This week on Speaking of Pets, we’re joined by our host, Cleveland-born veterinary dermatologist, Dr. Alice Novotny Jeromin, to tackle a topic that plagues countless dogs and cats—allergies. From itchy paws and ear infections to bald bellies and mysterious skin flare-ups, Dr. Alice breaks down how allergies show up differently in pets, when they typically start, and why cats definitely aren’t just “small dogs” when it comes to allergy!
Co-host Janet brings the relatable questions every pet parent has:
- How can you tell if it’s really allergies—or fleas, food, or something else?
- Are allergies contagious?
- What age do dogs and cats usually start showing symptoms?
- And what’s the deal with “allergy shots” for pets?
Dr. Alice dives into everything from genetics and breeds prone to allergies, to immunotherapy options like shots, drops, and even cutting-edge creams. She also shares safe, non-drug solutions—like omega-3 supplements and managing pollen exposure—to help pets feel more comfortable and keep that human-animal bond strong.
Whether you’ve noticed your dog constantly licking their feet or your cat over-grooming their belly, this episode is packed with practical tips, fascinating science, and a few laughs along the way.
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All footage is owned by SLA Video Productions.
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Listen to the podcast here
Help Your Pets Stop Scratching With Allergy Tips – Dr. Alice Novotny Jeromin
Welcome to Speaking of Pets. I’m Dr. Alice Novotny Jeromin, a board-certified veterinary dermatologist.
I’m Janet Novotny King. I’m the doctor’s sister. I am not medically trained in anything. We’re happy to have you here because we’re here to bring you some fact-based information to help you be the best pet owner and lover that you can be. I’m your average pet owner, lover, and rescuer. I ask all those questions that you’re dying to ask your own veterinarian. Here we are. We have a very special guest. Why don’t you tell us about that guest now?
Who is that?
That’d be you. It would be our own Cleveland-born and raised Dr. Alice Marie Novotny Jeromin.
It keeps on going and going. Thank you.
DVM.
Not DMV. That’s the motor vehicles. They give you a real hard time.
I have no initials after my name.
That’s okay. I thought we would talk all about allergies. It’s summer. The grass pollen, at least in Ohio, is horribly high. We went through tree pollen in the spring, grass in the summer, and weeds are coming up now. I thought we would talk about pet allergies in both dogs and cats. Janet, I know you have a lot of questions from the viewers. Let’s get started.
First of all, is it true, and this might not be the correct statistic, that 75% of pet issues are dermatologically or allergy-related?
According to some statistics, it’s the number one reason why people bring their pet to the vet or dermatologist. Gastrointestinal is the second reason. Sometimes, they have both.
Gastro makes sense to me because I have a chewer.
We don’t know what’s going down there. At 2:00 AM, you’re hearing the slurping of the feet, the scratching of the ear, or the rubbing on the floor. The sad part is that it’s not only that the pet, be it a dog or a cat, is uncomfortable, but then we get a little short-tempered. “Stop that.” It ruins that lovely bond that we have with them. We all hate to see our pets suffer. Janet, I know you and I have allergies. You’re miserable. You don’t want that for your pet. They don’t live as long as we do. We want every day for them to be a wonderful day.
PS, I don’t want to have to keep watching the couch slipcovers where they rub their eyes along it. It drives me nuts.
All about you again.
Allergies In Cats And Dogs
Let’s start with this. I might be right or wrong on this. The puppies don’t have allergies. Isn’t there an average age at which a dog or cat starts to get these allergic reactions? You’re sailing right along, and then all of a sudden.
Let’s start with dogs first. As I tell people, cats are not small dogs. We’ll talk about cats a little bit later.
They are completely different.
We know cats like to mix it up and do whatever. Dogs have a pattern. First of all, allergy in dogs is dermatological. That’s why a veterinary dermatologist is also an allergist. In human medicine, you go to an allergist separately from your dermatologist. The reason they’re combined in veterinary medicine is that when a dog is allergic, they manifest signs in their skin. As far as not coughing, runny eyes, and a runny nose, that’s pretty rare. They usually get ear infections.
