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Alps, allergy and a lot more!

Avacta’s Senior Veterinary Technical Manager, Johanna Gourlay and Principal Scientist Allergy & Dermatology, Jennifer Bexley, have recently attended the European Society and College of Veterinary Dermatology in Lausanne, Switzerland.

Read all about Johanna’s trip below

 

Picture 1

The 30th Annual Congress of the European Society and College of Veterinary Dermatology, was held earlier this month in Lausanne, Switzerland. In my previous life as a non-specialised small animal practitioner, despite a keen interest in dermatology, I would have felt a little intimidated attending a focused European event such as this, incorrectly presuming it would be too academic to be practically helpful at my level. I couldn’t have been more wrong!

The congress was held over three days and each was split into three streams; Dermatology in Practice, Advances in Clinical Dermatology and the Cutting Edge Programme. This enabled you to select from a variety of subject areas and also at a level you felt was relevant. Canine, feline and equine topics were explored, as well as fascinating insights into the latest thoughts on human atopic eczema.

Three, of the many, interesting points from the lectures I attended were:

  • In children who are genetically filaggrin deficient (filaggrin is part of skin barrier) early exposure to cats was shown to increase the chance of eczema, whereas exposure to dogs decreased the risk.
  • Equine atopic dermatitis commonly co-exists with insect bite hypersensitivity (a bit like atopic dogs also often having flea allergy dermatitis).
  • In a small study of cats with idiopathic head and neck dermatitis, environmental modification (following behavioural evaluation) was successful for long-term resolution of clinical signs. The impact of stress on dermatological cases and providing a more holistic approach may be something to consider for the future. The need for a holistic attitude, in the true sense of the word, was also discussed elsewhere at the conference.

Other ‘hot topics’ of the congress included; whether helminth and other endoparasite exposure at the correct age (or in utero) provide defence against atopic disease, the importance of the microbiome and how this can be utilised in therapy and the advent of monoclonal antibody therapies. With such a diverse range of treatment options available in practice, it’s now a question of knowing which to use when, thinking of them as reactive and proactive solutions and tailoring the best option to the individual patient (and then modifying when required).

As well as the cerebral work-out, there was much fun to be had at the social events in the evenings. The welcoming ceremony was held at the Olympic Museum, which provided a stunning venue by the banks of Lake Geneva, with entertainment in the museum itself (although I was disappointed to learn I am unlikely to achieve Olympic glory in anything involving running or shooting). We even found a perfectly named chemist on the way through to the museum at the Metro stop in a place called ‘Ouchy’. The following night was the dinner dance in Grandvaux, a beautiful quaint village just outside Lausanne again overlooking Lake Geneva.

3 Combined

In summary, the content of lecture material was diverse enough to offer something for everyone and provided practical straightforward guidance that could immediately be implemented in general practice to advance your dermatology case work-ups. The atmosphere of the congress was extremely welcoming and the social events gave the opportunity to meet and mingle with the great and the good of the dermatology world. I would highly recommend attendance for anyone with an interest in dermatology and I hope to see some of you in Croatia in September 2018!

Written by Johanna Gourlay – Senior Veterinary Technical Manager

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The Allergy Threshold, Companion Animals and Me!

The term allergy threshold is often mentioned when talking about allergies in both humans and animals but what does it actually mean?

One analogy that’s been used to help explain it is the humble bucket. When there is too much water in the bucket, it spills over and that makes a mess. Nobody is worried when the bucket is half full because it doesn’t cause anyone a problem. Likewise when your allergy burden gets too high you tip over the allergy threshold and then see the signs associated with allergy for example itching, scratching or sneezing.

We used to think one allergen, be that a pollen or dust mites for example, was responsible for ‘filling the bucket’. More recently it has become apparent it is far more likely several different allergens, whether they are in our food or from the environment, each contribute to getting you closer to that threshold or point of overflow. For this reason it’s really important to try and control multiple aspects of allergic diseases. The less that goes into the bucket day to day, the more leeway you have if you suddenly get a downpour!

It is suggested that 10-15% of dogs in the UK are affected by allergic disease, and it is being recognised with increasing frequency in cats.

