Welcome to October’s webinar topic which is Itches, Scratches and bites.
We have had an amazing itchy seasonal already. The last three or four weeks, itchy dogs and itchy cats have been coming out of the woodwork.
We’ve seen dogs and cats coming in who have not had issues for five, six, seven years.
The weather conditions are absolutely perfect; a couple of years ago we had all that massive fire which killed everything. Last year we had massive amounts of rain and now we’ve got plants and bugs and all sorts of things coming up that we haven’t seen for years and years and years and years. And so the itchy season has started really early and it’s going to continue on for quite some months yet, because the weather conditions are ideal.
- The most common things that your pet is going to be affected by are fleas.
Study after study after study shows that 80 percent of itchy, scratchy problems in Australia, in spring, summer, autumn have some degree of flea component. And the thing is that many people are reluctant to believe that and for a whole heap of reasons.
Number one; they can’t see fleas on their pet. Well because dogs and cats lick themselves, groom themselves incessantly, they will lick and groom the fleas off. What causes the reaction or what causes the itching, what causes the allergy is the flea getting in and biting. And then as soon as the flea’s bitten, it can be wiped away by the dog or the cat and the reaction will keep on going. And you only need one or two fleas on a sensitive pet to make that pet scratch incessantly.
It’s very hard to find one or two fleas.
The way to determine whether your pet has a flea issue or not is get a flea comb and comb the coat and then put it on some white paper and if you see anything come out on that white paper, then you know your pet’s got a flea problem.
If your pet’s scratching, the first thing I suggest is you use really good quality flea control.
Now the second catch is this; if you look at the technical data on most of the one month products – the products that are sold typically are supposed to last for a month, will protect your pet for a month and I’m not going to go into products names or anything else like that.
But if you look at the technical data, behind the one month type products and there are many one-month products, I’m not picking on anyone at all. You’ll find that the technical data shows you that most of those products only last 28 days.
This means that for two or three days a month, your pet is not protected.
What a lot of the manufacturers have done is they have tried to increase the quantity of the product in the top spot or in the chew, but at the end of the day it still only lasts for 28 days.
So if you want really good flea control with a one month product, you have to use it every 28 days.
In dogs and cats with bad flea problems, I’ll run them on two products and what I mean by that is we’ll use one product on the first of the month and on the 14th of the month we’ll use a different product.
This gives you really good quality flea control and one that lasts; the crossover thing works really well and lasts a long, long time and it gives you excellent control. If you’ve got a an itchy dog or an itchy cat and you want to prove or disprove fleas as being part of that problem, then why not try a two product combo like we’ve just been through.
Now the other thing about these products is that many large stores) and I’ll be very careful with what I’m saying, I’m not talking about pet stores here), have inferior products.
Essentially with flea control and tick control what you pay for is what you get.
And if you’re going to go to a Woolies, Aldi, Coles, IGA type environment and buy one of those cheaper products, typically they’re not going to work very well and they’re not going to last very long. Just a word of warning there.
That’s two things we’ve talked about now.
The third thing I want to talk about is Wandering Jew – it’s a sappy plant.
If a pet is allergic to a plant, it’s typically a contact allergy to a ‘sappy’ plant. And the plants that cause allergies like that, contact allergies are the ones that when you break them off, they’ll be sappy, they’ll have a white sap in there.
And just like some people are allergic to some contact plants, some dogs and some cats are, but most aren’t.
By definition, contact allergies occur in the contact areas.
That’s the thinly haired areas on the backs of the front legs, on the backs of the back legs and on the tummy.
And when a pet comes in contact with these contact plants, they’ll develop severe rashes on those contact areas. A lot of these plants are quite seasonal and you’ll only have allergies at certain times of the year.
These contact allergy plants can be very difficult to find.
I remember when I had my practice up in Maitland, I had a Dalmatian and I treated her for two years for all sorts of weird and wonderful things, till one day I discovered a tiny piece of Wandering Jew between the paling fence and the carport and she could- Emma could just get in there and walk through that area, but that’s typically where I threw a lot of the cut off timber and all sorts of things like that and I didn’t look there for two years.
So it can be really hard to find Wandering Jew.
