What is Atopy?
Pollen allergies (or atopy) are the second most common skin disease of dogs (flea allergy is #1). Affected animals have an inherited predisposition to develop antibodies to environmental allergens resulting in allergic disease. Purebred dogs are the most commonly affected. The breeds with the highest incidence are Cairn Terriers, West Highland White Terriers, Scottish Terriers, Schnauzers, Cocker Spaniels, Golden Retrievers, and the Shar Pei.
The primary symptom of atopy is scratching. The areas of the body most commonly affected include the muzzle, ears, paws, underarms, stomach, groin, and the areas around the eyes. The excessive scratching, licking, and rubbing of these areas leads to distinct changes in the skin. These changes may include discoloration (a change in pigmentation, usually to a darker color), hair loss and changes to the surface of the skin. The surface of the skin may become thicker and tougher and abrasions and self-inflicted injuries may occur from excessive biting and chewing. Bacterial skin infections occur in 50-75% of patients with atopy.
About 75% of atopic dogs develop signs between 6 months and 3 years of age. Typically, a patient initially licks the paws during a particular season. The scratching starts out mild and becomes progressively worse over time with the allergies and scratching eventually becoming a year-round occurrence.
There are a number of important types of treatment for atopy. Our overall strategy is to provide comfort, minimize self-injury of the skin and use minimal medications that may cause side effects.
Supplementation of fatty acids containing Gamma Linolenic Acid and Eicosapentanoic Acid have been shown to be beneficial in controlling allergies. These fatty acids are present in Omega 3 and Omega 6 fatty acids and are commonly found in fish oils. These products should be given daily with food.
Bathing on a regular basis will help to reduce your pet’s exposure to allergic pollens. Pollens are absorbed via the skin and by inhalation. The greater the number of pollens present, the faster a threshold for eliciting an allergic response will be reached.
Bathing is also extremely important as a treatment for damaged skin. Bathing helps to re-moisturize the skin, remove bacteria and reduce the production and presence of excessive oil, wax and epidermal debris. Different types of shampoos are useful depending upon the type and severity of the changes to the skin.
The following bathing schedule is recommended for dogs with allergies:
Mild Atopy: Bathe every 7 days with a mild moisturizing shampoo such as Aloe and Oatmeal.
Moderate Atopy (skin changes are present): Bathe every 3-7 days with a medicated shampoo such as Bioseb (salicylic acid with ethyl lactate) or Biohex (chlorhexidine and miconazole).
Severe Atopy (significant skin problems): Bathe every 3 days with an antibacterial medicated shampoo such as DermabensS (benzoyl peroxide with salicylic acid).
Hyposensitization is a therapy that attempts to modify the patient’s immune response to allergens. Patients are tested for sensitivity to specific allergens with either intradermal skin testing or via a blood test. An allergy serum is produced for the selected allergens and allergy shots are administered to the patient according to a set schedule. Hyposensitization allergy shots are effective 50-75% of the time within a 2-6-month period.
Hyposensitization therapy is usually the first treatment of choice for young dogs experiencing chronic, year-round allergies.
Hyposensitization therapy works by exposing the immune system to small amounts of the allergen regularly and gradually increasing the amount until the immune system shuts down its response to the allergen.
Hyposensitization is ideal in young pets who have mild allergies and the goal of hyposensitization is to control the mild symptoms and prevent the allergy from progressing to more severe symptoms and skin abnormalities which will require different types of medications
Cytopoint is an injectable monoclonal antibody therapy designed to specifically target the antibodies released into your pet’s system when they encounter allergens in their environment. Cytopoint intercepts the antibodies before they can trigger your dog’s itch response, offering relief for 4-8 weeks.
Cytopoint is for dogs with mild seasonal allergy symptoms without any secondary skin damage present. Approximately 25% of our allergy patients are good candidates for Cytopoint injections.
Cytopoint can be safely used with other medications and we have observed no significant side effects. Patients receiving Cytopoint injections do not require laboratory testing. Owners are encouraged to monitor their pet’s itch level to determine if or when the next injection will be necessary.
Apoquel is a new type of immunosuppressant medication that affects the white blood cells responsible for the mechanism of itch. Blocking the itch pathway ends the cycle of itch, inflammation and the resulting irritation and infection which can be associated with Atopy in dogs. Apoquel has been shown to be very effective, very safe and at this time we have observed no significant side effects when used according to directions.
Apoquel controls 80-90% of pollen allergies and can be used in conjunction with Cytopoint to control symptoms. Patients on Apoquel are required to have lab tests performed twice yearly.
Cyclosporine is an immunosuppressant that targets the lymphocytes (immune cells) that cause the allergic reaction in pets affected with atopy. Cyclosporine is commonly used in people who have received organ transplantation to prevent rejection of the transplanted organ. This medication is very effective at controlling allergies in dogs and it does not have as many adverse side effects as corticosteroids. Cyclosporine is normally used on a daily to every other day basis and side effects can include vomiting, diarrhea and gingival disorders. We recommend this drug for patients who have severe, year-round allergies that are not controlled with regular bathing and/or allergy shots.
Cyclosporine can be used in place of Apoquel in cases where Apoquel alone isn’t controlling the patient’s symptoms, or if severe secondary ear problems are present. We frequently find this to be the case with English Bulldogs.