Don’t you just love a bichon with a bouffant top-knot?
Little Annie is one such fashionista. This little dog with a big personality always has coordinated outfits with her mom.
In the winter, Annie wears a fuchsia quilted coat with matching collar and leash, and her mom wears a jacket accessorized with a handbag in the exact same shade. Only one thing marred this pair’s couture perfection, and that was Annie’s paws.
Persistent Paw Licker
Annie is a persistent paw licker. In fact, she licked so much that her feet were rust-colored, which is obvious when the rest of her coat was snow white. These stained paws were somewhat at odds with the rest of her stylish appearance, but what was the reason for her licking habit?
Annie has atopy, an allergic reaction that causes itchy skin.
Annie had a workup and went on a hypoallergenic diet, and all the results pointed to her having specific allergies surrounding common grasses and tree pollens. We tried Annie on 2 types of medication, but the first made her gain weight and the second gave her a nasty tummy upset.
I was left scratching my head.
Vaccinate Against Itchiness
We decided to try Annie on immunotherapy injections. This treatment works on the same principle as vaccination in that it primes the immune system but without causing illness.
The patient receives regular injections of small amounts of the allergens to which she is sensitive. The treatment starts off with miniscule amounts so the body registers the allergen but doesn’t think it’s worth doing anything about it.
Over the following weeks, the dose is slowly nudged up — the idea being to get the immune system used to the allergen but without priming it for a full-blown allergic reaction.
This means when the dog encounters the allergen for real, the immune system shrugs its shoulders and says, “So what?” and the dog doesn’t get itchy.
Immunotherapy is drug-free but requires a specialist lab to make a bespoke vaccine for each patient. This means identifying the substances the dog reacts to, by running either a blood test or a skin allergy panel.
After the initial “priming” injections, the dog receives 1 injection per month to keep topping up the protection. In Annie’s case, she had a panel of blood tests that rated her body’s immune reaction to a number of common pollens.
Annie was already regular with her parasite treatments, but this is doubly important for dogs with atopy. Why? Because flea saliva is a potent allergen, and it’s a rare dog who has atopy and doesn’t also react to flea saliva.
In this video, veterinarians discuss atopy in more detail:
Staying on Schedule
Annie’s mom brought her in regularly for injections.
Because Annie had treats every time for being such a good girl with the injection, I became worried she was putting on weight. I took the opportunity to weigh her each visit.
Indeed, Annie’s waistline was one reason her mom wasn’t keen on steroids. The short time she was on them, Annie’s hunger was unstoppable, and her size ballooned.
For some dogs, the drug-free option of immunotherapy is the perfect answer to their itchiness problems, and happily this was the case for Annie. Within a few weeks of Annie starting therapy, her mom was delighted to point out Annie’s paws were once again snow-white. No more licking!
Statistics suggest that around 4 out of 10 dogs respond completely to immunotherapy and don’t need other treatment.
Another 3 or 4 out of 10 partially respond, meaning they can reduce the amount of other medications they take (and if those drugs are steroids with side effects or other costly medications, the reduction matters).
However, immunotherapy is not a quick fix. If your pet has summer allergies, then the ideal time to start is in the autumn so the immune system gets trained over the winter when there are fewer allergens around.
If it’s mid-summer and you’re desperate for your dog to get relief, then conventional medications such as corticosteroids or new treatments such as cyclosporine (Atopica) or oclacitinib (Apoquel) will be needed to stop your dog from chewing himself to pieces.
Our story has a happy ending. Annie continues to do well. Instead of monthly injections, they’re now once every 6 weeks, which is enough to keep her allergen protection ticking over — not bad for a drug-free treatment when Annie would otherwise have required long-term medication.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Dec. 17, 2018.