It’s a ground cover. It looks a little bit like an ivy in my mind.
It’s impossible to kill with round-up type products; you need to dig it out. I regularly see people who say to me and I’m thinking they’ve got Wandering Jew causing the problem in their pet, and they say, “No, I- we don’t have Wandering Jew” and I say, “Look, just go and have a really careful look” and they’ll ring me up a few days later saying, “Yes, we’ve got this paling fence and there’s Wandering Jew on the neighbour’s side and a few tendrils have come under the fence and my dog has run into them and that’s caused the problem.”
Wandering Jew is another really common cause for itches, scratches, bites and you can go online get a picture print it out and walk around your backyard to find it.
Let’s talk about Scabies
Let’s discuss a thing called fox mite or scabies or sarcops or wombat mite.
Wombats are infested with this little parasite called scabies or sarcops, it’s the same species as head lice in kids and by the way, scabies is highly contagious to people.
If your dog has got scabies, then you can catch it from your dog.
I’ve caught it twice from client’s dogs.
If your dog plays with a dead fox or a dead wombat or goes down fox holes or wombat holes, then your dog can get scabies or sarcops very easily and one of the hallmarks of scabies is just incessant scratching.
If I ask a person on a scale of 0 to 10 how bad is your dog scratching? Typically with scabies, the answer will come back as seven, eight or nine.
Almost no treatment is effective, so if we give cortisone it doesn’t work very well and it doesn’t last very long.
You only need one or two mites on a pet to make them scratch incessantly.
In most cases where a pet comes in with scratching, I’ll do a skin scraping or vets will do a skin scraping and have a look at that under the microscope.
The chance of finding the one or two mites that your dog has, even if you’ve got a small dog like a foxy you might have to do 20 or 30 skin scrapings to find it. That’s just logistically crazy.
- The easiest thing to do is a treatment trial.
Most of the newer flea controls, flea, tick controls will also kill fox mite, scabies.
Bravecto, Nexgard, Simparica they’re probably the biggest three that are being used at the moment, they will all kill scabies.
So if you think your dog has potentially a scabies problem, then a treatment trial – put Bravecto on, Nexgard on and Nexgard is a tablet so you don’t put it on.
Bravecto is either a spot on or a tablet, Nexgard is a tablet and Simparica is a tablet as well. If you do that (a treatment trial) and the problem goes away, well then you know it was scabies.
The next thing we come into with itches and scratches that we see at this time of year is what’s correctly called Atopy.
Atopy- a t o p y. Atopy is a disease which has about a 40 percent genetic predisposition.
This means that your dog is predisposed genetically to this problem and certain breeds are over represented. Labradors are really common affected and West Highland White Terrier is another breed that is typically over represented, but there are many other breeds that that have a genetic predisposition to atopy.
Atopy is an allergy to “big picture” wind borne pollens.
Wind borne pollens, it’s also house dust mite.
And pollens can typically blow two or three miles on air currents. The source of the pollen does not have to be in your backyard or even on your street.
One of the classic clinical signs of atopy is seasonal itches and allergy.
For example I have cold weather asthma. In cold weather I will cough something crazy, but only in cold weather.
Dogs with atopy can have, can be allergic to pollens that are around in spring, or in winter, or in summer or in autumn and therefore, you’ll have these flare-ups on a seasonal basis.
If you have a dog who flares up and I’ll give you an example of a dog that came in today and he develops ear problems in March and September every year or has done for the last three or four years.
And so that looks a lot like it’s a pollen problem, it’s an atopy problem because it’s seasonal.
There are a whole heap of ways to treat this problem.
The first thing to do is to make a diagnosis; I’ll just go back to how this happens.
If you imagine a driveway made up of bricks, okay just normal house bricks and in between those bricks are grout.
That’s what the skin surface of your pet looks like under the microscope.
You’ve got skin cells and then in between the skin cells you have like a form of grout that holds them together.
With atopy in dogs that are genetically predisposed to atopy, the quality of the mortar holding the skin cells together is really and I’ll use a technical word here, really crappy.
