How common are allergies in dogs?

Allergies in dogs are fairly common. They can range from food allergies to environmental allergies like atopic dermatitis, an inflammation of the skin. Dogs can also suffer from flea allergy dermatitis and, in some cases, contact dermatitis, which is an irritation caused by touching certain substances. With regards to affecting health or causing issues in the dog, they tend to have a pretty big impact, not only for the dog but also for the owner themselves. Most of these animals are licking and scratching and can sometimes suffer from GI issues, causing vomiting or diarrhea. There are a lot of different reasons and things that we can physically see that bring distress to the pet.

An annoyance is quite consistent with allergies in that the pet is always licking and making that noise that can be irritating. Because this is something that tends to be chronic, it tends to consistently continue in the background. A lot of times it starts slow and progresses with time. Some of the signs we typically see are itching, scratching, and chronic ear infections. Sometimes allergies are acute and can resolve, but sometimes they're chronic and cause red areas of inflamed skin, what we call hot spots, and infections, which become painful, depending on how far down along the line the dog is. Rashes, sensitivity, not being receptive to petting, lack of sleep, discomfort, and irritation are common signs of allergies. The more acute allergies would be like a bee sting, for example, causing facial swelling, swollen lips, puffy around the eyes, and red eyes.

Dr. Justin Eckenrode
Carlisle Small Animal Vet Clinic

How do you diagnose allergies at home?

Diagnosing allergies in pets can be challenging due to the broad range of potential allergens. Certain clues can help narrow down the cause. For example, knowing how long the symptoms have been present, when they started, and the age of the pet can be useful. It's crucial to note if the symptoms began when the pet was a puppy and have continued to progress.

How does the veterinarian diagnose allergies?

The veterinarian's approach is similar. Managing allergies in pets is a team effort. The vet gathers information from the pet owner to help diagnose the allergy. This information is then relayed back to the pet owner to help manage the condition at home. Let's take flea allergies, for instance. Flea allergy dermatitis is probably one of the more common ones we get. There's a primary cause, which are fleas, and a secondary consequence, which is usually trauma and irritation to the skin, the dermatitis, the pyoderma, the infection that comes secondary to it. We can manage those hot spots with a topical medication or antibiotic, but if we don't get rid of the fleas, it perpetuates it.

With medications that we have, with new products that are out on the market, we can better manage, and possibly remove the fleas completely from the environment that they're in. By doing that, we clean up the skin and therefore cure the pet, which has a very good outcome. With environmental allergies, it takes a little more time to manage depending on where you live, the seasons, or how long the allergies have been going on. Is this something that started way back when they were a puppy, or is this a new thing? Food allergies can fit along the pathway where if it's a new treat, a new ingredient, or something that was just introduced to the pet, we can keep it away from the pet. The signs will go away and we move on. However, if it's something within the food that they're eating consistently, we might find that a big change or even a new routine altogether is in order. It not only takes the veterinarian's direction to get that accomplished, but also the work of the pet owner to really implement and work with the guidelines. Sometimes it's very simple, and sometimes it's much more complex. It really boils down to what the underlying cause is. All allergy management plans are aimed at improving those signs on the front end to improve the health and well-being of the pet. Those are the biggest considerations because the better the pet feels, the less problems, vomiting, diarrhea, itchy skin licking, and those kinds of things.

How do dog allergies get treated using anti-inflammatories?

Various products on the market can help manage allergies. Many people opt for antihistamines because they're easily accessible and come in different forms. However, caution is advised since some versions contain decongestants, which are typically not recommended for dogs. In pets, antihistamines with regards to allergies are lower on the totem pole. A lot of pet owners that come into the practice say that they've been giving this medication consistently for the last several months and they think that they're immune to it or it's not working anymore. We do know now that it plays a very small role in atopic dermatitis and environmental dermatitis in pets. It can be used very well for bee stings or other acute things, but as far as long term maintenance goes, it doesn't typically work very well. There are other medications that are on the market that will help consistently target the itching part. Whether it be steroids or something along those lines or medications like Apoquel or Cytopoint are aimed at decreasing itching and lessening trauma to the skin, meaning less dermatitis, pyoderma, infections, and inflammation. By improving that, it brings more comfort to the pet.

Take seasonal allergies or atopic dermatitis, for example. If the pet is allergic to something specific that is blooming or coming out at that time, we try to be proactive with managing it by starting these medications earlier in the process. There will be less trauma to the skin and less treatment of secondary issues. Therefore, we get better improvement on the front end. The moment we see a pet, typically in the month of March, starting to crash or itch or lick their feet, we might start medications now that we know a pattern that can be identified at home. If we get that information on the front end, we might be able to start medications or treatments ahead of it that are more proactive in managing the primary symptoms. I can't emphasize how much teamwork really goes into managing that.

