New options for managing pet allergies

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It’s allergy time of year again, and our pets are feeling it just like we are.

Seasonal allergies can lead to itchy, inflamed skin and are the most common underlying cause of chronic skin and ear infections in dogs. Do you have a dog that constantly has black debris coming out of his ears, is always licking her feet or gets hot spots regularly? Then you likely have a dog with allergies.

Dogs can be allergic to everything we are, like pollens, grasses and trees. An allergy is when the body mounts an immune attack against one of these substances that it considers a foreign invader. The skin and ears get inflamed, and then the yeast and bacteria that are on the skin normally take advantage of this inflamed skin and overgrow to cause an infection.

Because of this underlying allergy, just treating the infection will not solve the problem. For example, you may clear up an ear infection temporarily by treating with an antibiotic or topical cream, but in pets with allergies, if you don’t make a plan for managing the allergic problem long term, the ear infection will quickly reoccur.

Allergies are very frustrating for pet owners and veterinarians alike, but there are some new allergy therapies available now that are very effective and have fewer side effects than traditional therapies.

The traditional way we have managed allergies is with antihistamines, steroids or topical treatments.

Antihistamines like Benadryl still have their place for dogs with mild allergies. Benadryl is inexpensive and safe and is available over the counter. In dogs with mild allergies, Benadryl is a great place to start with treatment.

The dose of Benadryl for dogs is one milligram per pound. For example, a 25-pound dog will take 25 milligrams of Benadryl and a 100-pound dog will take 100 milligrams of Benadryl every eight to 12 hours. The downside of Benadryl (or other antihistamines) is that, for dogs with moderate to severe allergies, Benadryl isn’t strong enough to stop the allergic reaction.

Topical medications, like shampoos, sprays and creams with steroids, antifungals or antibiotics in them, are also used to help manage allergy symptoms.

For dogs that have very localized problems — foot itchiness, for example — we can sometimes get away with a local treatment. Topical medications can be effective if the client is able to administer them properly and regularly and the dog doesn’t immediately lick the medication off.

You and your veterinarian can decide if topical management of an allergies and secondary infections is a good fit for you and your dog. The biggest problem I see with topical medications is compliance. It is not always easy to rub a cream on the skin, especially if the dog is very furry.

Steroids, like prednisone, have also been used for many decades to manage allergies. Prednisone is very powerful and effective, but it has a lot of side effects that make it undesirable for long-term use.

Taking steroids long term prematurely ages the patient. Steroids will thin out the skin, weaken tendons and muscles and put undue stress on internal organs. Plus, they make your dog drink a lot and urinate a lot, so you need to be able to take your dog outside frequently to avoid accidents in the house.

Prednisone is cheap, and for short-term use is fine. I typically tell clients that if we have to use steroids for more than six weeks out of the year, we should discuss some of the new allergy management options that are available.

As a veterinarian, I love two new allergy medications that have become available over the past several years. Apoquel and Cytopoint are powerful medications against allergies but without the side effects that we see with steroids.

Apoquel came out several years ago. Unlike prednisone, which suppresses the whole immune system, Apoquel is not as broad spectrum of an immunosuppressive drug. It targets primarily cytokines, substances released by immune cells that are involved with coordinating an allergy response. It works quickly and with very few side effects. It is not side effect-free, however, and it is important that your dog undergo blood monitoring if he takes Apoquel long term.

Apoquel has been known to reduce white blood cells and elevate liver enzymes. At our clinic, we recommend a blood check one month after starting Apoquel and then every six months after that to screen for any side effects from the medication.

Cytopoint is an injectable medication that your veterinarian administers at the clinic. It is an even more targeted approach to stopping the itch cycle then Apoquel.

Cytopoint binds to one specific cytokine called Interleukin-31 (IL-31). IL-31 has been shown to be responsible for most of the itchiness that is seen with allergies. By binding and inactivating IL-31, some patients are completely itch free until the shot wears off. The Cytopoint shot will last for four to six weeks in most patients.

Cytopoint is very new for general practitioners. We have only had it available since the beginning of this year. So far, no real side effects have been reported. However, it is an immune modulating drug, and for that reason we are exercising caution and recommending blood monitoring with this medication as well.

Apoquel and Cytopoint are terrific, and I am so happy that I have these new allergy medications to offer my clients. The big drawback to these medications is the cost.

Depending on the size of the dog, it can cost $70–$150 per month to treat an allergic dog, and that doesn’t include the cost of blood monitoring. They are new medications, so hopefully the cost will come down over time. Also, because they are so effective at controlling allergies, there is a cost savings in that you won’t have to see the veterinarian so often to treat those secondary infections that arise.

Your dog doesn’t have to suffer through another allergy season. Talk to your veterinarian about the new allergy medications that are available. You and your dog will be happy that you did.

 

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