And so what happens is the pollen can come down and land on the skin surface and penetrate through that crappy quality mortar and get into the tissues underneath the skin surface and set off that reaction. Also, the skin will dehydrate up through that poor quality mortar.
If we’ve got a dog with atopy, there are a whole heap of ways that we can treat that patient and a whole heap of things that we can do to diagnose that patient.
One of the things we can do for example is we can run blood tests or we can run what are called intradermal skin tests.
We’ll do blood tests and that will tell us that your pet is allergic to kikuyu, wattle, tea tree, etc. etc. etc. That’s one way we can do to make a specific diagnosis or we can do intradermal skin tests, they’re also called patch tests.
We get 30 or 40 different allergens like wattle and tea tree and kikuyu and whatever else and we’ll inject a small bleb into the skin surface and then we’ll grade the reactions that we get and you’ll grade them from like a grade one to a grade four and a grade four is a nice big wheel or blister or flare and that shows a severe reaction to that allergen.
Based on the intradermal skin test or based on the blood test, you can actually have a vaccine made up and we will show you how to inject your dog and ‘vaccinate’ your dog against those pollens or against that atopy or pollen.
About 70% of dogs will have a reasonable response and it’s going to cost you about a thousand dollars a year to maintain that.
In my mind it’s an expensive investment and 70 percent isn’t a great number in my mind.
The other way of looking at this is to manage the skin and to manage the allergies without vaccination.
Improving the skin barrier can be done really well and there are all sorts of things that can be done to help improve the skin health.
Washing is a really simple one and if you wash with the right shampoo and then put the right conditioner on, you can improve the skin health dramatically.
A couple of catches here; you’ve got to use the right shampoo and the right conditioner and the shampoo has to be left on for 10 minutes.
If you don’t leave the shampoo on for 10 minutes, the chances of it working are very poor.
If you’ve ever washed a dog and sat there with 10 minutes on your phone or on your watch, it’s an awfully long time and that has to be done at least weekly and in some cases twice a week.
Most of us don’t have the time to do that. The more often you can wash the pet the better it will work. If you can only wash once a week or once a fortnight, then so be it. But that’s a really great way to improve skin health against atopy.
The other thing you can do is fish oil, omega-3 and omega-6 fish oil works very well at improving skin barrier function and skin health.
The normal dose of fish oil is (if you use the normal 1000 or 1500 milligram capsules), the normal dose for the normal dog is one capsule for 18 kilos.
To improve the barrier function of the skin, you really need to increase that dose to about one capsule for every four and a half kilos.
If you’ve got a 45 kilo dog that’s 10 capsules, which is a heck of a lot.
Yes, it’s doable, yes it works well but there are challenges.
Shampoos work really well, especially when you use conditioners with it as well and then omega-3, omega-6.
Antihistamines don’t work particularly well; in some dogs they will have some improved function. They’ll help a little bit, but not very much in in most cases.
Now we get to the ‘drugs’ and there are many drugs around now that help unbelievably.
The old standard is cortisone; it works very well and is as cheap as chips but it has a lot of side effects in many dogs and we don’t like dogs being on cortisone forever if we can help it.
Two newer drugs that have come out that are working exceedingly well, one is a tablet called Apoquel which is a one-a-day tablet; has no side effects and works excellently. Quite an expensive drug, but when the trade-off is the scratching going away, what’s that worth to you??!!.
You can also have a dog on both Apoquel and cortisone that will allow you to decrease the dose of the cortisone, so that it becomes a much safer drug to use.
And then a newer drug that we are using a lot now is a drug called Cytopoint. Cytopoint is an injection that lasts anywhere from, it’s registered for 30 to 35 days. Many of our patients are getting away with it lasting as long as six to seven weeks in between injections and we’ve got a couple that only need it every three months. That’s a really good product.
We’ve talked about;
- flea allergy,
- contact allergy,
- scabies
- atopy.
They’re four of the main causes of itchy disease that we see in in dogs.
Now what are the symptoms or the clinical signs that dogs show?
- licking,
- scratching,
- rolling,
- biting,
- gnawing at themselves,
All those sorts of things indicate allergies or rashes.
The other thing that a lot of people don’t twig to is ear disease.
