Itchiness can really affect the quality of life for our patients. When a dog’s skin is itchy a lot, they are continually irritated, have poor sleep, they smell bad, and they just seem generally down. So, how do we go about treating our dog’s itchy skin?
Whilst itchiness (“pruritis”) has many causes, by far the most common causes are allergic in origin. The allergies can be direct contact allergies, flea allergies or a skin manifestation of inhaled allergies (“atopic dermatitis” or “atopy”). Pollens, trees, grasses, mold spores, insects and house dust mites, are all common allergens. Typically, skin disease investigation involves ruling out other causes of itchiness and testing for secondary infections. Once we deal with these, we then look at allergen avoidance, improving the barrier function of our skin and medications to control symptoms.
Rule out other causes of itchiness and irritation
Sometimes, systemic illness such as an underactive thyroid or an overactive adrenal gland can manifest as skin disease. If we suspect this in your dog, we will run blood tests to check for these.
Treat for fleas
Experts estimate that up to 80 percent of itchy dogs seen by vets have flea allergies. This doesn’t mean your pet is crawling in fleas – it means that your pet is hypersensitive to even small numbers of them. Often, fleas will be resistant to older preventatives so we recommend the newer flea and tick preventatives. These include Bravecto, Nexgard or simparica. It’s then up to the pet owners to ensure that they treat all of the pets in the household regularly.
Sleep indoors
Cairns is full of mosquitos and midges. Imagine if you slept outside all night with no repellant – you’d probably be itchy too! Sleeping your pet indoors can reduce itchiness in many dogs.
Eat a good diet high in omega-3s
Diets such as Hills J/D, or fish-based diets and even supplementing omega-3s by giving fish oil capsules (not cod-liver oil) at 1000mg per 5kg of body weight, may reduce itching signs in some pets.
Test for and treat secondary infections
Often when something causes the skin to be inflamed for long periods of time, it stops functioning as an effective barrier and we can see overgrowths of the normal organisms in the skin. These may be fungi or bacteria. Unfortunately, the organisms themselves then tend to cause even more itchiness and the cycle continues.
We will often check for these organisms by testing a skin sample under the microscope during consultation. If found, treatment for these can significantly improve how your dog looks and feels.
Improving our barrier function
We may use topical shampoos and conditioners to soothe and return oil to your dog’s coat. If they have persistent secondary infections as described above, we may use antibiotic/antifungal shampoos and conditioners instead.
The conditioner part of treatment is critical, as shampoos tend to strip the oil from their coat which can lead to dryness and irritation.
Avoid contact with the allergens
If your dog has been diagnosed with contact allergies, getting them to wear a fitted shirt can prevent the pollens from coming into contact with the skin, thus reducing inflammation. The shirts we recommend are ordered online from Bromelli dog suits.
Medications for itchy skin
A number of medications are available to control itchiness. With all medications, our goal is to find the lowest manageable dose of the safest possible medication. For some dogs, their allergy season is all year round, whilst for others, it can be only a few months of the year.
We tend to use medications at a higher initial dose to bring down the inflammation, then a lower dose to maintain this reduction during our at-risk period.
Apoquel
Apoquel is the most commonly recommended allergy treatment drug due to its safety and efficacy. From a medical perspective, it is usually the best allergy drug for moderately to severely affected patients.
The cortisone group of drugs are effective and affordable, but can have some potentially bad side effects if used long term. They are available as tablets or even injections that can last four to six weeks.
Cytopoint
Cytopoint is a monthly injection that neutralises the itch. The main benefit is that it is an incredibly safe drug, being a ‘monoclonal antibody’. The main downside of this treatment is that it only appears effective in mildly affected patients.
Topical cortisones
Topical cortisones such as Cortavance spray can be quite effective if used on the correct patient. Therapies that are topical have the advantage of having few to no systemic side effects, but their efficacy is quite variable. They are best for pets whose flare ups occur mostly in non-haired areas. They can be used with other medications to reduce the dose of systemic drugs.
Antihistamines
Antihistamines are used less and less as better drugs are developed. Dogs tend to neutralise antihistamines after ingestion, before they can have an effect on the body. The second generation antihistamines such as Zyrtec can be used if necessary, but they are far inferior in safety and efficacy to tested, registered medications such as Apoquel.
Referral to the skin specialist
A dermatology specialist visits Cairns around four times per year. Dermatologists are excellent at managing dogs who are having difficulty achieving good results with treatment from their regular vet. This specialist is also able to perform intradermal skin testing to determine what allergens your dog is reacting to and then tailor an immunotherapy treatment to your pet.
Immunotherapy is where we take the allergens your dog reacts to and administer these to your pet in increasing dose and frequency. This can help to ‘retrain’ their immune system to react less. This has around a 70% chance of significantly reducing signs, meaning that your pet requires less allergy medication for management. If you are interested in referral to the specialist, ask your vet for a referral or contact our clinic.
Be prepared for lifelong management of itchy skin
Allergies tend to only ever be managed, not cured. Most patients will have good and bad seasons, but allergies do tend to last lifelong.
Treatment for itchy / irritated skin is worthwhile!
Many clients report their dog is significantly brighter, happier and ‘back to their normal self’ after we fix the itch. Managing this problem significantly improves their quality of life and keeping on top of their allergies goes a long way towards preventing the secondary infections as described. If you would like to discuss how to best manage your dog’s allergies, please give us call or book online.
