THE COMPLETE ALLERGY SERVICE

INNOVATION IN ANIMAL HEALTHCARE

THERAPY GUIDE FOR DOGS AND CATS WITH SKIN ALLERGIES

Your pet has been diagnosed with a skin allergy. This means that they have been found to have an abnormal response to one or more normally harmless substances, known as allergens. This is a life-long condition with no quick fix.

You may already feel it’s been a long journey to get this far. That is because to reach this diagnosis, lots of other conditions will already have been ruled out. The good news is that now you have found the root of the problem, you can make informed decisions about the best way forward. This leaflet is designed to help explain the treatment choices available to your pet.

As you will learn, the key to long-term success is to use a combination of the available options and remain flexible in your treatment plan when needed. Successful management also requires working in partnership with your veterinary practice. By adopting this approach, it will allow you to tackle any bumps that occur along the way together.

COMBINED THERAPEUTIC APPROACHTackling allergy from every angle provides the best chance of long-term success and reduces the risk of flare-ups.

SKIN ALLERGIESLONG TERM

MANAGEMENT

IMPROVING SKINAND COAT HYGIENE

Routine use of topicalproducts such as shampoos,

sprays or wipes can helpkeep bacteria and yeast

under control andreduce itch.

CONTROLLINGSECONDARY INFECTIONS

AND INFESTATIONS

Fleas, mites and lice can allcontribute to skin problems soall year round protection is vital.

Spotting skin infections earlycan help get the skin back

under control quicker.

REPAIRING THESKIN BARRIER

Certain topical products, foodsand oral supplements containingredients such as essentialfatty acids, which support the

skin barrier and helpprevent flare-ups.

CONTROLLINGTHE PRIMARY DISEASE

Most pets will also require regularinjections and/or oral medications

(foundation therapies) to control theallergy and help prevent flare-ups.

These may need to be given incombination, especially just after

diagnosis or to controla flare-up.

ALLERGEN AVOIDANCEMEASURES

Avoiding the problem allergens,or reducing exposure to them,

is often possible. Both our website,and the results pack provided after

allergy testing with us, havedetailed guidance forindividual allergens.

There is more information on the skin barrier, controlling infections and the foundation therapies you may consider in the following pages.

ALLERGEN-SPECIFIC IMMUNOTHERAPY This therapy helps re-educate the immune system. Very small amounts of relevant allergens are given to your pet, normally by a small injection into the scruff of the neck, or sometimes orally. The allergens are selected based upon your pet’s individual allergy test results, their clinical history and the relevance of the allergens to their local environment. Each therapy is tailor made. It may not be necessary to include every allergen that scored positive on their test results. The allergens stimulate the immune system in a controlled way and because such a small amount is given, the symptoms are not usually triggered. Over time, the injections are administered in increasing amounts until a tolerance/maintenance level is reached. Oral therapy is administered daily so a single dose can be used from the onset. This exposure helps desensitise your pet to the allergens so that when it comes in contact with them for real, they cause less of a problem. During the first few months other treatments are often used to control the symptoms.

FOUNDATION THERAPIES

STEROIDS, CYCLOSPORIN (ATOPICA®, MODULIS®, SPORIMUNE®, CYCLAVANCE®), OCLACITINIB (APOQUEL®) & LOKIVETMAB (CYTOPOINT®)

These drugs all reduce the symptoms of allergy by moderating the immune response. Although you want to stop the itch, the immune system also performs a vital role in defending the body against genuine threats such as infections. Each of these drugs has a different way of working, but generally speaking, some will help stop the itch with much less impact on other important functions. Steroids are considered the least specific at targeting the allergic response, so are associated with a higher risk of side effects (see table for more details). The other treatments offer a more targeted approach. However, the other important thing to consider, in addition to itching, is inflammation (redness and swelling) which is more often seen in dogs with ear and feet problems. Although the broader acting drugs have a higher risk of side effects, sometimes they are better at helping dogs where inflammation is a big part of their disease.

No one therapy is right for all pets. Your vet will provide you with the best options to consider for your pet’s individual requirements. The table opposite also provides an overview of some of the key differences.

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WHAT ELSE DO I NEED TO KNOW ABOUT IMMUNOTHERAPY?

