Atopy is the culprit in dog’s skin troubles
Q: I have a six-year-old pug with food and environmental allergies. For many years, she experienced digestive upset, vomiting, skin problems and ear infections. For the past year, she has been eating a veterinary hypoallergenic formula diet and she no longer gets any treats or snacks. As a result, the digestive upsets, vomiting and ear infections are gone.
However, the skin problems persist. She scratches constantly, to the point that she starts to bleed and loses her fur, and she is always rubbing her face on her legs and licking her paws. Her ears and paws are also irritated. These symptoms seemed to worsen during the summer, leading the veterinarian to believe she also has environmental allergies. He prescribed Vanectyl P (a steroid combined with an antihistamine) on two occasions. Each time, the medication helped as she stopped scratching and her ears and paws were significantly less irritated. However, once the medication was done, the symptoms returned.
While the medication works well, I do not feel that it is a long-term solution because I am concerned with the side effects she experiences and the steroids in her medication. For the past month, to help soothe her skin, I have been giving her Omega-3 once a day in her food. I have also heard that bathing your dog once a week with an allergen-reducing shampoo can help. However, I have also heard that this frequency can be harmful and drying to their skin. Can you please clarify and perhaps recommend a course of treatment? I would appreciate any suggestions you may have regarding controlling and eliminating her environmental allergies.
A: Your dog has a disease called atopy, an allergic condition that can occur seasonally or all year long. Atopy causes your dog to lick, scratch, rub, chew and bite at herself (also known as pruritus) because of allergies to her environment.
In terms of controlling and eliminating her environmental allergies, you basically have three options.
First, you can continue with the Vanectyl P treatment on an ongoing longterm basis as needed. If you decide to go with this option, an annual blood and urine test is recommended to ensure that the medication is not causing harmful side effects.
With regard to other therapies, shampooing your dog on a regular basis as you are doing will be very effective in reducing the level of pruritus because it helps to remove allergens from the skin surface. Using the shampoos provided by your veterinarian, such as a colloidal Oatmeal or Episoothe Shampoo, helps reduce pruritus without harming or drying the skin.
Similarly, supplementation with an omega 3 fatty acid as you are doing is also very effective in reducing the level of pruritus in about 30 to 40 per cent of allergic patients and also helps decrease the amount of Vanectyl P required (and thereby the unwanted side effects).
A second option is to treat your dog with a drug called cyclosporine (Atopica). It is a very effective alternative to steroids with much fewer side effects. However, it can take up to six weeks to become effective and is given for life. In dogs that show serious side effects or have a poor response to Vanectyl P, this drug is a good alternative.
Your third option, which I would recommend, is to have an allergy test done on your dog to determine what she is allergic to and then start allergy injections, a procedure called immunotherapy. This is a very reliable and highly effective treatment for dogs that have allergies throughout the year. Allergy testing can be done via a simple blood test (serology) or via multiple skin injections (intradermal testing).
Treatment involves a series of injections usually administered once every two to three weeks by the owner.
Dr. Bernhard Pukay is an Ottawa veterinarian. address letters to Pet care, Ottawa citizen, P.O. Box 5020, Ottawa, K2c 3m4. e-mail: pets@ottawacitizen.com
Talk For Health Workers Tonight on Peanut Allergy Treatment
Members of the Connecticut medical community are invited to a talk tonight on treating peanut allergies through desensitization.
The New England Food Allergy Treatment Center is hosting the talk at its office, 836 Farmington Ave., Suite 138. Dr. Jeffrey Factor of the center will be the main speaker. The treatment works by introducing gradually increasing amounts of peanuts into the diets of patients with the allergies. The procedure was developed at Duke University.
Allergy Treatment Helps Kids Tolerate Some Peanuts
By Duke Medicine News and Communications – A peanut solution given under the tongue can desensitize a child’s deadly peanut allergies, but further testing will be needed to determine if it may permanently eliminate their reactions to the foods, according to researchers from Duke University Medical Center.
In a double-blind, placebo-controlled study, Duke researchers built up tolerance to the allergen in 11 children with a year of small but escalating daily doses of peanut. The therapy allowed the children to tolerate 20 times more peanut protein.
These protocols were done in a clinical setting with close observation and emergency resources close at hand.
