First the bad news: Allergy season is here! Veterinarians around the area have started seeing the scratching, the inflamed ears, the biting of feet. Very soon we will see the flea infestations and the hot spots. A recent survey of pet owners showed that successful treatment of pet allergies also greatly improved the quality of life for human members of the household. Allergic skin disease keeps people up at night, makes the house smell bad, and decreases the amount of quality “up-close” time people spend with their pets.
Now the good news: We now have more tools than ever to treat even the most severe allergies. The most recent addition to our arsenal, at least for dogs, is an injection called Cytopoint. It’s a new type of immunotherapy called a monoclonal antibody. The antibody works by inactivating a protein in the body that is responsible for itching, IL-31. Most frequently, this injection is used as part of a multi-modal approach to severe environmental allergies.
Another advanced weapon to treat allergic dermatitis is called a Janus kinase inhibitor. This exciting class of drugs targets the production of specific proteins that the immune system uses during an allergic reaction. They are much more specific than broader immunosuppressive medications, so they are very safe. They also work very quickly – within a few hours! The only one currently available for dogs is called Apoquel, but there will probably be more in the future.
These modern “big guns” should be used to give initial relief and/or for the most severe chronic cases. For most pets, we will want to try to use other therapies to reduce the need for long-term medication. These therapies include medicated shampoos, skin conditioners, treatments that strengthen the skin’s “barrier layer,” nutritional support, and environmental modification.
In addition, gentle antihistamines can sometimes be utilized if they are started early enough. These tried and true medications are very safe, but only mildly effective. They work best when started well in advance of allergy season and used two or three times daily on a consistent basis. Occasionally we will still rely on steroids, like prednisolone, but hopefully only for very short periods of time. Steroid medications have a long list of very likely side effects.
Of course, the most important part of treating seasonal allergies in pets is to be sure the diagnosis is correct and complete. Skin infections, food allergies, parasitic infestations, and hormonal or medical conditions can all result in similar symptoms. Even if skin allergies are present these other conditions can complicate matters as secondary problems.
Even the treatment of parasitic dermatitis has changed dramatically in the past two or three years. Unhealthy, inflamed skin can impede the ability of topical parasite control to dissipate evenly over a pet’s body. In addition, the recommended medicated shampoos for mite or flea infestations often wash off some of the active product. Safe and rapidly-effective oral parasite medications now make it easier than ever before to kill mites, fleas, and other external parasites.
If you are still preparing for allergy and flea seasons like you did five or ten years ago, it is time for a conversation with your veterinarian. As with most things in the medical world, prevention of symptoms or early intervention will give you the highest chance of success.