Atopy

by | Mar 11, 2024 | Allergy

Atopy

By Dr. Karen Burgess

What is atopy?
Atopy is another way of saying airborne allergies or environmental allergies. In people atopy would be known as asthma or “hay fever”. Allergens are found in the environment and may be inhaled or come in direct contact with the skin.

What are signs of atopy in pets?
The most typical presentation is itchy skin, secondary skin infections, and ear infections or inflammation. Symptoms may be seasonal in nature or year round depending on the underlying allergen. All areas of the body can be affected, but in dogs the face, armpits, abdomen, feet, and legs are often predominant. Dome pets may have a red color to their fur from licking (saliva contains a pigment that thus stains the fur). Cats can have lesions anywhere on their body. Ears are a continuation of the skin inside so infections are common secondary to atopic inflammation of the ears. Respiratory signs can occur in pets but are much less common. Symptoms often start between 1 and 3 years of age and will usually get worse over time not better thus making treatment essential.

What causes atopy?
Just like in humans, allergies are an inappropriate and excessive response of the immune system. Essentially instead of ignoring an allergen such as dust or mold, the immune system becomes overly excited at any exposure leading to inflammation of the skin for pets. Genetics also play a part with certain breeds having a higher incidence of atopy.

How is atopy diagnosed?
Clinical signs and history are very helpful in identifying atopy as a cause of chronic itching or skin disease. The first step is ruling out other causes of itchy skin, in particular parasites (mites, fleas, lice), secondary bacterial or yeast infections, and systemic diseases (hormonal diseases, cancer). The next step is determining whether food allergies may be a factor. Pets can experience both food allergies and atopy and symptoms for both overlap, but their treatment is very different. Once all other possible causes of chronic itching/skin disease have been ruled out then atopy is the most likely diagnosis and definitive testing can be performed. Skin (intradermal) testing has for years been considered the gold standard. Similar to in humans, an area of skin (typically on the side of the body that has been shaved) is pricked with a variety of potential allergens and the subsequent response is measured. This information is then used to create injections that are used for treatment. Prior to testing steroid and antihistamine therapy must be discontinued for a period of time. Sedation is necessary for skin testing. Blood allergy testing has become more reliable; this method measures the pet’s antibody levels toward a particular allergen.

How is atopy treated?
There are many ways to manage or treat atopy. A few are listed here.

  1. Minimize exposure– Avoidance or removal of specific allergens (washing feet after going outside, frequent baths)
  2. Hyposensitization (“allergy shots”)- Information obtained from allergy testing can be used to design specific immunotherapy. By giving small doses of allergens at a regular interval, the pet hopefully develops tolerance to them and thus reacts less when encountered in the environment. Unlike in humans, pets do not outgrow allergies like some humans. These injections are typically given by owners at home and are found to be effective in 75% of treated dogs.
  3. Immune modulators– Atopica (cyclosporine) is a non-steroidal medication that alters how the immune system responds to an allergen. While safe and effective, this product can be expensive particularly for larger dogs. Corticosteroids (such as pred) act as an anti-inflammatory and immunosuppressive agent. While very effective at controlling symptoms and inexpensive, steroids have a myriad of negative side effect and are not a safe chronic long-term solution.
  4. Antibacterial/antifungals– It is common for pets with allergies to develop secondary bacterial or fungal injections. In essence pets with allergies have “sick skin”. While bacteria and yeast are found naturally on the skin, it is easy for their numbers to get out of control for pets with allergies. For severe infections or overgrowth, oral antibiotics or antifungals may be necessary. In milder cases topical products may be sufficient.
  5. Antihistamines– Commonly used to control allergy symptoms in humans, antihistamines such as Benadryl are far less effective in dogs and cats. The mechanism of action is to block the chemicals causing the itch (typically histamine). Any particular antihistamine may help only 10-15% of pets. Trial and error is necessary to determine which if any might be beneficial for an individual pet. Overall antihistamines offer a safe and inexpensive adjunct to atopy treatment.
  6. Omega 3 supplementation– Often referred to as fatty acid or fish oil supplements, Omega 3s overtime can decrease the inflammation associated with atop. DHA and EPA are the common fish origin omega 3 fatty acids. When determining a dose the sum total of DHA and EPA is used with a target of 70 mg/kg/day (range 50-100 mg/kg/day). Fish oil supplements are a supplement and thus not well regulated. Reliable brands include Nordic Naturals (online human product) and Welactin (veterinary product).
  7. Topical treatments– Shampoos, conditioners/lotions, and sprays can all be very useful in controlling allergic skin disease. Medicated shampoos need to be used frequently (two to three times weekly) and allowed to stay in contact with the skin for 10-15 minutes before rinsing. While for some clients this is not the most convenient therapy, it allows a relatively inexpensive at home treatment option that is safe and does not involve systemic (oral) medication. Sprays and lotions are used for specific or isolated areas. Steroid sprays allow the potent anti-itch effect without the same negative side effects of oral steroids.
  8. Flea and tick preventative– Year round prevention of parasites is recommended to avoid this complication for the already itchy atopic pet.

