QuestionMy parents recently got a Bichon puppy, who is now about 5 months old. The vet gave them a flea and tick preventative treatment to use monthly called Protocol. The puppy had a terrible skin reaction to it, so the vet arranged to give Bree (the puppy) an antihistamine shot several hours before the next treatment. Unfortunately it didn't help. My parents live in an area where fleas and ticks could be a problem. Do you know of any hypoallergenic way they can protect their puppy? Thank you!
AnswerThis is what the vet really should be saying and treating this allergy which is not uncommon:
1. SELECTIVE BREEDING
Allergy is a genetically influenced disease caused by changes in the genes that control T lymphocyte function. Allergic dogs have T lymphocytes that respond more vigorously than normal individuals. This causes the symptoms of allergy that are so common.
Consider not breeding allergic pets. If you are selecting a mate for an allergic pet, consider finding one that has no history of allergies. This may help reduce the chances of allergy in puppies.
2. START EARLY.
The earlier a patient with allergy is started on a treatment program designed with aggressive avoidance practices, the easier the disease will be to control. Patients that have chronic disease or recurrent infections have immune system changes as well as functional alteration in normal skin function which can make it more difficult to treat the dermatitis. By starting therapy early, cheaper, more simple therapies will likely work well to improve the patient's disease. "An ounce of prevention is worth a pound of cure".
3. TREAT ALL SECONDARY BACTERIAL AND YEAST INFECTIONS.
Allergic disease causes changes in the normal function of the skin that prevents it from preventing infections. As a result, up to 80% of allergic patients will have secondary infections. These infections can mimic other diseases making accurate diagnosis difficult. Additionally, the infections can cause severe itching and add to the inflammation of the allergic reaction.
Antibiotics for at least 21 days will be needed for each episode of bacterial folliculitis (pyoderma).
Yeast infections will require topical and/or systemic antifungal medications for at least 1 month.
Ear infections usually require ear cleaning every 3-7 days and a topical medication to kill the bacterial or yeast. Often a topical steroid is used to decrease the inflammation caused by the allergy and infection.
Infections of the feet (pododermatitis) are often treated with topical antimicrobial wipes, shampoos, or rinses used frequently.
4. AVOID COMMON ALLERGENS.
The most common allergens in the home environment are house dust mites, molds, and cigarette smoke. These as well as other allergens (wool, etc) can often be reduced or avoided with several easy techniques.
Throw away any foam or stuffed dog bed that is older than 1 year. Dog beds are one of the most common sources of house dust mites.
Wash all bedding every 7 days using hot water.
Do not allow anyone to smoke in the home.
Use a HEPA air filter to clean the air.
Dehumidify the home using a high efficiency dehumidifier to keep the humidity below 40%. This will help prevent house dust mites, mold growth, and fleas.
Consider using a spray to dissolve or denature the allergens (Allerase spray) and borate product to eliminate housedust mite exposure in the home.
5. BATHE YOUR PET EVERY 3-7 DAYS USING A MILD ANTIMICROBIAL SHAMPOO.
This will wash off any allergens and help to kill and prevent the secondary infections caused by bacteria or yeast.
6. USE FLEA CONTROL EVERY MONTH.
Fleas are very common in the South and can increase the allergic reaction to all other allergens including house dust mites, pollens, molds, etc.
7. CONSIDER CHANGING THE DIET TO A SKIN FRIENDLY FOOD OR EVEN AN AGGRESSIVE FOOD ALLERGY TRIAL.
Feeding a diet without beef or dairy ingredients but with high levels of essential fatty acids will help reduce any allergic reactions regardless of the cause.
If food allergy is suspected, feeding a diet with only one protein (rabbit, duck, kangaroo, or fish) and one carbohydrate (potato) for 10 weeks will help diagnosis any food allergy. During this time, NO other foods, treats, chew bones, or chewable medication can be administered.
8. USE SYMPTOMATIC AND TOPICAL THERAPY TO HELP REDUCE THE ALLERGY AND ITCH.
Antihistamines are cheap effective therapies with few side effects (clemastine, diphenhydramine, chlorpheniramine, hydroxyzine, amitriptyline).
Treat with high dose essential fatty acids (if not already in the diet).
Anti-Itch conditioners after each bath (oatmeal, pramoxine, hydrocortisone, etc).
Use Genesis spray (triamcinolone) to provide effective topical steroid therapy.
Consider low dose (every-other-day) steroids to put out the "pruritic" fires.
9. ALLERGY TESTING
Allergy skin testing or blood allergy testing can be used to identify to which allergens the patient is reacting. This information can then be used to formulate an allergy vaccine to try to desensitize the immune system to those reactive allergens. This therapy has few side effects and helps improve approximately 75% of allergic patients.
10. CYCLOSPORINE THERAPY (ATOPICA, NOVARTIS)
Cyclosporine is an effective treatment that stops the T lymphocytes from stimulating the allergic reaction. It is effective in 75% of patients and has few adverse effects but is very expensive. The treatments are started every day but can usually be reduced to an every-other-day schedule, thus reducing the cost. In some patients, other medications (ketoconazole) can be added that will help further reduce the cost of the cyclosporine therapy.
