The most common clinical condition that we see at our hospital is skin allergies. Skin allergies can cause intense itchiness, hair loss, skin rashes, and therefore great discomfort. Here we will explore the types of allergies, symptoms commonly seen, and available treatment options.
Type of allergies: The types of allergies that dogs and cats can experience include: food allergies, flea allergies, and environmental allergies (called atopy) which are comprised of inhaled allergies and contact allergies. In dogs, there is an even distribution of types of allergies, but the most common allergy in cats is flea allergy. Dogs and cats may have multiple types of allergies at the same time, as is common in humans.
Symptoms: Allergy symptoms differ between cats and dogs. In cats, the most common presentation of the various types of allergies involves small scabs around the collar region. Other less common symptoms can include hair loss or rashes on the abdomen and back legs. In dogs, food allergy and inhaled/environmental/or contact allergies can present as redness and licking of the paws, recurrent ear infections, abdomen and chest redness and rashes, and rashes of the inner thigh and armpit areas. Flea allergy dermatitis in dogs is unique in that it only usually causes rashes and hair loss on the base of the back near the tail or at the tail base. Fleas may or may not be seen in patients with flea allergies. It is always helpful to tell your veterinarian the level of itchiness your pet is experiencing. Think of your pet’s itchiness on a scale of 1 to 10 (1 being very mild and 10 being very severe), and this will help your veterinarian select the most effective treatment plan for your pet.
Treatment strategies: The most important thing to keep in mind when treating for allergies is that there is no “cure” for allergies. Just like in people, allergy symptoms can be managed with multiple types of treatment, but symptoms may not completely resolve or symptoms may resolve then return at some point in the future. The goal with allergies is to lessen symptoms, to make your pet more comfortable. There are many ways to try to treat allergies. Combination therapy (using different medications or treatment types) will generally be more successful than using just one medication alone. This is the strategy often used by dermatologists, because it is the most effective and leads to the least medication side effects.
Improved treatment outcome can also be achieved by early detection and treatment of allergies. If caught early (at the first sign of minor itching), generally fewer medications and lower doses may only be necessary. However, if allergic symptoms are allowed to progress over a period of time, it will be harder to get the symptoms under control, and will lead to more medications being used and higher medication doses being needed.
Your veterinarian will work with you to find the best treatment plan for your pet.
- Apoquel – Apoquel tablets belong to a class of drugs called Janus kinase inhibitors, which target the signaling pathway that results in itching and inflammation. The first drug in its class to be approved for veterinary use, Apoquel is specifically designed to address the source of the itch, providing fast-acting relief and minimal side effects.
- Antihistamines—These medications (such as Benadryl and Hydroxyzine) help to block histamine, a major chemical component of allergies. They may be a stand-alone treatment for mild allergies, or may be used in conjunction with other treatments for more severe allergies.
- Fatty acid supplements—These contain antioxidant and anti-inflammatory properties and are useful in treating dry skin, and can have some anti-itch properties. They are mild in efficacy and are usually not used for stand-alone treatment, but, similar to antihistamines, will help boost the efficacy of other allergy treatments
- Steroids—These are reserved for patients with moderate to severe allergies. Steroids provide the most effective relief for allergies, but may have side effects. Steroids can be given by injection from your veterinarian, and/or an oral steroid may be administered at home. Always give steroids as specifically directed, since this medication will need to be tapered. Never stop steroids abruptly. The most common side effects of steroids include increased thirst, increased urination, and increased appetite. There are certain prescription and over-the-counter medications that can have adverse reactions when mixed with steroids, so always ask your veterinarian before administering any other medications if your pet is on steroid therapy.
- Food trials—Your veterinarian may prescribe special prescription diets (available only through your veterinarian) that are designed for pet with food allergies. There are two types of special diets: limited ingredient (special protein and carbohydrate sources that are not available over the counter), and hydrolyzed (has common ingredients, but is broken down chemically to prevent allergic reaction). The purpose of these is to quiet down the immune system if there is a reaction to one or more food ingredients. It is critical in food trials that your pet not eat any food other than this diet (so no treats and do not allow your pet to eat other foods) in order to achieve the best results from the dietary trial. Expect that it can take 6-8 weeks to see the full results of the trial and in some cases, a few different diets may need to be explored to find the best diet for your pet. *A note about over the counter “hypoallergenic” or “grain free” diets: The purity of these diets cannot be guaranteed, so their use is not recommended.
- Allergy testing and allergy injections—Referral to a dermatologist may be necessary in some patients with severe recurrent symptoms. A dermatologist may perform skin testing (similar to skin testing in humans) to identify the specific allergens for your pet, so that allergy shots can be formulated. These shots gradually desensitize the immune system, thereby lessening symptoms. There is an approximately 60-80% success rate of improvement with allergy injections.
If you feel your pet may be suffering from allergy symptoms, talk with your veterinarian. As with any medical condition, early recognition can lead to more effective treatment and a better outcome for your pet. While there is no cure for allergies, together you and your veterinarian can find a treatment plan that will allow your pet to feel much more comfortable.