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More than an itch

dvm360dvm360 June 2023
Volume 54
Issue 6
Pages: 56

How to paint a broader picture of allergies in pets

dvm360 live ashley bourgeois

Content sponsored by Nextmune

Allergies are a go-to diagnosis when it comes to the itchy pet. However, there’s often more to the story. Adam Christman, DVM, MBA, and host of dvm360® Live!™ sat down with Ashley Bourgeois, DVM, DACVD to dive into various causes, emerging science, and treatments for itchy pets (Check out the video interview here).

Why might an itchy pet not be allergic?

Bourgeois: Not every itchy pet has an allergy. It is common, but other things such as hypothyroidism, pyoderma, scabies, mites, and even some lymphoma cases can be itchy. For the latter, that is something I would not want to misdiagnose as allergies. Going back to the basics with cytology, skin scrapes, and biopsies, allow for the correct diagnosis and treatment.

Tell us about the next generation of allergy testing.

Bourgeois: There are lots of allergy tests on the market. There are also lots of false positives, which can seem exciting, but they are only exciting if the positives are true. The idea behind the new generation of allergy testing is derived from what is happening on the human side: more standardization. Aside from standardization, we are beginning to look at the molecules. Can we figure out, isolate, and search through the knowledge we already have by examining specific molecules known to cause allergens in dogs, cats, and horses? This new test, Pet Allergy Xplorer (PAX) does just that.

I’ve been impressed by the fine tuning of these allergy tests. Nextmune is willing to adapt and learn from the test, which we all have to be willing to do.

As scientific breakthroughs happen, we will learn more about the different molecules that are causing problems. The chance of learning new things creates a lot of promise and excitement for PAX. It is currently available for dogs and will be available soon for cats and horses.

Why is this new test being so well received by veterinary dermatologists?

Bourgeois: It is advancing the veterinary science behind allergies. There are likely less allergens triggering itchy pets than we realize. Seeing less positives on an allergy test is a good thing because we can be specific with our immunotherapy. One factor behind these positives is cross-reactive carbohydrate determinants (CCDs). PAX has two anti-CCD measures to eliminate the chance of molecules interacting with CCDs and leading to a false positive result.

What role does immunotherapy play in dermatology?

Bourgeois: Allergies are multifactorial.They aren’t solved with just one medication. Rather, the solution involves flea control, topicals, diet, etc. The idea behind immunotherapy is to identify what these pets are allergic to and try to desensitize them.

Allergy testing is not a diagnostic test. It may provide some positives, but also come up negative. Skin is complicated as well as expensive for owners, so it is important to utilize tests in the right way. If I’m allergy testing a pet, I’m having that owner commit to immunotherapy. The hope is long term, there will be less use of pharmaceuticals and that pet will be able to lessen its number of reactions. That is because I’ve tried to teach the immune system to be used to all of these things in the environment. It does not mean they’ll get off all other medications or topicals. It means there can be less usage of those things or prevent their allergies from getting worse.

What about ectoparasiticides?

Bourgeois: If a pet comes in without being on an isoxazoline, sometimes, that is the first step for treatment. Flea allergies are easy to control. Isoxazolines also not only eliminate fleas, but they limit other causes of itchiness like scabies and lice. These are easy wins before pursuing diet trials and allergy testing.

What about topicals?

Bourgeois: As dermatologists, we can have owners utilize topical therapy to treat infections or even restore the skin barrier. Since dogs and cats have a defective skin barrier, good quality products take dander off the skin, allowing us to lessen the frequency of medications or the severity of infections.

Not everybody has the ability to bathe their pets. Are there other options?

Bourgeois: Yes. Some clients bathe their pet weekly, but there are products like sprays and mousses for spot treatments.No matter an owner’s lifestyle, they can still take care of their pet’s skin.

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