It’s springtime and that means allergy season is in full swing! The emergence of budding leaves and flowers can cause great distress to humans and dogs alike. Whereas humans tend to have runny eyes and noses with a tickle in their throat, allergies tend to manifest differently in dogs. It is common for dogs to start itching, sometimes constantly, leaving them with abrasions, and feeling downright miserable. We’ll cover how to recognize the signs, what’s changed in treatment options, and the latest immunotherapy breakthroughs that are giving dogs real relief without the side effects of old-school steroids. My guest, Dr. Randy Hutchison has some solutions for allergy sufferers that can provide relief almost immediately.

The most common allergic reaction in dogs

Allergic reactions can be caused by the environment, fleas, or food allergies. The most common reaction to all of these culprits is itching. Dr. Randy states that the location of the itching is a good indicator as to what the cause is. For example, itching from flea bites caused by the saliva in fleas, is mostly found at the base of the tail. Dogs will tie themselves into pretzels to try to reach that area. You will notice they will try to bite back there with their little incisor teeth.

When dogs lick their feet a lot or itch their nose, face, and lower legs, this usually indicates something in their environment. In springtime, pollen from budding trees falls on the grass they walk and lay in. In the fall, there are certain weeds and molds on leaves. All of these outdoor elements can cause allergic reactions. Dr. Randy can almost predict to the day when clients will bring their dogs in because they started itching a lot. Once a dog has allergies, they almost always will for the rest of their life.

Allergic reactions don’t form after the initial exposure to an irritant. In fact, Dr. Randy says if a puppy comes in for an appointment due to itching, he can start a history of the dates of the itching, but can rule out allergies as a probable cause. It takes over a year or two of exposure to an irritant for the body to react. As time goes on, the length of the allergic reaction will be longer and more pronounced.

Reverse Sneezing

Another reaction that can be caused by allergies is reverse sneezing. This is when your dog rapidly inhales air through their nose creating a honking sound. It can be triggered by excitement, prolonged tension on their collar, or allergies. It quickly subsides and the dog returns to normal breathing. The first time I experienced this with my dog Hank, I thought he was choking and couldn’t breathe and was having some kind of seizure. It was frightening to say the least.

Symptoms of food allergies

Food allergies are similar to seasonal allergies. Dogs can be allergic to certain foods, most commonly, certain proteins. They can cause dogs to itch all over their body and lick their paws. I have seen dogs’ paws that have turned raw and become a rust color because they have been licked so much. There are a lot of additives in dog food that their bodies have difficulty digesting and ultimately causing an allergic reaction. I have seen the itching subside after changing the protein source from chicken to turkey or other proteins. Prescription dog foods that hydrolyze the protein for easier digestion and relief from allergic reactions can be recommended by your vet. I will be discussing this further in a future episode concerning nutrition.

Allergy Testing and Shots

Allergy shots are available which involve injecting small amounts of specific allergens to build up tolerance. Dr. Randy states that if a client chooses this option, they have to commit to a long term plan. This is not a quick fix.

Allergy testing through blood samples and intradermal skin testing are also available. This can be costly and intradermal testing can be invasive, requiring mild sedation. This is usually done when immunotherapy drugs and protein elimination have failed. Specific blood panels can be ordered to pinpoint the irritant causing the reactions. It will test for approximately 60 different environmental factors and will identify food allergens as well. However, testing for food allergies does not yield as reliable results as environmental influences do. This type of testing and allergy shots used to be very popular before immunotherapy drugs were available.

Immunotherapy Drugs to Alleviate Allergic Reactions

The biggest advancement in veterinary medicine over the past five to ten years is immunotherapy treatments. Before then, when dogs and cats had allergic reactions, the only option was to prescribe steroids or antihistamines. Most of the time, they would stop the itching, but the side effects prevented them from being used long term. Antihistamines do not get absorbed to the level they need to be to become effective. Nowadays, two immunotherapy drugs are commonly prescribed for allergies: Apoquel and Cytopoint. They have revolutionized allergy treatment. However, certain cases still require administering steroids. Prescribing them has dramatically dropped with the introduction of immunotherapy drugs.

Apoquel is not an allergy pill. It is not a steroid or an antihistamine. It is an immunotherapy drug. It inhibits the attachment of specific molecules to receptors that trigger an itching and inflammatory response. According to Dr. Randy, it is very effective and can be prescribed to dogs 12 months and older. It can work almost immediately with little to no side effects. In fact, if it doesn’t work within approximately 48 hours, a different option will have to be explored. A higher dosage is not an option. Apoquel has also worked to relieve allergic reactions to food and proteins.

There is a misconception about Apoquel that it can cause cancer. Dr. Randy debunks this myth. Since Apoquel is an immunotherapy drug and suppresses the immune system in a particular way, it is not recommended for dogs who have been diagnosed with cancer. Their bodies need all the help they can get to fight cancer cells.

