The most common problem I see in the pet clinic is the itchy dog. Ears and toes are the usual signals. Some dogs may only shake their head a little more than usual or lick or bite their toes in summer while others are miserable for the whole year in a way you wouldn't even wish on George Bush. Some poor dogs are such a mess that they need urgent action to avoid further distress and misery. Some get under the coffee table and rub or roll on the ground or carpet to relieve the nagging irritation. It really must be a living hell. Those itchy under the tail may scratch by “scooting”. Many get wormed because they drag their rear end on the ground to scratch it when it is seldom ever to do with worms. That is caused by moist irritated skin under the tail or impacted anal sacs.

What causes it?

It is an allergic response to one or many things.
In the allergic form of this itch (the most common) the dog’s immune system is over-reacting to common things. We all need our immune system to repel invaders or to dispose of unwanted errors in our cell reproduction but sometimes the response is too much or wrong.

The allergic substance agent initiating this over-reaction is called an “allergen” and the disease name for this inappropriate immune system response is called “atopy.” The allergen might be the occasional flea bite or the demadex skin mites that all dogs have a few of or it may be pollens or dust mites taken via the lungs, nose or eyes or landing on the skin. It might be certain foods. So really it is similar to the human allergic problem and just as in us it can be dust mites (house mites). Just as in us, this over-reaction to ordinary things can be hereditary but some breeds and some families have much more trouble than others. The more common way for humans to show allergy is upper respiratory symptoms (sinusitis or hayfever).The most common way that dogs show allergy is by itchy skin, especially showing itself worst in moist protected places.

Why does the dog over-react to natural things around it? We don't know. One over-simplified theory (of mine) is that our environment and that of our pets (and children) may be too sterilized when young and we may lack enough traditional parasites to keep our immune system quietly employed. The bored immune system may become mischievous due to lack of occupation. Give it something to do such as save our lives once a week from infected saber-tooth tiger bites or assegai spear wounds, mosquito or flea bites or internal hookworms and the immune system won’t have the time, energy or leftover capacity to cause trouble making us itchy or giving irritable bowels or hayfever. The TV programme “Body Snatchers” featured this point in two episodes. It showed that humans can be relieved of certain allergic diseases by being medically infested with certain parasites. (I digress, though I find that idea interesting). Other theories for causes of excess allergic responses include modern chemicals in foods, over-vaccinating. None have a firm scientific standing yet but some seem to be credible.

To recap, The disease is called atopy, the animal over-reacts to allergens. Allergens are the things to which the immune system reacts. It is the most common disease of all in dogs usually showing first in the ears. The reasons are obscure. There is a lot of genetics in it and it varies from easy to impossible to treat.

Just which allergen is causing the problem can be very hard and very expensive to determine. Mange as we see it in some breeds is just an over-reaction to natural skin mite parasites called demodex canis that live in the sebaceous glands. All dogs have them but some cannot live at peace with due to immune system over-reaction and "mange" is the allergic over-reaction to these mites.

Fleas
Fleas bites are just one of the allergic initiators. They are difficult (probably impossible) to eliminate in heavily infested premises and backyards. The next issue of "The Mersey Post" will go a little further into fleas and their control. Powders and flea collars are very inadequate. Fleas do not live ON animals, they live in the animals’ environment. Carpets, bedding, soil, garden rest places. They only have to get on your pet or you every few years to take a feed for reproductive purposes. After the eggs are laid they can remain dormant for many years needing no animals and no food. The removal of fleas from your home is really the job of a pest control expert, hopefully a well informed one. The best commercial preparations for killing fleas on your pets turn them into flea vaccuum cleaners and any flea which gets on them either dies or is sterilized before it reproduces. So theoretically the dog or cat can still suffer from bites even though killing or sterilizing every flea that jumps aboard. However these treatments do help a lot and I usually see much less itch soon after using the good products. The main problem is that most owners don't persist with the treatment. These products are available from vets because that is usually where the best advice and follow-up comes from too.

Food Allergies

Some foods may also cause reactions but I don't think it is as common as often said. However it is one cause.