They rub their face, they lick their feet, or they rub their butt. When you think about it, it’s the non-haired areas of the body because you’re absorbing what you’re allergic to, say pollens, molds, or dust mites, across the skin. There’s not much hair on the underside. To address your question, an allergy in the dog is called Atopy. It’s called that by the Latins because they saw the same disease in the same generations of people.
That was very strange. We’re going to call it atopy, which means it’s genetic. The problem is that when you get a twelve-week-old puppy, they don’t manifest an allergy until at least 6 months of age to 3 years of age. We used to say 1 to 3 years of age, but after many years in practice, I can tell you I would see some six-month-old puppies that I knew were becoming allergic.
This happened to my friend. He had a rescue, Rosie. All of a sudden, when she turned four years old, it was the paws and her belly. I said, “Get her to an allergist.” It was a seasonal allergy. She was treated, but it came on. She had been healthy as a horse.
The genes can turn on. Sadly, that’s true for us, too, but we tend to outgrow our allergies. I know you have an allergic husband and an allergic son. I’m going to throw cats in here, even though I told you we will talk later about cats. Dogs and cats get worse as they get older. We want to nip this in the bud. You’re not going to cure a genetic disease. We want to get them under control, some safe medications, or maybe incorporate a diet. We’ll talk about that a little bit later, natural things you can do versus all the drugs that are out there. We’ll talk about the pros and cons. They start anywhere between 6 months and 3 years of age.
Having said that, say I have an eight-year-old black Lab. Never itched, never had an ear infection, and never licked his feet. Remember, face, feet, or butt, any one of those, two of those, or all three. He’s itching like crazy. Chances are that’s not an allergy because he’s eight years old. He’s had eight years to become allergic. Chances are, he was exposed to some fox with scabies, or he’s got fleas or another ectoparasite. If you have an older dog and they’ve never itched before and they’re itchy now. Allergy is on the back burner. It’s possible, just like anything’s possible, but it’s not likely.
Let’s get back to felines, to cats. When do they start getting that allergy?
First of all, cats can look one of four ways. We call them bald bellies. They lick their hair off their belly. They rub their face and get infections on their face. They get something called miliary dermatitis, which is little crusties all over their body. The fourth thing is they get an eosinophilic granuloma complex. That means there’s a cell called an eosinophil, which is an allergy cell. That makes little nodules on their body or makes a big fat lip. We called it a rodent ulcer because back in the day, they’d get this big fat lip. People thought, “They bit a rodent. They bit a rat.” No, it’s a sign of allergy.
Supercalifragilisticexpialidocious.
Cats are miserable because they’re closet itchers.
They like to be clean.
They lick, and then they can cause more harm to themselves because they have that rough tongue. They don’t start from 1 to 3 years of age. They can start at any age. Middle age, 5 to 7 years of age, is the most common age for cats to start. I do have to add one more thing. I have two Golden Retrievers, and I have gold cats. I don’t know how that happened. Everything around here is gold except my bank account.
Gold cats, at least in my years of practice, seem to be more allergic, such as Gold containing cats, gold cat, tortoise shell cat, and calico cat. I’m not sure if the color is associated with the gene for allergy. I’ve seen gray cats, black and white cats, and black cats all allergic, but when I see a gold cat coming in for the first time, and I’m reading their vet’s history that they send. I’m thinking, “I bet we’ve got an allergic cat.” One more thing. There’s a new term for an allergy in cats. It’s not called atopy. I used to call it Catopy.
It’s called Catopy.
That’s my creation. It’s called atapurr. It’s FASS, feline atopic skin syndrome. Every once in a while, smart people have to rename stuff. They renamed it that because they think the underlying mechanism is different from that in dogs. We’re not going to go into that. It’s the same tomato, tomato, the same disease.
How To Know If Your Pet Has An Allergy
How do I know if my pet might have an allergy? You said the butt in dogs.
There are other signs besides the ears, feet, butt, and the underside. Sometimes, they have ear infections that keep coming back. The deal with that is you’ve got to jump on that because the more inflammation you have in that ear, the ear canal swells up, and it shuts off that ear. Can you imagine having the worst earache you’ve ever had in your life?