“A treatment like this means that some families won’t need to be as concerned about their children taking a bite of something that has peanut in it and could cause a life-threatening reaction,” said Wesley Burks, MD, chief of the Division of Pediatric Allergy and Immunology at Duke and senior author of the study. “It would really provide them a margin of safety.”
This form of therapy, called sublingual immunotherapy, is different from Burks’ previously published research on oral immunotherapy, which involves eating milligrams to grams of peanuts in the form of flour mixed in another food, such as applesauce. That research continues to help kids tolerate peanuts without reactions, and Burks is looking at how the therapy may help resolve their allergies.
Burks’ new research builds on a therapy that has been helpful to people with allergic rhinitis and asthma, but has not been studied extensively as a therapy for food allergy.
More than three million Americans have peanut or tree nut allergies and fewer than 20 percent will outgrow the allergy without therapy. Currently, there is no treatment for the disease. Once a diagnosis is made, physicians have to try to help the family avoid the food, which is not a perfect plan because accidental exposure can still happen.
That is one reason Burks and his team are trying to develop a new, successful therapy for peanut allergy sufferers.
“Ideally we want to eliminate the allergy,” Burks said. “But, we are not there yet.”
The study included 18 children who completed 12 months of dosing. One group (11 children) received the liquid peanut concentration, which was held under the tongue for one or two minutes and then swallowed.
The other group (seven children) received the placebo. The dose started at 0.25 micrograms of peanut protein administered in clinic and was increased biweekly by 25 to 100 percent until 2,000 micrograms was reached. In the time between the biweekly doses in the clinic, the children took daily doses of the previously administered dose at home. The 2,000 microgram dose was continued for six months.
After a year of dosing, the children on treatment tolerated significantly more peanuts when they were challenged. They tolerated the equivalent of six to seven peanuts compared to those that received placebo and tolerated less than one peanut.
“We were able to raise the threshold for the amount of peanuts these kids could tolerate,” Burks said. “But, we are not ready to take this approach to clinical practice,” he cautioned. “It’s not a long-term cure. That part of the process is still being studied now.”
Those that were on treatment are continuing and those that were on placebo have entered the treatment phase. Both groups will be followed three or four more years to determine if it’s feasible to eliminate their allergy.
“The good news is we have successfully helped these kids tolerate about five peanuts and that means accidental ingestion is less of a hazard,” Burks said. “Most kids with peanut allergies are not going to accidentally eat five peanuts and most reactions from accidental ingestions occur from just a trace of a peanut, well below the study groups’ new threshold.”
The study, which published online January 31, 2011 in the Journal of Allergy and Clinical Immunology, was funded by the National Institutes of Health, the American Academy of Allergy, Asthma & Immunology, and the Wallace Research Foundation.
Co-authors of the study include Edwin H. Kim, J. Andrew Bird, Michael Kulis, Susan Laubach, Laurent Pons, Pamela Steele, Janet Kamilaris, and Brian Vickery, all of Duke University Medical Center, and Wayne Shreffler, of Massachusetts General Hospital.
Allergy treatment company fined for contempt of court
A DIRECTOR and his company have been fined $15,000 for contempt of court after breaching undertakings to stop claiming they could diagnose and cure allergies through ”muscle testing” and ”positive conditioning”.
Federal Court judge Ray Finkelstein found in August 2009 that Allergy Pathway had engaged in false, misleading and deceptive comments by advertising that it could safely eliminate allergies.
Yesterday he fined the company and its sole director, Paul Frederick Keir, for continuing to make the claims in contravention of those orders, including on the internet via a YouTube video, Facebook and Twitter.
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The company, which according to its website has five clinics in Australia and New Zealand, said it used muscle testing to diagnose allergies because ”a normal muscle will weaken when exposed to a substance the person is reacting to”.
”Positive conditioning” – stimulating a patient’s spine while exposing him or her to a vial of the allergy trigger – was said to ”retrain the body to no longer perceive the substance as something that is harmful”.
In a report to the court, Associate Professor Jo Douglass, head of The Alfred hospital’s allergy and asthma service, said she was unaware of any scientific evidence to support such practices, which were unsafe and, if followed, would ”expose some individuals to the risk of severe allergic reaction or even death”.
Justice Finkelstein ordered Keir and the company to publish corrective statements at the company’s clinics, on its website, on Facebook and Twitter, and in a letter to customers.