Ava at the Allergist!

[Stacy]

Some people wanted to hear how the appointment with the dermatologist went. This got long! My little summaries are not so little.

 

So we’re home from the dermatologist! I feel like I was exceptionally well prepared for this visit, after everything I’ve read and the really great resources here. There wasn’t a lot that the vet had to say that surprised me.  I’m just going to give a little summary of the visit and the plan going forward.

 

Food allergies: Food allergies are comparatively rare, and you can’t test for food sensitivities with skin testing. We could do a food trial – either alone or consecutively or concurrently with intradermal testing. She recommends the food trial for at least 6 weeks and she recommends prescription food during that time. I suggested one of the limited ingredient formulas that are on the recommended food list. But she said testing on those shows cross contamination and for at least the first 6 weeks she likes to do the prescription formula. I didn’t ask which prescription diet – I know that some are better than others, but I opted not to go that route at this time, because I really feel like we are dealing with environmental allergies.

 

I do wonder if I should change their food up a little. They haven’t ever had the pork and applesauce or the duck and sweet potato. The salmon gave Katie gas… But on the other hand, sometimes I think when you start changing everything you create so many variables that you can’t tell what is actually helping. So maybe I will leave their food alone for now.

 

Environmental allergies/intradermal testing/immunotherapy:  She needs to be off meds for about 3 weeks before testing. Testing is done under light sedation and reversed afterwards. Approximately 65 allergens are tested. They make their own antigens and you go home with them the same day. The majority of dogs see improvement with immunotherapy, but it takes weeks – months to build immunity to the allergens.

 

She gave me the choice of doing injections about every two weeks (once we get to the maintenance phase) or doing a liquid drop daily. I asked which was more effective and she said that they were the same (I still have a hard time believing that the injection isn’t at least a tiny bit more effective) The cost is the same. But there is a convenience factor to not having to do it daily. Or a convenience factor not having to give them a shot, if that’s an issue. I opted to do injections, so we’ll see how that goes. Ava has an appointment to have the testing done on Feb. 10^th.

 

We talked about Apoquel, and she seemed to think it was safe, although it’s only been out for about 3 years, so long term is still hard to say. I did agree that it was probably okay short term. My goal is to keep her off medicine with harmful side effects as much as possible. But for some reason Apoquel is exempt from the no medication before testing rule. I didn’t ask why. So they sent me home with Apoquel for the next two weeks before testing. 16mg/day either daily or divided into morning and evening doses. (Ava weighed 60 pounds today) Then as we are waiting for the allergy shots to work we can continue to use it as needed, or not.

 

They did smears of her ears and her feet and determined that she doesn’t have an ear or skin infection. So that’s good. I worry about her stinky ears, but they said they look really good. And I clean them regularly. So I guess she is just going to have kind of stinky ears.  

 

Today’s visit was the exam, cytology, and apoquel and the total was $185.00

 

The estimate for the allergy testing  is $515.00. That includes the first set of antigens that she said should last 4 – 6 months.

 

I feel like this is a really good first step toward getting Ava’s itchy feet under control. It’s just got to be a miserable way for her live.

 

I’m very pleased with our dermatology experience!

[Amy and Annabelle]

Glad to hear things went well and as expected. Some day I may have to go through it with Annabelle. She has seasonal allergies. Normally winters are good for her, but since it has been so warm here, she is being bothered by them. I give her Benedryl on occasion to help on days her scratching and licking appears worse. It does help for now.

[Stacy]

I hope Annabelle continues to get relief from Benedryl. It can be a wonderful drug! It just didn't work very well for us. But it does feel great to have a plan and know that for most dogs this is a successful treatment. I have a good feeling about it. 

[Jane, Guinness and Murphy]

So glad you saw a specialist and have a plan in place.  Please continue to keep us posted.

[Stacy]

Thank you! And I will. I just want Ava to have the best life. 

[Linda, Charlie Brown and Beau]

Thanks for sharing your dermatology experience.  There seems to be so any dogs with allergies these days.  I hope Ava will see some relief very soon.  Looking forward to updates.

[Stacy]

There do seem to be so many dogs with allergies. And the dermatologist was saying that it's genetic. It makes me sad thinking about all of Ava's puppies out there with itchy feet. And I know there are a lot of them - puppies, I mean. I have no idea if they have itchy feet. 

[Karen, Jasper and Jackdoodle]

Labrador Retrievers are the number 2 breed affected by Atopic Dermatitis (GSDs are #1), and Golden Retrievers are also over-represented. 

[Karen, Jasper and Jackdoodle]

I once ran across this picture when looking at breeder's website, and I saved it because it bothered me so much. This was one of their breeding dams. Take a look at her feet. I wonder how many people would have known that wasn't just dirty feet:

[Karen, Jasper and Jackdoodle]

I don't know how I missed this!!! I was wondering how your appt went!

It sounds like you have a good plan, and I'm glad you were pleased with the experience. (I also have to tell you that the prices are less than what I paid when JD was tested 8 years ago. )

My wish for you and Ava is that the immunotherapy works as well for her as it did for JD. :)

[Stacy]

I was also very pleasantly surprised by the price. I know you live in a higher cost of living area than I do, but it was definitely less than I expected. I am not complaining one bit! 

I was curious what you thought of her thoughts on the food trial. I specifically mentioned the Wellness LID and she was talking about cross contamination. I didn't think that sounded correct, but I didn't ask her to cite her sources. 

I have my fingers crossed for the immunotherapy also! But I have to tell you, even though we don't want to be on it long-term, this Apoquel really works! I'm actually pretty impressed with the effectiveness. 

[Karen, Jasper and Jackdoodle]

That "cross contamination" story is from Hill's and Purina's marketing departments. As consumers have gotten more savvy and more companies are manufacturing high-quality limited ingredient diets, they've had to come up with new ways to get people to buy their crap. Their new big thing is to invite vets to come tour their facilities, and they make a big point of showing how all the machinery is cleaned between batches. Of course, the other companies we recommend clean between batches, too, but they don't conduct tours of that. Their budget dollars go into their ingredients, not their marketing.

I would be willing to bet next month's mortgage payment that there has been no testing of the higher quality LID diets, (Acana, Wellness, etc) and that if there has, there was no "cross-contamination". I just know too many people whose dogs with serious digestive diseases are eating the recommended LID foods, including mine, without incident, and we are talking here about dogs who, if they did eat something they shouldn't, wouldn;t just get itchy, they'd end up in the ER. This doesn;t mean your specialist doesn;t know what she's talking about, it means that she is not a canine nutritionist, (that's another 3 years of post DVM study, lol)  and that BIG DOG FOOD does a very good job of brainwashing. 
Yes, Apoquel works well, and if you could use it for a month or two every year, during allergy season, there would be no reason to do anything else. But that's not the case for Ava. 

[Stacy]

It's funny because when she was talking to me about food all I could think is, I know you don't know anything about dog food! And it's really easy to get sucked in to all the official sounding information that you're told - especially when it's from a so-called expert in their field (referring to when the big dog food companies are speaking to the vet, not when the vet is speaking to me!) I am planning to stick with Fromm until and unless the allergy shots don't seem to be effective, then I will consider a food trial. But in the meantime I plan to play the odds and assume that it's the environmental allergens that are the problem. 

I was looking at her feet this morning and it's amazing how much better they already look. They never looked as bad as that poor dog in your picture, but if you looked down between her pads they were all red and inflamed. I'm so glad she's getting some relief from the apoquel.

And I'm very glad that we decided to skip to the dermatologist. I even told them that I'm sure that there were a lot of dogs who were worse than her, and they told me that they don't judge on severity. They were really very sweet.