IS SOMETHING ITCHING AT YOUR DOG?
If an allergy is to blame, it probably falls into one of three categories, according to Dr. Scott Miller, who recently completed an internship in small animal dermatology at the University of Illinois Veterinary Teaching Hospital in Urbana. The options are flea allergic dermatitis, food allergies and environmental allergies, also called “atopy” and “atopic dermatitis.”
“Flea allergy is considered the most common allergy affecting dogs, though that varies based on geography,” says Dr. Miller. “For example, fleas do not survive well in the southwest. Environmental allergies are more common there.”
Food allergies are less common. When they do occur, these allergies are most often tied to a specific protein source, such as chicken or beef, rather than to a grain, like corn or rice.
“ IN ENVIRONMENTAL ALLERGIES, THE IMMUNE SYSTEM OVERREACTS TO THESE ALLERGENS AND CAUSES A VARIETY OF SIGNS, INCLUDING ITCHING, SKIN INFLAMMATION, SKIN INFECTIONS AND EAR INFECTIONS.
“Immunotherapy, commonly known as ‘allergy shots,’ is one of the oldest and still most-effective treatment options for environmental allergies in dogs,” says Dr. Miller. “It is the only natural way to truly try to change the immune system’s response to allergens, but it requires a long-term commitment on the part of the pet owner.”
HOW IMMUNOTHERAPY WORKS
Immunotherapy is delivered by a specialist in veterinary dermatology working together with the pet’s general practice veterinarian to ensure continuity of care. Immunotherapy is a good choice for a dog that has not responded well to basic allergy medications or a dog that has frequent, severe allergic signs throughout the year.
“Overall, 60% to 80% of dogs with environmental allergy will respond very well to allergy shots, often eliminating the need for other medications the pet may have been given to control signs,” says Dr. Miller. “Young dogs may respond better to immunotherapy than do older dogs.”
Immunotherapy works by introducing small amounts of what the pet is allergic to and gradually increasing the dose over time, so that the pet builds a tolerance to these allergens. This is most often done via injections under the skin, but in some instances is completed via drops placed under the tongue, usually twice a day. Frequency of shots can vary, but most often they are given every other day initially and then decreased to once or twice weekly.
Immunotherapy must be continued for at least one year before effectiveness can be determined. During this first year, the pet will also take medication to control the allergic signs.
SKIN TESTING IDENTIFIES ALLERGENS
As in human medicine, skin testing is used to identify an individualized formulation of allergens the animal reacts to. The dog is placed under sedation during skin testing. A trained veterinary dermatologist uses tiny needles to introduce small amounts of potential allergens under the skin. The dermatologist then watches for a skin reaction, indicating a positive allergy.
“Skin testing is the gold standard. Blood tests are also available, but reactions in the blood and the skin are not always the same. When investigating symptoms on the skin, we want to go directly to the skin to test reactions,” explains Dr. Miller.
Dr. Miller wants owners to understand that skin testing does not diagnose allergies. Testing is done only in the context of pursuing immunotherapy treatment. In some circumstances, a dog can be allergic yet have normal or negative allergy test results. This does not mean the dog is not allergic. Rather, it means that allergy shots are not a treatment option for that patient.
“After one year of shots, we start to wean the pet off the other allergy medication to see if any improvements have been made to the allergic signs. If there has been no change, we may stop giving shots and choose a different therapy. If the shots appear to be working, they may be continued for life,” explains Dr. Miller.
The goal of immunotherapy is to control the allergies, not to cure them. With proper treatment and owner education, many dogs with allergies can have perfectly normal, happy lives.
If you have questions about allergies and immunotherapy, contact your veterinarian or the veterinary dermatology service at the University of Illinois Veterinary Teaching Hospital.
From Pet Columns at the University of Illinois Urbana-Champaign College of Veterinary Medicine http://vetmed.illinois.edu/petcolumns.
The heart is essential to the body, regardless of the species. Luckily, when dogs have heart problems, veterinary cardiologists, like Dr. Ryan Fries at the University of Illinois Veterinary Teaching Hospital in Urbana, are able to keep things ticking along.