The more inflammation pets have in their ear, the ear canal swells up and shuts off that ear. Share on XIf you’ve been in your vet’s office, mine has a model of the ear canal.
It goes down.
You can put your whole hand in there. That thing is huge.
The other thing, our ear canal goes straight in. Your ear canal goes down, and then there’s a sharp turn. We don’t take those lightly because when you have a recurrent ear infection, we have to get to the bottom of that. That could be environmental allergies, atopy, or it could be food allergy. The other thing is that your dog can get skin infections. We call it pyoderma. Pyo means pus. Derma means skin. It is pusy skin.
It sounds like a sports team.
It is an infected sports team. You don’t want to go barefoot in that locker room. These are little crusty round patches. People think it’s a ringworm. It’s not. It’s a bacterial infection. Ringworms in dogs are pretty rare. Bacterial infection is all the time. You get a dog. They get this recurrent bacterial infection. Why do they have this? It is because when you have the gene for allergy, your skin’s immunity is not right. The normal bacteria on your skin aren’t quite right to fight off other bacteria coming in. These dogs get a lot of bacterial infections. For the most part, they’re not contagious. They didn’t pick this up anywhere. They have it because their skin immunity is compromised.
A couple of questions. Are these skin allergies not contagious to humans?
No.
The fleas could go onto a human.
Yes, they give us horrible diseases, which we talked about.
We don’t like those. Is an allergy different in humans than in pets?
Yes.
Do we get more runny eyes and nose?
We get more respiratory or eczema, and we grow out of it. Dogs and cats grow into it. It’s much easier to control a pet, be it a dog or a cat, when they’re starting with an allergy to get them onto a program to either desensitize them, which we’ll talk about or treat the symptoms, which is not my preference. Say they’re rubbing their face 365 days a year because they’re dust mite allergic. It is because dust mites are everywhere in your home.
Humans grow out of allergies. Dogs and cats grow into it. Share on XIt’s in upholstery, bedding, carpet, and mattresses. It’s all year round. Worse in the dark times of the year, however. They’re scratching. That skin gets elephantitis. It gets what we call lichenified. It’s hard to thin that down. Your skin has its own immune system. When you keep repeatedly excoriating it, you’re destroying that normal skin immunity.
How To Treat Seasonal Allergies
I bring my pet in, and they have seasonal allergies. What does a veterinary allergist do? What do you prescribe?
First, I make sure it’s not anything to do with fleas. Before you can tell the owner that this dog has allergies or is atopic, I need to make sure it’s not fleas, because fleas can give you the same amount of itching, rubbing, and that kind of thing. I have to make sure it’s not scabies, which is often mistaken for an allergy, and that it’s not some other kind of parasite like walking dandruff. I’ve ruled that out. It takes me about five seconds to do that because I’m combing and looking at things under the microscope.
You can see the fleas and the scabies.
I can see flea dirt. Most people don’t know that flea dirt is digested flea blood. It’s a little speck, like a little pepper. I put it on a wet paper towel. Guess what that blood does? It makes a stream of blood. I knew it wasn’t dirt. It was flea poop. We got a flea problem here. Here’s the bad part. When your dog has environmental allergies, fleas like them. Flea allergy is more common in pets that have other allergies.
It’s a two-for-one. First, I make sure that it’s not any fleas or cheyletiella, which is walking dandruff, or scabies. We then talk about how old the dog was when this started. There are certain breeds that are prone, all the Retrievers, the Shepherds, the herding breeds, and now the Poodles. There’s almost a breed that doesn’t have it anymore, sadly. At what age did this start?
A lot of the dermatology appointment is talking to the owner and finding out all this information. We decide what we are going to do about this? Also, is the time of the year when the dog is affected the same time every year? Once you’re grass allergic, it doesn’t go away. You get allergies to more things each year. It used to have it in the fall, but now it’s summer and fall. Now, it’s spring, summer, and fall.
It is the whole cycle.