Although I have been mildly allergic to various things throughout my life I hadn’t considered this concept until starting work at Avacta Animal Health. But shortly after starting I experienced my personal ‘real life’ example.

The allergy threshold concept works as follows:

Allergy Threshold A

 

In this dog only environmental allergens are present and these are above the allergic threshold so clinical signs are seen. If completely controlled the clinical signs should resolve. The same would apply if food allergens were present in isolation and above the threshold.

 

Allergy Threshold B

 

The combined allergic stimulation from the environmental and food is below the threshold so no clinical signs are seen. In this case if any intermittent compounding factors such as ectoparasites or seasonal pollens were added, the allergenic stimulation could easily then go above the threshold and cause clinical signs.

 

Allergy Threshold C

 

The combined allergenic stimulation is above the threshold so clinical signs are seen. Clinical signs could be managed by either controlling dietary or environmental allergens but by only considering one aspect the pet is left close to the threshold and therefore vulnerable to compounding factors.

 

Allergy Threshold D

 

The allergenic stimulation is above the threshold so clinical signs are seen. It is not only in combination that this will occur as both environmental and food allergens individually are above the threshold. Even if one component is completely controlled there may not be a reduction in clinical signs. Both must be identified and controlled for resolution.

 

My ‘real life’ example:

I have had mild hay fever since I was a child, but nothing more irritating that a mild cough and a runny nose. I have also always been allergic to dogs and cats, but again nothing more than a slight itchiness and the odd sneeze whilst in their presence.

But last summer my then 9 year old daughter played the ‘only child card’ and said that because she didn’t have any brothers and sisters then she neeeeeeded to have a pet. We went through the various options and decided a cat would be the most sensible choice given our current circumstances, and being the fabulous father that I am I agreed even though the beast may cause me some discomfort. For the first 6 months my life didn’t change much (however, initially my wife and daughter were so terrified of a kitten tearing around the house and would lock themselves in their bedrooms!), but when spring came along everything changed.

The clinical signs of allergy manifest themselves in many different ways from dermatological signs, such as itching or repeated skin infections, through to gastrointestinal signs (diarrhoea, vomiting, weight loss). This is dependent on the allergens involved and individual response, but for me it was mainly respiratory.

I started getting breathless after going for a run, which I put down to hay fever, but eventually I started finding it difficult to breath even when I was just sitting in the living room (and not just when I was watching Game of Thrones!).

I believe the combination of pollen and cat dander had tipped me over the edge i.e. I had reached my threshold.Allergy Threshold - Gary

I went to see the doctor and he gave me an inhaler to use just before exercise or when I was having a particularly difficult time breathing. I used it for a couple of weeks, but once the pollen levels subsided the wheezing stopped. The cat dander is still there, but on its own it’s not enough to cause any major symptoms.

So that’s my experience of the allergy threshold. If you have any examples, either human or animal relates, then you can share them with us at marketing@avacta.com. If we get a few we will share them in a future blog.

Written by Gary Skipper – Marketing Manager

 

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Clinical signs associated with allergy in horses

Figure 1

Figure 1

Allergens normally considered harmless, can interact differently with the immune system of certain horses resulting in an allergic response. These allergens enter the body in several different ways (Figure1) and trigger a variety of clinical signs, which may occur singly or in combination. Because horses can exhibit such a variety of clinical signs, in response to the same allergen, it may take some serious detective work to identify the offending perpetrator(s)!

The first step in diagnosing equine allergies is making the link between the history and clinical signs. Obvious dermatological and respiratory signs can be clear to spot, and are most common, but sometimes signs may be less apparent such as a change in behaviour or drop in performance.

 

Dematological

These cases are generally divided into horses with atopic dermatitis or insect bite hypersensitivity. As noted by Jensen-Jarolim et al. (2015) “atopic dermatitis in equines is becoming a more commonly recognised disease. It is interpreted in horses as an inherited predisposition to form specific antibodies to environmental allergens such as pollens of grasses, weeds, trees, but also to mould and dust.1

Insect bite hypersensitivity is a term used to describe the condition induced by an overreaction to biting insects. The most common example is sweet itch, where the irritation is believed to be caused by the saliva of the genus Culicoides2 (midges) and can lead to secondary infection and severe discomfort compromising the horse’s welfare at times.

