Allergen immunotherapy for dogs: is it worth trying?
November 8, 2013 8:28 PM   Subscribe

My dog is allergic to a lot of things (39 out of 54 in her allergy test), some of her worst reactions were to several types of very common grasses and her own yeast. The doctor recommends allergen immunotherapy -- exposing her to low levels of the allergens to increase her tolerance to them over time. It is expensive and it takes a while -- about $1,200 over about 1 year. I would love to hear about people's (and their dogs') experiences about this therapy to get a better sense of its efficacy and safety. How well did it work? Were there any side effects?

A lot of details, in case it helps: The dog is a 7-year old mutt, some sort of small Terrier mix. We adopted her two years ago and since then she has been constantly scratching and licking herself. I think we have tried everything else -- steroids, which gave her only temporary relief; dietary changes, which established that it's not a food allergy; many different types of medicated shampoos, which made little/no difference; neither did anti-histamines. She has taken anti-yeast medication and antibiotics but those only helped her marginally. After reading some other ask mefi posts on allergic dogs, I found a vet dermatologist who did the allergy test, recommended the allergen immunotherapy, and prescribed anti-fungal medication (fluconazole), steroids, and a another allergy medication -- Atopica, as a stop-gap measure. The dog is doing better but has had very soft stool. I don't think she can be on all this medication for very long. I did receive some information from the vet about the immunotherapy but so far what I have read has not been enough to help me to make a decision. The cost of the therapy is certainly high enough to give me pause and it will be burdensome to afford it but I also love this dog dearly and would do just about anything to make her feel better. This also means I am terrified of putting her through anything that might make her feel worse.
posted by ethand to Pets & Animals (6 answers total) 1 user marked this as a favorite
Did this itching, scratching licking start within the last couple of months or less? I have a Jack Russel Terrier that has started this. I have started itching too but so far I'm not licking. A friend was over a few days ago with her dachshund mix with exact same symptoms you report. Somethings going on here. My best friend is a vet and I get suspicious about expensive treatments. Like MD's a lot of vets are doing the ole maximize profits routine. If it were me I would have a pound of suspicion about new expensive treatments. You might do some google research on success rates of the treatment.

Anyway, I hope all our dogs feel better. I use benadryl, occasional prednisone. Last night I rubbed some human itch lotion and she seemed to get relief, so did I. It might be there weather change, heaters running. Good luck (as I scratch the back of my neck).
posted by nogero at 9:13 PM on November 8, 2013

I have a mutt that was diagnosed with allergies. He licks and has a little white patch of skin on his belly that he doesn't leave alone. I take allergy shots and after his diagnosis got him on a regimen. After a year and a half of religious administration, there was still no improvement and I couldn't afford them any more. He still licks that spot but we both live with it.
posted by buzzkillington at 10:36 PM on November 8, 2013

Best answer: I can't say if allergen immunotheraphy would work on a dog but I know of one human that has gone through it and both are happy with the results, though they take a while. My friend could not even go outside if someone on the block was cutting grass in summer because of her discomfort levels (itching, breathing problems, sinus headaches) and if she is having reactions now a days they are minor.

I know it's not directly what you asked, but you say you have eliminated food as the source of the allergies, it might not be the cause, but it might not be helping either. I have a dog with food issues (that lead can lead to internal hemorrhaging so I am very skeptical of most commercially produced dog foods), and maybe you have already tried this but I'd suggest Maybe drop her back to a low allergen diet chicken and rice and veg you cook yourself (its not as hard as it sounds for a small dog and you can freeze the meals) for a couple of months to give the skin time to heal. I'd add fish oil to her diet to, talk to your vet about dosages it's easy to drain a capsule over their food before serving. I add eggs and safflower oil too to make sure they are getting enough good fats but again that depends on what foods your dog is sensitive to. At the very least I'd be looking for grain free foods on the whole theory of grains become sugars which feed yeasts, which I don't know if it is actually medically true but the first thing I heard when I had yeast infections myself.

Soft stools can be helped by adding a little tinned plain pumpkin to their food, so if the medications seem to be helping I'd be trying to keep your dog on them.

