Relief for An Itchy Pet

SCRATCH THAT!

Relief for An Itchy Pets with Sublingual Immunotherapy by Dr. Laura Weis

Published in the September 2019 issue of Natural Awakenings

Allergies and skin problems continue to be the number one reason people seek veterinary care for their dogs, and allergic skin disease is the third most common problem seen in cats.  Helping find relief for an itchy pet that suffers from irritated skin and the resulting scratching and licking may seem like a never-ending battle. The situation is often characterized by multiple cycles of prescriptions to treat secondary yeast and bacterial infections, ear washes, eye drops, hypoallergenic diets, and various conventional drugs to suppress the immune system.

Stepping off this merry-go-round of constant treatment can be challenging, so it is best to consult with a practitioner who focuses on the underlying causes of the pet’s allergies, rather than merely suppressing the symptoms of the inflammation.

Focusing on the importance of a species-appropriate diet, ensuring a healthy gut microbiome and decreasing inflammation through herbs and omega supplements are crucial foundational steps, but sometimes they are not enough.

Many pets are hypersensitive to environmental allergens, including dust mites, molds, grasses, trees and weeds.  A quick trip outside can result in a pet being covered with millions of allergens. A thorough rinse-off will significantly reduce the allergen burden.  Sometimes foot soaks after every trip outside are enough to keep a dog comfortable when the primary symptom is licking and chewing at the feet.

Desensitizing a pet to allergens present in the environment is another approach to treating allergies and finding relief for an itchy pet. Traditionally, the process includes allergy testing, followed by a series of injections in which the concentration of allergens in the injection is gradually increased.  However, this therapy usually takes months to years to “re-train” the immune system, and some pets require life-long maintenance injections.  The efficacy of this approach varies, but one of the biggest hurdles is for a pet parent to consistently inject their pet.  When the injections are not given, the success of treatment drops.

In human allergy treatment there has been a shift for many years from subcutaneous immunotherapy (allergy injections) to sublingual immunotherapy.  With this approach, a tiny amount of the allergen is administered as a drop or spray to the underside of the tongue or oral mucous membranes.  This delivery system is available for pets, with the additional new option of regionally specific immunotherapy, which eliminates the need for allergy testing.

Using this approach, up to 22 allergens common to an area are included in a vial that lasts from 14-22 weeks.  This method only requires a small (less than 1 ml) daily spray between the cheek and gums.  Approximately 60-70% of patients show excellent response to this therapy, although other means of decreasing itchiness are usually needed for the first two to three months.

A sublingual delivery system more closely resembles the normal way the body is exposed to allergens, as contrasted with the injection method.  Not surprisingly, there are far fewer side effects and a faster response to sublingual immunotherapy.  In addition, the inclusion of a panel of regional allergens may help the immune system to “normalize” its response in a way that only using allergens shown to be a problem for a given individual through testing does not.

While there is no perfect answer when a pet is scratching, sublingual immunotherapy can be a gentle and effective tool for environmental allergies.