Figure 2

Figure 2

Interestingly, the clinical signs for atopic dermatitis can be similar to those caused by insect bite hypersensitivity and it is has been recently noted that it is extremely common for horses to have both diseases.1

It is also worth bearing in mind that adverse food reactions are in many cases also expressed as a skin issue. This is where there is an immune mediated hypersensitivity, or intolerance to a food constituent.

Clinical signs to look out for include:

  • Pruritus (itchy skin)
  • Urticaria (also known as hives see Figure 2)
  • Alopecia (patchy hair loss)

 

Respiratory

Figure 3

Figure 3

The phrase ‘equine asthma’ is fairly new and is a helpful way to describe respiratory problems to owners. Previously, terms such as recurrent airway obstruction (RAO) and chronic obstructive pulmonary disease (COPD) have been used, with summer associated versions to contend with as well. All refer to issues with the respiratory system and can present as trouble breathing, excess nasal discharge and/or chronic sneezing and coughing (Figure 3). These debilitating issues can lead to secondary problems such as loss of performance and lethargy.

Gastrointestinal

Allergy may not be the obvious first thought for cases of recurrent low-grade colic, however where other possible causes have been ruled out it may be useful to consider a food reaction. Clinical signs such as diarrhoea and weight loss can be the result of hypersensitivities and in these cases an elimination diet may help resolve them.

Behavioural 

Understandably allergies can cause horses to become uncomfortable and therefore sudden or unexplained changes in behaviour and temperament (including headshaking vices) may be a clue pointing to an underlying hypersensitivity.

 

The next step once you have identified the clinical signs:

 

Figure 4

Figure 4

If you suspect that one of your client’s horses may be suffering from an allergy it is vital a comprehensive work up has first ruled out other differential diagnoses. Serological blood testing and intradermal skin testing can then be really useful aids to diagnosis and tools to identify the offending allergens.  Avacta Animal Health recommends taking blood straight away when the horse is most symptomatic before giving any medication, or implementing dietary restrictions, which may influence the results. We offer a free three month blood storage facility to allow the diagnostic work-up to take place and give time to discuss the options with your client.

Results from a SENSITEST can be used to form a management plan; whether this be implementing different husbandry techniques (Figure 4) and /or considering a course of allergen specific immunotherapy. For more information regarding our SENSITEST or the use of immunotherapy in equines please contact our customer services team.

References:
1Jensen-Jarolim, E., Einhorn, L., Herrmann, I., Thalhammer, J.G. & Panakova, L. (2015). Pollen allergies in humans and their dogs, cats and horses: differences and similarities. Clinical and translational allergy 5:15
2Mueller, R.S., Janda, J., Jensen-Jarolim, E., Rhyner, C. & Marti, E. (2016). Allergens in veterinary medicine. Allergy 71: 27-35

Emma Kilmurray is a Customer Service Advisor for Avacta Animal Health.

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An Update regarding Feline Asthma

Feline asthma is a common inflammatory disease of the lower airway affecting approximately 1-5% of the cat population and is believed to be triggered by aeroallergens1,2. The median age of presentation is at 4-5 years of age although, it is thought many of the cats presenting at this time will already have a long-term history of the disease, so the actual age of onset could well be significantly younger2.

Feline asthma

Clinical signs are variable and are sometimes categorised as acute, where episodic severe respiratory distress on expiration is seen, or as chronic, where more persistent wheezing and coughing of various degrees of severity may be observed1. However, approximately 10-15% of cases will present with a history of vomiting or paroxysmal hacking and coughing. This may result in a diagnostic work-up for gastrointestinal conditions such as hairballs, rather than one for respiratory issues2. Some cats with a history suggestive of asthma may be asymptomatic at the time of presentation. In these patients gentle tracheal palpation will often easily elicit a cough2. The subtly of clinical signs in some cats with chronic disease means the condition can remain undiagnosed for a significant period of time. This delay allows progression of pathological changes within the lung tissue2.