Cytopoint is an injection that is effective in eliminating the itching response and can last up to two months. Both Apoquel and Cytopoint can be stopped and started at any time that is recommended by your veterinarian. Cytopoint is different than Apoquel in that it targets a specific protein that is responsible for sending signals to the brain to stop the itching. Due to the difference in how these two immunotherapy drugs work, Cytopoint can be given to dogs diagnosed with cancer and to those with compromised immune systems.

A key takeaway when calculating the possibility to prescribe either Apoquel or Cytopoint is to ascertain the reasons for using them. It is essential to determine the root cause of the itching. Both of these drugs are very effective but costly to pet parents. Dr. Randy likes to be sure that he prescribes them for the right reasons. He believes that immunotherapy is the wave of the future for treating not just allergies, but also for treating other common conditions he sees in dogs and cats.

My dog’s history of allergic reactions

It took me a few years to realize that my Leonberger, Ebi, was allergic to something in the environment in the fall. One August, I was visiting my parents in Rochester, New York. I had been warned that pesticides had been applied to the grass in their townhouse community to kill crab grass. By the time I got back home to Cleveland, Ebi was itching almost constantly. In a few days, she stopped. I never went to the vet because it started to subside quickly. I thought maybe she had a reaction to the pesticide used to kill the crab grass.

The following year, around the same time of year, Ebi started itching again. This time it lasted longer. I noticed abrasions and scabs on her sides and belly when she would lay on her back. It went away in about a week to 10 days. I did not go to the vet this time either. Then, around the same time of year as before, I went to Rochester again and Ebi started itching so much that she could barely sleep (neither could I). I finally started to believe that she was allergic to something in Rochester. By the time I got back home, the itching subsided, but it lasted longer.

I didn’t want to put Ebi through that ever again! So, as soon as she started itching the following August or September, I took her to Dr. Randy and told him my story. He gave her a Cytopoint injection which stopped the itching almost immediately.

Just last year, I tried a supplement for seasonal allergies around mid-August until the end of September. That worked! However, I am noticing for the first time, Ebi is itching a little more than usual this spring. She is now 8 years old with an 8 year old immune system that doesn’t work as efficiently as it used to. Dr. Randy says that dogs can have allergies year round. Once they manifest symptoms, they can last longer each time. It is very rare to see dogs or cats become less allergic to things over time.

Arthritis in Dogs

Just as humans suffer from arthritis typically in their senior years, so do dogs. Arthritis in general is referred to as osteoarthritis or OA. A type of arthritis that is familiar to most of us dog lovers is hip dysplasia. This is when the ball and socket of the hip joint does not form a tight fit with enough cushion around it. Instead of rotating smoothly with movement, it is more of a pounding bone on bone action causing discomfort and inflammation.

Osteoarthritis can be caused by the following:

* Hereditary factors - large and giant breeds are more susceptible

* Strenuous exercise - repetitive jumping

* Excess weight

* Previous injury

* compensatory damage due to lessening the load on the affected joint

According to Dr. Randy, when dogs walk, they carry about 60% of their weight in the front and 40% in the back. Therefore, if a back leg or hip is hurting, more weight will be put on the front legs. Over time, this will contribute to the wear and tear on the front limbs, compounding the existing problem. As osteoarthritis progresses, the cartilage in the affected joint deteriorates causing inflammation and irritation. Pain management is critical to keeping the pain in check.

A way to confirm that a dog has arthritis is to take an x-ray. This can be a very challenging procedure that sometimes requires mild sedation. Not all dogs will lay on their side or back and be perfectly still for several seconds! Vet techs will try to keep the dog as calm and comfortable as possible. Dr. Randy believes this method of diagnosis is crucial in order to avoid prescribing medication for a condition that possibly does not exist. Certain conditions can get worse by adding incorrect treatments.

“Know what you are treating”. - Dr. Randy

Common myths that Dr. Randy hears about arthritis:

* glucosamine and chondroitin prevent arthritis

* walking your dog short distances will prevent arthritis

* arthritis can be cured

* it only affects older dogs

* a few extra pounds won’t affect the arthritis

* treating arthritis will prevent further degradation of the joints

* dogs should not exercise when diagnosed with arthritis

Osteoarthritis is a progressive, incurable disease that can affect young and old dogs alike. Treating arthritis with various medications and alternative medicine will help manage the pain associated with it. If the synovial fluid around the joint is lacking, and the cartilage is compromised, inflammation and pain will result. Therefore, managing the pain is crucial. This can be difficult to initially diagnose without x-rays since cats and dogs are good at masking their pain. However, if you notice your dog being reluctant to climb stairs, struggling to get up from lying down or being more lethargic than usual, this may indicate they are suffering from stiff, arthritic joints.

If pet parents suspect or just want to find out if their dog has arthritis, they can first seek the counsel of a veterinarian who can properly diagnose it through x-rays. One of the worst things pet parents can do is to stop taking the dog for walks and cease all activity. Regular activity like walking can strengthen the muscle around the affected joints, improve circulation around the arthritic area and nourish cartilage that exists.

