Itchy Beginnings
A new season arriving sometimes bring a new (or recurrent) arrival of a head shake or a persistent scratch. These can be so frustrating to deal with! Usually when we think of these issues, our first thought is that our furry friend must’ve gotten water stuck in the ears (the usual suspect for people’s ear issues) or rolled in something like poison ivy. But how often are they going swimming? How often do you see them rolling in poison ivy? The answer is probably not often when you actually think about it. All of these roads lead towards one usual suspect – allergies.
What do allergies look like for pets?
In people, when we think of allergies, we think of sneezing, wheezing, coughing, and runny eyes. In dogs and cats, this is not as much the case. What usually happens is that they get itchy ears, itchy skin, itchy paws, or possibly recurrent GI signs such as vomiting, regurgitation, diarrhea, soft stool, or affected anal glands. This is because in dogs and cats, allergies lead to the epithelium of the skin (or inner lining of the GI tract) to be chronically inflamed, leading to the aforementioned signs. This inflammation then traps in the normal flora found on the body or in the GI tract, leading to a catch-22 of more itchiness. What an uncomfortable cycle! But what kind of allergies cause these issues?
Ectoparasites
In dogs and cats, allergies are generally broken down into 3 broad categories usually based on easiest to treat/modify to most difficult to treat/modify. The first is ectoparasites (i.e. fleas, scabies, demodex, ear mites, etc.). This is why we always ask about flea/tick preventatives. It’s best tested with a skin scrape, most easily treated with most oral flea/tick preventatives including Simparica Trio (or topical Revolution Plus for cats) as well as a deep clean of the environment, and usually ruled out if the dog or cat is consistently on these medications. The most common signs for ear mites are a coffee-ground debris in the ears and chronic head shaking (this is more common in cats). The most common signs for scabies or demodex are a lot of hair loss especially on the limbs and underside of the pet and uncontrollable itching. The most common signs for a flea infection are really bad itching right above the tail base as well as seeing the fleas!
Food Allergies
The second category is food allergies, because this is the next easiest thing to change. There is no diagnostic tool to test for food allergies, even though online may say otherwise. The best way to test this is with a 2-3 month strict hypoallergenic food trial. When we think of food allergies, we more commonly think of this in dogs who are really itching at their ears and paws, as well as having on/off loose stool, anal gland issues, or random bouts of vomiting. The usual age that this takes place is either before the age of 1 or in older friends (think 8 years or older). In cats, they usually have itchy ears without an infection present and will randomly vomit from time to time. The most common allergens in these cases are poultry or cow-based proteins, so the hypoallergenic diets usually either have a novel protein or the protein source is cut up so small that their body can’t register it.
Environmental Allergies
The third category is environmental allergies, as no one can change the environment. The golden age for this starting is 1-3 years old and our best ways to treat this is baths with an anti-septic base such as chlorhexidine, medication to help stop the itching cascade (such as Apoquel or Cytopoint), or allergy shots. These allergy signs usually are the skin infections or ear infections that pop up like clockwork at the time of a Season change.
So if these are the general categories, then why do we give different medications for the diarrhea, ear infections, or skin issues? This is because the allergies are the underlying root cause, but the medications use to treat the presenting issues are a Band-Aid to fix the problem at hand. If we cannot address the underlying issue, then the problem will just keep presenting itself. And even with the root of the cause addressed, there can still be a flare-up from time to time. The goal with treatment is to lessen the flares as much as possible. Itchiness can be very frustrating to deal with, but with the right approach and mindset, they can be kept at bay much easier!
Written by Dr. Harris Fitzgerel