Thunderstorm/Noise Phobia

by | Jan 19, 2024 | Anxiety/Phobias

Thunderstorm/Noise Phobia

Thunderstorm/Firework Anxiety

By Dr. Karen Burgess

Crash, Bang, Boom!  Thunderstorm Season is Here!! With spring and summer sunshine come thunderstorms.  These downpours not only affect our lives, but are also devastating for pets that have noise phobias. Dogs that have anxiety during storms may also have problems with other loud noises such as fireworks, gunshots, or loud vehicles (ex. trash trucks). This is not just a dog being silly but a major behavioral issue when a pet becomes destructive or harms themselves or others. So let’s look at the basics for thunderstorm phobia…

Who: Dogs of any sex, age, or breed (including mixed breeds). A dog may develop this phobia as an adult and it will often get worse rather than better on its own.

What/When/Where: Clinical signs may be as mild as pacing, difficulty settling down, or panting.  Some dogs destroy rooms, soil in the house, or even jump through windows.  It has been suggested that dogs actually detect the barometric and electrical changes in the air prior to the actual storm.  This may explain why some dogs display symptoms several hours prior to an actual storm or thunder.

Why: It is unknown what causes noise phobia. There is a link between thunderstorm phobia and separation anxiety. Dogs with storm phobia are more likely to also experience separation anxiety (although vice versa is not true).

How do we help these dogs?

  • Safe place– whether this be a crate, under the bed, or a specific room, it is important that the dog has free access to this area. Watch to see where the dog tries to go when they are frightened. Other considerations are a room in the interior of the home with no windows, covering the crate with a blanket, or playing a fan or music in the room to help block out storm noise
  • Owner behavior– it is very important that owners not unintentionally reinforce a dog’s fear of storms. Petting, soothing, or giving treats to a pet that is acting fearful may be interpreted as a reward for the behavior. The best thing for an owner to do is to go about business as usual and not acknowledge their pet’s anxious behavior at all
  • Distraction– try preoccupying the pet with an activity they enjoy, playing fetch, Kong toy, or a favorite toy. If the dog is trained on a regular basis you can also practice sit, stay, down, and come with appropriate rewards to try and get their mind off of their anxiety
  • Behavior modification– for some dogs playing audio tapes of thunder at gradually increasing volumes can help desensitize them to the noise when a real storm comes.
  • Medication– the dog appeasing pheremone or DAP diffuser is a relatively new product that owners can obtain over the counter. It is plugged into an outlet and secretes a scent that is soothing to dogs.  This has not been shown to be 100% effective, but many people claim success and it is in no way harmful to the pet. Many people want sedatives for their dogs during storms. These must be used with caution since they may make the dog sleepy but not take away their anxiety in the least bit. Clomicalm (clomipramine) and Xanax (alprazolam) have been shown statistically to help with thunderstorm anxiety.

Arthritis options, Canine

by | Jan 19, 2024 | Arthritis

Arthritis options, Canine

Arthritis Treatment Options

By Dr. Karen Burgess

NSAIDS (non-steroidal anti-inflammatory drugs)
Prescription obtained from your veterinarian.  Human examples include aspirin and motrin, but neither of these should ever be used in dogs.  Veterinary approved products include etodolac, carporfen, deracoxib, tepoxalin, meloxicam, and firocoxib.  The goal over time is to reduce the amount of these products used by using other more natural remedies (see below)

Glucosamine
Glucosamine has been shown to have a preventative effect with patients receiving it prior to an acute joint injury- allowing the injury to heal more quickly than those who start to receive it afterwards.  80% of glucosamine products do not contain the amounts of glucosamine indicated on the label.  Cosamin DS, made by Nutramax has historically been a reliable product and contains not only glucosamine HCl but also chondroitin sulfate and manganese.

Recommended product:  Cosamin DS, purchased at Costco or Sams, 230 count,  1500 mg capsules, $59.99, 50-100 pounds take 1 capsule orally daily, $0.26/day

Adequan (polysulfated GAGs)
GAGs are building materials for joints, have anti-inflammatory properties of their own that help slow down the actual damage to the cartilage, and they help the joints create more lubricating fluid.  Prescribed in significant quantities at first, dosage decreases over time: given as an injection twice weekly for 4 weeks, once weekly for 4 weeks, every other week for 4 doses, every third week for 4 weeks, then once monthly for life.

50-100 pound dog $55.00-$76.00/injection; after first 2-3 weeks typically will teach owner to administer at home which greatly decreases expense.

J/D
Prescription diet J/D is clinically proven to reduce pain in dogs with arthritis and to help dogs with arthritis walk & run better, play better and climb stairs more easily. 82% of dogs fed j/d showed improvement in weight bearing ability.