Steroids are another good option. They're great for acute allergies but do not have great long-term benefits because of the side effects. They cause increased drinking, urination, increase in appetite, and weight gain, and it can come along with its own skin issues secondary to it. It also has long-term effects on the internal organs. Some better products on the market can manage that better.

How is shampoo therapy used for dog's allergies?

I tend to lean a lot more toward topical therapy, with concerns growing with antibiotic resistance and using antibiotics in ways that may be appropriate but are selecting for problems down the line, especially for chronic and continuing things. Topical therapy does mean a little more work or a little more effort from the pet owner because bathing the pet more often, especially if they don't like to be bathed, becomes more of a challenge.

There are mooses, topical sprays, and other options that don't always require giving your dog a bath. If they're very itchy or painful, I will start them on medications before we even attempt to put anything on them topically. This is a perfect example of chronic otitis or ear infections. These allergies have often been brewing underlying, and they're getting worse and worse. What happens is they build up, and then you get these super painful and severely inflamed ears, and then you try to put medication in, and the pet just won't have it. In those pets, we won't even touch the ears initially. For a couple of days, we'll try to use something else, like a steroid, to decrease that inflammation and make those ears feel more comfortable before starting topical treatment. A lot of these treatments are used interchangeably to really make an improvement because if we can't treat the pet effectively, then we never cure the underlying process, and we never get better, which is why allergies can be exceptionally frustrating. Unless it's something focal, it tends to be long-term management with multiple checkups and follow-ups and ensuring we have the best plan.

It also depends on our expectations. Every expectation from a pet owner is a little different. Some people get irritated when there's just a little licking and stuff, and others don't mind that much. Long story short, with shampoo therapy, I can get the skin back under control and improve the skin. The other thing that goes along with shampoo therapy is skin. You could touch and feel skin. We can help the skin with an antiseptic direction. Even just bathing them to rinse things like allergens and pollens mechanically can make a big difference. I tell most of my pet owners that we take a shower and change our clothes and wash our face and stuff, and we remove a lot of those allergens and pollen that are out there. Whereas pets, we only bathe them once in a while. Maybe we should be doing it more often sometimes, especially during the seasons when allergies are higher.

I have used something very simple over the years: take a paper towel, dampen it down, and just wipe their face and down over their body daily. Mechanic wiping is cheap and can be effective in bringing their allergy down just enough to take the edge off. The other thing with shampoo is that it can hydrate the skin and improve that barrier. If we improve that barrier, it keeps those allergens and pollens from working their way through and stimulating their system. With some pets, the management ends up being a weekly generalized bath to remove those allergens and pollens and strengthen their coat. I have some pets that don't need oral medications, but during allergy season, you can bathe them weekly. A great thing to help us gauge whether we're making improvements or not is using a one to ten scale, one being they don't itch at all and ten being they are itching constantly. As we start that treatment, I have the pet owner give me some info, and we settle on a number to use as a tracking system.

How does hyposensitization and desensitization work for allergies?

There is a lot of discussion about it because I do have people ask periodically about testing. With food allergies, we'll use that in particular. The blood tests are not always very effective. They give you information, but they don't give you enough to tell you to avoid this or do that. If they are allergic to food, it's usually a protein source. Let's just use chicken because it is very abundant. Over-the-counter diets tend to have mixtures, and even if it says it's lamb and rice or something along those lines, it's all made in the same factory. There's the possibility of particular matter getting in their food, like little pieces of chicken.

Because of that, you might still have this underlying allergy. We often reach for these prescription diets to help us with food allergies. Staying strictly on that diet allows us to possibly identify what's causing that allergy. Then, we have to manage the secondary symptoms in the GI tract with probiotics and anti-inflammatories to get that back to normal. If the food allergy manifests in the skin, we might need to use anti-itch or topical therapies while we do that treatment. Typically, we'll go six to eight weeks with that, then we can reassess. It would be perfect if everything got back to normal, and we could reintroduce that food that we used to be on so we could figure out, yes, that seems to be the issue.

However, some people want to stick with the prescription food. We can stick to the diet long term, but there are plenty of options. When it comes to hyposensitization and desensitization, I typically will talk to clients about seeking information from a dermatologist, especially if I think this will be long-term. The reason I recommend that is because they're able to do more specific testing. You can run the allergy testing specifically on the skin and find out what a pet is allergic to. Because you're actually looking at the organ that's having a problem, you can give injections and try to get their body to not react as badly to the allergen. I always say it's more about trying to win the war, not the battle. We can fight the battles, but sometimes, we need to look at the bigger picture. Routine checkups, discussions, and follow-ups are going to be very important to know whether we are seeing an improvement.

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