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Tuesday, January 26, 2010

More on allergies

I think I passed out nearing the end of writing the last post. While I haven't documented it officially, about 25-40% (addendum: 50-60%) of my appointments are related to allergies. The dog with a chronic or recurrent otitis (ear infection): primary allergies. Chronic or recurrent pyoderma (skin infection): primary allergies. Chronic or recurrent client kvetching: primary allergies.
If symptoms are classic, and the pet responds favourably to antihistamines, a presumptive diagnosis of allergy can be made (though not a complete diagnosis). If a pet doesn't respond to antihistamines, allergic disease cannot be completely ruled out, as some dogs respond poorly, or not at all, to these medications. This often occurs in cases of food allergies and severe cases of atopic dermatitis.
Again, pets can be atopic or have a food allergy (to keep things simple). They can certainly also have both.
In cases of non-seasonal symptoms (itchy throughout the year), a food elimination trial is indicated. There are a few ways to do this. You can cook for your pet. In this case you must choose a novel source of protein and carbohydrate, i.e., something the pet has never consumed before. This could mean rabbit, horse, ostrich, kangaroo, and other things that completely gross me out. The source of carbohydrate is often either rice or potato. If you don't want the hassle of cooking the meat of these beasts, a prescription diet, made of hydrolyzed protein, can be tried for a minimum of 12 weeks. These foods include, but are not limited to, Purina HA, Medical HP, and Hill's z/d Ultra. Dogs with confirmed food allergies will respond to one of these diets in at least 75% of cases.
If the pet continues to itch after 3 months of a STRICT food-elimination trial, the dog or cat may have concurrent atopy or just atopy with no food allergy. Intradermal skin testing or serum allergy testing would be indicated in this case, with the aim to have the pet desensitized based on the results of the aforementioned tests (desensitization is essentially a process of vaccinating the patient, slowly however, with multiple and frequent injections, to slowly build up antibodies against the offending antigens).
If your dog or cat has chronic and/or recurrent skin problems, talk to your vet about allergic skin disease. Just be very patient as the diagnosis may take a while to elucidate, and the response to therapy may also require time and trials. Just keep the communication up with your vet because he/she needs to know what works, and what doesn't!
Remember, not only allergies cause itchy skin in dogs and cats.

They may be hypoallergenic.


GoLightly said...

Can they develop allergies to a food, if it's fed exclusively? Even if they were not allergic before?


You made me laugh, thank you!

novel protein sources, yes, they are myriad,indeed.

OrganicCatFoodBlog said...

I see there are two types of cause to occur pet allergies. Could it be environmental as well? It sounds just like a child with allergy and complicated. Thanks for informative post, bookmarked!

TorontoVet said...

Yes, that's exactly right. Environmental allergies = atopy (or atopic dermatitis). That means that allergens in the air that are inhaled or physically touch the cat/dog elicit an allergic response.
Children and adults can develop seasonal allergies or allergies to anything in the air (like dust, pollutants, molds, etc).
I hope that's clear. Thanks for reading!

Ben Simmons said...

I am currently reviewing my pricing structure and looking at the fees I charge my clients.

I always feel diagnosis of allergies where there is not obvious cure beyond avoidance to be a tricky problem to charge. I always somehow feel guilty about it. What fee structure does everyone look at?

cat health said...

Are there any chemical treatments that may be used to help your dog with its itchy problem?

- Mathew

Diane said...

Is eosinophilic granuloma (not sure I'm spelling that right) in cats an allergic reaction? I have a six year old indoor cat who maybe every other summer gets nasty sores on her lips and the roof of her mouth. I've gotten conflicting information from vets at the clinic as to whether this is allergy-related or not.

TorontoVet said...

Eosinophilic granuloma complex (indolent or "rodent" ulcer, linear granuloma, etc) is a clinical syndrome that far likely has allergic disease as a primary etiology. These lesions sometimes spontaneously regress, and often require treatment in many other cases. Environmental allergens and adverse food reactions (and of course flea allergy dermatitis) often play a major role).

TorontoVet said...

Forgot to add: next summer, I'd try the cat on a course of cetirizine (Zyrtec in the US, and Reactine in Canada) at a dose of 5 mg per CAT once daily.

Anonymous said...

I have the exact same issue! My 5 year old cat gets skin reactions every other summer (2008, 2010, & now in 2012). It'll go from itchy paws (which she chews & gets infected) to lip lesions, to a puffy lip, and back again! Or sometimes just one symptom... This time around she started with lip lesions, those went away, & now she had the infected itchy paw. I can't figure out if it's food or seasonal - do you have any clues? I just noticed this post is 2yrs old, so maybe you've figured out the cause??