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Discussion Starter #1
I met today with an Allergy, Skin & Ear specialist for Tess. I thought I would start a thread of our experience & what we learn as we go through this for others who may be having allergy problems with their pets. I'll state right up front: I'm not an expert,. I also realize there may be other ways to go about dealing with this issue and this may not be the right path for everyone. After careful consideration, I have decided to go to this doctor and then follow his advice, using a very methodical approach, and hopefully find a cure for Tess, or at least relieve her symptoms. I was concerned that if I just tried to deal with this on my own I would spend far too long stumbling along and never really solve anything, while spending a ton of money. (This way, it'll take me less time to spend that ton of money, :biggrin1:)
 

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I will be very interested to follow this thread Jill. Give Tess scratches behind the ears from me a very allergic human who loves to scratched myself.
 

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Kodi has allergies. At first I thought they were just seasonal allergies. Then I found a flea, so thought it had to be an allergic reaction to flea bites. But now there are no fleas and he is still scratching. I think it would be so much easier if they were both scratching, but it is just Kodi. I don't think it is his food, because I tried switching brands, and he still scratched. I'll be very interested to keep following this thread.
 

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History: Tess was 5 years old when I got her in December '07. Because she had been a puppy mill breeder up to that point, I don't have much history on her health. When I picked her up she was already scratching at her ears, chewing on her feet, etc.

I'm a little sketchy on the early treatments we did with her so please forgive me. I'll give you what I remember.

In late December '07 Tess was put on 4mg Chlorpheniramine, to try and help the itching. The hope was to break the cycle of her itching to see if it was maybe stress related or possibly just a habit she'd developed. It didn't relieve her symptoms so about 2 weeks later she went on 5mg Prednisolone and 10mg Doxepin. We continued this for about a month, with no change in her symptoms.

In mid-February '08 my options were to take her to an allergist for the skin prick test (similar to what they do to people) or have a blood samples sent to a lab. I chose the blood test due to cost and less stress on Tess (they sedate them for the prick test). My regular vet sent the blood samples to Bio-Medical Services for the testing at a cost of around $370.

I received a lengthy report of all the items (categorized by: food, trees, grasses, weeds, molds, other (i.e., dust mites, cat, fleas, etc.) and how allergic she was to each item (negative, borderline, borderline-positive, positive, highly-positive).

In early March I started giving Tess allergy shots (cost of about $250). The shots are given in gradually increasing dosages over a couple of months. First every 3-4 days, then 4-7 days, then 7-8 days, then monthly. (During high allergy season you might have to give shots more often.) You work up from .10cc to .75 cc. The vials lasted about 10 months. I was told it could take anywhere from 3-12 months before we saw any improvement.
 

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Discussion Starter #5
The allergy tests found that Tess was:
Highly Positive: Dust mites (poor thing, living in my house!)
Positive: Mold, fungus, floor mites, pigwood weeds and penicillium
Borderline-Postive: Food (chicken, pork), trees (birch, alder, willow, elm), grass (Timothy), molds (yeast), mites (storage, mold), nettle weed and fleas
Borderline: Food (potato, corn, sweet potato, turkey), trees (privet/olive, mulberry, hazelnut pollen, ash), grass (bluegrass, reed/sweet vernal, babia), weeds (goldenrod, cocklebur), more molds, and cats (so much for getting a cat).

I changed her diet to Wysong Anergen (lamb & rice) ,which she soon refused to each, at which point I started combining that with canned 95% pure lamb, venison, rabbit or beef. She would get that for one meal a day and then Nature's Variety Raw Medallions (lamb, venison, or beef) for her second meal. At some point she started refusing the kibble/canned combination and has been strictly on raw for a few months now. For treats she gets the Natural Balance rolls (beef or lamb).
 

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Discussion Starter #6
I had been giving her the shots for about a year and it didn't really seem like they were making any difference. I would see a slight improvement for a few days after the shots but that was about it. I occassionally gave her prednisone, if the scratching was really bad but didn't want to have her on that long term. I would give her antihistamines a little more frequently but the relief was limited.

Her symptoms are: licking her paws (that's why her feet always look pink in her pictures), scratching her eyes/ears/armpits/shoulders/belly, licking her groin.