Some other ideas that might help, to help keep pollen off of your dog brush them with a soft brush regularly and put them in a coat which is washed regularly when they go outside.

Good luck.
posted by wwax at 7:31 AM on November 9, 2013

Best answer: My dog has allergic dermatitis. He licks and bites his paws until they are red and raw. I hate to see him so uncomfortable.

A few things to keep in mind when dealing with this particular problem:
1. It has a genetic basis, so there is no cure
2. It can have environmental and/or dietary triggers
3. Multimodal therapy is most effective. That means a combination of baths, topical therapy (humectants, emolients), immunosuppressive medications (prednisone, cyclosporine or Atopica), control of yeast and bacteria that take advantage of the disrupted skin barrier, rigorous flea control, removal of antigens from environment, dietary restrictions, and immunotherapy
4. Treatment is a long term commitment and sometimes fails even when you employ all of the modalities above

Successful allergen immunotherapy requires a very committed owner who has an excellent relationship with a knowledgeable veterinarian who will be very available for questions and adjustments over the course of treatment. And, of course, a responsive patient. Management is key. The variables of the multimodal therapy may require frequent tweaking. Results can take upwards to 2 years.

All of these treatments and visits can be expensive. That is the nature of the beast. I wish folks would understand that your veterinarian is not seeing dollar signs when they suggest 'expensive' treatment for a chronic and complicated problem like atopic dermatitis. They see your suffering pet and a concerned owner. A good veterinarian will present you with all of your options, regardless of cost, so that you can make an informed choice.

So, I do this for a living, and I find it hard to keep my dog comfortable when his allergies flare up. My dog and I are about to start allergen immunotherapy with the dermatology department at my veterinary school. I know he will still require multiple treatment modalities, but I hope that he will require pharmacological intervention less frequently. And, as both a student of veterinary medicine and a former protein biochemist, I think that it is incredibly cool that immunotherapy is available for veterinary patients.
posted by Seppaku at 7:50 AM on November 9, 2013

Best answer: My last dog had severe allergies - she was given 3-4 Benadryl up to 3 times a day, was regularly doing courses of prednisone, and was in a cone for almost two years because she would still tear herself to shreds if she was able.

I got her on the shots - it starts out at once per day and tapers down to a maintenance dose of once per month. The first month was hell for her as the shots trigger the allergies even more, but as they started to work they gave almost complete relief from her symptoms. When we got to the once a month maintenance point, I'd have to dose her for a couple days following her shot, but no meds the rest of the month and no cone at all!

I think if we hadn't done the shots I would have had to put her down. She was truly miserable in that state and I could see the depression overtaking her.
posted by tkolstee at 12:34 PM on November 9, 2013

Response by poster: Thanks all for your answers so far. The scratching/licking has been going on for well past a year, so we (and the vets) don't believe it's something entirely seasonal. Grass allergies would certainly be worse in the summer, and the dogs spend less time outside in the winter so I'm sure it varies some but her issues are year-round. The itchiness doesn't appear to be localized - she'll bite/scratch her paws, hips/groin and shoulders obsessively.

I'm confident our vets are trying to help our dog, not just trying to get us to buy more services/meds. I'm sure the pooch-dermatologist is inclined to recommend pooch-dermatology as a solution where it could work, but that's a general issue with medical care (surgeons recommend surgery, etc) and I trust that they really believe the immunotherapy will help our dog's symptoms.

We've done a lot with her diet - at this point we've settled on the Wellness whitefish & sweet potato but we've tried other limited-ingredient options as well. Fish oil's a good suggestion - I'm seeing that elsewhere too and we'll start adding that for her. We generally give the dogs 1 egg yolk per day now, I can't say whether this makes a difference for allergies but it certainly makes them happy. They do like pumpkin, but that tends to loosen them up if anything (our other dog has issues with constipation at times and this is what we give her to help.)

I think we're leaning towards going ahead with the shots, and it's encouraging to hear that route's worked for some of you. I'm really just trying to find what's going to provide the best quality-of-life for my dog here, it's tough to see her suffering. The immunotherapy's going to involve a lot of shots and trips to the vet but if it's promising then it is something we can afford.
posted by ethand at 3:11 PM on November 9, 2013

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