We have to talk. What is right for that owner and that dog? My preference is to find out what they’re allergic to. We’ll either do some skin testing or blood testing, then let’s desensitize them. That is the safest way to do things. It’s the least expensive way in the long run. There’s a chance for a cure. This isn’t treating a symptom. This is treating what’s wrong in allergy. What’s wrong with allergy is that your skin’s immunity is off. Your skin’s immunity is working too hard against what’s going on with you.
I will tell you with my two humans, immunotherapy works.
We call it immunotherapy. I like to call it desensitization because most people understand that word. Let’s talk about immunotherapy. You can either give the dog an allergy shot, which is for the life of the dog. We used to start ours once a week. What is in that shot? It’s not cortisone. It is made up of what the dog is allergic to, such as oak trees, Junegrass, ragweed, or what have you. That’s determined by the skin test or the blood test. That’s immunotherapy.
Do you have to knock the dog out to do the skin test?
I didn’t, believe it or not.
You just do a little.
Yes. They’re very good for that. Being a former pharmacist, I don’t like to use drugs if I don’t have to. There’s always a chance that the dog’s going to have a reaction to that sedative. Most dogs that came to see us are happy. They’re jumping in the door and jumping on all of their owners and us.
I have to tell you. When my son had the testing done, he was probably in 2nd or 3rd grade. They did it on his back. He had his Game Boy. He’s playing. They did all those pricks. It was no big deal.
In dogs, we inject a little bit into the dermis. It’s called intradermal. Personally, I like to do skin and blood testing together because that gives me the most information. I want to put everything in there to cover their allergies. We can either put them into a shot, which they would give. In our office, we did it once a week. We teach the owner.
Do you do it once a week, and then it tapers off? We were going once a month. It was no big deal.
Let me tell you. My technician had her Boxer. Her Boxer’s name was Pretzel. Pretzel was mold allergic. Jan lived right next to the reservoir in Akron. It was pretty moldy around her property. As we all in veterinary medicine do, she forgot to renew the allergy shots. He was on it for three years. She told me, “I forgot to renew Pretzel’s allergy shots, but she’s doing great. It’s been a year.” I said, “Let’s keep going then. Don’t renew it. If she flares, we’ll start again.” That was the cure.
That’s what happened with my son and my husband.
Remember, they also grew out of it.
We have all the adenoids and all that taken out.
That’s true, too. We do allergy shots once a week. We teach the owner. The other way is that the company puts what they’re allergic to in an allergy drop. That’s called sublingual. You have this little bottle. You pump twice a day. It is about the same efficacy as the shot. There’s something brand new, which I ordered for my Annie. It’s called transdermal immunotherapy. She’s allergic to putting it in a cream. You put a little bit on the ear. That’s every day, but I’m fine with that. It’s very new. There have been a few studies on it. It looks pretty good to me, or I wouldn’t have started my own dog on it. We’re looking forward to having them on the show and talking about this.
Think about all these patches that are out there. There are patches for insulin. There are patches for cessation of smoking and nausea. It’s pretty cool.
We will talk about cats a little bit, but imagine transdermal in a cat. Although I will say weekly allergy desensitization shots work fabulously. It works better in cats than in dogs. I will tell you this, and I’ve mentioned it before. When I say, “We’re going to start your cat on a shot once a week,” people have to sit down. They turn away.
I know. I’ve been there.
You gave yours twice a day of insulin. I told you about our local police officer. We were showing him how to give his cat the shot, and he almost passed out. Jan, my technician, the one who owns Pretzel, said, “You carry a gun, and you can’t even give your cat a shot.” He would bring the cat in once a week. We’d give the cat a shot. Believe it or not, if I had the choice of giving my cat a shot once a week to desensitize, as opposed to a pill once a day.
I agree especially because my Atticus doesn’t like me.
May I just say this while we’re on this subject of cats and shots? A lot of cats that have allergic symptoms, be it flea allergy, inhalant allergy, atopy, or what have you. Your vet will want to give them a long-acting Depo shot. Depo stands for Depo-Medrol. It’s a long-acting cortisone shot. If your cat is maybe having problems six weeks out of the year, I don’t have a problem with that.