Ears are simply skin that’s modified and lining a hole in the head if you want to put it that simply.
and the ear is typically reflective of the skin and the skin is typically reflective of the ear.
If you’ve got an ear problem, it’s often associated with a skin problem and a skin problem is often associated with an ear problem.
Both ears are slightly different, because it is a hole or a tunnel or a canal into the head and it gets moist very easily and it can act like a little incubator.
If you’ve got a dog with skin problems and it gets ear problems as well, often the ear problems are much more severe and much harder to control than the skin problems, because it acts like a little incubator.
Ear disease is very interesting.
I’ll give you an example; I had a dog who was in last week scratching and itching and whatnot and what I always do with the dog that comes in that’s scratching, I will always get a cotton bud, get some of the wax out of each ear and look at it under the microscope. Therefore I know exactly what bacteria is in there. Are there yeasts there? Are they’re fungi there? And so I can diagnose it really accurately and therefore determine exactly what product that we’re going to use.
In this particular dog, the left ear had a totally different population of bacteria to the right ear.
We had to use a different treatment protocol for this ear to the treatment protocol for that ear.
If we did just use the one, the same ear drop in both ears, one ear would have been fixed and the other ear wouldn’t have been fixed.
We had to totally individualize that treatment protocol.
The reason for that is that the ear is made up of three pieces of cartilage and they’re not mirror images of each other.
And so the microclimate in one ear is not the same as the microclimate in the other ear and therefore you can have different bugs growing in different ears.
I just saw Catherine Mitchell write down, “We love that injection.” In the chat box. She’s referring to the Cytopoint. Yes Catherine, I love that injection as well.
Michelle Perry you ask, “What one is the best?” And are you talking about shampoos or what are you talking about, so that I can answer that question for you.
I’ve covered a lot of what I want to cover tonight.
If you want to prevent skin problems in your dog or your cat, what’s the best way to go about it?
I just want to talk about cats for one sec because I haven’t talked about them to any great degree and I will say that you will almost never see a flea on your cat. You may see fleas on your dog, but you’ll almost never see a flea on your cat and yet cats are very reactive and very sensitive to fleas and flea problems.
The reason that you never see a flea on your cat is because when cats groom, they’ll lick the fleas off and you’ll never see the fleas.
- Now, if you’ve got an animal that’s flea allergic, if you’ve got a dog or a cat that’s flea allergic, then you’ve really got to think through how you treat this situation and what product you use.
- For example, many of the products that we use are oral or topical, they’re typically one of the two.
- Depending on the product it may either circulate in the bloodstream or it will sit on the skin surface.
If you are using a product that is either given orally and then circulates in the bloodstream or it’s put on the skin surface and it penetrates the skin surface and then it circulates through the bloodstream….
So whatever product you’re using, if it’s one that ends up in the bloodstream, then the flea has to bite the dog or the cat to suck up the product to die.
Now what your pet is allergic to (if your pet has flea allergy), what your pet will be allergic to is the bite and the saliva that’s injected when the flea bites.
You may be using a fantastic product, but it’s not going to work in this situation because your pet is going to get bitten by the flea before the flea dies.
The other type of product is a product that sits on the skin surface. As soon as the flea lands on the skin surface, that flea will die, it’ll never have to bite. That’s the sort of product that you need.
I’m just reading the chat box here, “Can you cover food sensitivity or allergy?”
Okay, let’s do that!
Food allergies are quite common in pets; they can occur at any age, but usually they’ll start in younger pets.
- My rule of thumb is that if I have a dog that comes in under six months of age for the first time with a skin problem or an ear problem, there’s a 95 percent chance that that dog has a food allergy.
- If the pet comes in for a skin problem or an ear problem for the first time under 12 months of age, then it’s about a 90 percent chance of a food allergy.
- 40 percent of dogs with a food allergy will also have a an atopy problem and 40 percent of dogs with an atopy problem will also have a food allergy.
Let’s look at the difference between atopy and food allergy.
Food is food, if you’re allergic to chocolate cake, it doesn’t matter whether it’s a French, a Dutch, a German, a Swiss or a Nigerian chocolate cake, you’re allergic to whatever is it is in the chocolate cake.