She's also had 3-4 ear infections over the year. Unfortunately, because she's forever scratching it's tough to realize she has an ear infection (there's never any smell.)

The vet also found that one of her ears is blocked or damaged - they were unable to tell (the specialist will take care of this issue also). Because the ear infections never seem to completely clear up, the thought is that she may have an inner ear infection.
 

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Discussion Starter #7 (Edited)
So, a month ago I made an appointment with this specialist. Tess had to be prednisone free for a month and antihistamine free for 2 weeks before we could go in.

For what it's worth, the doctor is 1 of 5 double-boarded veterinary dermatologists in the US (American College of Veterinary Dermatology and American Board of Veterinary Practitioners).

He wasn't able to do the allergy tests today. Tess has not been eating well for the past week and hardly at all since Friday (I almost took her to the emergency room yesterday due to her reaction to finally eating just a little bit of cheese). He wanted my regular vet to rule out any other problems before putting her through this.

What he did tell me:
- The blood tests I had done last year are of some value, but limited
- You can test for environmental allergies but not food
- Stress does not cause allergies but will definitely aggravate them
- Tear staining is not usually associated with allergies
- Ear infections are frequently related to allergies

I didn't ask about vaccinations, I'll remember to do that next time.

What they will do:
- To test for environmental allergies, they would typically sedate the dog/cat and do the skin prick test. It looks like there's about 90 things they test for: indoor inhalants (house dust, wool, cat hair, feather mix, cotton linters, mites), tree pollens, grass pollen, weed pollens, molds, and insects.
* Because one of Tess' ears is blocked, instead of just being sedated, they will anesthetize (sp?) her, unblock the ear and check for inner ear infections and then do the prick test while she's under.

- To determine her food allergies, we'll be doing an elimination diet. She'll be put on a protien that she's never had before plus a starch. It will be home cooked. (He told me it can't be raw but I forgot to ask why, I'll do that next time). Since we think she's allergic to chicken, pork and turkey and is currently getting lamb, venison, rabbit and beef and showing sypmtoms, she'll be on an ostrich or emu diet. (Yes, you read that correctly, ostrich or emu!!! And must be pure meat, no additives, etc.) Since she's allergic to potatoes and sweet potatoes I'll be combining the meat with oats. This is all she'll be allowed to have for the 1-3 months it will take to determine if she has food allergies. She cannot put anything else in her mouth - including heartworm pills, vitamins, treats, etc. We'll know she has food allergies if there is relief in her symptoms on this diet. If we decide she has food allergies we'll either start adding items to the emu/ostrich/oats or try slowly adding the foods she had been on. Because it's not a balanced diet to start with, Tess will probably lose weight (one of the reasons the doctor wants to make sure there's nothing else going on with her.) He also doesn't want to start the new diet when she's not feeling well so that she doesn't associate these new foods with having an upset stomach.
 

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Discussion Starter #8
While going through this process with the elimination diet I'm required to keep a "Daily Itch Calendar" using a scale of 0 (normal itching) to 10 (non-stop itching).

This will help determine whether a particular antihistamine helps in lowering the amount of steroid that is needed to keep the itching (licking/scratching/chewing/biting/rubbing) at a comfortable level ("steroid sparing effect").
 

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Jill,
I will be watching this as for the first time, Belle has allergies. I originally thought it was a hot spot she developed on her back as she would lay on her back and rub or itch removing hair. A maltese breeder down here called it summer kennel itch and her dogs get it and she told me to use a product "happy jack" which did help stop it temporarily. But she has been itching on occasion again. I think Belle is allergic to SC!!! I have really been watching when we are outisde for a long time is when she gets bad and itches her back. I am just watching her, trying to distract her and bathing her a lot and this seems to be working right now for us. If it gets worst I will consider taking her in but I want to avoid any shots if possible.
 