If they are allergic all year round, I can tell you that the Depo shot can set them up for heart failure or diabetes. We cannot keep doing the long-acting repeated cortisone shots in cats or dogs, for that matter. I would never do that long-acting cortisone shot in an older cat. I’ve seen it throw them into diabetes. FYI, in my experience wanting the safest for your pet. That’s immunotherapy, oral, transdermal, or injectable.
Non-Drug Treatments For Pet Allergies
What are some non-drug things that I can do?
There’s a lot of misinformation out there. Remember, a lot of these herbal companies, there’s not a lot of studies behind them. When I say herbal, I also mean supplements. The one that we know has some validity is fish oil, Omega-3 fatty acids.
I squirt that on Libby’s food.
It also works. Remember, it’s an anti-inflammatory. We use it for arthritis. We use it in heart disease. In allergy, there are studies to show that it can be effective, especially when used with other things like an Omega-3 fish oil capsule with an antihistamine or Omega-3 fish oil with Apoquel, another drug for allergy, which we’ll talk about. You can get a diet that is high in Omega-3s as well.
My caution about fish oil in the dog or cat is to start low because if you put them on an oil, I guarantee they can either have vomiting or soft stool. I’d say the average dose is about 50 milligrams per pound. I’ve got Gidget lying here. She’s 50 pounds. Fifty times 50 would be over 2,000 milligrams a day. You would never start with that. I would start low and build up. The doses of fish oil that are being used for ailments in pets are high.
I forgot the brand of the stuff I have.
It’s Welactin. That one has been very well studied.
It comes with this little tiny scoop, tiny like bird size. It says for our dog, two. We don’t do it because, quite frankly, I’m not going to wash that little scoop every day.
How’s their stool, though? Is it normal?
She’s fine. As someone who did the poop walk, all systems go.
Good. As far as supplements, you’re looking for something high in Omega-3. There are some chewable things out there now that are good. Some have zinc in them. Some have quercetin. There are some studies out on quercetin about using it for allergies. With any of these, if I have an itchy dog now, Omega-3 is not going to help them tomorrow. You’ve got to have him on it for a couple of months, or the diet high in fatty acids for a couple of months, before you’re going to see results. It’s more preventative than it is therapeutic.
Monitoring The Current Pollen Counts
What about pollen counts? As humans, we’re like, “It’s bad pollen today. I’m not going out. I’m staying in the air conditioning.”
Pollen.com is a wonderful source. You put your zip code in. Every morning, I get my Pollen.com report. Grasses and a weed called dock sorrel were moderately high.
Mine is in my weather app.
That’s good. Let’s talk about that.
I go to ‘Today,’ and it tells me what my pollen is.
Pollen counts are measured 5 feet off the ground. Where are our dogs and cats?
Pollen counts are measured five feet off the ground. Share on XWay down there.
It helps explain why fall is the worst time for pets with allergies because all that spring tree pollen, summer grass pollen, and fall weed pollen, leaf mold is there. They’re stepping on it. They’re coming in and licking their feet. Wet feet make you absorb better across the skin of what you’re allergic to. Bathing will help. Even if you just rinse them off, you’re getting the pollen off of them. Janet, it’s like when you go out, and you mow the grass and come in, you’re sneezing and everything. Get in the shower. That pollen is all over.
It’s everywhere. My dog goes for a swim in the pool. Is that okay for their skin?
Yes. I love swimming in the pool. Get them out. You have a Golden. I will tell you. The heavily coated breeds like Bernese Mountain Dogs, Samoyed, and Goldens, you’ve got to dry them off because the normal staph bacteria on their skin, if that wetness stays, it will overgrow. Newfoundlands, too.
If she goes in the ocean or in the lake, we wash her off.
I would.
I know I use Dawn because it cuts the grease, all the oil, and all that stuff, and she doesn’t react to it, but there are all kinds of fancy shampoos out there.
Chlorhexidine is a nice antibacterial. The other thing, you mentioned that she swims in the ocean. Be careful about lakes because there’s a lot of algae. In Ohio, it’s very hot and algae overgrowth is out there. When you see algae, is that good algae or bad algae? Assume it’s bad.
Recommended Diet For Pet Allergies
Is there any special dog food or cat food for allergies? My cats are on that, “Humans, don’t be allergic to me,” which works.