CYCLOSPORINE THERAPY TIPS
Author's Suggested Protocol:
Eliminate fleas, scabies, pyoderma, yeast dermatitis, otitis.
Cyclosporine is miraculous but it doesn't kill fleas or bacteria...
In young dogs, try a food trial and consider Allergy testing.
Would you rather avoid what you were allergic too OR have to take cyclosporine forever?
Screen for tumors and check viral status in cats. Above all else Do No Harm...
Bath every 3-7 days.
It helps remove allergens and organisms plus clean pets are more pleasant :)
Begin prednisone for 1-3 weeks.
This may help hit the immune reset button providing better response.
Begin cyclosporine after a meal for 14 days then discontinue the food before treatment to maximize absorption.
If GI symptoms develop, divide dose into bid and give after a full meal.
Administer cyclosporine daily for 6-8 weeks to determine efficacy; then attempt to taper the dose to every other day.
Some dogs will require daily therapy but most can be tapered.
RESPONSE RATES
Cyclosporine therapy works better than antihistamines, topical antipruritics, and works as well as steroids and immunotherapy (allergy vaccines).
If the patient is responding by the 4 week point they will likely do well and have a 75% chance of being tapered to an alternative day dose.
IMPROVING EFFICACY
Eliminate all secondary infections (pyoderma, yeast dermatitis, otitis) before beginning cyclosporine therapy.
Not all cyclosporine is the same. Use AtopicaR first to verify its efficacy; only then consider generics.
Ideally give AtopicaR 1 hour before or after a meal to maximize absorption (this may increase GI symptoms).
For severely pruritic dogs, consider administering antiinflammatory doses of prednisone with cyclosporine for the first 1-3 weeks.
The target dose is usually 5 mg per kilogram per day; however, the addition of drugs that compete with the cytochrome P-450 enzyme system in the liver can increase cyclosporine blood levels by approximately two times (double). This will allow the daily dose to be tapered to every-other-day or the 5 mg per kilogram dosed be lowered.
Ketoconazole (5 to 10 mg per kilogram per day) can be administered concurrently to increase cyclosporine blood levels. In these patients, the dose of cyclosporine can be reduced (approximately half) or possibly tapered sooner than in patients not receiving the combination protocol. The addition of ketoconazole is especially useful in allergic patients with concurrent Malassezia dermatitis or otitis.
Recheck the patient only after 4-6 weeks since rechecking earlier may not identify improvement and produce more owner frustration.
Some patients do better with BID or daily dosing rather than being tapered to every other day administration.
Make sure the owner has a back-up supply to prevent treatment gaps.
PRACTICAL TIPS
For bid dosing, the capsules can be ruptured and half of the content expressed into the food or a treat. (It may help to let the capsule set outside of its foil wrapper for several minutes to let it soften.)
Educate the owner about the long-term prognosis and need for continual treatment.
Only treat animals that have failed more conservative therapies; antihistamines, topical antipruritics, food trials, allergen avoidance; these are less expensive and less medically invasive.
Use poly-modal therapy protocols; concurrent antihistamines, topical antipruritics, EFAs.
The cost for the 10 mg is the same for the 25 mg so consider dividing the 25 mg capsule.
Don't forget to monitor the patient for pyoderma, yeast dermatitis, demodex, otitis, and UTIs.
If the patient is flea allergic, make sure the owner keeps current with control measures.
In cats difficult to pill, consider using the injectable cyclosporine every 2-3 days.
MANAGING ADVERSE EFFECTS
25% of patients will develop GI side effects but less than 5% will be serious enough to require the cyclosporine to be stopped.
If the patient demonstrated GI symptoms, give after food or divide the does into 12 hour increments.
The Bloom Protocol to avoid GI symptoms: For the first 7 days, the cyclosporine is gradually increased so that the maintenance dose is achieved on day 7. During this induction phase cyclosporine is administered with metoclopramide and food. On day 10 the metoclopramide is discontinued and the cyclosporine is administered with food until day 14 at which time the cyclosporine is administered on an empty stomach to maximize absorption.
Pretreatment survey blood work (CBC, serum chemistries, and urinalysis) is usually performed to identify patients with concurrent renal or liver disease. Generally after the first four to six weeks of cyclosporine therapy, survey blood work and urinalysis is reevaluated to identify any developing problems.
Do not treat dogs with neoplasia and monitor dogs for tumor development; especially lymphocytic neoplasias.
Watch for warts.
Now I shall continue:
Take the dog off commercial food start NOW by buying a good raw feed if in uk:
www.prizechoice.co.uk
if in USA
www.bravofoods.com
If the dog is prone to this allergy it is far likely that hey will also develop other allergies as they get older. This will reduce that risk. Give the dog Flax oil , or any good quality oil that is high in GLA (look at he health shop) we use here Cod liver oil or flax, or Starflower oil. Give 1 tab daily .Fatty acids in the diet reduce ALL allergies.
