We all scratch our head or rub our eyes once in a while and think nothing more about it. Most dogs and cats will occasionally lick their feet or rub their face against the carpet and it too, means absolutely nothing. There are some pets, however, that are consumed by this activity to the point that they traumatize their skin till its raw and inflamed. These pets are suffering and need a therapeutic plan of action to help control their itching.
Itchy pets may be suffering from parasites, like fleas and mites, food allergies, autoimmune diseases, skin infections, inhalant allergies or contact dermatitis. The exact etiology for a pet's itchy behavior can be determined by a comprehensive physical examination by a veterinarian along with a good history provided by its pet owner. Regardless of the cause, the following discussion hopefully will be helpful to a pet owner and their itchy pet.
My response to six questions a pet owner may ask about their itchy pet:
- What are the symptoms of an allergic pet? A classic allergy patient may have all or some of the following symptoms, which I am going to group into two broad, but not exclusive, categories: the respiratory allergy patient and the dermatological (skin) patient. Similar to people, the respiratory allergy pet may have red eyes, clear runny nose, dry cough and sneeze. The dermatological allergy patient may scratch its ears, rub its face, lick its paws and anus and scratch its sides and between its legs. For food allergy patients, it is rare for them to show just gastrointestinal signs like vomiting or diarrhea. They frequently show dermatological signs as well. Your allergy patient may do all of the above with varying severity or maybe just do one or two of these activities.
- How do I know if my itchy pet has allergies? Your history plus a good physical examination by your veterinarian will help lead to the appropriate diagnosis. In addition, your veterinarian can collect a blood sample and send it to their laboratory to identify which allergens your pet is allergic to by measuring your pet's antibody levels to specific allergens. Alternatively, a veterinary dermatologist can perform an Intradermal allergy test to identify which allergen your pet is allergic to. This test does require sedation, shaving your pet's fur and multiple skin injections. I recommend allergy testing your itchy pet if you are going to proceed with a desensitization program. The desensitization program involves giving your pet "allergy shots" at home to decrease your pet's immunological response to allergens in its natural environment. Desensitization helps 50-75 percent of the patients by reducing the severity of their allergic presentation. It does not cure them.
- Why does my pet have allergies? You may think of your pet's skin, gastrointestinal or respiratory tract as a porous membrane that allows allergens to pass through. Your allergic pet is immunologically responding in an exaggerated manner to these intruding allergens. This exaggerated response may manifest itself by itching, sneezing, coughing or diarrhea.
- Why does my pet only itch sometimes? Some itchy pets have seasonal allergies, which means it is only problematic at a specific time of the year. For instance, tree pollen is worse in the spring. Grass allergies during the spring and summer. Ragweed is usually problematic in the fall. Most allergy pets have multiple triggering allergens and may show their symptoms multiple times throughout the year.
- Why does my pet itch all the time? Pets with food, dust and mold allergies may itch all year round. Unfortunately, some pets may initially present as seasonal allergy patients but as the years go by, may proceed to year round or non-seasonal itching.
- What can I do to make my pet more comfortable?
If your veterinarian suspects food allergies, there is NO RELIABLE blood or skin test available to date to identify which ingredient your pet is allergic to. The only way to identify food allergies is by performing an eight to twelve week food trial where you feed your pet only one protein and one carbohydrate source during this trial period. If the pet's itchy behavior diminishes during this food trial, the owner can then introduce one new ingredient each week to see how the pet responds. If the pet starts itching on the new ingredient, then the owner will avoid feeding it in its future. If the pet does not improve on this new diet, I'd recommend trying another protein source. Food trials can be time consuming to perform but can be really rewarding if successful.
- Keep your pet's hair short. Long hair can act like a dust mop and hold onto the environmental allergens.
- Bathe your pet with hypoallergenic shampoo at least once or twice weekly. Use cool water. If your pet has a skin infection, make sure you're using a shampoo that can help flush the hair follicles and remove the cellular debris. If your pet has a highly resistant staphylococcus skin infection, make sure your shampoo contains chlorohexidine. If your pet has a yeast infection, I recommend ketoconazole-based shampoos.
- After bathing your pet apply a moisturizing conditioner on your pet. This helps rehydrate and calm the skin.
- Spray a topical anti-inflammatory or immune modulating product on your pet's skin. There are a number of pharmaceutical products that help strengthen your skin's barrier to intruding allergens -- just ask your veterinarian which one would best for your pet. One of my new favorite products is called Duoxo Seborrhea Microemulsion Spray. It's extremely safe and you just mist it on your pet's skin.
- Give your pet an antihistamine. There are numerous antihistamines on the market. I believe that every antihistamine has a 50 percent potential to make your pet less itchy. For dogs, I like to use Zyrtec or Clariton. For cats, I like to use chlorphenaramine. Ask your veterinarian for a dosage for your pet.
