A huge portion of our patients are Dogs that come into the clinic for the many various forms of itching. These patients present with clinical signs from: itching all over, itching their ears, licking their feet, or scooting on their rear ends. For a long time we treated all of these things as individual disease problems, but it has become clear that they are all symptoms of an immune system that is not functioning correctly. This dysfunctional immune system results in a condition we all know as allergies.
A few years back, we started working with a company called Spectrum who actually had the ability to get us useful information about the underlying allergies. Previously we had received no data on possible food allergies, and the data we had gotten about “pollen type” allergies did not seem to be accurate for our area. With the data Spectrum could provide, we were able to work with them to set up our patients to use allergy shots (or oral) desensitization protocols, just like are used on the human side. Our goal changed from just controlling the symptom if itching to retraining the immune system to stop over reacting to normal things in the environment, such as pollen. Our goal utilizing the immunomodulation techniques is to have our patients completely off medications within a year of slowing retraining the immune system.
We have seen the benefits through the course of our patient’s lives in a decrease in additional disease processes when our patients are not asked to tolerate long term meds and are not in a continual cycle of inflammation. We will continue to add updates as we learn more about the long-term effects of the chronic medication use as well as uncontrolled chronic inflammation.
There are several pharmacological options for controlling the itch. Steroids were the most commonly used medication for a long time, and while the itching certainly resolved, the side effects and long term complications have made it clear that option was just causing huge problems in the long run. Later medications have come to the market that are designed to selectively suppress the immune system. Apoquel and CytoPoint are two of the more commonly used medications. These medications still have some down sides. First, both of these medications seem to loose efficacy in our patients over time. That is to say, patients that seemed to do well on the medication at the beginning of treatment seem to start itching again while still on the medication after several months of treatment. The second down side is that neither of these medications is actually fixing the problem, rather they are just helping with the symptoms. Finally, since the underlying problem is not actually being addressed, we have to expect patients to be on these medications long term, in some cases, life long and neither of these medications are inexpensive. Though we were unhappy with the long-term medications and often unsatisfied with the outcome, we struggled for many years to find an acceptable alternative.