It also helps maintain a healthy weight. Your veterinarian can tell you the ideal weight for your dog. You may have to start counting calories and measuring their daily food instead of just eyeballing it. A few extra pounds is more to carry around and puts more stress on the joints.

The good news is there are several options to keep your pooch comfortable:

* non-steroidal anti inflammatories such as Galliprant and Rimadyl

* immunotherapy drugs such as Librela for dogs and Solensia for cats

* alternative medicines such as acupuncture, laser therapy, water therapy, shockwave therapy, swimming, and massages

* platelet rich plasma (PRP)

* Arthramid - hydrogel injected directly into the joint

* All natural supplements including Omega-3, glucosamine and chondroitin, and MSM

When pet parents get a diagnosis before the arthritis has progressed too far, they can start managing the pain as needed with an anti inflammatory medicine. However, this is not for long term daily usage as they affect internal organs. As the arthritis progresses and noticeable symptoms appear, such as limping and favoring a particular side when lying down, an immunotherapy drug such as Librela will be recommended. This is administered by a veterinarian as a monthly shot. As with any drug, there can be possible side effects. Dr. Randy stresses the importance of confirming the diagnosis of arthritis before starting this type of treatment. The story below illustrates accurately how Dr. Randy handles arthritic dogs.

I can attest first hand to the effectiveness of Librela. Dr. Randy diagnosed my friends’ German Shepherd, Heidi, with arthritis - more specifically hip dysplasia. It was confirmed by an x-ray when she was young. It was nothing to be alarmed about, but something to keep an eye on.

Dr. Randy took another x-ray a couple years later to see if it progressed. There wasn’t a lot of difference in the hip dysplasia, which was good but later x-rays showed arthritis in various parts of her body. Heidi was able to continue her daily walks and had arranged play dates often with no noticeable discomfort.

Not until she was about 9 years old were her symptoms more obvious. She started hesitating walking up stairs, and then later injured her CCL (the equivalent of the ACL in humans). The injury was not bad enough to warrant surgery. In fact, she recovered after not being as active for a period of time. She did re-injure the same CCL and it took longer to recover. Her pet parents gave her anti-inflammatories to manage the pain.

Occasionally, I walk Heidi for my friends. I noticed the progression and how it seemed Heidi was struggling while walking. She was limping and panting from the stress and pain. That’s when Heidi’s pet parents took her back to see Dr. Randy. He suggested the Librela shot. From that point on, I notice when Heidi gets the shot, she walks more comfortably. When it is time for another monthly shot, she is more uncomfortable, so I won’t go as far as we usually do. Heidi started receiving laser treatments under the supervision of Dr. Grace Schmeiser. She was mentioned in an earlier podcast about the therapy programs offered at Animal Clinic Northview. I walked Heidi a few days ago and she lasted the entire walk like we usually do. She still limps a bit but seems to be in less pain.

Other types of therapy mentioned earlier that is offered at Animal Clinic Northview are swimming in a pool, underwater treadmill, laser therapy, shock wave therapy, and acupuncture. In addition to these modalities are supplements such as glucosamine and chondroitin, Omega-3, and MSM. Please seek the guidance of your vet or a holistic vet. I am a certified herbalist and can advise on correct dosages.

A more up-to-date way to treat arthritis is Platelet Rich Plasma or PRP. This is when blood is drawn from the dog, is centrifuged, and then injected back into the affected joint. The purpose is to reduce inflammation which helps manage the pain, improve joint mobility, and accelerate healing for injured ligaments. It is a safe alternative to medications and steroids. Your veterinarian can discuss with you if this is a good option for your dog.

Arthramid is another option for treating arthritis. It is a hydrogel that can restore the elasticity of the synovial fluid and can provide relief for up to 2 years. Again, your veterinarian will determine if your dog is a good candidate to Arthramid.

The very last option for dogs suffering from hip dysplasia is hip replacement surgery. It is difficult to find doctors who specialize in this operation. Dr. Randy will refer these patients to The Ohio State School of Veterinary Medicine. As with any surgery, there are risks involved such as infection. The rehabilitation can be challenging for the dog and the pet parents. Some pet parents who find themselves in this predicament will choose alternative methods, immunotherapy drugs, and/or supplements instead.

I would like to personally thank Dr. Randy Hutchison for once again sharing his expertise and giving us a clearer picture of what our dogs are going through every allergy season. The big takeaways: know the signs — itchy feet, rubbing faces, reverse sneezing — and know that there are real, effective options beyond steroids, including Apoquel and Cytopoint.

Dr. Randy also shares his highly proficient knowledge on how to diagnose and treat arthritis in dogs. X-rays provide the concrete evidence of the prevalence of arthritis and where it is located. There are many options to treat arthritis depending on the location and severity of the symptoms. If your dog is struggling, don't wait — talk to your vet.

Thanks for reading From A Dog’s Eye View! This post is public so feel free to share it.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit canineconcierge.substack.com