Do not feed cows milk, use goats milk if you must, Do not feeD dry foods at each meal, give fibre green beans, cucumber , pumpkin and apple and mashed potatoes instead of rice.
Natural Healthcare - The health needs of each animal can vary and the most important part of your animal's health is good communication with a veterinarian and or the breeder. As for pet supplements and flea treatments the green choice is to stay away from petroleum-based and synthetic chemical products and look for natural solutions.
2) Natural Flea control - As the season warms the bugs re-emerge and fleas hop back into our lives. Fleas can be controlled naturally using a two-pronged approach of treating the animal and treating the area.
For the House and Yard:
Orange Guard - Light spray around entryways, baseboards, and hiding places
Cedarcide Granules - Apply to lawn, flower beds, around home perimeter and under elevated decks
Diatomaceous Earth - Apply to lawn, under elevated decks, and under pier & beam homes - also apply to carpets and then vacuum
For the Furry Friend:
Vet's Best Flea Shampoo - Bath weekly or bi-weekly, d-limonene from orange and tea tree keep fleas at bay
Diatomaceous Earth - For infestations, rub down an animal avoiding face, but not too often as it can dry the skin.
3) Natural Clean Up - Keeping Paws clean, fur shiny, and the home mud-free can be a challenge with the spring rains and we recommend washing your pet with our natural, safe, and ecologically-sound shampoos and cleaners. ** Also very importantly, please think of your pets when considering cleaners and chemicals to use around the house - Dogs, cats, ferrets, and everything with 4 legs like to nose around and their proximity to floors, tubs, and toilets make them even more susceptible to the chemicals released by conventional cleaners, degreasers, and polishes. Clean your home with natural cleaners and remove the risk. These and more are found at Green Living:http://www.green-living.com/info/NaturalPets.html
We have several recipes that have worked and continue to work on our site of which you are welcome to join. Its free ad I think it will prove invaluable to you throughout the life and development of the little one
http://www.eurobichons.com
Garlic although a poison to dogs cane be beneficial to reduce flea treatments. Teatree is also very good but it will have some side effects which we have noted on site.
Salt carpets overnight then vacuum up this will kill any fleas present.
Veterinarian's Best natural Shampoos and Conditioners help reduce dander, control fleas and making your pet smell so good you'll want to snuggle
Earth Friendly Products' pet care line includes Natural Pet Wipes, Kitty Litter Treatment, and Aviary Cage Spray Cleaner
Oxy Boost - All-purpose non-chlorine bleach which is often used to soak litter pans. The waste water can be used to water and fertilize plants.
Earth Friendly Products' Eco Breeze - A plant-based natural alternative to Febreeze. In Lavender and lemongrass scents.
BioKleen - Gentle and very effective cleaners such as All Purpose Cleaner for floors, walls and everything and Bac-Out, an enzymatic stain remover
4) Health Supplements - Veterinarian's Best provides high-quality, all-natural supplements to make life easier for an animal, from natural Home Alone Anxiety Relief, to Aches & Pains Formula, and Vita-Derm Food Supplement and more.
5) Entertainment & Accessories - Sustainable toys, collars, and leashes. Planet Dog leashes and collars made from ultra-durable hemp and chew-toys made from recycled materials. Are we embarrassed to say that one of the most popular animal products at Green Living is the 100% natural and biodegradable poop pick-up bags from BioBag? Nah.
6) Food - The next step to 'green' your pet's diet is to switch to an organic, sustainably-raised food source. Each pet has different nutritional needs, so discuss options with your vet and explore the options at your local pet or grocery store. Green Living does not sell pet food but we feed our pet Newman's Own Organics, a company that we trust (and because we like his movies).
7) Waste Control - Whether your pet uses the 'toilet' indoors or out, pet waste can be diverted from the landfill. The easiest way is to compost it, and the safest way to do that is to make sure your compost 'cooks', meaning that it gets hot enough to kill bacteria. Animal waste shouldn't constitute more than 20% of a compost pile and the compost made from animal waste shouldn't be used on plants for food consumption. Another method of pet waste disposal is to dig a hole in your yard and cover with a sturdy lid - dump waste into hole and intermittently cover with soil.
Dogs - Many of our customers use and recommend our BioBag doggy waste bags made from biodegradable corn-starch plastic. Take on walks and dispose of easily into the compost to break-down.
Cats - For litter boxes, we highly recommend using a non-synthetic litter such as those on the market made from Wheat, Corn, Pine, or Paper. Products that come from the Earth and readily break-down and won't hurt your kitty.
8) Natural Lawn & Garden Care - Pets like to nose around and when outside they spend many hours with their nose, snout and entire body in the grass and soil. Natural lawn and garden care protects your animals from the harsh chemicals found in synthetic fertilizers and pesticides. This also goes for inside-only pets, because if it's on your lawn it will be on your shoes and make its way indoors.
