By Joe Spoo DVM

One of the more frustrating cases we see in veterinary medicine is the case of an itchy dog—those dogs that are constantly battling skin infections, ear infections, or are just plain miserably itchy. There are a number of things that can make a dog itchy, from bugs to behavior, but this article is going to address dogs with allergies—those dogs that seem incredibly itchy all the time or every year seem to get the same skin and ear infections.

Unfortunately this is a very common problem in our beloved sporting breeds. Whether it be springers and cockers with chronic ear issues, labs with itchy skin, or goldens with their seasonal hotspots, there are very few breeds that are unrepresented with some form of allergies.

ALLERGIES IN A NUTSHELL

When you or I think of allergies in ourselves we think of things like hay-fever, asthma, sinus problems, etc. The same irritants that cause allergies in us can cause them in our pets. The difference is dogs get itchy and irritable skin instead of respiratory problems. Where this problem becomes even more of an annoyance is when this already irritated skin becomes infected, which I’ll examine later.

Basically there are two types of allergies in dogs. The first type is inhalant with allergies to various pollens, dusts (both outdoor and indoor), dander, etc. These dogs are typically itchy seasonally, and you can practically set your calendar by various bouts with ear infections, hotspots or excessive itching. The other type is food allergy. Some dogs can develop an intestinal irritation or allergy to food, but an even larger group will develop an allergy to some component of the food that will show up as itchy, irritable skin.

The most important thing to understand as an owner of an itchy dog is that this is a condition that will only be managed and likely never completely resolved. It is also extremely important to stay in touch with your veterinarian about the success, or lack thereof, of treatment protocols. During the initial stages you may need to schedule rechecks every 2-3 weeks to ensure infections are controlled and the symptoms are in check. Likely you have a dog that will either need some type of treatment for a large portion of the year or potentially a prescription diet for the rest of its life. Too frequently we want to give a shot or a pill and have the problem go away, unfortunately with allergies that doesn’t happen. Think about how many people, young and old, take at least some type of medication daily? Why should we not expect the same to occasionally occur in our pets?

OK, so now you have the bad news, the good news is that often we can make these dogs much better, more comfortable, and in some cases, head off these annual infections.

ALLERGY DIAGNOSIS AND TREATMENT

The first place I start with these dogs is to determine if there are any secondary infections (i.e. ears, feet, skin), usually bacteria and/or yeast, and to diagnose and treat these before addressing the allergies. If you were going to rate an allergy dog on a scale of itchiness of 1 to 10, and let’s say your dog scores a 6, the same dog with secondary infections may be an 8, 9, or 10. Often times these infections are treated for 2-3 weeks with some combination of antibiotics, anti-fungals, and medicated shampoos. Depending on the individual case I will either begin management of the allergies in conjunction with the treatment of these infections or immediately following.

To keep things somewhat simplified I’ll address management of inhalant allergies in depth in this article, and we’ll assume that if these options fail that the source of the problem is food, and the dog will need to undergo a diet trial of 6-8 weeks. During this trial the dog will only be able to eat the prescribed diet—no treats, rawhides, or tablescraps. I also would strongly encourage sticking with a veterinary diet, as many over-the-counter diets contain similar ingredients to one another, and although the bag may claim to be for sensitive skin, if the dog is truly food allergic it may not help in the least.
Inhalant Allergies

The aim of controlling inhalant allergies is to keep the skin from becoming irritated and prone to infections. Most of the time this control can be achieved with the use of fatty acids and antihistamines. There are blends of Omega-3 and Omega-6 fatty acids available that are specifically designed to aid these allergy dogs. These seem to improve overall coat quality, potentially help to stabilize cells, and provide some anti-inflammatory properties. Alone they likely will not be enough to control the problem, and that is why they are often used in conjunction with antihistamines. Antihistamines work well in people, but are often not as effective in dogs. For this reason I’ll have clients try three different antihistamines, one at a time, switching at two-week intervals and try to determine which was the most effective. Again, there is no magic bullet…we are aiming for management.

Some dogs reach a level of itchiness and inflammation that they’ll require steroids, more specifically, corticosteroids, not the anabolic type that have the baseball world in a frenzy. Corticosteroids have an amazing ability to decrease inflammation and provide great comfort to many of these dogs. The catch is that the body also produces steroids for many purposes, and by adding some from outside the body we are altering the natural systems. It is for this reason that I use them only when needed and try them for a short course at a relatively low-dose. Because we are altering the body’s production, oftentimes steroids will need to be tapered down as opposed to just quitting them all at once to allow the body to return to normal production. For those dogs that need to be on steroids long-term because it is the only way they get relief, it is best to have them on an every other day course, as this lets the body continue its normal production on the ‘off’ days.

A few words on “allergy shots.” True allergy shots are when either a blood test or skin test is performed on the dog to determine what is causing the allergy. From this information a vaccine is created that the owner administers at home. The vaccine contains small amounts of the substances causing the allergies, with the hope of training the body to not over-respond to the stimulation. Though this system sounds like the way to go, the testing and treatment are relatively expensive and often have a poor success rate. For this reason I often save this option for very frustrating cases.

Many pet owners have their vet give an injection often referred to as an “allergy shot.” These shots are often a steroid injection that stays in the body long-term and can help control the symptoms for several weeks. The problems with these injections can be many. If your dog only requires one or two shots per allergy season to remain comfortable there is probably not much need for concern. However, if you find your dog needs these steroid injections frequently, the treatment plan probably needs to be reviewed. Often the secondary infections are not being addressed, and although the dog is more comfortable, the real problem is essentially being masked. The bigger source for concern, though, is effects to the internal system discussed previously. When these shots are given repeatedly, the internal system can shut down, which can lead to many long-term problems. Long-term use also can cause the development of diabetes, cause dogs to be unable to respond in shock situations, and cause numerous other internal disorders. As you can see, sometimes those quick fixes have a bigger price.

TAKE HOME POINTS

Essentially I’ve just scratched the surface of a very complex problem. Many times when an itchy dog comes in for its first visit, it will come with records from many veterinarians who the owner has become frustrated with because of a lack of a complete solution, and I have no doubt other veterinarians in town see former clients of mine who did not want to manage a problem but would rather have a quick fix.

The key point is to understand these itchy dogs are frustrating from both sides of the exam table, because these are not normal dogs. And although it may not be what you want to hear, these are dogs with conditions that will need to be managed for the rest of the dog’s life. Take an active role and try to find the best options for you hunting partner. Work with your veterinarian to find a treatment plan that works best for you and your dog’s situation.