Pollens / House dust mites (common human allergens)
Some dogs are allergic to one dust mite or another. House dust mites which can cause upper respiratory / sinusitis symptoms in humans also cause skin troubles in your pets (rather than nose and eyes) although they can do so.
These dogs may need a desensitizing course of injections of the very thing they are allergic to. Other dogs may be allergic to inspired pollens in the air breathed in or which land on the coat and make their way to the skin. (Which is why regular gentle shampooing with almost any quality shampoo often works well. Scrubbing the skin or heavy rubbing while shampooing is not good. It will remove the protective fatty barrier and outer skin layers allowing the allergens instant access making it worse.

Allergy Tests

Blood tests to see if allergy is the main factor are useful (IgE). Some human and veterinary specialists also test-inject the pets skin with multiple skin allergens to see if a reaction occurs. Sometimes this comes up with the answer as to which allergen(s) are causing it. This is great when it does tell you because that special allergen might be able to be denied eg. a certain meat source, or you may be able to eliminate fleas (not easy at all) or possibly a course of de-sensitizing injections using that allergen extract may be given against pollens or fleas or whatever. Recently laboratories have got together a blood test instead of skin test injections. It now gets a lot closer than we ever did before from any old blood tests. It is called the "Allercept test" and it costs about $280.00 with the blood taking and admin costs. It can be worth it however.

TREATMENTS. Removing the allergen(s) that are causing it is not where it ends. The allergic reaction causes the skin to become redder and a bit “juicier”. If that was all it did then we’d not see so much trouble unless it was severe. Because the skin surface has as much biology as a tropical forest, some of these skin inhabitants take advantage of the juicy changes, especially staphylococcus bacteria and yeasts. They make things a lot worse. HOW...Well all micro-organisms need three things to flourish and multiply. They need food, warmth and moisture. Their multiplication causes more irritation. The first steps therefore should deny the three basic needs of micro-organisms.

BUG FOOD REMOVAL. First we attempt to deny food to these skin inhabitants. There is always scurf, protein and fat on the skin but this increases with allergy and with the irritation caused by the growth of bacteria. I also have a Dr. Jim theory that over-fed dogs have richer skin secretions giving the skin bugs more tucker. Well anyway, fat dogs are often itchier and that's my guess why.

Shampoos are useful

Skin exudes protein rich secretions when inflamed because the blood supply is greater and the inflammation causes sticky exudates to accumulate on and in the skin. Have you felt the sticky, tacky feel of the itchy dog? Not to mention the “doggy smell”? The skin inhabitants (bacteria etc.) grow much faster in this richer food environment. The allergic increase in bacteria on the skin adds to the irritation already present by accumulating bacterial toxins on and in the skin. ("bacteria poo"). We have to get rid of them and their itchy by-products but also importantly remove the allergic agents on the skin and in the dog's hair. How? …By regular gentle washing with a mild shampoo made for the purpose. The shampoo if done regularly also removes the allergens, eg. pollens waiting in the fatty protective layer and in the upper layers of dead skin and hair. However beware...Too much vigorous lathering can also remove some of these protective surface layers which act as a barrier to the contact of allergens with the deeper skin cells. It is better also if the shampoo has anti-bacterial and anti-yeast chemicals added which bond with the skin surface and continue to keep bacteria under control between washes. Regular shampooing means... as often as needed, seldom longer than fortnightly. The good shampoos are expensive, the cheaper ones still work adequately in mild cases.

WARMTH. In some places the skin is warmer, moister and more protected. ie. tropical. In these places there is often the worst trouble. They are inside the ears, between the toes, under the tail, in skin folds, around the rear end and on the lower lip where sloppy foods leave residue. A short clipped coat will cool and dry the skin and reduce the allergen storage depot in the hair. I also see bad skins persisting well into winter in dogs that sleep inside especially near the fire or in warm air conditioning.

MOISTURE Those parts of the skin that remain wet longer are worst affected. They are the protected places. I’ve already mentioned most of them above. Once again a short clip is an effective method to increase evaporation and deny bacteria enough moisture to multiply excessively.

In many dogs, just doing the above (short coat and shampoo) is all that is needed.

