Q: My Bichon is 2 years old and has a skin allergy. We had him on special food and there was no improvement. Then he was on Atopica 50 mgs and no improvement. I do not want to keep him on steroids. Any suggestions? He does not have any signs of allergy on his skin. He just appears to be itchy.
A: Allergies are one of the most frustrating conditions to treat in dogs and in people for that matter. The ultimate goal in treating allergies is to try to figure out what the pet is truly allergic to which can be challenging. Your veterinarian will require a thorough diet and environmental history from you before deciding how to proceed with treatment and diagnostics. Any changes in food, treats, bedding, detergent, or any other environmental factor should be discussed. Making sure all dogs are on a regular flea prevention product is also essential as flea allergy dermatitis is very common and can mimic food or environmental allergies. It is also important to take note of whether the dog’s itchiness seems to have a seasonal pattern to it or whether it is a year-round issue. This can help differentiate between allergies due to the environment or due to food.
You mentioned trying a ‘special food’ which brings up an important point. A true hypoallergenic food trial must follow a strict course. First, the diet chosen should include a novel protein source that the pet has never eaten before. Common protein ingredients in hypoallergenic foods include venison, duck, and fish-based diets. Also, this diet must be given for a minimum of eight weeks before deciding if it is helping with your pet’s signs. It is essential to note that no other food can be given during this time as it may interfere with the trial. That means no treats other than prescription hypoallergenic treats, no table food, and not even an oral heartworm preventative pill as these can all have allergy-inducing ingredients. Prescription veterinary hypoallergenic diets have a better track record of success as opposed to over-the-counter diets that might be labeled as ‘sensitive skin’ formulas.
Medical treatment for allergies can range from antihistamines, both over-the-counter and prescription, to steroids to topical therapy. Different antihistamines have varying levels of success in every patient and several may have to be tried before finding one that works for your dog. You also mentioned the use of steroids like prednisone which tend to work very well for suppressing itchiness but are generally not a good long-term solution because of the potential long-term side effects that can be seen with this class of drugs. They are often necessary in the short-term to make them more comfortable until the offending allergens can be identified and maintenance therapy instituted. Atopica is a relatively newer treatment for allergies. The active ingredient is cyclosporine which dampens the inflammatory response in the body but doesn’t work for every patient and it can be expensive in larger dogs. Topical therapy such as medicated shampoos and conditioner combos can be very useful adjunctive treatments to flush environmental allergens off your pet and sooth the skin. There are also antibiotic and anti-inflammatory sprays that can be utilized for localized skin lesions.
Diagnostics that your veterinarian might perform may include skin scraping to look for mites, skin cytology and cultures to help treat the secondary bacterial infections that tend to concurrently exist with allergies, and ultimately, allergy testing with allergen-specific immunotherapy. Blood testing for underlying endocrine diseases like hypothyroidism or Cushing’s disease may also be indicated. Working closely with your veterinarian to come up with the most suitable diagnostic and treatment protocol for your allergic pet is essential because at the end of the day, allergies are rarely cured, they are managed.