Controlling Allergies in Dogs with Complementary Therapies
Allergic skin disease, also called atopic dermatitis or simply atopy, is an extremely common skin disorder in dogs (and to a lesser extent in cats.) In my practice, it is probably the #1 skin problem we treat. Many of the affected dogs have not only atopic dermatitis, but other problems that often occur in allergic dogs including staphylococcal bacterial dermatitis or Malassezia yeast dermatitis as well.
Atopic dermatitis has also been called inhalant allergic dermatitis to signify the animal's reaction to foreign proteins (antigens or allergens) that are inhaled. In people, common signs of inhalant allergies include sneezing, runny eyes and nose, and wheezing. In dogs, while these respiratory signs are becoming more common, the most common signs are directed towards the skin. We now believe that the dog absorbs a large amount of allergens through the skin rather than by inhaling them through the respiratory tract.
While even mixed breed dogs can develop allergic dermatitis, the condition is by far more common in specific breeds. Purebred dogs that are commonly affected include terriers (Cairns, Boston, Fox, Westies, Scotties), Shar Peis, Lhasa apsos, Shih tzus, Dalmatians, Boxers, Setters (Irish, English) and retrievers (golden, Labrador). The most common breeds affected are the terriers with the West Highland White Terrier topping the list of sensitive breeds. In my practice, retrievers are the number one breed affected, no doubt because this is the most popular group of dogs in our area.
Age of onset of clinical signs varies, but most dogs show signs of atopic dermatitis within 1-3 years of age (or more correctly, 1-3 years of living in a place where they are exposed to allergens to which they become sensitized.) Atopy results in dogs that are genetically predisposed to become sensitized to environmental antigens, involving IgE immunoglobulin (mainly) and probably allergen-specific IgG antibodies as well.
Clinical signs most commonly seen in dogs include itching, often quite severe, which is usually directed at the feet, abdomen, groin, armpits, and/or face. Some allergic dogs exhibit generalized itchiness all over the body. As a rule, the skin looks normal unless secondary infections are present. Some allergic dogs have chronic ear infections as their only or main sign. Doctors not familiar with this often mistakenly treat the ears without searching for the underlying cause. As a result, the dog never really improves.
Diagnosis of the atopic pet is usually easy. The classic sign of itchiness without primary skin lesions points towards a diagnosis of atopy (other rule-outs would include food allergy and occult sarcoptic mange). Atopic dermatitis should also be suspected with chronic skin infections, including ear infections as mentioned above.
The conventional treatments have relied on corticosteroids and antihistamines. While effective, there are numerous side effects of long-term use of corticosteroids including increased thirst, increased urination, increased appetite, weight gain, Cushing's disease, Addison's disease, osteoporosis, increased susceptibility to infection, fatty liver disease, diabetes mellitus, gastrointestinal ulceration, cartilage degradation, and blood chemistry abnormalities. Side effects of antihistamines are less common but include sedation and failure to control the itching.
Complementary therapies are used to reduce or preferably eliminate the need for chronic drug therapy, allowing resolution of the itching without the troubling side effects so often seen with conventional treatments. They include:
Topical treatment - A very important part of therapy for atopic pets is external decontamination using various shampoos, conditioners, and "leave-on" residual products. The most benign include ingredients such as aloe vera and colloidal oatmeal. More stubborn cases might require the addition of pramoxine, antihistamines, or corticosteroids. Frequent use is essential to minimize antigen exposure by the pet, thus reducing the need for systemic medications. Any program that does not emphasize topical decontamination in the severely itchy dog is doomed to failure.
Fatty Acids - What once seemed bizarre or complementary is now accepted as part of the conventional approach to treating atopic disease by most doctors. Still, being a nutritional product, fatty acid therapy could fit under the banner of complementary treatment. We still don't know what is the best fatty acid, or even the best dose. I have been using omega-3 fatty acids at double to quadruple the label dose. Some experimentation with the various products might be needed.
Antioxidants - Higher doses of vitamins C, E, and A offer relief for some atopic pets. They function to detoxify histamines, optimize adrenal function, decrease skin cell destruction, and optimize function of the immune system. Because antioxidants can alter blood levels of cortisol and thyroid hormones, a blood profile checking for adrenal and thyroid diseases is important.
Enzymes - Some pets respond to health blend formulas, enzyme preparations, and barley grass supplementation. These products in some way minimize the body's chemicals that cause the itching and inflammation. Enzymes allow increased nutrient absorption (especially plant enzyme preparations); these nutrients can then alter the chemicals responsible for the dog's itching.
Diet - While hypoallergenic diets can help pets with food allergies, they are not routinely prescribed for atopic pets. A trial dose using one of these diets might lower the itching in pets with both food allergy and atopy; diets with fatty acid supplementation might also help atopic pets. Finally, most complementary doctors would suggest a trial dose of homemade rather than processed food, or at least a "natural" processed food. These "preservative-free" diets can reduce itching in some pets. At some point in the treatment of the itchy pet, before giving up and resigning the pet to a life of
corticosteroids, try a homemade diet using fresh ingredients. Some pets respond dramatically just to this simple step.
Homeopathy - Homeopathy involves the use of extremely diluted substances to heal the body through the release of vital energy. The rule in homeopathy is that "like treats like", so a thorough history, examination, and laboratory testing are needed to properly choose the correct remedy. There are a number of remedies that can be tried in allergic pets. Usually remedies of high potency are prescribed. Here are some remedies that may prove helpful: Sulphur, Hepar Sulph, Arsenicum Album, Rhus Tox.
Acupuncture - By stimulating specific acupuncture points, you are able to help stimulate the pet's immune system and reduce the itching and inflammation associated with allergic dermatitis. The first case I ever treated with acupuncture was a dog with atopic dermatitis that had failed to respond to other complementary therapies. The dog, a Boxer, responded after 3 treatments and was maintained for over a year with treatments every 3 weeks before developing another problem that required additional treatments.
Herbal Therapy - Both Chinese and Western herbal therapies can be useful in treating the atopic pet. It is important to try different herbs or combinations in order to match the correct therapy with the pet (similar to other complementary therapies). I have had most experience with Chinese herbal formulas. While I usually am able to treat pets with other therapies without the use of herbs, some owners prefer herbal medicine and some cases require a trial with herbs if they do not respond to other therapies. Several herbs that may be helpful include:Scutellaria, Tribulus, Anemarrhena, and Capillaris.
Because atopic dermatitis is a heritable condition, affected dogs should not be bred. Decreasing the gene pool for this condition will do a lot in decreasing the number of allergic pets produced in the future.
There is no one best treatment for atopic dermatitis in dogs. There are a number of options and what works well for one dog may not have any effect on my next patient. By working with your doctor, which may take time, you will hopefully find what works best for your pet. The goal of treatment is to reduce (but probably never totally eliminate) itching and do so with a minimum amount of medications.
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