Suspected Allergy – What Now?

Milo suffers from severe itching and recurrent ear infections. There is a suspected allergy. Read his case history here.

Milo, a 5-year-old Jack Russell Terrier, has been suffering from severe itching for some time. He scratches frequently and gnaws at his paws, especially at night. This significantly disturbs not only his sleep but also that of his owners. In addition, Milo repeatedly experiences ear infections, which quickly disappear after treatment by the vet but flare up again a few weeks later.

What Causes the Symptoms?

Itching is a common symptom of allergies. But there are a number of other conditions that can cause a dog or cat to constantly scratch, including, for example, parasites, bacterial or fungal infections.

Milo is therefore taken to the vet, who examines him thoroughly. She finds neither fleas nor other parasites, and a skin smear preparation also shows no signs of bacterial or fungal infection. A yeast infection is found in one ear, but this does not explain the itching on the body and paws. The vet therefore suspects that an allergy could be the cause of the symptoms.

What Causes the Allergy?

In dogs and cats, flea bite allergies and allergies to environmental substances (house dust mites, pollen, fungal spores, etc.) are most commonly encountered. The third most common allergy is the Food allergy. Beef, dairy products, chicken, and wheat are the most common allergy triggers in dogs, while in cats, these are beef, dairy products, and fish.

How are Allergies Diagnosed?

A flea bite allergy is easy to diagnose and treat. Fleas or flea dirt are present on the animal, and symptoms quickly disappear after successful flea treatment. Since no fleas were found on Milo, this type of allergy can be ruled out.

Diagnosis becomes more difficult with a suspected environmental or Food allergy. Clinically, the two types of allergy cannot be distinguished. Itching and frequent ear infections occur with both an allergy to environmental substances and Food allergies. Thus, it is not clear in Milo's case which allergy it could be.

Common blood tests offered by some laboratories unfortunately do not provide sufficiently conclusive results. Even dogs without an allergy often show positive test results, and there are sick animals whose tests turn out negative. It is therefore not advisable to perform a blood test as the first step for allergic symptoms.

The Elimination Diet

On the vet's advice, Milo must adhere to a strict elimination diet for 8 weeks. This means that during this time, Milo may only eat a special food and receive no treats, chews, table scraps, or anything else. Two different types of food are available for this purpose. Firstly, there are foods that contain only proteins that are so finely broken down (hydrolyzed) that they can no longer trigger allergies (e.g., Royal Canin Anallergenic). Secondly, there are foods that contain proteins and Carbohydrates that are rarely used in dog and cat food, and therefore rarely trigger allergies. To determine which food should be used for Milo, his owners must create a long list of all foods, rewards, chew snacks, etc., that Milo has ever eaten in his life.

Since neither eggs nor rice have ever been on Milo's menu, the vet opts for the new Hill’s Prescription Diet Derm Complete. This contains eggs as the sole protein source and rice as the sole carbohydrate source. The benefit of this food is that it is suitable as an elimination diet and also provides relief to dogs suffering from an environmental allergy. This benefits Milo, because to assess the effect of the elimination diet, it is unfortunately not possible to give him medication for the itching. Thanks to a high content of Omega 3 fatty acids, bioactive compounds, and phytonutrients, Derm Complete helps promote skin health and strengthen the skin barrier to ward off environmental allergies, so that the itching is at least alleviated.

Check-up after 4 Weeks

Thanks to the treatment of the ear infection, it quickly subsides again. After one month, Milo scratches significantly less and gnaws at his paws less often. The nights are calmer, and both Milo and his owners can sleep through again. Milo is doing well, but he misses his chew sticks and also the special treats during walks.

Check-up after 8 Weeks

Milo's condition is unchanged. The itching is much better but has not completely subsided. Especially the paws are still being gnawed, which is evident in a distinct brown discoloration of the coat. The cause of the itching therefore does not appear to be a Food allergy.

The Intradermal Test

For further clarification, the vet refers Milo to a specialist. An 'Intradermal Test' is performed there. Milo is lightly sedated, the hair on the side of his chest is clipped, and different environmental allergens are injected into the skin at this spot. After a few minutes, large, red wheals appear in several places. It shows that Milo reacts allergically to various grass pollens and house dust mites. The diagnosis of an allergy to environmental substances is thus confirmed.

Therapy

The specialist prescribes anti-inflammatory medication for Milo to further relieve his itching. She also arranges for an allergy vaccination for Milo, which his owners will inject under his skin, first weekly, then monthly. Small amounts of the substances to which his body reacts allergically are administered. The goal is desensitization, meaning his immune system learns not to overreact when in contact with the allergens.

Since Milo loves the allergy food and it has already helped reduce the itching, his owners will continue to feed it to him. Milo is happy that he can now also receive certain chews and treats again.

The Result

After just 3 weeks, the itching has completely disappeared. Milo stops gnawing at his paws. He appears generally calmer. After half a year, the brown discoloration of the hair on his paws has also vanished. No more ear infections have occurred.

The allergy vaccination continues to be administered monthly. The dose of anti-inflammatory medication can be gradually reduced without the itching recurring.

Milo's allergy is not cured, but it is under control. A peaceful sleep for him and his owners is now assured.