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Discussion Starter #10
Atopic Dermatitis

From a handout I received at Dr. Bloom's office:

Definition: Atopic Dermatitis is a pruritic (itchy) skin disease of dogs and cats. In atopic dermatitis, an allergic reaction occurs when an animal inhales airborne substances or ingests a substance to which they are sensitive. Unlike man, animals with atopic dermatitis only occoasionally cough, sneeze or get asthma. Instead, they itch. The itching may be localized to certain areas or may be over their entire body. Usually the feet, face, ears, armpits, and front legs are affected. This is in contrast to flea allergy where the rump, tail groin and thighs are affected. About 1/2 the pets with atopy will also be allergic to fleas so will have symptoms of both diseases.

Atopic dermatitis due to food reactions can be cured, while those due to airborne substances can't be cured, but in most cases can be controlled. Usually, cortisone type drugs (steroids) are used. They are very effective anti-inflammatory, anti-itch medications. Steroids have more side effects (excessive drinking, urinating and eating along with increased susceptibility to infection) than other treatments. If used long-term without supervision, steroids may decrease the pet's longevity. It may also be the only treatment to control the pet's symptoms.

Alternatives to steroids:

Antihistamines in conjunction with essential fatty acids will control 10-25% of atopoic dermatitis due to airborne allergens. Only side effect: grogginess. EFA's work better in combination w/ antihistamines than either product by themselves. There are no side effects to EFA's but may take up to 60 days to be effective. They do not help pyodermas (bacterial skin infections), Malassezia infections (yeast infections), otitis externa (ear infections), cutaneous adverse food reactions, or flea allergies.

Cyclosporine works by suppressing the immune system but in a safer manner than steroids. 40-50% effective but must be given life-long and is not effective for the same things as the antihistamines/EFAs.

Allergen specific immunotherapy (ASIT) (allergy shots) is the ONLY method that is currently available to help IMPROVE the health of the immune system (vs. MASKING symptoms). Allergen specific immunotherapy makes it possible to desensitize your pet to airborn allergens. (It does not work for food allergies). Works for 60-70% of the atopic dermatitis due to airborne allergens (either needing no other medication or less potent medication than previously). ASIT stimulates your pet's own protective mechanism (immune system), which stops the allergic reaction from occurring. Requires giving an injection every 7-21 days for the LIFETIME OF YOUR PET. It may take 6-12 months for the injections to be effective.

Pets with atopic dermatities are prone to secondary skin infections, ear infections and Malassezia (yeast) infections and frequently have sensitive skin. Any skin infection, irritating substance, or fleas will aggravate the allergic condition.
 

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Discussion Starter #11
Preventive Measures

Because Tess has allergies to outdoor substances I should:
- Wipe her body and legs off with a damp rag every time she comes in from outdoors
- Bathe her every week to remove those same substances (Please note: Medicated shampoos do not lather well.)

I need to ask whether full coat protects her skin from the allergens or makes it worse (I'm thinking it will help to be in full coat.)
 

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Discussion Starter #12
Pain Levels

I'll post this as a separate thread, but here also, so all of the info I collected is in one spot...

Pain Level: None
Observations:
- No pain
- Relaxed and freely moving
- Does not notice the surgical site
- Normal attention to the environment
- Interactive, playful and normal behavior

Pain Level: Mild
Observations:
- Limps or guards affected area
- Slightly depressed
- May pant or breathe hard
- Dogs may still wag tails and cats may still purr

Pain Level: Moderate
Observations:
- Depressed, trembling, head down
- Loss of appetite
- May cry or bite when touched
- Abdomen tense if involved
- May assume the prayer position
- Doesn't sleep

Pain Level: Severe
Observations:
- More vocalizing and more depressed
- Unaware of surroundings
- May thrash about intermittently
- May scream if approached
- Increased heart rate and respiration

Recommend that any patient displaying signs of moderate or severe pain be evaluated at the hospital. These patients may need to be hospitalized for more aggressive pain control.
 

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Oh Jill! what a wonderful mom you are! where on earth are you going to find Ostrich? Good luck-- I will keep checking in. Poor Tess. Poor you. This does not sound easy.
 

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I agree with Missy's post. I was thinking the same thing about you as I was reading all that you had posted so that you can help others. Thank you!
 

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Discussion Starter #15
So that brings us up-to-date on everything I learned from the specialist today.

To follow-up on a few other things I mentioned...