It’s by Purina.
Clear Coat, Go Clear, or something like that.
That is for humans who are allergic. That reduces the cat allergenicity to human by 40%.
It works.
That’s pretty good. For pets, though, you want to look for a diet high in Omega-3s. For example, Blue Buffalo makes HF, hydrolyzed fish. It’s a salmon diet that has huge amounts of Omega-3s in it. You’ll find other ones on the market, too. Hill’s, Royal Canin, and Blue Buffalo all have their own special allergy diets.
I want to tell our audience that we have Libby on the salmon diet. You’ve got to like fish breath.
I know. A lot of people complain about that. One of my favorite diets was IAMS FP. It was a fish-based diet. I loved it. Mars bought IAMS out, and they got rid of the diet. People used to complain about the fish’s breath.
It’s so bad.
It never bothered me. I don’t know.
Honestly, some of her toots are bad.
That’s the other thing. When you have a diet or you’re using fatty acid capsules, if they’re gassy, you’ve got to pull back on it. That’s why I tell people, “Start low.”
I think she also supplements with dead things outside.
That’s true. You’ve got a lot of critters around you.
I’ve got a lot going on here. From 5:00 to 5:30, our next-door neighbor said, “There’s a coyote across our front yard.” I went flying outside to make sure the cats were in, which they were, because I never know where they are. That was a little scary. I don’t worry about the dog as much with that.
Different Drugs For Dog Allergies
You should, though. The cats, I would. We should also talk about the other drugs for allergies because I get a lot of questions about that. Immunotherapy, allergy testing, and starting them on immunotherapy, be it cat or dog, that’s my favorite.
What was the one that some vets give?
The long-acting cortisone. That’s my least favorite. Let’s start with dogs. First of all, let’s talk about prednisone and cortisone. Janet, you’re familiar with that. It is a very potent anti-inflammatory. It will stop all of this inflammation that’s going on with the allergy, the redness, and the licking.
It makes the pet more comfortable.
Short-term, not a problem. No dog or cat should live on chronic prednisone. You can name an organ in the body, and I can tell you the adverse effects that prednisone has such as eyes having cataracts, hair falls out, and weakened ligaments. We don’t like to use long-term steroids. Prednisone is a steroid. In cats, we use prednisolone. It’s just a different form of it. A short-term, maybe two weeks at the most. That’s fine. Take the fire out. That’s prednisone. That’s short-term. What about antihistamines? Name an antihistamine we recommended.
No dog or cat should live on chronic prednisone. It can have adverse effects on any organ in the body, which leads to cataract, hair fall, and weakened ligaments. Share on XBenadryl.
People ask me, “How much Benadryl can I get?” The normal dose of Benadryl for an allergic dog is 1 milligram per pound of body weight up to three times a day. Let’s say I have a 25-pound dog. That’s 25 milligrams, three times a day, morning, noon, and night.
How much is in one of those little pills?
It is 25 milligrams, over the counter. You would never start at that dose because some dogs get extra sleepy. Every once in a while, you get a dog that gets hyper from it.
If I take Benadryl, I’m out for a week.
Same here. Here’s the thing. Now that we know more about the underlying mechanism, the immunology of allergy, there’s so much more involved than histamine. What is Benadryl? It is an antihistamine. That’s 1 of 100 things that you’re blocking. All the other 99 are still working there. If Benadryl helps, it’s only because it’s making the dog lethargic. If you’re going to use an antihistamine in cats, antihistamine in cats works a little better than in dogs, but they’re bitter.
As I tell people, “You’ll get the first one in,” because it’s so bitter. They salivate. It’s horrible. Antihistamines have fallen out of favor. It’s great if you’ve got a bee sting or something like that, but as far as control, it probably only works if it works at all by sedating the dog. The first targeted drug that came out is called Cyclosporine or Atopica. Atopica is still available. It’s available in generics now for humans. In humans, it’s an anti-rejection drug.
In dogs and cats, it normalizes those immune cells that are way out of whack. It brings them back into equilibrium. The only problem is that it doesn’t work tomorrow. It can take a good 4 to 6 weeks. It’s a good drug overall. I’ve always used way below the textbook dose. Cats seem to do very well on it. Dogs can, too. Now that there’s some generics out, it’s less expensive, which is good.
