Allergic Skin Disease

Allergic Skin Disease

Allergic skin disease can be due to many things and often pets are allergic to a mix of things rather than just one, so diagnosing what your pet is allergic to can be tricky! There are also lots of treatment options and every pet is different in which treatment works best for them.
Signs of a skin allergy:

• Pink or red skin
• Chewing at paws
• Constantly scratching or rubbing themselves on furniture
• Recurrent skin and/or ear infections
• Spots or dermatitis over the body
• Hair loss around the paws/legs, face, under the belly or around the bottom
• It usually occurs after a year old but can be at any age.

What could my pet be allergic to?

• Contact allergy – this is where a pet is allergic to a substance or material, they come in to contact with – e.g., metal, or plastic bowls or collars, biological washing detergent, household cleaning products, certain fabrics.
• Food intolerance – food intolerant pets are usually intolerant of a type of protein in their diet, and only occasionally intolerant to a type of carbohydrate. It is a common misconception that grains are the most common allergen when in fact it is usually the protein. We do not recommend feeding a grain free diet unless your pet has been accurately diagnosed with a grain intolerance: studies have shown that grain
  free diets can predispose to heart disease.
• Environmental – this condition is also known as ‘atopy.’ Environmental allergens include various things such as dust mites, pollens and moulds. Sometimes you may notice a seasonal reoccurrence of the allergy which may suggest it is pollens, or more itching when at home which may suggest dust mites or itching around the after eating which may suggest storage mites.
• Flea allergy – this is commonly seen in cats, where just one flea bite can set off an over-responsive skin rash.
• Occasionally pets can be allergic to more than one of these!

How can these be diagnosed?

• Contact – This can often be diagnosed by the presentation and localisation of the symptoms and removal of allergens with improvement of symptoms.
• Food – The first step in diagnosing an allergy is doing a ‘Food trial.’ This involves an 8-week course of a specialised food such as Purina HA, Royal Canin Anallergenic or Hills Z/D. During this time, your pet will not be allowed ANY other treats or flavoured chews or pastes. If your pet’s clinical signs improve on the diet, it can be an indication that they are food intolerant. Pets can remain on this diet lifelong if it helps them. If you want to do more investigating, reintroduction to one protein and
  carbohydrate at a time can help us understand what it is your pet is intolerant to.
• Atopy – Allergy blood tests are available to see what it is we are possibly allergic to in the environment. Initially an ‘Allergy Screen’ test can be helpful. This screen will detect a positive or negative result to indoor and outdoor allergens. If positive, it can be followed by more detailed testing. These blood tests can be expensive but can help us understand how to control the symptoms better. Furthermore, this information can be used to create a personalised ‘vaccine’ against the allergens. Sometimes we make the diagnosis of atopy by exclusion i.e., we rule out food, parasite and contact allergy to conclude it must be something in the environment.
• Flea allergy is diagnosed by the presence of fleas or flea dirt on the coat or clinical suspicion if no or ineffective parasite treatment is being used. This can also be detected on an allergy blood screen

How can these be treated?

The aim of treatment is to reduce the symptoms to a much more comfortable level but may not completely resolve them. It is important to be aware that if your pet is allergic, their treatment plan will likely be a management plan, rather than a cure: and they may have intermittent flare ups from time to time.

• Contact allergies can be treated by removing the allergen, sometimes
  antihistamines, anti-itching medication (Apoquel) or a short course of steroids is required.
• Food intolerance is treated by staying on a specialised food.
• Atopy can be treated in several ways;

Immunotherapy injections: Are personalised vaccines created from information on the allergy blood tests. These vaccines are specifically produced for your pet and include any allergens that have been indicated via blood testing. We start by injecting very small amounts of the vaccine every 2 weeks, building up to a maintenance program of a monthly injection. It can take 6-12 months before we know whether this program has been effective: we see an improvement in approximately 2/3 of patients.

Cytopoint injections: These are given monthly and are an immunomodulating
injection: designed to try and adapt your pet’s allergic response. Many patients do very well on these, and we often see a response within the first 1-2 months.

Alternatively, oral medication may be necessary to control your pet’s symptoms. A commonly used oral medication is the specific antipruritic medication (anti-itch), Apoquel in dogs, which can be used in conjunction with the immunotherapy and cytopoint injections during a flare: or as a sole treatment. Atopica is an immunosuppressive medication, designed to reduce your pet’s immune response to the allergens.

Prednisolone steroid therapy and antihistamines are also commonly used but it is important to note these medications are human medications and not specifically licensed for pets. Some pets will only need therapy during certain seasons of the year, but some pets will need treatment all year round and may require regular 6 monthly health checks to ensure they are doing well.

For further information on these medications please see the links below
Apoquel – (Oral Tablet)

Cytopoint – (This is a monthly Injection) 

Atopica – (This is an oral tablet or solution) It works by altering the body’s immune system.

Prednisolone – this is a steroid oral tablet and often used to control moderate symptoms in the short term, but in severe cases that do not respond to other medications may be necessary longer term.

You can also reduce your pets contact with the allergen depending on what it is. For example, storage mites in dry food – wetting the food can reduce an allergic response to this, buying wet food instead or buying smaller bags of food. Another example is grass pollen – washing your pet’s feet with water after walks.

Flea Allergy

Flea allergy is easily controlled with a strict parasite regime and good house cleaning. 90% of the flea life cycle is in the household environment so it is important to ensure using a flea spray in the house every 6 months, regular hoovering and washing of bedding.
Often more than one therapy will be required as sometimes one is just not enough to control the symptoms.

Sometimes other treatments are necessary: your pet may need regular baths with a specialised shampoo to improve the coat condition, soothe the skin or
reduce surface bacteria or yeasts. If they suffer with otitis (inflammation of the ear) they may require regular ear cleaners or treatments. Coat support therapies that are rich in omega oils such as Viacutin, Nutramega, Dermoscent or Yuderm can also help in the overall management of a patient with skin disease.