Even with a thorough diagnostic respiratory investigation, discriminating feline asthma from other lower airway disorders (including chronic bronchitis and parasitic, infectious, cardiac or neoplastic conditions) is difficult which is, at least in part, why there are relatively few clinical trials into therapeutics for the disease1-3. Diagnosis is usually through a combination of history, clinical signs, thoracic radiography, exclusion of respiratory parasites, bronchoalveolar lavage cytology and response to trial therapy with bronchodilators and glucocorticoids1. Once a diagnosis has been made, allergy testing can then be used to identify allergens to which the cat is showing a hypersensitivity response2. These are then interpreted alongside the history to establish their clinical relevance. Intra-dermal skin testing and allergen-specific IgE determination by ELISA were both found to specific in a study by Lee-Fowler et al. (2009), with the conclusion being drawn that either test could be used to guide the selection of allergens in allergen-specific immunotherapy (ASIT)4.

Treatments which are typically used include oral, parenteral and/or inhaled steroids and bronchodilators. Lung function may still decline over time as these therapies are palliative in nature and do not ameliorate chronic airway remodelling2. While effective in many cats some cases will be minimally or unresponsive to the drugs, furthermore, the long-term use of steroids is contraindicated for various common feline conditions (diabetes for example) and are not always well tolerated2. Therefore, it is advantageous to consider other treatment modalities as part of the solution for this lifelong condition. When allergen identification has occurred it opens up two additional possibilities; allergen avoidance through environmental changes and allergen-specific immunotherapy (ASIT) which has been shown to be a successful treatment option for some cats5,6.

  1. Reinero, R. (2011). Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. The Veterinary Journal 190: 28–33
  2. Trzil, J.E. & Reinero, C.R. (2014). Update on feline asthma. Vet Clin North Am Small Anim Pract 44(1):91-105
  3. Moriello, K.A., Stepien, R.L., Henik, R.A. & Wenholz, L.J. (2007). Pilot study: prevalence of positive aeroallergen reactions in 10 cats with small-airway disease without concurrent skin disease. Veterinary Dermatology 18(2):94-100.
  4. Lee-Fowler, T.M., Cohn, L.A., DeClue, A.E., Spinka, C.M., Ellebracht, R.D. & Reinero, C.R. (2009). Comparison of intradermal skin testing (IDST) and serum allergen-specific IgE determination in an experimental model of feline asthma. Vet Immunol Immunopathol 132(1):46-52
  5. Halliwell, R. (1997). Efficacy of hyposensitization in feline allergic diseases based upon result of in vitro testing for allergen-specific immunoglobulin E. Journal of the American Animal Hospital Association 33: 282-288.
  6. Prost, C. (2008). Treatment of allergic feline asthma with allergen avoidance and specific immunotherapy: Experience with 20 cats. Revue française d’allergologie et d’immunologie clinique 48(5):409-413

Jo Gourlay is the Senior Veterinary Technical Manager for Avacta Animal Health.

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Common Pitfalls During an Elimination Diet Trial for Dogs and Cats

Conducting an elimination diet trial for dogs and cats while juggling owner’s expectations can be challenging. Undeniably this is often a lengthy process, but the rewards can be well worth the effort.

Dog at Vets

As a veterinary surgeon it is important to explain to owners that this is a diagnostic test in itself which needs to be carried out with total commitment. Communicating your expectations to the owner and ensuring their understanding will hopefully result in a higher level of compliance.

Getting a definitive diagnosis will mean, that in most cases, an effective lifelong treatment plan can be put in place which is both convenient and affordable for the owner. Making your clients aware of potential pitfalls, such as the ones in the list below, will give a greater chance of success!

Common mistakes during a diet trial:

