Dog Skin Allergies - Beat the Itch in 6 Simple Steps!
There’s little worse than having a dog who’s scratching all the time, keeping you awake at night while they scratch themselves to pieces. In fact, I feel that a dog who is always itchy is little different to a dog who is in constant pain.
Dog skin allergies are really that bad!
Today I’m going to run through the main ways we can treat a dog with skin allergies and discuss the 6 main options that make up a successful skin allergy treatment plan to stop your dog scratching all the time. While some involve working closely with your vet, others are simple steps you can take at home that may make all the difference.
How To Treat Dog Skin Allergies
Ensure the diagnosis is correct
Avoid all other causes of itch
Optimize skin and coat condition
Use anti-allergy medication
Feed a skin-friendly diet
Allergy testing and immunotherapy
1 - Does your dog really have skin allergies?
Jumping straight into my six-step plan for the treatment of allergic skin disease in dogs, the very first thing you need to consider is that the correct diagnosis needs to be made. There are lots of other causes of scratching and long-term itchiness in dogs, not just allergies.
I’ve written more extensively about the causes of scratching in dogs, but briefly, these can include:
Anal gland disease
Because skin allergies are diseases that are going to be with your dog for the rest of their life, and as a result are going to need ongoing, lifelong management, it’s vital that you are actually treating the right thing.
After all, you don't want to spend years treating skin allergies at home when in fact simply giving an anti-mite treatment could eliminate your dog’s itch forever!
2 - Avoid Other Causes of Itch
And so once you've got the diagnosis nailed down, the second step to treating a dog with skin allergies is to avoid what are known as flare factors. These are other things that will cause dogs to itch, and are vital to manage, because a dog with skin allergies is also going to be super sensitive to anything else that causes itchiness and scratching.
It doesn’t take much to tip them over to the edge, and for them to start scratching like crazy.
Controlling flair factors includes:
Controlling dust mites
Reducing pollen exposure
Eliminating specific foods
Recognizing skin infections
Preventing flea infestations is vital, as many dogs with environmental skin allergies (known as atopy or atopic dermatitis) especially are also actually allergic to flea saliva. It might only take a single bite to become incredibly itchy.
You can read more about this in my post all about how to treat and prevent fleas.
Minimizing dust mites comes next. The presence of dust mites is a fact of life. Reducing levels includes your normal vacuum routine, paying particular attention to the corners of rooms, under furniture, and other hard-to-reach areas. Having hard floors, rather than thick carpets, also helps in reducing dust mite numbers. Washing your dog’s bedding regularly in a hot wash can also help in controlling their skin allergies.
Reducing pollen exposure is similarly important, and I’ll discuss this in more detail in step 6. When it comes to flair factors however, it may be that your dog is actually not particularly allergic to grass pollen, but after running through a field of long grass they start scratching all the time.
If you can pinpoint something like this in your allergic dog, then trying your best to avoid this situation really helps.
In a similar vein, avoiding food ingredients that you know trigger your dog to start scratching. This really just applies to dogs suffering from a food allergy, where you know there is something very specific that they are allergic to.
If you know pork sets your dog off, make sure they can’t even scavenge a morsel.
Finally, when it comes to controlling flair factors, you also need to identify and treat any skin infections promptly. An allergic dog is much more likely to develop bacteria or yeast skin infections. We need to identify these in the early stages of infection, and then treat them effectively.
If caught early, skin infections can often be successfully treated with topical creams of antibacterial shampoo. If the infections are deeper (which happens if they are left longer, then oral anti-fungal medication or antibiotics will be needed to eliminate the infection.
3 - Optimize Your Dog’s Skin and Coat
Step number 3 in the treatment of dog skin allergies is to actually optimize their skin and coat condition. I’ll be discussing diet in step 5, but this step is all about shampooing.
Certain specific shampoos have been shown in trials to have a significant anti-itch effect when a dog with skin allergies is having a flair-up of their disease. These shampoos are Allermyl and Douxo Calm (which you can find here and here on Amazon). Washing your dog with these will really help to reduce their level of itch, although may not be enough alone to completely eliminate all scratching.
Routine shampooing also plays an important role in managing a dog with allergic skin disease, helping to prevent them from itching in the first place. Not only do they help to maintain coat and skin quality, but shampooing your dog also has the effect of washing out all of the dirt, pollen and other substance that could start causing your dog to start scratching again.
While you can use the shampoos I’ve just mentioned for maintenance washing, there are other options which may be cheaper and just as effective at helping prevent the itch (rather than using to treat a dog who is already itching). The best one will vary, depending on the type of skin and coat your dog has. For allergic dogs with “normal” skin, that is not too dry or greasy, a quality oatmeal based shampoo (like this one) is a good place to start. If your dog has quite a greasy coat then something like Douxo Seborrhea would be the shampoo to use. And for dogs with very dry skin, applying a conditioner after washing will really help to improve skin hydration.