MEDICATED SHAMPOOS Do not use a medicated shampoo until you have the irritation mostly under control or you will make it worse. Most good medicated shampoos are expensive but you can get better value from them by first using a cheaper but proper pet shampoo to clean the coat (not too vigourously) then rinse it well off before you apply the more expensive medicated one. That way it goes further with less wasted just for doing the cleaning. The good quality medicated shampoo from your vet preferably loosens the upper layer of the skin and bonds its microbe fighting chemicals. That bonding takes time so you have to leave it on for 10 to 15 minutes before rinsing. After cleaning the coat the medicated one may even be applied by a spray diluted 25 to 1 and not rinsed. Most medicated shampoos have a bonding life of about 2 to 3 weeks on normal skin but less time on inflamed skin.

Sea Water. It is NOT of benefit, it makes it worse. Many dogs that get wet at the beach and then dry off with salty water and sand in the cracks and crevices get very irritated by it. Sea swimmers should be rinsed very well with fresh water especially in the folds of the female and between the toes.


EARS Many dogs have bad ears because of skin allergy. (Atopy is the name of the allergy we are talking about here). In some dogs, bad ears are the only way it shows upbut some are also often toe lickers and bum draggers. It can be one ear or both or change about. Once they have had a very bad bout of ear trouble it will never be “cured” but only reduced by treatment to where it can be maintenaned OK. Leave off the maintenance and the ear(s) will get very bad again. If the ear maintenance routines are continued along with the shampooing of the rest of the body, then comfort should be adequate. The method of ear maintenance I use is to dispense one of our medicated shampoos in a very dilute form (1/30 and no stronger) and use it warmed to body heat as an ear wash. Most people need instruction in how to properly use ear washes. I do not like the mildly acidic and drying spirit based ear washes.

Drugs for allergies. (Mild ones first). There is well-founded belief that some oils such as omega 3 fatty acids as found in fish oils and plant oils like flax-seed and evening primrose oil (EPO) may have benefits, possibly by pacifying an over-active immune system. I usually recommend flax seed oil from the health food shop because it is not as expensive as EPO and it doesn’t have a strong flavour like fish oil. If these oils do work the effect is not immediately seen and you have to keep it going. Your health food shop should have a quality supplier and it needs refrigerating, even in the shop.

Some or all of these methods of control may be sufficient for the majority of dogs. Once you have the routine of fortnightly shampooing, clipping often in summer/ and the feeding of omega-3s, then that may be enough. Maintenance of flea control is enough for a few dogs only.

Heavier Drugs from the Vet. I believe that at least half the failures of the non-drug or milder methods are failure to do them correctly or leaving it until it’s too bad again. You can drop your guard in winter and spring because they are not usually as bad at those times. Some people don’t have the time and others don’t have the patience or persistence. Fair enough, we are busy and stressed and overlook it. In unresponsive cases and those that don't get maintained we may need to give drugs. The common drugs available to us are cortisone (usually prednisolone), antihistamines (very unreliable in dogs but occasionally useful) and an immune suppressor called cyclosporin. This latter is quite expensive but works well often. I usually use prednisolone at first to ease quickly the suffering of any itchy dog in crisis along with antibiotics to reduce skin bacteria survival. A check for mange mites and fleas is often done and if present then I reduce them with appropriate treatment. Along with that and after some control has been made I attempt to use the non-drug methods as a continuing therapy. Where that fails I may use prednisolone or cyclosporin for longer terms. Putting a tiny tablet into the food every second day can be a lot easier for an owner than washing an unco-operative dog. Carefully managed, the side effects of cortisone are less if “every other day” therapy (EOD) is used. Pred is also fairly cheap and we get the dose as low as possible by trial and error. We aim at EOD therapy to avoid the worst of the side affects and dependence on the drug. Not many dogs will stretch to every third day treatment but some might. It is better to use a slightly higher dose EOD than it is to use a lower dose every day.


De-sensitizing injections After identifying the allergen(s) by skin tests (by a vet skin specialist) this can be used. It is expensive and a little tedious to give injections for many many months.

My practice manager Kylie has a very badly atopic dog. She avoids his contact with skin allergens by using a lycra suit made to his size. He wears it whenever romping outside. It seems to work and his dependence on drugs is small now.

I hope that covers most of the big problem of allergic itchy dogs.

Finish (for now anyway)

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