If I bring my pet in, I know you like to do the skin test. Is that uncomfortable or anything for the pet? Is it just like a little scrape?
In my residency, we sedated everything for skin testing. I remember then giving a Dalmatian the sedative. We used to always have the owners come back with us and pet the dog while we’re doing it, unless they’re going to faint, then they could stay over here.
When you say sedative, is that propofol? Are you knocked out?
No, they’re not under general anesthesia.
Are they just chill?
It’s like a colonoscopy. No, you’re out for that. You don’t poop. It’s not propofol. It’s a minor sedative.
Are they knocked out?
They’re just la-la. However, I remember giving a Dalmatian a sedative. You know me. I’m so ultra-cautious. That dog turned white as a sheet. Dalmatians are white, but the gums turned white, and I gave it the reversal right away. From that day on, I didn’t sedate anything else.
It’s a little scratch.
It’s a little injection into the skin. I would have the owner petting and talking, or we can feed him treats while we’re doing it. It was no problem.
Peanut butter on their paw?
Absolutely. If we have a very fractious or aggressive dog, then they’ll need some premedication that won’t interfere with the testing. There are some people who have show dogs that don’t want you to shave the little area on the side to put the skin test in, so then we just do the blood test. Both ways have pros and cons. Skin test has pros and cons. That’s why I like to do both, because I figure there are some dogs that’s skin test positive, and some dogs that’s skin test negative, yet they’re both allergic. It’s a good way of combining results.
Can you get the blood work with the dog being awake?
Absolutely. I did want to talk about Apoquel, though.
I hear Apoquel a lot.
They advertise it. Thank goodness our new Secretary of Human Health is going to take off the drug ads on TV.
I couldn’t agree with you more because I can’t see those people dancing anymore.
I know. I’ve had it. You’ll see commercials for Apoquel. Zenrelia is the newer one. There’s something called a JAK inhibitor. What that means is, when you’re allergic, and all the right things or wrong things happen, your body releases a bunch of things called cytokines. Remember, in COVID, people died from a cytokine storm because these cytokines bring in all this inflammation, itching, and redness. What a JAK inhibitor, Apoquel or Zenrelia do is they bind to the JAK inhibitor and prevent that cytokine. Especially in dogs, it’s something called interleukin-31. They prevent that and other cytokines from doing their job. That job is not a good job.
That’s like herxing from having the spirochetes. When you have Lyme, and you take those major drugs. All those spirochetes are going bananas. You get the Herxheimer reaction because there’s so much waste. I’m using the word waste because I don’t know what to call it.
The body is hyper trying to treat it.
They tell you to drink a ton of water. It can be pretty bad. I did not have a bad Herx response, but it can be intense.
These JAK inhibitors work to inhibit those bad cytokines from flooding your system. When I would put a patient on Apoquel, which is a nice alternative to cortisone, that’s the main advantage to it. I would rather see a dog on a lifetime of Apoquel than a lifetime of prednisone. We would always get blood work because in some dogs, Apoquel lowered their white count, and occasionally, their red count.
We were very cautious of that. We got them down to the lowest dose and used it only when they needed it. It’s quick-acting. It works within four hours, but it’s short-acting, so you have to give it twice a day. That’s the scuttlebutt on Apoquel and Zenrelia. There’s also something called Cytopoint, which is a monoclonal antibody. Remember, I talked about that one cytokine, interleukin-31. Cytopoint binds to that and dissolves it.
It gets it out.
It usually lasts about a month. I’ve had it last two months in some dogs. It doesn’t work for every dog. Interleukin-31 is responsible for their itching, but so are some other cytokines. This specifically targets that, only interleukin-31.
Identifying And Treating Hotspots
I hear, “Ginger has a hotspot.” What’s a hotspot?
It’s a bacterial infection, very superficial.
I always thought it was where the dog was itching.