Whichever you choose, you certainly need to be avoiding anything that is soap based or a human shampoo. This is because they can be very drying and they're really good at stripping the oils from a dog's coat and skin, which actually then causes more problems with itchiness.
Don’t ignore your dog’s ears
Still in the optimizing skin quality line of thought, dogs with skin allergies very often have problems with long term ear infections which keep coming back. We can think of the lining of the ear as an extension of a dog’s skin. It just can’t be washed and kept clean quite so easily!
If your dog often has really waxy or inflamed ears, then this just leads to inflammation and infection. Using an ear cleaner (I really like Malacetic which you can find here) will help mobilize the wax and many cleaners also have a drying and antimicrobial effect to help not only keep the ears clean but also help prevent ear infections.
While home treatment and management of dog skin allergies play a major role in keeping a dog free from itchiness, drug therapies are needed more often than not, especially as a dog gets older and the disease worsens. The unfortunate fact is that it is often the case that seasonal allergies slowly become more and more regular, often ending up with the need for year-round treatment to control.
For short term use, we can use topical steroids such as Cortavance spray. With this treatment, you just spray onto a particularly itchy patch for rapid relief. While it is a steroid, and I’ll come onto steroid side-effects in a bit, this steroid spray doesn’t actually get absorbed into the body. Instead it just has a really effective local effect, and is perfect when the itchy area is small and localized.
If your dog is well controlled but then suddenly starts targeting one specific area, a topical steroid might be just enough to nip it in the bud, damping down that that inflammation and controlling the disease.
As well as steroid spray, there are also creams that you can use as well, especially if there is a little bit of an infection building up, as many creams also contain an antibiotic and anti-fungal component.
Prednisone is another drug that we can use to treat dog skin allergies, and is very effective at controlling flea allergic dermatitis and atop (or atopic dermatitis). In fact, up until recently, prednisone was the most common anti-allergy treatment given. It is a very cheap drug and, like I say, it really does work. The major issue though is that there are side effects, and these can be pretty severe.
I’ve got a separate article dedicated to prednisone uses and side effects coming out next week, so be sure to check back if you want to learn more about this common drug.
Apoquel and Cytopoint
We're all really fortunate that in the last few years we've got a couple of other drugs that have revolutionized the treatment of dog skin allergies.
Apoquel is a really targeted treatment for allergic skin disease. It targets the specific cause of itch as well as having some anti-inflammatory effects. It's a medication that's generally very well tolerated. It doesn't come with all the side effects of steroids and, by and large, would be considered a much better, safer option than prednisone. It works just as well too.
Even more recently, the drug Cytopoint has been released. This is a highly targeted treatment that doesn't work in all allergic skin disease, but instead is used to treat atopic dermatitis specifically. Atopy is an environmental allergy which we can think of a bit like hay fever for dogs, but instead of sneezing and runny noses, dogs get incredibly itchy skin.
Rather than being a daily, or every-other-day tablet, Cytopoint is an injection that is given monthly, or every 6 weeks depending on the dose administered. Given how difficult some dogs are to give pills (and actually remembering to give it to them in the first place!), not only is Cytopoint incredibly effective, it might also be far more convenient for you.
One thing Cytopoint doesn’t do is to reduce inflammation. This means that if a treatment is needed for a dog who is already itching, Apoquel may be preferred at first to settle everything down, before switching to cytopoint to maintain control of your dog’s atopy.
Antihistamines are commonly used by people to treat their environmental allergies, such as hayfever. Unfortunately though, they really not as effective in dogs as they are in people.
Antihistamines may provide a small benefit, but the response is highly variable, not just between dog’s but also between different antihistamines themselves. This means that they shouldn't be relied upon as the sole treatment, with many dogs simply not responding at all. They are something to consider, and for those dogs on long term prednisone, their addition may help you to reduce the steroid dose without compromising control of your dog’s allergic skin disease.
Interferon and Ciclosporin
And then other less common drugs that we use include things like Interferon and Ciclosporin. These are typically not the first drugs to be reached for, especially since the launch of Apoquel and Cytopoint, however, there will be individual patient factors that may make them an option for your dog.
Skin Allergy Diets
Diet is the fifth piece of the puzzle when it comes to treating allergic skin disease in dogs, and the first reason for this is because an itchy dog may be suffering from a food allergy.
Now, food allergies are not as common as a lot of people will make out, but the only way to diagnose them is to do a diet trial. This involves feeding a novel protein and carbohydrates to a dog. This means a protein source (or meat), and ideally a carbohydrate source as well, that your dog has never come across in their life. Finding such a diet can be challenging to say the least.
An excellent alternative, and one I generally recommend, is to feed what is known as a hydrolyzed diet. These diets essentially chop up the food ingredients into smaller molecules which are not then recognized by the body, even if there is an allergy to the “parent” ingredient.