  • Giving treats – if the owner wants to continue to give treats suggest having a container with a small amount of the approved food in it for those moments when they want to give a reward.
  • Flavoured medication – owners should avoid tablets and other medications which contain a protein based covering or flavouring to aid palatability.
  • Other potential sources of allergen – list with the owner everything else the pet normally consumes as they may not assume these are included, for example; supplements, dental or rawhide chews, pigs ears, bones or anything used to coat the inside of chew toys.
  • Accidently contaminating the diet – owners must take great care to wash bowls, serving scoops and their hands before preparing food to avoid stray proteins being passed on. It is also worth changing to a ceramic or glass bowl if the clinical signs are predominantly around the muzzle and face in the (albeit unlikely) chance of a contact reaction with the bowl.
  • Children dropping food – removing animals from the dining area at meal times and making sure any spills are cleared up straight away is important.
  • Cats going to other houses and being fed by neighbours – making neighbours aware of the diet will help. The owner may also wish to invest in a bright coloured ‘do not feed me’ safety collar and tag if a collar is appropriate for their cat.
cat eating grass
  • Someone else looking after the animal – making sure that kennels, dog walkers, pet sitters and friends and relatives who visit, all understand what food is to be fed will ensure the diet is strictly kept to. The more people involved the greater the chance of a lapse.
  • Stealing food from work tops, bins or raiding feed stores – keeping all kitchen and dining areas clean, general waste bins inaccessible and all cupboards and feed bins secure will help avoid mishaps.
  • Eating something out on a walk / while out of house – keeping dogs on leads while walking will help prevent this. Putting a bell on a cat (if appropriate and safe to do so) will make hunting more difficult. In addition keeping them inside at natural hunting times (dawn and dusk) may decrease hunting activity.
  • Having more than one animal in house – separating pets at meal times and cleaning out bowls afterwards will stop animals eating food intended for other pets.
  • ‘Non believers’ in the house sneaking a snack – it is really important that everyone involved is on board. Owners should sit down and explain the ‘rules’ and why the diet trial matters (the impact the condition is having on their pet) to all family members and friends who live there, visit the house or have contact with the pet.
  • Stopping too soon – some animals can take eight weeks or longer to show a positive response to a diet trial, so owners must understand the importance of persevering right through to the agreed end date. Gastrointestinal signs usually improve faster than skin signs so a positive improvement in the gut can be helpful in persuading owners to keep enduring.

A list of common mistakes can be downloaded here which can then be printed off and handed out to clients.

dogscratch2

The re-challenge!

Owners must understand the need for a re-challenge of the diet, the improvement could just be coincidental and caused by something totally unrelated to the diet. This is something which many pet owners are not keen to carry out for obvious reasons, but it is the only way to confirm a diagnosis.

Brief the owner before so they feel prepared and reassured about what will follow. Talk them through what plans are in place in case the animal flares up so they feel like they are one step ahead.

Supporting owners from start to finish

  1. Starting the process by running a SENSITEST for your client will help to select suitable foods for an elimination diet.
  2. Talking owners through the rules of the trial and the reasons for it will help keep them going through the challenging moments.
  3. Regular check-ups or phone calls to monitor progress will help to keep motivation high and iron out any problems along the way.
  4. Provide details of a specific named person to contact at the practice if they have any concerns or for general advice and support.
  5. Having nurse led allergy clinics where owners can drop in for support would help offer a guiding hand all the way through the trial.

 Supporting you from start to finish

We know that there are never enough hours in the day so our customer services team are always on hand to offer you and your clients extra advice relating to diet selection.  They can also help you in setting up a nurse led allergy clinic at your practice, to give added time and support to owners.

If you are interested in running a test or speaking to one of our advisors please contact Customer Services.

Emma Kilmurray is a Customer Service Advisor for Avacta Animal Health

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Help with Explaining the Clinical Signs of Allergy in Dogs and Cats to Clients

There are several common clinical signs associated with allergy in dogs or cats, but what is the best practise for veterinary professionals when explaining them to pet owners?

Pet Allergy Week was launched on Monday and over 500 veterinary practices, up and down the country, have signed up to join in the campaign to increase clients’ awareness of the clinical signs of allergies within companion pets, whether it be from environmental factors, food or signs associated with secondary bacterial and yeast infections where a little encouragement is needed to help owners hunt for an underlying cause.

As part of the campaign Avacta Animal Health developed a dog and cat character (named in our BSAVA competition as Fred and Ginger) to help veterinary professionals educate pet owners as to what to look out for if they suspect their pets has an allergy.

A challenge of all professionals is how to explain complex problems to clients in layman’s terms, especially when the diagnostic process and treatment is also far from simple as well as being time consuming and costly. Even if you missed out on signing up to PAW, the following information may come in handy for future consultations with your clients.

