Category Archives: Allergy Season

A new approach to an old problem

posted on November 01, 2018 by Dr. Jamie Hartman

Allergies are a common complaint in our animals, with up to 15% of dogs suffering from atopic dermatitis.  Treatment focuses on diminishing exposure to allergens (special diets, bathes, HEPA filters), treating secondary skin infections, and altering the immune system so it does not react.  Antihistamines and steroids are the most common methods of changing the immune response, with immunotherapy injections being another option.  However, steroids can be broad spectrum in their effects on the body, so newer medications and modalities are constantly being researched.  There are more specific medications available such as Atopica and Apoquel.  An even newer approach is Cytopoint.

Cytopoint is an injection given every 4-8 weeks.  It differs from steroid injections in that it targets specifically itch receptors instead of the immune system at large.  Cytopoint is an antibody against a chemical called cytokine IL-31, which is a chemical that triggers the process of sending itch signals to the brain.  By targeting this signal, it is able to interrupt the itch cycle before it even starts.

Cytopoint is a safe medication as it mimics the dog’s own immune system.  It is used and broken down inside of cells into amino acids and peptides.  It is not converted into reactive or toxic metabolites in the body.  It is not metabolized by liver or kidneys, and is not excreted in the urine, meaning it should be safe to use when there are other disease processes present in your pet. (Please note, it is still up to your veterinarian to determine if it is safe to use Cytopoint in your pet’s specific condition and instance).  Cytopoint can be used in conjunction with other medications, including many that are typically used for allergies.

The local dermatologists have been using Cytopoint for a few years, and we were happy with their results, so we are now proud to also offer Cytopoint injections here at Heritage Animal Hospital.  If you feel your dog is suffering from allergies, please schedule an appointment to discuss options for your pet!

Apoquel and Cytopoint are trademarks of Zoetis.  Atopica is trademark of Elanco.

May is Asthma and Allergy Awareness month

posted on May 02, 2017 by Dr. Jamie Hartman

One of the most common issues we see in our pets is allergy issues, and the month of May is dedicated to allergy and asthma awareness.  In our pets, 90% of allergies are environmental, versus only about 10% which are due to food.

If your pet is experiencing symptoms such as eye discharge, sneezing, chewing on feet, anal gland issues (scooting or licking anal area), thickened skin, recurrent ear infections, skin infections, or overall itching, it may be allergies.  An examination by your veterinarian should be performed to determine if it is indeed allergies and then appropriate treatment can be implemented.  Cats with allergies can develop wheezing and respiratory issues (allergic bronchitis and asthma).  However, breathing issues can also be due to many other illnesses and can be an emergency.  Please seek immediate medical attention for your pet if it is having difficulty breathing.

Allergies are the immune system over-reacting to things it does not or should not need to.  The goal of treatment is to try to decrease the immune response, either by suppressing the immune system and it’s activity, or to decrease the body’s response to the items it is over-reacting to.  There are a number of ways we can try to do this.

  1. Decrease exposure:  Most allergens are through contact in pets, so decreasing contact is important.  Things such as weekly bathing, soaking the feet in Epsom salts nightly, washing all bedding, and using HEPA filters in vacuums and air filters can help decrease exposure.  If the allergy is food related, finding diets without the offending ingredients can also help.  If allergy testing is pursued, it can further help point us in the correct direction for decreasing expsoure.
  2. Control histamines:  Histamines are released by white blood cells in response to allergens, and they are responsible for many of the symptoms we see such as itching, running eyes and nose, and sneezing.  Antihistamines are a relatively inexpensive, well tolerated, and safe way of controlling these.  Often anti-histamines alone are not enough to completely stop allergies, but they can be of great help.  We can help direct you with the correct dosing of antihistamines for your pet.
  3. Suppress the immune system:  Steroids are the most common medication used to do this.  Steroids work very well to suppress the immune system, but they have side effects.  Short term, they can cause increased thirst and urination, which may lead to house soiling.  They can also cause an increased appetite, which can lead to weight gain.  Long term use can cause weakening of ligaments and muscle loss, along with elevations in liver enzymes and even potentially damage to the liver.  Steroids can also make your pet more prone to infections.  Because of these reasons, we often try to use bathing and antihistamines first, and add in steroids as a later treatment for cases that don’t respond as we would like.

Veterinary dermatologists such as Dr. McKeever or Dr. Eisenschenk have immunosuppressive medications that cause less side effects than steroids.  We now also have a medication like this, called Apoquel.  These medications are more expensive, and may still require monitoring of liver and kidney enzymes or white blood cell counts as they suppress the immune system.  However, these medications are more specific to what part of the immune system they target, reportedly have fewer side effects, and may work better for some pets.

