No Cure for This

Pets can get really itchy in the fall, for a variety of reasons. Fleas start to really believe they can overthrow the world right about this time of the year, and airborne allergens are switching over to their autumn spectrum. Both of these things can be extremely irritating to dog and cat skin, but we find that the pet owners are often irritated as well. Many of them do not fully understand the concept of “management vs. cure”.

Allergies are a perfect example and, in my experience, the most frequently misunderstood medical condition of dogs and cats. Occasionally I’m faced with a disgruntled pet owner who thought that their pet’s allergic skin would have been cured by the last doctor (or the doctor before that, and so on). When subjected to further questioning, they report that the skin got better right away, “but then this came right back.” Allergic skin will continue to flare up every time the offending particle reasserts itself. If that particle is saliva from the bite of a flea, you may be able to insulate your pet from exposure with a multimodal flea control regimen: that means using a good quality flea product to address the pet, all of the other pets, the house floors and perhaps the yard, and expanding your flea eradication efforts to 12 months out of the year. If the offending particle is shed from a dust mite—a common scenario in human beings and pets—you might have some impact via purifiers and barriers in the home, but the dust mites themselves are not going anywhere. If the offender is something like pollen from a ragweed, you won’t be able to escape it at all. Every time the ragweeds try to do their thing, your ragweed-sensitive pet is going to flare up. Therefore, we cannot currently cure allergies, although many have tried and continue to do so.

When you take your pet to the doctor for itchy, allergic skin, you are receiving therapies to manage—not cure—the condition. Various medications, old and new, are directed at blocking the itch that results from exposure to an allergic trigger. We are hoping to withdraw the medication if and when the offending particle begins to dissipate (for example, when the ragweeds have gone into hibernation or when you have eradicated fleas from your immediate environment). The damage will recur and medication will be needed again with the return of the ragweed pollen or the fleas.

Antibiotics are sometimes needed because allergic skin cannot defend itself properly. Constant bombardment with inflammatory particles and trauma from scratching and licking prevents the skin from keeping its normal inhabitants in check, so pharmaceutical assistance is sometimes required. Again, since the root cause is allergy and the allergic trigger is often impossible to remove, these prescriptions tend to be repetitive.

Some conditions are never cured. If you work proactively with your doctor to anticipate flare-ups and select the least invasive kinds of therapy, management of skin allergies might not be quite so repetitious and irritating.

Dr. M. S. Regan