When and how?

The first thing pet owners need to consider is when and how the clinical signs occur. Allergic disease in dogs usually first appears between 6 months to 3 years of age. In both species the clinical signs may start seasonally which can give clues to the potential allergens involved, but might then progress to become a year round problem and it is possible for signs to both increase and decrease in severity over time.

Gastrointestinal signs

gastro wobbler

Gastrointestinal signs associated with food allergens can be allergic (IgE mediated) or could be an intolerance or occur through another non-immune mediated mechanism. Reactions can manifest themselves in many forms from a softening of stools and the excretion of mucus to any of the other listed clinical signs below. It’s worth probing to get as detailed a general and dietary history as possible, as many owners will refer to any GI upset as just diarrhoea or vomiting, which could be easily attributed to many other commonly seen conditions (these do need to be ruled out first).

    • Colitis
    • Gastroenteritis
    • Tenesmus
    • Borborygmi
    • Weight loss
    • Reduced appetite

Ear problemsears wobbler

Ear problems are usually one of several presenting clinical signs when hypersensitivity to an allergen is present, however some dogs present with only recurrent otitis externa. Owners may not think of allergy as a potential cause when all they see are itchy, sore and hot ears or notice certain behavioural changes in their dog such as constantly rubbing their ear on the ground.

Skin problems

Itchy, hot, red skin is often how owners describe their pet especially when secondary infections or ectoparasite infestations are present. However, the itchiness is only the tip of the iceberg. If left untreated, chronic cases can develop alopecia, excoriations, lichenification and hyperpigmentation.

For cats, some of the signs of allergic skin problems are very different to dogs and less predictable so owners may be less likely to make the connection to allergy. Symmetrical alopecia (which can also be caused by stress), lesions on the lips and erosions or ulcerations on the chin or neck (sometimes caused by eosinophilic granulomas) can all be seen.

skin wobblerPaw chewing, over grooming and constant face rubbing are all behaviours of self-trauma also associated with skin problems which can cause secondary damage.

Secondary bacterial and yeast infections

Secondary bacterial and yeast infections, commonly caused by Malassezia and Staphylococci, can cause pyoderma and the variety of skin lesions associated with this (e.g. pustules, papules, and epidermal collarettes). Clients may simply describe this as smelly, spotty or scabby skin.

Respiratory signs in cats

If an owner’s cat is suffering from a persistent cough, wheezing, sneezing or is having difficulty breathing it is worth keeping feline asthma high on the list of differential diagnoses.

respiratory wobblerOf course, as most of the clinical signs listed above can also be caused by other conditions it should be explained to clients that the alternatives to allergy should be eliminated before allergy testing commences.

Free blood storage

Avacta Animal Health provide a free storage service for blood/serum samples for up to 3 months if other causes need to be ruled out before allergy testing commences. This allows blood to be taken when the animal is most symptomatic before any medication has been given or a food trial is commenced. For further information contact customer services.

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10 TIPS TO HELP WITH THE CONTROL OF ALLERGIES IN HORSES

 

When a horse is found to be hypersensitive to a particular allergen, regardless of whether this is found in culicoides saliva, lurking in a dusty feed bin or is airborne such as a grass pollen, the most logical solution to prevent the horse reacting to it is to avoid the allergen in question. This sounds great in theory but in reality can prove a little more challenging. The tips below are designed to offer some both strategic and practical ideas that horse owners can implement to reduce exposure and help control the clinical signs.

Insect bite hypersensitivity

Horse in rug CircleFly-proof garments

Creating a physically barrier with fly-proof garments can be helpful. Knowing your enemy is beneficial here as certain insects will attack the belly or legs, whereas others target the ears or face. Within the culicoides species alone you find location preferences and variable clinical signs as a result. You can then provide strategic accessories to a fly rug such as ear nets, face masks, belly bands (to ensure the ventrum has no sneaky gaps) or tail covers. Make sure these fit properly as if too big or small they won’t work well and may rub, leading to additional problems. Face masks may need some tactical extra securement like attaching to the head collar (as long as this is safe to do). All garments should be changed frequently, hot weather combined with soiled material against the skin is a recipe for secondary infections.