  1. Re-training the immune system:  Lastly, allergy testing can be performed to determine what the pet is specifically allergic to.  Using this information, the environment or diet can be modified to avoid triggers.  Also, an allergy extract can be made.  This extract is injected in very small amounts and slowly increased to try to teach the immune system that the allergens in it are not to be reacted to.  Allergy testing and allergy extract injections can be costly and require a lot of follow up, but may provide your pet with very specific relief and much fewer side effects than some of the other medications available.

Allergies are frustrating for all of us because they are not easily fixed, often require life-long therapy, and flare ups are common.  However, we will try to implement many of the above therapies in the best approach for you and your pet to help alleviate their symptoms.

 

Icky Ears

posted on September 01, 2016 by Dr. Jamie Hartman

This time of year we start seeing a lot of seasonal allergies pick up again, and one of the things that goes hand in hand (paw in paw?) with allergies for some pets is ear infections.

There are a number of different types of ear infections, also known as otitis.  There are a normal amount of bacteria and yeast that live on the skin, and the immune system usually keeps them in check.  When conditions are right for the yeast or bacteria to overgrow, or if the immune systems is not able to work properly, an infection can start.  Infections can be just bacteria, just yeast, or a mixed infection of both.

Wet conditions and lack of airflow into the ear can cause yeast and bacteria to overgrow.  Pets that swim a lot, or get water into their ears during bathing, or even pets with long floppy ears, may be more prone to ear infections.  We generally recommend using a veterinary ear cleaner after bathing or swimming to help prevent this.  The ear cleaners we carry have a drying agent in them to help prevent the water buildup leading to bacteria or yeast overgrowth.

Allergies are the immune system over reacting to things in the environment, usually things it does not need to react to.  This can change the skin’s immune response, and can also lead to secondary infections especially if there is inflammation or if the pet is scratching the skin raw.  This can lead to overgrowth of bacteria and/or yeast as well.

Pets can also get mites in the ear.  These usually occur in young puppies and kittens, but can occur in any pet exposed to them.

If left untreated, ear infections, regardless of cause, can cause further problems.  If the pet is shaking their head excessively, an ear hematoma can form.  This is when the small blood vessels in the ear flap (pinna) break and the ear pinna fills with fluid.  Ear infections can also affect the ear drum and potentially hearing and balance.

If you notice your pet has a foul odor in it’s ear, has discharge or redness to the ear, or is shaking it’s head and scratching excessively, we should probably examine them.  We will likely want to take a sample of any discharge present, so don’t clean it before coming in.  We will examine it under a microscope to look for yeast, bacteria, white blood cells, red blood cells, skin cells, or mites.  This helps us determine which type of medication and treatment is best.  We may also examine the ear drum and perform a thorough cleaning for you.  Medications and cleanings may be prescribed for you to do at home, and we will show you how to do these.  Call us today if you think your pet has an ear infection!

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Hot weather, hay fever, hot spots….

posted on May 21, 2012 by Dr. Jamie Hartman

Ah-choo!  Yup, you guessed it, allergy season is here again.  Allergies are an overreaction of the immune system. Immune cells release histamines, which can cause inflammation in the body, usually in the skin, gastrointestinal (GI) tract, or respiratory tract.  This leads to secondary issues such as ear infections, skin infections, fungal (yeast) and bacterial infections, pyoderma, hot spots, anal gland issues, sneezing, runny eyes, breathing issues, or vomiting and diarrhea.  In severe cases hives or even anaphylactic shock can occur.
Signs of allergies can include:

  • Asthma problems
  • Runny eyes or nose and sneezing
  • Itching and scratching
  • Licking and chewing, especially of feet, flanks, or tail areas
  • Redness of skin
  • Ear infections-odor, discharge, or redness in ears
  • Skin infections which may present as open sores, pimples, red bumps, dry skin, scabs, and crusts

Pets can be allergic to a number of things, which usually fall into the categories of fleas, environment, and food.  Examples of environmental allergens can include pollens, dust mites, and molds, and examples of food allergens can include meat, grains, and dairy ingredients.

There are many things we can do to help you and your pet manage their allergies including:

  • Treat for fleas-even if not seen, they may be contributing to the problem
  • A food elimination trial-feeding a special diet with no flavored medications or treats for 8 weeks
  • Antihistamine trial
  • Bathing regimen with medicated or otherwise recommended allergy shampoo
  • Steroids or other immunosuppressive medications
  • Allergy testing and desensitization
  • Treating secondary skin or ear infections which may be contributing to the itching

Call us today to set up an appointment to discuss your pet’s allergies and come up with a treatment plan specifically for your situation.