I get many people come in with a pet and it’s scratching and they say, “Look, it can’t be a food allergy because I used to give Pal Meatybites and then I went to Royal Canin and the allergy hasn’t changed, the dog’s still itching, so it can’t be food.”
Well, I’m sorry, it can be food because all you’ve done is gone from a Nigerian chocolate cake to a French chocolate cake, it still has chocolate and eggs and flour and all those sorts of things.
Most of the ingredients that most of the brands of food out there will have in them will be; beef, lamb, horse, chicken and kangaroo as part of their ingredient list and you have to look at the labels really carefully to recognise these ingredients.
A lot of them will have chicken on the little ingredient panel, but you need to learn to ‘decipher’ what they are telling you; it may say something like ‘chicken fat or chicken by-products’ and chicken’s a really common one to add in because it’s cheap and it’ll be added in as an antioxidant.
The big five allergens that we have in Australia are;
- beef,
- lamb,
- horse,
- kangaroo and
- chicken.
The problem we have here is that most of the websites in the world are going to be US typically or European/English.
And so if you go and look up food allergies on the web, in Europe and the States, they don’t have food chicken allergies and kangaroo allergies.
And if you and I had met 20 years ago and you brought your dog in and we thought your dog had a food allergy, I’d be saying “Go get some Kangaroo and feed your dog roo as an elimination diet and this will work out whether your dog’s food allergic or not.”
That whole scenario has changed in the last few years, because roo is now one of the big players.
Beef is number one and chicken and roo are number two and three as far as allergies go, but you won’t find much about it anywhere because we’re dealing with overseas websites.
Let’s look at food allergy and atopy.
If you’ve got a dog with a food allergy, that dog is going to be scratching 24/7/365 because he or she will be allergic to beef or lamb or artificial colours, colourings, preservatives, flavourings or chicken or roo whatever.
And so even if you change brands, that allergy isn’t going to go away.
Atopy shows up as a flare; we’ll have spring, summer, winter and autumn, flares.
As I said, 40 percent of dogs that have a food allergy will have an atopy problem.
What we’ll see happen is these dogs is they will have a baseline level of scratching and then flare’ three or four months later, another flare. So you’ll have a baseline scratching and seasonal flares, I hope that all makes sense.
If you’ve got a young dog that’s allergic or scratching, there’s a high chance that that dog has a food allergy.
The only way and let me repeat that again, the only way and just to make sure I’ve explained myself properly, I’ll say it again, the only way that you can diagnose food allergy in a dog is by doing an elimination diet.
There are people who will have you believe that you can run blood tests to diagnose food allergy, that is totally and completely incorrect and false. It is just not possible and if you talk to any of the skin specialists, then they will tell you that as well.
The only way that we can diagnose a food allergy in a dog or a cat is to put that dog on what’s called an ‘elimination diet’.
An elimination diet means putting your dog and I’ll just say dog, I won’t say dog and cat anymore, on a diet to which he or she cannot be allergic and that means giving a protein source that your pet has never been exposed to before.
How do we do that?
There are two ways; one is home cooking and one is a commercial diet. There are commercial diets and one of the ones I like a lot that we use a lot is a product called Hills ZD.
Let me give you an example of how it works.
Imagine seeing a cathedral, so you’re walking down your local street and you walk to the local church, we’ll say church, it’s easier than a cathedral. When you see a church, then you can recognize that as a church and you can see the bricks in the wall and everything else.
Now imagine that someone has demolished that church and has laid all the bricks in a field nearby.
When you walk to that field you can only see a whole heap of bricks, you cannot recognize that as a church.
What the ZD people have done is that the food ZD is what’s called a hydrolysed food. It’s been broken down into the component protein pieces, just like the church bricks laying in the field and therefore the dog’s immune system cannot recognize that as being the protein it originally came from. I hope that makes sense.
What you would do to diagnose your pet as food allergic, is you’d either put your dog on something like ZD (there’s a couple of brands around like ZD) for eight weeks and it is a minimum of eight weeks.
If you or I were put on an elimination diet, we’d be on that for six months.
