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 Allergies in Dogs
Many dogs have allergy problems. It is estimated that as many as 10% of all dogs are afflicted with allergy symptoms. Moreover, certain breeds are even more likely to have allergies: golden retrievers, Irish setters, Labrador retrievers, Lhasa apsos, miniature poodles, miniature schnauzers, pugs, Scottish terriers, West Highland White terriers, and wire-haired fox terriers are all breeds known for thier tendency towards allergies. Most dogs with allegies will first show symptoms at 1 to 3 years of age.
Dogs with allergies are often allergic to some very common things. Most dogs with allergies are allergic to things like house dust mites, house dust, human dander, feathers, molds, and pollens from trees, weeds, and grasses. We call this type of allergy to inhaled irritants atopy. Also, food allergies are quite common in dogs. Many dogs react to the large proteins found in many common foods.
Dogs with allergies often have different symptoms than people with allergies. While people typically experience runny eyes, runny nose, sneezing, and asthma-like bronchoconstriction, dogs typically experience itching as their main symptom. Allergic dogs will typically lick or scratch at their flanks, groin, and arm-pits. They may rub their face on the carpet. They often lick or chew their feet. The areas that the dogs lick frequently can become stained a reddish color by the saliva. This is particularly noticable in white dogs. Some allergic dogs' only symptom is chronic ear infections.
As in people, allergies in dogs are not curable. Our goal is to reduce the symptoms to where the patient is more comfortable and has an acceptable quality of life. Mild allergies may require no treatment. On the other hand, dogs with severe allergied can be quite miserable, with near-constant licking and scratching, and can require extensive treatment.
Because dogs react to allergies in different ways than humans, it makes sense that human allergy medications are less effective when given to dogs. While many people experience considerable relief from their allergy symptoms with antihistamines like Benadryl or Tavist, we find that antihistamines don't work very well in dogs. Similarly, the new-genration allergy medications for humans like Nasonex and Flonase are not very effective in dogs either.
There are three qualities to consider when discussing allergy medications for dogs: Safety, Efficacy, and Cost. It turns out that you can only have two out of the three in any given treatment. There are some allergy medications such as Atopica that are quite safe, quite effective, but fairly expensive; some medications such as steroids that are not very safe but are quite effective and quite inexpensive; and some medications such as antihistamines that are quite safe, quite inexpensive, but not very effective.
As a first choice treatment for most dogs who are mildly or moderately affected, we often choose to combine three of the safe, inexpensive, but not-so-effective treatments in the hopes that using three at once will overcome the lack of effectiveness problems. And often this protocol works. We start the allergic patient on a new diet, Z/D from the Science Diet people. This food is very hypoallergenic, and helps many itchy dogs to feel much better. Because it is a food, it is easy to give, and has absolutely no side-effects. It is more expensive than regular dogfood, but much less expensive than other allergy treatments. Click here for a moderately-informative link to the Science Diet website.
We also start allergic dogs on a special fatty acid supplement called Derm-Caps. The fatty acids in Derm Caps help reduce the skin inflammation that allergies cause in dogs. Since this product is more of a food supplement than a drug, there are no side effects. Many dogs like the taste as well.
The third thing we add is an antihistamine. Although antihistamines are less effective in dogs than we might wish, when used in this three-pronged approach they do contribute significantly. We often start with benadryl, and we use relatively high doses. Benadryl has minimal side effects in the dog, with very few canine patients experiencing drowsiness. Nonetheless, it is recommended that your pet not drive or operate heavy equipment while taking benadryl.
If the first choice treatment does not provide enough relief, we may try a different antihistamine. If that doesn't help, we move on to plan B. Plan B involves using either Atopica or steroids. Of the two, Atopica is by far  the best choice because of the safety issues that chronic steroid use presents. Simply put, Atopica is a drug that reduces the body's reaction to the things it is allergic too. It is relatively new, having been on the market only a few years, but it has proven itself to be quite effective and very safe. The main adverse effects are mild stomach and GI irritation, which is seen as vomiting and or diarrhea.
Atopica is given daily for 30 days. After that, we try reducing the dose to every other day. In my experience, about 60% of the time we can reduce the dose and still control the symptoms. If every-other-day dosing works, we then try every-third-day dosing. While not many patients (less than 20%) do well on every-third-day dosing, it is worth trying. It is worth trying because Atopica, while being very safe and very effective, has the drawback of being expensive. A box of 15 tablets big enough for a 16-pound dog costs about $35, while a box of 15 tablets for a 33 pound dog costs about $65. The relief from itching is significant in most cases. Atopica takes three months to achieve maximal effect but noticeable improvement should occur in four to eight weeks
Click here to go to the official Atopica website. If your dog ends up taking Atopica, your homework assignment will be to read through the entire website!
If Atopica is not an option for your dog, we can consider chronic steriod administration. Once a main-stay in veterinary allergy treatments, we now know that steriods can have so many adverse side effects that the side effects may become worse than the original condition we are using the steroids to treat. To quote Dr. Keith Hnilica, DVM, MS, DACVD, a dermatology expert from the University of Tennessee, "Steroids are like cigarettes: one cigarette will not kill you; social smoking is probably OK, but at some point smoking becomes detrimental. One in five smokers get lung cancer; nicotine has some benefits - a sensation of well-being, memory improvement, energy booster. Likewise steroids have benefits but with chronic use and more importantly, repetitive use - at some point problems develop."
However, in some cases, steriods can be used long-term with fair safety as long as precautions are taken. Never give your dog any other medication, whether over-the-counter or prescription, without clearing it with me. Your dog will need periodic examinations and labwork, usually every six months to one year, to watch for problems. We always try to use the lowest effective dose. Click the link for a more detailed discussion of long-term Steroid Use.
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