Annoying itch

Skin conditions can be frustrating for everyone involved and once they have become chronic they can take a lot of unravelling to get to the underlying cause. Year-round environmental allergies can be indistinguishable from food allergies, recurrent ear infections and skin infections can be due to underlying allergies, and bacterial and yeast infections can complicate an itch due to allergies.

We offer dermatology consultations to get to the bottom of your pet’s itch. The steps we take include an in-depth history, combings and skin scrapings to rule out external parasites, cytology to rule out infection, and treatment trials and long-term management plans.

Once mites and infections are ruled out, a food trial might be recommended if history suggests a food allergy. If an environmental allergy seems more likely, a long-term treatment plan is developed. For the management of environmental allergies there are two main options: manage the symptoms without knowing exactly which allergens are causing the problem; or, identify the allergens with intradermal skin tests or blood tests, and start desensitisation injections. The latter can seem costly but when compared to multiple vet visits for allergy flare-ups, it may not be that much different in the long run.

Management of the symptoms is often multifactorial and aims to:

• Reduce the itch and inflammation in the skin. Drugs such as prednisone, Apoquel and Cytopoint are good options here.
• Reduce allergen load on the skin. Regular bathing during the worst allergy times helps by physically removing allergens from the skin.
• Manage secondary bacterial or yeast skin infections. This may involve oral medications, medicated shampoos, lotions or ear drops.
• Improve the skin barrier. Healthy skin is more resistant to infection and allergens than inflamed skin. Moisturising products and omega 3 supplements can help, though not all omega 3 supplements are created equal. Dogs and cats are not very good at converting plant oils (eg flax seed oil) to EPA and DHA, which are the omega 3 fatty acids most important in skin. Fish oils already contain EPA and DHA and are of much more use to our pets.

We often hear how multiple diets have been tried for an itchy pet, with little or no improvement. A diet trial is only of benefit when it is fed as a SOLE diet for at least 8 weeks. That is, only that diet and water should be given to your pet. No treats, scraps, supplements or flavoured medications. The ideal hypoallergenic diet should contain no protein that your pet has ever been exposed to before. It takes repeated exposure to develop an allergy, so if they haven’t eaten it before, they won’t be allergic to it. Most food-allergic dogs are allergic to a meat protein, so going ‘grain-free’ isn’t necessarily the answer either. A diet trial is hard work but can be very rewarding!

When preparing for your pet’s dermatology consult think about the history of your pet’s skin problem: when it started – how old your pet was, what time of year the problems started, and what it looked like. Are there any other health concerns? Does your pet feel the cold, or seem to drink a lot of water? Are faeces normal in consistency and number?

Don’t shampoo your pet before the consult – we want to see the skin at its worst. Most importantly remember that there is no quick fix. Allergies cannot be cured, only managed, and the management plan is likely to change as your pet ages.