Pacemakers have been used in human medicine since the early 1960s. In the late 1980s, Dr. David Sisson at the University of Illinois became one of the first veterinary cardiologists to place intravenous pacemakers in canine patients. Currently, the university’s Veterinary Teaching Hospital is the only veterinary facility in the state of Illinois that offers this procedure.
In dogs, pacemakers are used both as a life-saving intervention and to improve quality of life.
How Pacemakers Work
“A pacemaker is made up of two parts,” says Dr. Fries. “One part consists of a generator, a lithium battery and a computer chip that we can program to meet the dog’s needs. The other part consists of wires, called leads, that extend from the generator through veins in the neck and are attached to the inside of the heart.”
The pacemaker is activated when the dog’s heart rate slows below the acceptable range set by the veterinarian, generally between 80 and 120 beats per minute. When the pacemaker kicks on, it stimulates contractions of the heart until the heart’s rhythm is reset and can continue on its own.
Cardiologists like Dr. Fries place pacemakers while the dog is under anesthesia. The surgery is most commonly done using minimally invasive techniques. The equipment used is the same that’s used in humans, but the procedure is much more affordable: “The entire procedure typically costs between $3,500 and $4,000, which is consistent with other specialized veterinary procedures,” says Dr. Fries.
“ IN DOGS, PACEMAKERS ARE USED BOTH AS A LIFE-SAVING INTERVENTION AND TO IMPROVE QUALITY OF LIFE”
How Pacemakers Are Placed
“A small incision is made in the dog’s neck, and the leads are fed through the external jugular vein, the same vein used to draw blood. Once the leads are in, the generator is tucked in the skin and stitched up,” explains Dr. Fries.
These radiographs show the pacemaker in place at the patient’s neck and the leads travelling down to the heart. The patient, Lucy, is shown in the photos on this page.
Fluoroscopy is used to visualize the leads going into the heart so the veterinarian can ensure that the leads are attaching in the right place. Fluoroscopy, a form of real-time radiograph, or X-ray, is also used during a heart catheterization.
“Dogs might benefit from a pacemaker if they have an arrhythmia (abnormal heart rhythm) or a heart rate that is too slow to support the dog in daily activities,” says Dr. Fries. “Some arrhythmias can stop the heart and be life threatening. Other heart conditions may simply impede the dog’s ability to exercise and live a normal life.”
How Pacemakers Help Dogs
A classic presentation of a non-life-threatening heart problem occurs when an otherwise healthy dog suddenly faints while doing routine activities because of reduced blood flow from a slow or irregular heartbeat.
Certain breeds are genetically predisposed to heart abnormalities that can be helped with a pacemaker. Sick sinus syndrome, which affects heart rate, is commonly found in older West Highland White Terriers, Miniature Schnauzers and Cocker Spaniels. English Springer Spaniels are susceptible to a heart condition called atrial standstill.
breed, an advanced atrioventricular (AV) block — a condition in which the impulse that causes contractions in the heart’s atrium is not conveyed appropriately to the ventricle — can be treated with a pacemaker.
“Pacemakers can be a long-term solution and often allow the dog to return to full capacity. If placed early in a dog’s life, the battery may be used enough to wear out. However, the battery can be replaced quite easily,” says Dr. Fries.
A dog with a pacemaker will likely need checkups every six months, alternating visits between a primary care veterinarian and a veterinary cardiologist, according to Dr. Fries. If needed, the settings on the pacemaker can easily be reprogrammed by a veterinarian, who will adjust the computer program by placing a magnet over the skin. No surgery is necessary
Following a month of rest after the surgery, dogs with pacemakers should be ready to resume normal activities. The only thing owners need to do is switch from a collar to a harness to keep pressure off the dog’s neck where the generator is.
“Pacemakers may offer the only treatment option that allows a dog to return to a normal life. We even put them in working animals that return to their jobs,” says Dr. Fries. “They are more common than you would think. There are no outward signs to tell the difference between a dog with or without one!”
If you have questions about pacemakers for dogs, contact your local veterinarian
From Pet Columns, University of Illinois College of Veterinary Medicine: vetmed.illinois.edu/petcolumns