Diet trials really are the only effective way to diagnose a food allergy (for the time being at least). You might read about blood tests that are able to diagnose dietary allergies but the honest truth is they are not at all reliable. Hopefully this changes in the future, but for now, it’s only those selling the test that would claim otherwise.
Storing your dog’s diet appropriately is the next consideration, and one that could also have been included in the section on reducing flair-factors. This is because improperly stored kibble especially, can become contaminated with storage mites. For healthy dogs this isn’t a problem, but for those dogs with skin allergies, storage mites are one of the things many are allergic to.
You should keep your dog’s dry food in a clean, sealed container, and at the same time try and avoid warm, humid areas.
Fish oil + essential fatty acids
Diets that are particularly beneficial to skin will include omega 6 and omega 3 fatty acids. These have the beneficial effect of improving the skin barrier function, effectively making the skin a lot less leaky to all of the substance that are triggering your dog’s skin allergies
Essential fatty acids also have a proven anti-inflammatory effect. Actually helping to reduce inflammation in the skin that is caused by the underlying allergy. This effect shouldn’t be overstated, but when combined with the other dog skin allergy home treatment options I’ve discussed, the result could be that your dog does not need permanent treatment with anti-allergy medication (or at least can cope with a reduced dose in the case of steroid treatment).
These omega 3 + 6 essential fatty acids are included in skin specific diets, which also include a few other ingredients, such as increased zinc levels, that can really improve skin condition and make a massive difference in the long term management of dog skin allergies.
Rather than switching to a skin diet (although this is generally the preferred option), you can also add essential fatty acid supplements to your dog's normal diet. While there are many different sources out there on store shelves, for dogs by far and away the best source comes from oily fish. The most common of which is cod liver oil. This provides high levels of the omega fatty acids in a biologically available form.
Flax seed oil is another commonly used source but really is inferior when given to dogs. The reason for this is that the major flax seed oil fatty acids need to be converted to other fatty acids to have the anti-inflammatory effect. Biology is such that, unfortunately, dogs really aren't able to do this efficiently. So while flax seed oil may have very high levels of omega 6 and omega 3 fatty acids, they are actually not available for use by the dog.
If you do choose to supplement your allergic dog’s diet with cod liver oil then there are some pitfalls to avoid. First, talk to your vet before starting because it may not be appropriate for some dogs (such as those with pancreatitis), and your vet will also be able to advise you on the right amount to give your dog. Sticking to a dog-specific formulation is best, but if you do opt for a human version it is vital there are no added supplements. Some cod liver oil products contain the artificial sweetener xylitol which is incredibly poisonous to dogs. Others contain added vitamins which can end up building up in a dogs body over time, resulting in poisoning.
You need to always be certain any supplement you give your pet is safe (and actually works too!).
Blood tests and Allergy Shots
And finally, at number six we’ve got the option of blood testing your atopic dog. I’ve already mentioned that blood testing is a waste of time and money in a dog with a food allergy. A dog with atopy is a different matter.
Blood testing is an effective way to find out exactly which pollen or other allergens (and there is normally more than just one or two) that your dog is allergic to. Another way to find out this information is to carry out a test known as intradermal skin testing, although this is something typically only done by dermatologists.
Ideally, knowing exactly what your dog is allergic to would then allow you to help your dog avoid these things altogether. The problem with this is that often the allergens are pollens or other things in a dogs environment that are virtually impossible to eliminate. You can’t go chopping down all of the Willow trees in your neighborhood for example!
What we can do with this information however is start a course of immunotherapy injections, also known as allergy shots. These can be thought of as similar to a vaccine against the things that your dog is allergic to. These allergy shots are then given at regular intervals (often monthly) over a period of a couple of years, although this may vary depending on your dog’s response to the treatment.
While some cases may not respond at all, while others will be able to have their allergic skin disease controlled much more easily than before. Immunotherapy is, however, the only treatment that has the potential to cure a dog of their allergic atopic dermatitis. It really can be that powerful.
Atopy is a disease that starts when a dog is young, typically developing between about one and five years of age. This means that their skin disease will need to be managed for a really long time, especially considering pet dogs are living for longer than ever before. This means that while allergy testing and immunotherapy are going to be a little bit more expensive in the short term, over the course of your dog’s life you could end up saving a significant amount of money.
I often say to my clients that allergic skin disease can be incredibly frustrating to get on top of, to settle down a dog’s itch and control long term. There really is no one-size-fits-all strategy, and management changes (like starting a skin diet) can take several months before any benefits are seen. This is also a condition that will last their lifetime. Once you find something that works, stick to it.
Working your way through these 6 steps to treating dog skin allergies, and keeping in close contact with your vet will really help to keep your dog itch-free. They will be so much happier if you do!