January 6th, 2011
Skin issues, Allergy and Diet
It’s 2 a.m. you are awakened by scratching on the floor and soft whining. Your dog is at it again – scratching, licking his feet and legs and whining every so often. This has been going on for days now. You yell at him to stop and lie back down, but within 10 minutes, he’s started up again. What do you do? You take him to the vet again, the third time in 6 months. You are given a two week supply of antibiotics, steroids and an antibacterial/antifungal shampoo.
I get a lot of questions about skin problems including atopy (or dermatitis from allergies), skin infections, food allergy and hair loss. The crux with almost all of these problems is that the body is not appropriately handling exposure to opportunistic pathogens, ingredients in food or the environment. The question that I have is NOT how do we stop the itching, scratching and hair loss, but how do we actually stop this type of problem from recurring.
When I talk with owners, many of them just want to stop the problem, they don’t understand that fixing the cause of the problem will fix the reason they arrived at my office. This crux seems to come down to a miscommunication or misunderstanding between the owner and the treating veterinarian. For the most part, anytime a pet has repeated skin infections, hair loss or itching and scratching there is something else wrong systemically, not just on the outside of the pet. However, if the pet is not on a topical or oral anti-ectoparasitic medication, we definitely need to check for fleas, ticks and mite exposure. This is typically the first thing to do: examine the skin, take skin scrapings, send hair samples to a lab and take impression smears of the skin. However, most owners who approach me about repeated skin problems are actually treating the pet with a topical antiparasitic medication (such as Frontline, K9 Advantix or Advantage, etc.) In this case, we really need to figure out what is happening, because if the pet’s blood work is “normal”, the underlying problem is most likely the immune system. This is often a sign of allergy. Unlike hay fever in people, allergy in dogs is often seen on the skin.
Seeking help from your veterinarian to determine the exposure is extremely important. There are various types of tests for this, including skin testing (which I prefer) and blood tests. However, your pet may show a reaction to a substance on a test, but not exhibit an allergy when fed the allergen or exposed in a different manner. Once your pet has been sensitized to a certain allergen, it is often difficult to stop the immune reactions that manifest as skin problems. Whenever possible, determining the culpable allergen(s) (environmental, food, plants or tree pollens, etc) and eliminating them will help with the symptoms. Stopping the exposure is a good start; however, the body will continue to have an aberrant response to these environmental exposures if the body’s overall inflammation is not decreased.
In my opinion, this problem is more than skin deep, which requires more than the topical and oral fixes of which we generally think. For the most part, we as pet owners have to look at the diet as the first line of defense against these diseases. Stress and exposure to pathogens seems to trigger these symptoms, but these allergic conditions appear to develop due to some underlying problem with the immune system. Basically, the immune system is not responding properly. This means, the immune system is not clearing yeast, bacteria or other opportunistic pathogens on the skin as it normally would and it may be irritating or attacking the skin inappropriately. This is a bit simplistic, but overall, it explains what’s going on. This is not to say that the pills or shots or oral antibiotics and shampoos will not alleviate the symptoms (the itching, scratching, hair loss, etc). Rather I am pointing out what many owners find; these symptoms keep returning.
Because I think that the diet and overall body health is extremely important, I will give some general guidelines about what I find has worked for stable pets (without a lot of other health problems). However, most of these guidelines can be applied to pets with other chronic illnesses, it is even more important to talk about it with your veterinarian and modify it as needed. I am not advocating a specific diet because there are many ways to rectify the dietary problems.
First of all, we are very busy and we do what is easy. We feed our pets, usually, one specific diet out of a box, can, or bag. However, we have to realize that the diets that have been processed and preserved in this way most often lack something that our pets probably need. I liken these bag diets to me or you living off of frozen lean cuisine meals. It is not as healthy as fresh foods and, often as animals’ age, they have a harder time extracting nutrients that they need from these diets. There may be the added problem of some diets lacking adequate quantities of specific nutrients. Therefore, when a pet shows up with even the hint of an allergy problem such as redden skin, mild hair loss, ear infections or increased licking, scratching or chewing, I try to have a discussion with the owner immediately concerning the diet. This is client and pet dependent, but it usually results in me suggesting supplements or changing the food altogether. I have seen pets improve dramatically, sometimes within a week or two, if the owner was feeding the pet a low quality brand and switched to a better quality food. However, if a pet has developed the tendency for allergy, you should not stop there, as the “disease” process is already afoot.
After looking at the diet, one of the first things I suggest is an omega-3 fatty acid supplement. I personally like Nutramax products but there are many other providers available. The best advice on products is to do some research, talk to other pet owners and talk with your vet about these specifically. I often suggest supplements that I know contain EPA and DHA, which are very important types of essential fatty acids. Some of the quality food providers add these to the food, but the quantity of added nutrients may not be adequate for pets with deficiencies or who have chronic problems.
Secondly, pets may need additional B-vitamins. These are water soluble vitamins that we need in our daily diet and usually get in whole grain foods. However, some dogs may become deficient in specific B-vitamins, especially as they age. There are various brands of vitamins, but one cheap option is adding brewer’s yeast to your dog’s food; however, you should make sure this is appropriate for your pet and discuss it with your veterinarian.
Exercise is the other major factor in your pet’s overall health. With dogs, a walk once or twice a day for most breeds is adequate. However, lack of exercise and resulting obesity appears to increase the risk of allergic disease. Obesity is also becoming a major problem for many of our pets in the United States. The extra fat does appear to have consequences that hinder good health in addition to the extra weight. Research has also shown that the immune system behaves better and is “stronger” in people who exercise regularly. This phenomenon also appears to impact our pets.
Finally, if you have noticed skin problems or they are recurring, the best way to assist with diagnosis and determine the cause is often by keeping a good record or diary of symptoms and when you notice them. When you talk with your veterinarian about allergic conditions, you will likely be asked for changes in the diet, treats and the environment and approximately when they occurred. Due to the chronic nature of these allergic skin problems, the veterinarian is very reliant on you for information as we see the patient often weeks or months apart. Starting a diary and keeping track of outbreaks, improvements and making note of when food/treats change or other events occur will often help with determining potential culprits and help you to eliminate allergens from the environment to improve the course of treatment, remission and prevent relapse.
S. Mason, DVM