HOW LONG WILL IT TAKE TO SHOW AN IMPROVEMENT? Allergen-specific immunotherapy is a proven, effective treatment for allergies. However, every animal is unique so may respond differently to it. In most cases, improvements can be seen after a few months, but some animals may require more time before their tolerance of the offending allergens is built up sufficiently. Other factors such as severity and duration of the symptoms, age and general health of your pet will affect the timescale for improvement.

WHAT IF MY PET SHOWS NO IMPROVEMENT? After around 10 months (the first vial if using injections) your vet will review the situation and decide with you whether to continue. It may be necessary to review the dosage levels/frequency and also assess other treatments currently being used. In addition, they are likely to check for infections or parasite infestations that may be complicating the allergic disease.

HOW OFTEN DOES MY PET NEED THE THERAPY? Generally, injections are initially given every 2-3 weeks over a 13 week induction period. This then decreases to monthly “allergy shots”. If given orally, generally daily or twice daily administration is needed.

An example injection based protocol is as follows:

• Week 1 – 0.2ml

• Week 3 – 0.4ml

• Week 5 – 0.6ml

• Week 7 – 0.8ml

• Week 10 – 1.0ml

• Week 13 – 1.0ml

• Maintenance dose – 1.0ml every four weeks thereafter

WHAT ARE THE RISKS? As with any medication there can be side effects, but these are uncommon. Sometimes mild itching or redness is seen 24 to 48 hours after the injection. If you do see anything unusual in your pet’s symptoms or behaviour after administration, contact your vet immediately.

REALISTIC EXPECTATIONS – FLARE-UPSSkin infections are more common in allergic pets. It’s important to understand that occasional flare-ups are inevitable, even if you do everything right.

SOME OF THE TREATMENTS USED FOR FLARE-UPS

TOPICAL STEROIDS

Steroid sprays can be very useful to control

localised areas of itching without the same side effects as giving oral

steroid tablets or injections.

ORAL/INJECTABLE ANTIBIOTICS

For deeper or prolonged infections, oral or injectable

antibiotics might be required. A swab of the skin may need to be taken to identify the type of bacteria causing the problem, help select the right antibiotic

and check there are no resistant bugs.

TOPICAL ANTIBACTERIALS AND

ANTIFUNGALS

Shampoos, mousses, sprays and wipes can all be extremely

effective in treating skin infections.

These are often now used in preference to oral

antibiotics.

ORAL/INJECTABLE STEROIDS OR APOQUEL®

Short courses of oral steroids (dogs and cats) or Apoquel® (dogs) can be helpful to break the

itch-scratch cycle.

LEAKY SKIN BARRIERThe skin normally acts as a barrier, keeping allergens out and moisture in. In allergic pets, this barrier has been shown to be ‘leaky’ so more allergens get in causing itching and irritation, and more moisture gets out making the skin dry.

SELF-TRAUMA Even a small amount of licking, rubbing or scratching can cause significant physical damage to the skin. This creates a vicious circle as the inflamed skin is then prone to infection.

ALLERGEN OVERLOADDepending on your pet’s individual triggers, the season of the year can make a difference. Exceptionally high pollen counts in the summer months, or exposure to mould spores during the winter, could make normally well-controlled pets start itching again.

THE SOLUTIONYour vet will need to identify what has triggered the flare-up before advising appropriate additional treatment. If you start to get flare-ups more often, a full review of your foundation therapies and further investigation may be required. Bear in mind that allergic disease can change over time with new allergens contributing to the problem, so always speak to your vet if you are concerned.

AAH_42/11/18

FOR MORE INFORMATION VISITWWW.AVACTAANIMALHEALTH.COM

OR ASK YOUR VET FORFURTHER ADVICE

INNOVATION IN ANIMAL HEALTHCARE

“SENSITEST® has quickly allowed me

to identify the root cause of my patient’s skin condition

and treat the underlying cause, rather than just managing the

resulting symptoms. The owner can understand what is going on with regards to the treatment process and see the results in their pet.”

John Whitwell, Vet Surgeon, Grace Lane Veterinary

Surgery

“Taegan is much happier in himself. He

struggled on walks to enjoy himself as he would constantly roll over to scratch himself on the floor, now he has stopped. We are so pleased his hair has

grown back too!”

Taegan’s owner