Allergic Dermatitis
How to Treat Allergy in 12 Easy Steps
1. SELECTIVE BREEDING
Allergy is a genetically influenced disease caused by changes in the genes that control T lymphocyte function. Allergic dogs have T lymphocytes that respond more vigorously than normal individuals. This causes the symptoms of allergy that are so common.
Consider not breeding allergic pets. If you are selecting a mate for an allergic pet, consider finding one that has no history of allergies. This may help reduce the chances of allergy in puppies.
2. START EARLY
The earlier a patient with allergy is started on a treatment program designed with aggressive avoidance practices, the easier the disease will be to control. Patients that have chronic disease or recurrent infections have immune system changes as well as functional alteration in normal skin function which can make it more difficult to treat the dermatitis. By starting therapy early, cheaper, more simple therapies will likely work well to improve the patient’s disease. “An ounce of prevention is worth a pound of cure”.
3. TREAT ALL SECONDARY BACTERIAL AND YEAST INFECTIONS
Allergic disease causes changes in the normal function of the skin that prevents it from preventing infections. As a result, up to 80% of allergic patients will have secondary infections. These infections can mimic other diseases making accurate diagnosis difficult. Additionally, the infections can cause severe itching and add to the inflammation of the allergic reaction.
Antibiotics for at least 21 days will be needed for each episode of bacterial folliculitis (pyoderma).
Yeast infections will require topical and/or systemic antifungal medications for at least 1 month.
Ear infections usually require ear cleaning every 3-7 days and a topical medication to kill the bacterial or yeast. Often a topical steroid is used to decrease the inflammation caused by the allergy and infection. Infections of the feet (pododermatitis) are often treated with topical antimicrobial wipes, shampoos, powders (corn starch) or rinses used frequently.
4. AVOID COMMON ALLERGENS
The most common allergens in the home environment are house dust mites, molds, and cigarette smoke. These as well as other allergens (wool, etc) can often be reduced or avoided with several easy techniques. Throw away any foam or stuffed dog bed that is older than 1 year. Dog beds are one of the most common sources of house dust mites. Wash all bedding every 7 days using hot water. Do not allow anyone to smoke in the home. Use a HEPA air filter to clean the air.
Dehumidify the home using a high efficiency dehumidifier to keep the humidity below 40%. This will help prevent house dust mites, mold growth, and fleas. Consider using a spray to dissolve or denature the allergens (Allerase spray) and borate product to eliminate housedust mite exposure in the home.
5. REMOVE COMMON ALLERGENS
BATHE YOUR PET EVERY 3-7 DAYS USING AN ANTIMICROBIAL SHAMPOO
This will wash off any allergens and help to kill and prevent the secondary infections caused by bacteria or yeast.
6. PREVENT EXPOSURE TO COMMON ALLERGENS
Keep your pet indoors on dry, windy, high pollen count days, and if they go outside cover them with dog sweaters, coats or pajamas (with feet attached).
7. USE FLEA CONTROL EVERY MONTH
Fleas are very common in the Northwest and can increase the allergic reaction to all other allergens including house dust mites, pollens, molds, tapeworms, etc.
8. CONSIDER CHANGING THE DIET TO A SKIN FRIENDLY FOOD OR EVEN AN AGGRESSIVE FOOD ALLERGY TRIAL
Feeding a diet without beef or dairy ingredients but with high levels of essential fatty acids will help reduce any allergic reactions regardless of the cause. If food allergy is suspected, feeding a diet with only one protein (rabbit, duck, kangaroo, or fish) and one carbohydrate (potato) for 10 weeks will help diagnosis any food allergy. During this time, NO other foods, treats, chew bones, or chewable medication can be administered.
9. USE SYMPTOMATIC AND TOPICAL THERAPY TO HELP REDUCE THE ALLERGY AND ITCH
Antihistamines are cheap effective therapies with few side effects (clemastine, diphenhydramine, chlorpheniramine, hydroxyzine, amitriptyline, Zyrtec). Treat with high dose essential fatty acids (if not already in the diet). Anti-Itch conditioners after each bath (oatmeal, pramoxine, hydrocortisone, etc). Use Genesis spray (triamcinolone) for effective topical steroid therapy.
Consider low dose (medrol) (every-other-day) steroids to put out the “pruritic” fires.
10. ALLERGY TESTING
Allergy skin testing or blood allergy testing can be used to identify to which allergens the patient is reacting. This information can then be used to formulate an allergy vaccine to try to desensitize the immune system to those reactive allergens. This therapy has few side effects and helps improve approximately 75% of allergic patients. Specific or nonspecific immunotherapy.
11. CYCLOSPORINE THERAPY
Cyclosporine is an effective treatment that stops the T lymphocytes from stimulating the allergic reaction. It is effective in 75% of patients and has few adverse effects but is very expensive. The treatments are started every day but can usually be reduced to an every-other-day schedule, thus reducing the cost. In some patients, other medications (ketoconazole) can be added that will help further reduce the cost of the cyclosporine therapy.
12. APOQUEL
APOQUEL® (oclacitinib tablet) is used to control the pruritus associated with allergic dermatitis and the control of atopic dermatitis in dogs at least 12 months of age. Pruritus, or itching, is the most common sign of allergies in dogs. Developed by Zoetis, APOQUEL is the first Janus kinase (JAK) inhibitor approved for veterinary use that targets the itch and inflammation pathway. APOQUEL provides fast-acting relief from itching and improves inflammation.