Improving the lives of itchy pets - Part Two: Itch Reduction Strategies

The Itchy pet Part 2

Itch Reduction Strategies

 

I hope you have all payed close attention to the title of this blog.  Itch REDUCTION strategies.  Note that terms such as “magic never itch again potion”, “no effort or commitment from you non-itch powder” and “simple course of tablets” have all been omitted from the title!  Read on to see why!

Like my last blog on explaining itch in pets, this blog is to help you understand the often convoluted journey of managing an itchy pet which can be as complicated as working out why your pet is itchy in the first place!  I hope that after reading this, next time your pet finishes a course of prednisolone and becomes itchy again a week or two later that your thoughts will  jump to “ah hah….I know why it has come back…lets review our strategies” rather than “these tablets don’t work and were a waste of money!”.  If you are able to think in this way, not only will you be less frustrated but you will also be a much better help to your pet – they are relying on you!

To start, I would like to go back to the key word I continually referred to in part 1.   Allergen.

In the human nutrition world – everybody has caught on very very well to the concept of Allergen avoidance.  This is because it works!  If you are gluten intolerant, you avoid gluten and you feel normal.  Fructose intolerant – go for the fructose free option and all is well, peanut allergy…..its not rocket science!  So to reduce itch in your pet – have a chat to your vet about what the most likely allergen is and how you can avoid it.  For a lot of pets it will be fleas and grass, unfortunately for some pets it will be dust mites, pollens, plants all throughout your garden and occasionally food proteins.

The easy one is fleas.  Keep your pet on an effective flea prevention all year round.  Simple and non negotiable, I really don’t feel the need to elaborate more.

To explain how grass avoidance can help let me tell you the story of Axle the Staffy.  Axle was a lovely boy who loved to lie flat on his sparsely haired tummy on the grass.  He would come into the clinic every few weeks, red raw and miserable underneath his abdomen.  Sometimes he was just in the allergic stage and responded to medications such as prednisolone (with side effects to go with them) but often he also had a secondary infection as discussed in part 1.  Axles’ Mum was at her wits end.  She had decided that all she could do so Axle could have some quality of life was to keep him on prednisolone daily.  When I suggested she could also keep him off the grass and never need prednisolone, she looked at me like I was some kind of crazy lady!  I received her opinion of the idea loud and clear and busied myself filling a very large jar full of prednisolone.  A few weeks later, Axle was running on his favorite place – the grass – after a ball.  Snap! Yelp! Poor Axle ruptured his ACL (knee injury)!  He recovered from surgery very well and was immediately more comfortable yet mum now had the next challenge of confining him for 6 weeks!  She used a play pen on an area of decking and concrete outside the back door.  He slept in the laundry at night and for toilet breaks he was taken to an area with just tanbark and no grass. She thought – I can do this for 6 weeks, then he can go back to the grass. Axle never went back to the grass!  Mum had been forced to keep him off the grass for another reason and had been blown away by the fact that his skin was normal, not red at all without one single tablet of prednisolone.  She was able to schedule in two brief walks a day on the foot path for Axles to replace the exercise he usually did for himself on the grass and Axle went on to live a much happier life with the same set up.  In fact he ended up getting more exercise now that the walks were included and despite having some long days in the smaller fenced deck area, this was a small price to pay for not spending the day itching and chewing in desperation!  So if your pet’s problem with grass is really severe, please try and be creative and think about how your pet could really have a great life without ever needing to touch grass or a prednisolone tablet again!

Ok – so now for those in the situation where the allergen cannot be avoided.  For example dust mites -they are everywhere, your pet will never escape them. Or, maybe you have a pet allergic to multiple allergens, you do your best to avoid them all but occasionally it is impossible.

There are 4 points your vet is considering and targeting every time they see your itchy pet.

  1. The allergen – have we avoided it or removed it if practically possible?
  2. The allergy – how can we settle this itching?
  3. Secondary infection – is this present also and contributing to the itch? If so, how can we nail it?
  4. The pets skin barrier function – how can we improve this?

Firstly, the allergy.  What do we use to settle the itch and inflammation itself? 

There are four main drugs that we use to stop your pet itching, the table below is my take on the pros and cons of each and how effective they are.

Drug

Cost

Efficacy

Pros

Cons

Prednisolone

$

Excellent

Cheap, small tablets, easy to give

Common obvious side effects, long term use detrimental to health at high doses.

Apoquel

$$

Excellent

Fewer side effects than prednisolone but not completely benign

Expensive, occasional side effects but not common.

Atopica

$$$

Very good

Fewer side effects than prednisolone but not completely benign

Expensive, takes 1 month of medicating before effect, tablets are very big. Side effects occasional.

Cytopoint

$$$$

New medication, so far results very good (ask me again in 6 months)

Once a month injection – no tablets!  Expected to be very low side effects.

Expensive, limited data at this stage, new drug on the market.

 

Barrier function:

Skin is essentially a barrier.  It is there to stop allergens accessing our immune system and causing it to make a confused allergic reaction.

A lot of itchy pets are more susceptible to itch because their barrier function is poor.  They struggle to retain moisture in the skin and struggle to avoid letting allergens in.

The essentials of improving barrier function involve increasing the oils and moisture in the skin.  This can be both orally with fatty acid supplements or skin diets as well as topically with essential oil spot-ons and moisturizing shampoos and conditioners.  Be aware however, that regular application and use of these products for the life of the pet is required.  A one of quick wash or an extra can of sardines here and there won’t cut it. Talk to your vet about a thorough barrier function routine.

 

Finally, to combat your pet’s itch problem, the best thing you can do is adopt a relentless and multifaceted approach. Prepare for setbacks and keep getting back on the horse when your pet relapses.  I promise when I find the blanket – fix all treatment I’ll let you know!