Fly prevention

Check that fly prevention products are true repellents (>2% permethrin if this is the active ingredient) not just insecticides and also what residual efficacy they have. How much does the product adhere to the skin and will rain, sweat or UV exposure render it much less effective? Frequent reapplication is normally required. Following the manufacturer’s instructions for general good coverage, also target in particular any areas especially relevant to the flies known to be a problem. For head shy animals, and to avoid direct contact with the eyes, squirt sprays onto a cloth before application or use roll on products or creams for the head and ears to ensure this area is also well covered.

Turnout schedule

Modify the horses turnout schedule to minimise exposure to the type of flies causing the problem. For culicoides this means stabling when they are most active (dusk and dawn) but other flies are most bothersome in broad daylight, such as Stomyxs calcitrans (stable fly) or Tabanidae spp. (horse fly). Avoid fields with standing, stagnant water (slow running streams or muddy banks count too) where flies are more likely to breed. If you are in a hilly area chose the highest windiest field!

Stabling environment

You can improve the stabling environment by installing fine-mesh screens to keep insects out and also set up strong fans (if possible safely) in front of the stable, or entrance and exit points, as culicoides struggle to fly in wind. Turn lights off when possible at night as this will attract flies. Finally, consider sticky fly tape on the ceiling or fly traps which can also help you monitor the number currently hatched in your area.

General yard maintenance

General yard maintenance, such as removal of manure and also standing water when possible, disrupts insect breeding and will help reduce their numbers. Encouraging seasonal fly eating birds such as swallows and house martins is a novel approach!

 

Other environmental allergies

white horse in stable CircleIndoor allergens

If indoor allergens are suspected turn the horse out as much as possible. Source good quality forage with minimal dust and mould. Feed forage from the ground so the inhaled particles drop downwards rather than into the airways. Haylage or bagged grass is usually a better option than hay, if only hay is available soaking or steaming it will help minimise the dust.

When stabling is necessary low dust bedding for the affected horses stable and all other stables within the same airspace is a good idea (ideally they should not be fed dusty hay either). Ensuring adequate ventilation is also very important.

Storage mites

For storage mites always empty the feed from the original packaging into resealable plastic containers discarding the dust at the bottom of the bag. Clean these plastic containers regularly, again discarding any dust at the bottom and always do this before adding new feed. Keep the feed in dry, cool conditions. Wipe the horses muzzle with a damp cloth after finishing hard feed to remove any food residues.

Dust mites

Dust mites can take up residence in horse rugs so it is advised, if these have been identified as an issue, to frequently wash and dry the rugs on a hot wash ideally drying them in the sun afterwards (not always easy in the UK in winter) as mites struggle in hot/dry conditions. Old rugs are believed to often house both live and dead mites so before putting them away for the summer clean thoroughly as previously described and store individually in either an airtight container or sealed plastic bag.

Outdoor allergies

If a horse’s outdoor allergies are aggravated by the pollens of summer pastures, when the pollen count is high move the horse inside. Again the devil is in the detail, if you know what to avoid there may be certain hacks you can steer clear of while particular crops are in flower. Using a pollen net or face mask may be beneficial.

Concurrent allergies

Check for concurrent allergies. It is now thought that the allergy threshold in usually made up of multiple different allergens rather than one single allergen. The more relevant allergens you tackle successfully the better the chance of getting below the threshold and the horse becoming asymptomatic. Avoidance and reduction of exposure to allergens, while playing an important role, is usually just part of the solution in helping control allergies in horses.

If you are a veterinary surgeon and you’d like to discuss other components such as allergen-specific immunotherapy please contact us for more information.

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Pet Allergy Week 2016 – Harvey MacKay Case Study

Harvey 3 CircleHarvey suffered from repeated bouts of otitis externa, with occasional mild dermatitis and pruritus since January 2016. He was on Prednisolone treatment that helped to control the inflammation in his ears however, his owner didn’t want him to be on the steroids long term. Therefore Harvey’s blood was sent to Avacta Animal Health for a Complete Plus allergy test during PAW in June 2016. By using the results from SENSITEST Harvey started on immunotherapy and his diet was adjusted.

