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From the perspective of January, March seems like a warming glow in a near-future sky. I hope my expectations are fulfilled and by the Spring equinox life and light are restored. Note the use of ‘hope’ and ‘expectation’ in the same sentence! Anyway, let’s stay positive and see what’s dished up. What is predictable is the need for Dermatology support. 10-15% of the pet population suffers from itchiness caused by environmental allergens!
So what are these environmental allergens? They are the return of pollen to the air, tree pollens starting early, especially hazel, elm and willow with beech and oak, ash and birch not far behind. Weed and grass pollens follow later on in the spring and early summer, with some weed pollens lasting until October. Hay fever sufferers are all too familiar. Nature’s bombardment of their immune systems and the resulting misery of inflamed eyes and nose, not to mention the complication of asthma. At least antihistamines and inhalers provide some relief in humans.
The situation in cats and dogs is similar, although skin itchiness replaces hay fever. Whilst dogs don’t get asthma, cats do. “Atopy” is the term used to label a group of chronic, inflammatory skin disorders that are caused by the immune system reacting to environmental allergens, including food. So, do you own an itchy pet? Millions of people do as 10-15% of the UK pet population get itchy, often really itchy, particularly in spring and summer. Their owners are well aware of this pattern of itchiness. It causes many trips to the vet in the warmer months and the accompanying expense of trying to control the symptoms.
Research has shed more light on canine and feline atopic diseases in recent years. It’s been driven by pharmaceutical companies attracted to the huge number of pet patients that need treatment. Sometimes year-round and lifelong. Unfortunately, it’s not just pollen that causes problems. Fungal spores and house dust mites are also well-known allergens. Exposure is greatest in the winter months when pets and owners spend more time indoors.
So what do we know now that we didn’t 40 years ago? I guess it’s a greater understanding of the interplay between genetics, the environment and the characteristics of the individual that influences the risk of developing atopic skin disease. Not as though this helps us much in prevention or treatment! What does help is the modern approach of topical treatment rather than the steroid/antibiotic combinations. These were used exclusively in the past. We now think of the bacterial skin infections that complicate many atopic cases as “dysbiosis” of the skin, an imbalance in the normal ‘microbiome’ of the skin, directly analogous to the population of microbes in our guts. We also now know that the barrier the skin represents is deficient in atopic individuals, allowing allergens to penetrate and trigger inflammation.
Last week a little white cat called Snowdrop came into the clinic with her neck covered in a bandage. No wonder the owner was upset as when we peeled off the protective layers, poor Snowdrop’s neck was red-raw. This is a classic and dramatic presentation of one of the ways cats display atopic skin disease. It is called an eosinophilic plaque. (An eosinophil is a type of white blood cell involved in allergy). There are plenty of different patterns that atopy presents in cats. For example, overgrooming flanks or tummies, chewing feet or rubbing ears. Some cats will appear to suddenly pounce on a part of their body like a flea has just bitten them. Providing flea treatment is up to scratch (can never resist a pun) then atopic skin disease is most likely for cats with unexplained bald patches and often dramatic itchy reactions.
In Snowdrop’s case, her symptoms were classic, but I still wanted an impression smear of the area. This simply involves gently pressing a glass slide against the raw skin, letting it dry and then staining it for examination under the microscope. I was certain I would impress our student vet, Amelia! I was hoping to demonstrate the cells that cause this condition (eosinophils) along with bacteria that may be complicating the issue. Well, I must say, the slide was a beauty, every detail preserved and bacteria easily identified! Unfortunately, not an eosinophil in sight! It just so happened that our visiting dermatology specialist, Peri, was in the clinic that day seeing problem skin cases.
Peri was impressed by the slide but couldn’t see any elusive eosinophils either, putting it down to my staining technique. Bit crestfallen, I asked Peri what the best treatment for Snowdrop would be, only to be told “antibiotics and steroids”. Well, I guess what goes around comes around! We started some topical treatment, along with little rubber foot socks that cushioned the effect of Snowdrop’s back feet on her neck.
The important thing with super-itchy pets is to get control over the itchiness as soon as possible. Once comfortable, we can then switch to longer-term treatment. We now use sprays, washes, foams and food supplements for this second phase of treatment but it’s important to recognise we do not know what works for an individual until we try it. Even though two cases may look identical, they may respond to totally different treatments. And that’s the frustratingly beautiful nature of medicine in general and dermatology in particular!
Dermatology-based problems in pets extend far beyond itchy skin. They can cause extreme discomfort and affect wellbeing. Pets can’t tell us when something is wrong. This is why we need to identify those signs and seek help when required. Dr Peri is our visiting specialist for these types of cases. You can read more about her here. Our visiting specialists enable us to treat these more complex cases in-house and provide the best care to your pets.
If you have any concerns, be sure to get in touch with our team.