Your pet would go on an elimination diet which consists of say ZD and water for eight weeks…
I probably do a second opinion on a skin case once a week, where someone (a vet) has put a dog on an elimination diet and it hasn’t worked and what I will see is that that dog has still been getting Nexgard or a worm tablet for example and ‘it’ has beef flavouring.
If you’re giving an elimination diet and you’re giving your dog Nexgard with beef flavouring, that’s not an elimination diet, because beef is the number one allergen that we see or there’ll be some other ‘stuff up’ like a worm tablet with flavouring.
If your dog’s on an elimination diet and I’m really very simple or simplistic about this, I’ll say to people, “Hey look, water and ZD. That’s it” and I’ll say, “Don’t ring me asking me, can I give this treat or can I give that treat? Because you know the answer is going to be no. Can I give a heartworm tablet? No. Can I give a worm tablet? No. Because of the potential flavourings and it doesn’t matter if your dog misses a heartworm tablet for one month or a flea tablet or a worm tablet for one month, it doesn’t matter that much.”
If your pet is food allergic, then over those eight weeks, your pet’s allergies will subside.
If your pet has, is one of the 40 percent who has a food problem and an atopy problem, then the itch won’t totally go away, but it will subside substantially.
That’s one food thing we can do.
Now the other thing that we can do if we don’t want to use a commercial food like ZD, then we can ‘home cook’.
If you remember, I said a little while ago, that we have to find a protein source to which your dog has never been exposed previously.
A protein source that we commonly use is duck. Most dogs have never had duck before, so that’s a nice novel protein source; or goat or venison.
The problem with venison is that some dogs get tummy upsets on venison.
Another good novel protein source is fish.
We can sit down and talk together you and I and work out what your dog’s never had before and then use that protein source and we will also add in a carbohydrate source like pumpkin, potato, rice and then you will have quite a few things there that you can feed a nice meal of and you can be happy and your pet can be happy.
After the eight weeks, if your dog is better, then that proves that your dog has a food allergy.
If and I’m going to go sideways for a sec, if I had a dog that had an allergy and I had the choice between a contact allergy like Wandering Jew, atopy or any one of these other things that we’ve been talking about tonight, flea allergy, etc. – if I had a choice of choosing one, what would I choose my dog to have? It will be food allergy, because it’s so easy to manage. Once you know what your dog is allergic to, you just avoid it. So very easy to do.
Once you have been through that eight-week elimination trial and once your dog’s better, you’ve then got two choices.
“Hey, I’m happy with this. My dog’s on ZD, my dog’s on duck and water and pumpkin or whatever. I’ll just do that.”
That’s cool, that’s one opportunity.
The other opportunity or the other potential is, “Hmm, I’m a little bit curious I’d really like to know what my dog’s allergic to.”
Your dog’s on ZD or duck or whatever and then this weekend, you’d add in a bit of chicken and there are a couple of things that can happen…
- You’ve got immediate reactors and
- you’ve got delayed reactors.
Immediate reactors will react in 12 to 36 hours. If your dog’s allergic and is an immediate reactor to chicken, then within a day your dog would start to scratch madly again and you’d say, “Yep, okay cool, chicken is a problem” or you can have a delayed reactor, which is a four to five day later reactor.
This test is called a ‘challenge’. When we’re challenging your dog with new foods to see what he or she is allergic to, if you’re doing a challenge, then the way I do it is to add a new food in every seven days.
This weekend I might put in chicken, if there’s no reaction by next, what is today? Wen- Tuesday, Wednesday? If there’s no reaction by next Wednesday, next Wednesday I might add in some pork and if there’s no reaction the Wednesday after that, I may add in some beef and I would just keep doing this until one day the pet ‘reacted’.
Then I’d know that that last food is one that my pet is allergic to.
I’d then ‘wash out’ my pet by using the original diet, until all the scratching / licking / itching had stopped and then start testing more allergens.
Over time I’ll build up quite a list of ‘good’ and ‘bad’ foods.
Well – that’s it for tonight!~!
If you have any questions about itches, scratches and bites, please contact me at the Hospital and I’ll be only too happy to work through them with you.
See you next month – Diederik