I took Tess to her regular vet this afternoon to make sure she doesn't have anyting else seriously wrong with her before we start on this process. The specialist was concerned because she hasn't hardly eaten since Friday - she seems hungry but the second she smells the food she turns away. Her poor little belly grumbles through most of the night. I thought her teeth might be bothering her, but she's had no problem chewing on a bully stick. She's been eating lots of grass, but she always does that. When she did get a little food down, she looked really uncomfortable so I was concerned about an obstruction, but she's having regular bowel movements - not real solid and small, but not bad.

So the vet did a full blood panel (I'll get the results of that tomorrow) and an x-ray of her belly. The vet came back in with the x-rays and said "Well, this is not good. But I can't tell what I'm looking at." :jaw: There were a couple of little "pellets" that were lit up in the bottom of her stomach. "These look like stones, or pieces of metal.....That's what bone looks like."

At that point I just laughed. Tess had finally eaten some of her NV raw medallions earlier that afternoon....with their pieces of bone. The vet was almost in tears she was so relieved.

She suggested I give Tess 5mg of famotidine (Pepcid AC or its equivalent) once a day. Since it's prime allergy season that's probably whats making her miserable.

If everything comes back okay with the blood tests I'll try to schedule the ear procedure and prick test for later this week so we can start getting Tess some relief.

Oh, and finding ostrich or emu......I happened to find an alternative pet foods store less than 2 miles from my house. They have ordered 24 lbs of ostrich for me. The owner suggested I cook it with the oats in a slow cooker to make a stew. She can also order freeze dried ostrich for me to use as treats but those are really pricey ($235 for a case!) ... Miss Tess may be spoiled, but she's not that spoiled! (Actually the owner can order ostrich steak and I could make my own treats.) Believe it or not, since I have to find foods she's never had I have a few options: buffalo, venison, llama, kangaroo...
KANGAROO??? All of this is through a company called Oma's Pride.

She also gave me the name of a homeopathic DVM that she has been studying under. He is out of Louisiana but does phone consultations. She said he has had very good results in treating allergies and even emotional/stress issues (which Tess has a ton of). If this doesn't work with the specialist, I may give this a try. (I can't find his business card right now, I'll post his name/website when I find it.)

She also suggested supplements from a company called "Animal Essentials" - they have a 'detox/allergy blend' that she said there have been good results with.
 

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Wow, Jill, you've really got a rough time ahead of you. I know, because two of my kids had severe food allergies, and I spent 3 years cooking radically weird foods on a rotation diet for them. It took hours to figure out what to cook that day, then a long time to find the ingredients. At least it will be easier to cook for Tess!

Hope you can resolve this for poor Tess. You are a wonderful doggy-mom!
 

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In mid-February '08 my options were to take her to an allergist for the skin prick test (similar to what they do to people) or have a blood samples sent to a lab. I chose the blood test due to cost and less stress on Tess (they sedate them for the prick test). My regular vet sent the blood samples to Bio-Medical Services for the testing at a cost of around $370..
I had that test done on me. Cost me a fortune and when I got back the results my jaw dropped. It totally missed what I'm allergic to and told me I was allergic to things that don't bother me. I talked to my doctor about it and he told me I should have talked to him first before running the test and he would have told me I'd pay a fortune for nothing. I heard about it and just had the nurse draw my blood to send in to them. I called the company and asked them to redo the test and they agreed to do it and then ignored me.
An elimination diet works pretty well without the expense.
 

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She also gave me the name of a homeopathic DVM that she has been studying under. .
That could be where you find your answers. Have you put her on a good probiotic? I can't remember all of the top 5 on the market but know "NOW" (the one you keep in the fridge) is one of them. She may have a leaky gut and not allergies but either way the probiotic won't hurt her and is good for her. This is a hot topic with me that I researched for a few years because I went through it. I was dx with allergies and restless leg. My legs itched so bad that I'd kick my husband all night long. Watching a play was totally out as I couldn't hold still that long. That's when I found a dr that was into holistic things and found my answers.
 

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Discussion Starter #20
Thanks Jan,

I'm going to keep probiotics (along with the homeopathic vet) in mind if this doesn't work. I want to try the elimination diet first and hold off on confusing the results by adding anything else. This is good information to have though so I know I have options.
 
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