We suspect your pet may have either Atopy or Food Allergic Dermatitis (FAD). Symptoms of Atopy/FAD include:
- Scratching/licking/rubbing the face, feet, armpits, and/or groin.
- Recurrent anal sack irritation.
- Recurrent ear infections.
- Some may have recurrent eye infections, sneezing and coughing as well.
- Some may also have recurrent vomiting/diarrhoea if they have food allergies.
Atopy and FAD are lifelong problems that are rarely cured and require continuous management. It can take up to a year to diagnose and tailor your pet's treatment regime.
We strongly recommend telling your insurance company as soon as we suspect your pet has Atopy/FAD as failure to do so may mean they will not cover future costs that they deem to be associated with these problems.
What are the most common allergens?
- House dust mites – these live wherever people live
- Storage mites – found in dry food stuffs
- Chicken – the most common protein source in pet foods and treats
- Cow's milk proteins – found in cheese and milk
How do we investigate Atopy/FAD?
Food allergy is investigated by performing a food trial (see attached sheet). Blood tests for food allergy are not accurate and so we do not recommend these. Food trials can be done from any age.
Environmental allergens are diagnosed by either taking a blood sample or performing intradermal allergy testing. Some animals will give a negative result with one test, but a positive with the other. This test should not be done until your pet is approximately 1yr or older.
How do we treat Atopy/FAD?
Step 1 – control any skin/ear infection that may be present:
- Take swabs and skin scrapes to identify any infections.
- Apply a good flea/mite treatment ie Bravecto.
- Use antimicrobials
- Malaseb – topical shampoo that treats yeast and bacterial.
- Vetsoothe wipes – a wet wipe version of Malaseb, good for feet and face.
- Isaderm – topical antibacterial and steroid cream.
- Ear flushing – at home or under anaesthetic to remove debris from the ear canal.
- Topical ear antibiotics/antifungals - used after flushing.
- Antibiotic tablets/injections.
Step 2 – manage the itch short-term:
- Cheap and highly effective.
- Can interfere with allergy blood testing.
- Short term side effects include increased thirst and urination, increased appetite, panting.
- Long term side effects include weight gain, thin skin, muscle loss, possible diabetes, increased infections.
- Moderately expensive.
- Doesn’t interfere with allergy blood testing.
- Less side effects than steroids.
- Dogs only.
- Not licenced in pets.
- Rarely effective in animals as they need to be given before exposure to the allergen.
- Can sometimes be effective in pollen allergies.
- Doesn’t interfere with allergy blood testing.
Step 3 – investigate the allergy:
- A thorough history of your pet may give us a clue to the allergy.
- Food trials can be done at any time including when your pet is on steroids or under 1yr so is often done first.
- Allergy bloods – can be done at Elm.
- Intradermal skin testing – requires referral to a dermatologist.
Step 4 - long term management:
- cheap and effective but lots of side effects.
- moderately priced tablets, not great for patients where ears are their main problem.
- Monthly injections with a monoclonal antibody (not a drug), which blocks the itch.
- Very effective but may need additional treatment for ears.
- Can be expensive in big dogs.
- Very few side effects.
- Very effective.
- Moderate side effects.
- Monthly injections (maintenance course) with small doses of the things your pet is allergic to.
- Expensive at the start.
- 1/3rd of cases “cured” but require lifelong treatment.
- 1/3rd of cases improve.
- 1/3rd of cases no better.
- It takes 9 months before you can decide if it is working or not.
- Side effects rare.
- Longterm maintenance on a diet free from the food allergens we have identified your pet reacts to.
- Can be problematic if your dog scavenges and they may need steroids alongside their diet to prevent flare ups.
Topical Treatment - Some cases with very localised problems maybe suitable for local treatment only. Your vet will discuss this with you if we feel it is appropriate for your pet.
- Steroid spray.
- Vetsoothe wipes.
- Trizchlor/steroid ear flushing twice weekly.
Improve the skin barrier
- Essential fatty acid supplementation
- Shampoos ie Vetsoothe, Episoothe, Sebocalm, Allermyl.
- Avoid long grass.
- Wipe feet with a damp cloth after walks.
House dust mites
- Use household flea spray.
- Vacuum regularly.
- Hot wash bedding.
- Don’t let your pet on sofas and beds, avoid carpets if possible.
- Don’t store dry food in a bin, keep it in the bag.
- Put water on dry food.
- Wipe your pets’ face after eating.
Allergies are complex to diagnose and manage.
You may need to trial multiple different treatments before we find the optimum for your pet.
Breaks in therapy may result in expensive flare ups of symptoms. It is always better to maintain your pet on a daily low dose of therapy, than manage the boom-and-bust cycle of treatment-stop-breakdown-repeat.