic treatments. What’s the next step to getting to the root of his problem?
A: Allergic dermatitis is one of the most common skin disorders in dogs and cats. At my practice in Texas, I see tons of cases every year. This means it’s important to be able to properly diagnose and treat animals with allergies. In this article, I’ll discuss the various treatment options — and when to consider allergy testing.
Diagnosis usually involves taking a good history and ruling out other diseases that resemble allergies, such as mange, ringworm, and various infections.
Testing can include:
- Skin cytology and culture
- Fungal culture for ringworm
- Skin scrapings
- Blood/urine testing
- Skin biopsy (when needed)
Because allergic skin is abnormal, dogs and cats with allergies often have chronic skin or ear infections. Until the true cause of chronic infections is diagnosed, treating with antibiotics or antifungals will not give long-lasting results.
Treatment Options – Conventional and Holistic
Conventional medications for allergies include corticosteroids, antihistamines, and newer immune-modulating treatments like Atopica, Apoquel, and Cytpoint. Antihistamines rarely work, so I don’t typically use them. The newer immune-modulating therapies can be helpful, but they are expensive, and I worry about side effects as these are strong medications. Steroids can be used safely in a holistic treatment program when utilized with various natural medicines and given infrequently at low doses.
Since my practice is holistic and focuses on functional medicine, I rarely find drugs are necessary to help my itchy patients. However, some animals are so itchy at the first appointment that judicious steroid use is needed to make them more comfortable and prevent self-mutilation while my natural regimen is taking effect.
The holistic/functional medicine approach appreciates the uniqueness of each individual. The treatments I use are not the only options but are a good starting point.
Regular bathing is really important to remove allergens from the skin. Using an organic shampoo specifically designed for daily use cleanses the skin without damaging it and reduces itching and infections.
Herbal therapies act as “natural steroids”, support the immune system, and are very beneficial. In my practice, they have reduced or eliminated the need for steroids in most patients. Xiao Allergy Support and Herbal Relief are my two favorite products for allergic dogs and cats.
Finally, antioxidants (I like Advance Antioxidants), probiotics, and Omega-3 fatty acids reduce cell damage caused by antigen-allergen interactions.
In my practice, I usually try several treatments before we consider allergy testing. Because the treatments I use are very successful in helping allergic pets, I rarely need to do allergy testing. However, if the natural approach doesn’t give us ideal results, allergy testing and treatment with diluted allergens can be helpful in up to 70% of dogs and cats. It’s important to realize that some animals can take one year or longer to respond, so continuing treatment with natural therapies is important. I actually continue using herbs and supplements even when hyposensitization works, because they improve cellular health and function.
Allergy testing can be done with skin testing at a dermatology office (the gold standard) or via blood IgE testing done by your veterinarian (this option is easier, possibly less expensive, and quick). The goal of testing is twofold — to confirm the dog or cat really has allergies, and allow the preparation of the specific allergens to be used in treatment (hyposensitization). The goal of hyposensitization (immunotherapy) is to induce tolerance to environmental (non-food) allergens, which reduces the clinical signs of allergic dermatitis.
Allergy testing can be done with skin testing at a dermatology office, or via blood IgE testing done by your veterinarian.
Treatment can involve either injection (“allergy shots”, the older or traditional way) or oral (sublingual) drops. Sublingual immunotherapy (SLIT or “allergy drops”) is a treatment that’s more favored in Europe than in North America. As with injections, SLIT has been used in humans for over 50 years; a growing body of evidence and research supports the utilization of SLIT for human allergies, and the World Allergy Organization endorses its use.
One big advantage of sublingual immunotherapy is the ease of administration. While some people don’t mind giving injections to their dogs or cats, most are delighted to be given an alternative to shots. Most animals accept oral drops/sprays easily. However, many dermatologists believe that successful SLIT requires faithful twice-daily administration, and because of this, some people may find it much more convenient to give their animals an infrequent injection instead.
In both people and pets, anaphylactic reactions to SLIT are rare to nonexistent. SLIT can also be used in patients with a prior history of reaction to allergy shots. Additionally, with some SLIT formulations, you can include mold extracts with pollens in the same vial without losing the efficacy of non-mold allergens. SLIT treatment bottles can be stored at room temperature for a shelf life of six months; refrigeration may not be necessary as it is with shots.
Why does this oral therapy work? The mucosa under the tongue is a privileged immunologic site with unique characteristics that allow the uptake of antigens while preventing invasion by pathogens.
In conclusion, skin allergies are very prevalent in dogs and cats. Diagnosis is usually easy, but other diseases such as mange, infections, and thyroid disease can present as allergies or complicate the disease. Frequent bathing is important, as are properly chosen herbs, supplements, and homeopathic to minimize the need for strong medications. Allergy testing and hyposensitization are helpful for many dogs and cats and are particularly useful when other therapies have not produced the desired response.