Click HERE to read the full story on Harvey’s PAW success story.

 

Therapy Guide of Dogs with Skin Allergies

Therapy imageAvacta Animal Health has published its latest aid for clients – ‘Therapy Guide for Dogs with Skin Allergies.’

The DL leaflet has been design to specifically help dog owners:

  • understand the treatment choices for dogs diagnosed with an allergic skin condition
  • explore both avoidance techniques and therapies
  • manage potential flare-ups
  • consider the pros and cons of each therapy through a direct comparison

Copies of the leaflet will be distributed in May to practices who have registered for our Pet Allergy Week pack. Alternatively, a PDF version can be downloaded here.

EQUINE ALLERGY

THE GROWING ACCEPTANCE OF TESTING AND SUBSEQUENT TREATMENTS

HORSE HIVES circleBoth allergen-specific immunotherapy (ASIT), and the use of environmental serological testing as an aid to the diagnosis of atopic dermatitis, are clinically well accepted within canine practice 1. This is not currently the situation for equine allergy cases, although ASIT in horses is becoming a much more accepted and frequently conducted treatment, with the benefits discussed at the World Congress of Veterinary Dermatology in Bordeaux last year 2,3.

Dr. Yu, who presented in Bordeaux, wrote in the proceedings of the American Association of Equine Practitioners convention 2015, these take home messages; 1) “Treatment of equine allergies requires a multi-modal approach including environmental control, topical, and systemic therapy, and allergen-specific immunotherapy”. 2) “Allergen-specific immunotherapy should be considered for all presentations of equine allergies including hives, heaves, scratches, and head-shaking as it is a cost-effective weight independent treatment option that is not banned by the FEI, has minimal adverse effects, and may eventuate a cure”.4

To enable ASIT, and also allow targeted avoidance, problem allergens first need to be identified. Much of the recent literature states that either serological testing or intra-dermal skin testing are acceptable methods for equine allergen detection in atopic dermatitis, respiratory allergies and insect bite hypersensitivity (IBH).2,5,6,7

Similarly to canine allergy diagnosis, judicious interpretation of either test result is critical as Marsella (2013) states; “the single most important aspect in formulating a successful immunotherapy is not which test is used but how the allergens are selected (i.e., emphasis is placed on correlating the results with the seasonality and environmental exposure of the individual patient to increase the likelihood of including clinically relevant allergens among the ones that tested positive”)8. With the recent advent of more relevant allergens available through our serological test (UK and Northern European panel), it is hoped more horses will now benefit from ASIT.

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(1) Olivry, T., DeBoer, D.J., Favrot, C., Jackson, H.A., Mueller, R.S., Nuttall, T & Prélaud, P. (2015). Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee
on Allergic Diseases of Animals (ICADA). BMC Veterinary Research, 11:210
(2) Mueller, R.S., Janda, J., Jensen-Jarolim, E., Rhyner, C. & Marti, E. (2016). Allergens in veterinary medicine. Allergy 71: 27-35
(3) Loewenstein, C. & Mueller, R.S. (2008). A review of allergen-specific immunotherapy in human and veterinary medicine. Veterinary Dermatology 20(2): 84(15)
(4) Yu, A.A. (2015). Treatment of Equine Allergies. In: Proceedings of the 61st American Association of Equine Practitioners convention, Las Vegas, 2015
(5) Fadok, V.A. (2013). Update on equine allergies. Vet Clin North Am Equine Pract. 29(3): 541-550
(6) Jensen-Jarolim, E., Einhorn, L., Herrmann, I., Thalhammer, J.G. & Panakova, L. (2015). Pollen allergies in humans and their dogs, cats and horses: differences and similarities. Clinical and
translational allergy 5:15
(7) Stepnik, C.T., Outerbridge, C.A., White, S.D and Kass, P.H. (2012). Equine atopic skin disease and response to allergen-specific immunotherapy: a retrospective study at the University of California
Davis (1991-2008). Veterinary Dermatology, 23(1):29-3
(8) Marsella, R. (2013). Equine allergy therapy: Update on the treatment of environmental, insect bite hypersensitivity, and food allergies. Vet Clin North Am Equine Pract. 29(3): 551-557