- If an antihistamine alone does not work, try a combination of antihistamine with a touch of a steroid, called Temaril P. This product enables you to give a steroid to your pet at a much lower dose than if you would give a steroid to your pet on its own. This product is available by prescription only and dispensed by your veterinarian.
- Don't overlook a secondary skin or ear infection. If your pet has a skin or ear infection as a result of traumatizing its skin, you must treat with antibiotics or anti-fungal medication for an appropriate time period. Don't stop your antibiotics prematurely. I recommend at least 2 to 3 weeks of antibiotics beyond the last appearance of a bacterial skin lesion. To help your pet's skin recover from a skin infection, I frequently prescribe a topical spray, called Vetericyn VF, to speed up wound healing and kill bacteria. For fungal skin infections, I may continue the anti-fungal medication for at least 1 month after it's disappearance. If you are not having success with your antibiotic, have your veterinarian do a bacterial culture and drug sensitivity test to make sure you are giving your pet the right medication. In addition, a skin biopsy may be indicated to confirm or dispute the diagnosis. For chronic re-occurring ear infections secondary to allergies, I have had great success with a new product called Easiotic. After the ear infection has resolved, I have the clients treat prophylactically ONCE weekly during their allergy season to decrease inflammation in the ear.
- Make sure your veterinarian skin scrapes your dog for a mite infestation prior to placing it on medication, especially steroids. It is not uncommon in my young itchy pets to discover an underlying mite problem. The treatment for a mite problem (like sarcopte and demodex) is dramatically different than an itchy allergy patient.
- Give your pet Fish Oil. Fish oil is a great source of Omega 3's (eicosapentaenoic acid and docosahexaenoic acid), which helps moisturize and decrease inflammation in the skin. This can be purchased at a veterinary clinic or drug store. Ask your veterinarian for your pet's dose. I typically dose 20 mg /lb of body weight ONCE daily of eicosapentaenoic acid (EPA). If you dose correctly for EPA in most fish oil products, the docosahexanaenoic (DHA) dose will be correct. For instance a 40 lb dog would get 800 mg EPA per day. (On the bottle of your Fish Oil it should list how many mg of EPA are in each capsule and dose accordingly.) It takes up to six weeks to see the benefits of fish oil on your pet.
- For my respiratory allergy patients I frequently prescribe an inhaler with a steroid, called Flovent, to help reduce their coughing. It's really simple to use and takes only 15 to 30 seconds to administer once or twice a day. Since it takes around one week to see the benefits of Flovent, I will frequently prescribe an oral steroid to help them during the first week of therapy. Ask your veterinarian which product is best for your pet.
- For red runny eyes I always recommend flushing the eyes with an over-the- counter saline eye irrigating solution two to three times per day to help flush the allergens out of their eyes. I especially recommend using this on your allergy pet after it has played outside. In addition, I frequently recommend using an eye lubricating solution, like Refresh, to help lubricate their eyes during their allergy season. Finally, in some patients that are only showing red eyes and not responding to the previously mentioned products, I will prescribe topical steroid ophthalmic drops to help with their burning red eyes.
- For my outdoor allergy pets, I think it's a good idea to wipe their feet when they enter the house with hypoallergenic children's diaper wipes to reduce some of the outdoor allergens that they can tract into the house.
- Don't forget your flea and tick control. I'm shocked how many times I find fleas on my itchy pets. Buy it and use it!
If your pet is severely itchy and uncomfortable, in some instances, I will prescribe immuno-modulating drugs, like oral steroids or modified cyclosporine. A steroid, like prednisolone, can be given orally once or twice a day and provides great quick relief to your allergy pet. I never recommend long-acting steroids, like Depomedrol, which can stay in your pet's body up to one to two months. The potential negative side effects of long acting steroids (like liver and kidney disease and aggravating diabetes mellitus) are too high for me to risk. Modified Cyclosporine (Atopica) is a great drug to reduce your pet's inflammatory response to allergens. It is a more expensive drug than prednisolone, but has less overall side effects for your pet. Cyclosporine may take a week or two to work but it is very effective. The most common side effects of cyclosporine are diarrhea and loss of appetite but I rarely see this in my allergy pets.
Allergies in pets are not only frustrating for the pet but also for the owner. No one likes to be woken up in the middle of the night to hear their pet chewing on its feet or scratching its sides. Although this list of things to do for your itchy pet may seem daunting and time consuming, the rewards can be very dramatic and fulfilling to all involved. So, let's begin today to help reduce your pet's allergy symptoms by discussing my advice with your veterinarian. I hope you and your pet have an itch-free summer!