$74.78 for a 27.5# or $2.00/day for a 50# dog (27.5# bag will last a 50# dog 36 days feeding the recommended 3 ½ cups per day)

Additional recommended therapies include weight loss, acupuncture, hydrotherapy, and stem cell therapy.

Adequan

by | Jan 19, 2024 | Arthritis

Adequan

By Dr. Karen Burgess

What are symptoms of arthritis in pets?

“Slowing down”, fatigue, difficulty rising, reluctance to go up and down stairs or jump, abnormal aggression, and lagging behind on normal length walks may all be signs of joint pain and/or arthritis.

What is Adequan?

Adequan is an injectable polysulfatated glycosaminoglycan (PSGAG or GAG). In common terms, it is an injectable medication that when given regularly, acts as a lubricant and inhibitor of proteins that damage joint cartilage. Adequan provides the joints with chondroitin, a GAG that helps with compression in the joint. It also allows for production of collagen which helps create building blocks to make new cartilage. In summary, Adequan protects and helps rebuild joints slowing down the development of osteoarthritis

How is Adequan given?

Adequan is given as an injection either in the muscle or under the skin (subcutaneously). The dose is tapered down from twice weekly initially, to once monthly. These shots are typically not painful and relatively easy for owners to administer at home with some instruction. It is important to understand the annual cost of Adequan is significantly less than the initial four months due to this tapering dose.

What benefits are seen with Adequan usage?  What are the potential risks?

Adequan is a chronic joint pain supportive medication. Pets that benefit from Adequan typically show increased mobility, decreased pain, and overall improvement in arthritis symptoms. This improvement can take several weeks to appreciate. In cats, Adequan is one of the safest available arthritis management tools available. Very rarely, pets are sore at the site of injection for a short period after administration. This is much less likely with subcutaneous injection.

Anxiety, Canine

by | Jan 19, 2024 | Anxiety/Phobias

Anxiety, Canine

Recommendations for Pets with Anxiety

By Dr. Karen Burgess

Punishment for destructive behavior:
Do not use verbal or physical punishments in response to destructive behavior. Punishment has many side effects and often makes anxiety worse. If he/she is being destructive prior to your return home, he/she will not be able to associate this behavior with the punishment. Punishing when you get home might also increase anxiety, as your pet will feel conflict over wanting you to return but may associate your returns with being punished. At this point you are not using punishment in response to your pet’s destructive behavior so this statement is here for informational purposes.

Clicker training:
Training with a clicker is a very effective and fun way to teach Piper new tasks. After your pet has been introduced to the clicker and associates its unique sound with the presentation of food, it becomes a conditioned reinforcer. This means the click sound advises that a reward is coming. It is also an event marker, meaning that it clearly and immediately tells your pet which behavior is being rewarded. The goal in using clicker training during relaxation and response substitution exercises is to allow you to clearly and consistently communicate to your pet which behaviors are desired. An excellent resource for using clicker training for obedience exercises (and tricks) is  and “Clicking with Your Dog” by Peggy Tillman.

Departure counter-conditioning:
Give your dog a delectable food treat or food stuffed toy that will take a number of minutes to consume at departure. The intention of this exercise is to distract him/her from your departure and allow them to associate owner departures with a pleasant event. Use these treats or toys only upon departing and remove them when you return home. Kong toys are great to use for this exercise and many recipes for Kong stuffing can be found

  • Modify your departure and greeting routine: Ignore your dog for 30 minutes prior to departure. Feeding, walks, and elimination should occur before this period. When you return, you may allow Piper to go outdoors to eliminate, but only give attention when he/she is calm and quiet. These exercises are meant to prevent inadvertent reinforcement of anxious behaviors.
  • Change the predictive value of departure cues: Make a list of activities that you perform prior to leaving your home which signals that you are leaving and makes him/her more anxious (signs of anxiety may include panting, pacing, or following).  Perform these activities at times when you have no intention of leaving (repeat 2-4 times daily until he/she does not respond to your cues with anxious behaviors). You may notice that, at first, they will show increased anxiety when you do these things, but, over time, the anxiety will decrease as he/she can no longer use these cues as reliable indicators of your departure.

Indoor relaxation exercises:
Begin training your pet to assume a calm, relaxed behavior on a specific mat or bed during gradually increasing periods of separation. Use the clicker followed by delectable food treats as positive reinforcement for appropriate behavior. Begin by asking for a relaxed down-stay (such as down with head on paws) for increasing lengths of time before giving a reward. The goal is to reward not only the down behavior, but also relaxed body postures. Build up to about 10-15 seconds between the cue and the reward. Once you can do this, take one step back and immediately return to your dog and reward.

Repeat this step several times until he/she is relaxed. Then take two steps back, three steps back, etc until you can leave the room. Return to your pet each time before giving a reward. Repeat each step several times until he/she is relaxed before moving on to the next step. When you can leave the room, gradually increase the time you are gone before returning and rewarding. Repeat these sessions several times per day.

For further information regarding anxiety in pets, please contact Healthy Paws Animal Hospital to schedule an appointment with Dr Burgess.