Red Maine Coon sits on examination table while vet inspects the cat and talking to the owner

Allergy Treatment for Companion Animals

Atopic dermatitis is one of the most common and frustrating conditions seen in veterinary dermatology. It leads to chronic itching, inflammation, and skin infections. While many treatment options exist to manage the clinical signs of atopic dermatitis, immunotherapy stands out as the only treatment that addresses the root cause of the disease.

As veterinarians, it’s crucial to understand the importance of treating atopic dermatitis with the only causal approach available: immunotherapy. This method is not just another treatment option but the foundation of effective, long-term management of allergic patients.

The Basics of Atopic Dermatitis

Atopic dermatitis is a hypersensitivity reaction caused by environmental allergens, such as dust mites, pollen, mold, and certain foods. The condition is driven by the immune system's exaggerated response to these allergens. While clinical signs (itching, redness, and skin lesions) can be managed with symptomatic medications such as corticosteroids, oclacitinib, lokivetmab, cyclosporine, etc, these do not treat the underlying immune dysfunction.

Immunotherapy: The Only Causal Treatment for AD

Immunotherapy works by reprogramming the immune system to stop overreacting to environmental allergens. This is the only treatment option that targets the root cause of the disease, providing long-term relief and improved quality of life for pets suffering from atopic dermatitis.

How Does Immunotherapy Work?

Allergen Identification: Immunotherapy begins with identifying the specific allergens causing the allergic reactions in each patient. This can be achieved through PAX serum testing (IgE testing) or intradermal skin testing.
Gradual Desensitization: Once allergens are identified, immunotherapy involves administering gradual doses of these allergens. Over time, the immune system becomes less reactive to these allergens, reducing the inflammatory response and the clinical signs of atopic dermatitis.
Tailored Treatment: Immunotherapy is highly individualized, making it a superior approach for managing allergic patients. By specifically targeting the allergens a pet is sensitive to, we ensure a more effective and efficient treatment plan.

Why Should Every Atopic Patient Be Placed on Immunotherapy?

1. Causal Treatment with Long-Term Benefits

Unlike symptomatic therapies, immunotherapy is the only causal treatment that targets the immune response itself. By addressing the root cause of atopic dermatitis, immunotherapy helps reduce the frequency and intensity of allergic flare-ups, leading to better long-term control of the disease. Pets that undergo immunotherapy often experience lasting remission or significantly reduced clinical signs.

2. Reduces Reliance on Symptomatic Medications

Long-term use of corticosteroids, cyclosporine, and other immunosuppressive drugs comes with significant risks, including side effects like weight gain, gastrointestinal issues, and increased susceptibility to infections. Immunotherapy offers a safe alternative that reduces or eliminates the need for these medications over time, improving the overall health of the pet.

3. Improved Quality of Life for Patients

Atopic dermatitis can severely affect a pet's quality of life, causing constant itching, discomfort, and secondary infections. Immunotherapy helps control the underlying allergic reactions, reducing the chronic pruritus and inflammation that make pets miserable. Many patients experience a significant improvement in their quality of life, with fewer flare-ups, reduced itching, and healthier skin.

A study assessing the quality of life (QoL) in allergic cats treated with allergen-specific immunotherapy (ASIT) was conducted. The study aimed to evaluate whether ASIT improves QoL compared to symptomatic treatments alone. The findings indicated that cats receiving ASIT experienced significant improvements in various aspects of QoL, including reduced disease severity, better behavior and mood, and less disruption to daily activities. Additionally, owners of these cats reported lower treatment costs and reduced emotional distress. In contrast, cats not treated with ASIT showed no significant improvement in QoL measures. (Kotnik, T. 2023).

This study highlights the effectiveness of ASIT in enhancing the QoL of allergic cats and underscores the importance of considering ASIT for managing atopic dermatitis in veterinary practice.

4. Safety and Tolerability

Compared to some systemic treatments, immunotherapy is highly safe and well-tolerated, even for long-term use. The risk of adverse effects is much lower, and immunotherapy is an ideal treatment for pets that need ongoing management for their allergies. There are very few side effects, and those that do occur (e.g., mild local swelling at the injection site) are typically temporary and manageable.

5. Sustained Remission

One of the key advantages of immunotherapy is that it offers long-term relief. While other treatments may need to be continually adjusted to control flare-ups, immunotherapy often leads to sustained remission.

6. Cost-Effective in the Long Run

While the initial cost of allergen testing and immunotherapy may seem higher than traditional treatments, the long-term benefits often outweigh the initial investment. By reducing the need for frequent visits, and other symptomatic treatments, immunotherapy is a cost-effective solution in the long run. It also improves overall outcomes, reducing the likelihood of chronic flare-ups or secondary infections.

7. Scientific Validation

Immunotherapy has been clinically validated through numerous studies and is considered the gold standard for the treatment of atopic dermatitis in both human and veterinary medicine. It is the only treatment proven to induce immunologic tolerance, thus reducing allergic symptoms permanently or for extended periods.

Implementing Immunotherapy in Your Practice

Allergen Testing: Begin by conducting thorough allergy testing to identify the environmental triggers causing the immune reaction in your patients. PAX test is the only and first molecular allergen-based test in veterinary medicine, the current standard in both human and veterinary allergology. Read more.
Initial Treatment Phase: The initial phase typically involves administering injections with gradually increasing doses of allergens. The goal is to build tolerance, so the pet’s immune system gradually adapts to the allergens. This phase requires close monitoring to ensure the patient’s response is as expected.
Maintenance Phase: Once the pet reaches the optimal desensitization level, the treatment moves into a maintenance phase, where injections are administered at less frequent intervals, typically every 4 weeks.
Follow-Up and Monitoring: Regular follow-ups are essential to assess the effectiveness of the immunotherapy and make any necessary adjustments to the treatment plan. Some pets may require modifications to their allergen profile or dosing schedule.

Immunotherapy is the only causal treatment for atopic dermatitis in pets, offering long-term relief and improved quality of life by directly addressing the immune system’s hypersensitivity to allergens. By incorporating immunotherapy into your practice, you can provide your patients with a scientifically proven, safe, and effective solution that reduces their reliance on symptomatic medications and helps manage the chronic nature of atopic dermatitis. This is primarily relevant when considering that most atopic patients are diagnosed at an early age.

As veterinary professionals, it is our responsibility to provide the best care possible, and immunotherapy is the most effective tool we have to treat atopic dermatitis at its core.