They’ll lick at it. The problem is here’s the normal bacteria on the skin, and they’re licking at it. What does licking do? It pushes bacteria deep into the dermis. The body starts reacting to it. It’s hard to get them to leave it alone. It’s like sucking your thumb. It gets to be an addiction. There are different reasons for hotspots. Some are allergy-related. Some are heat and humidity. It’s awful humidity in Ohio. Florida is cooler than here. That’s the thing I mentioned about dogs that are swimming, the heavily coated ones. When they come out, if you don’t dry them thoroughly, they’ll get a “hotspot.”
When you’re looking at these spots or questionable areas on a pet, do you ever find any that are pre-cancerous like the ones my derm looks for?
Yes. We also find cancerous ones. There’s something called epitheliotropic lymphoma, skin lymphoma. Golden Retrievers are the most common breed we see it in, but I saw it in some small dogs too, like Shih Tzus and little Terriers. It’s older dogs. It can look like an allergy. It could look like those circular bacterial infections. Most dogs that were referred to me had been on 4 or 5 different antibiotics.
Why isn’t it getting better? This is the perfect reason why you do something called cytology. You put a little needle in one of those and press a slide. I go look under the microscope. There are cancer cells. You do a biopsy. It’s so sad because by the time I would see them as a specialist, they probably had it for at least a year or so.
It’s far gone.
I have to tell you. It’s one of the most unpredictable. They can live for three weeks. They can live for three months. The longest I had was two years. It’s very sad. I do want to say that the same disease in people is like, “You got CTCL or cutaneous T-cell lymphoma. Put some cortisone cream on it.” They do light therapy for it, too.
Different Drugs For Cat Allergies
Anything else for our pet owners to know about allergies? It is not allergy season. It’s all year.
Let’s talk about the drugs for cats real quick because I love skin testing, blood testing, or doing both on cats. I love having them on the once-a-week allergy shot or maybe the new transdermal. I haven’t done that yet, but that’s on my list to do. Occasionally, we would use oral prednisolone, not every day. Maybe for two weeks to get them under control.
I’m assuming that’s prednisone.
Yes. Cats have different enzymes to detoxify drugs than we do our dogs. If I give a cat prednisone, it can’t convert it to prednisolone, which is the active form. We say, “Give them prednisolone. That’s the active form.” It is prednisolone in the cat. Instead of giving that long-acting Depo shot, we will put them on a little bit of prednisolone, maybe for a week or two to break that itch cycle if the owner can pill the cat.
Remember, we talked about how cyclosporine is available in a little liquid for cats. Atopica doesn’t taste that great. I try to keep medication for allergic cats down to the least amount that’s given orally because I know it’s hard to pill a cat, pill or liquid, what have you. That’s why I like the weekly desensitization shot in the cat. I did have one owner who gave the sublingual drops to the cat. I don’t know how she did it twice a day.
It depends on the person.
She did it.
I put the tick medicine or whatever that is between their shoulders. I’m curious to see how it is behind the ear on the cat.
It’s on what we call the ear pinna, the inside of the ear flap. There are medications for cats that are called transdermal, especially if they have an overactive thyroid. There’s a transdermal medicine to block that thyroid overactivity.
If the cat doesn’t like it, it doesn’t bother them?
No, because it’s rubbed in. It’s like if you took a smidgen of hand cream. It is easy peasy.
Remembering Luigi, The Most Famous Beagle
This has been super informative. This is great. I’m sure we’ll get a lot more questions from our audience. We should wrap it up. A couple of things. We had one of our favorite family pets go over the Rainbow Bridge. If you want to talk a little bit about it.
A special shout-out to Cheryl, who was lucky enough to have Luigi, the most fabulous Beagle, with her for all those years. Our hearts go out to you. We love the picture of Luigi on our Facebook page. I do want to say a happy birthday to Midnight, owned by Tom Warder, who’s a high school friend of mine. She’s a Euclid Panther. Midnight, we love you. We send our love to the Warders. We send our love to Cheryl. I wish I could have met Luigi. That’s my main regret. I know all of us feel that way.
We also have a round of applause for some of our followers who are faithful.
Who tuned in that were following?
We have Kim, Shelly, and Danny. I sound like Romper, Stomper, Bomper, Boo.
Is that Shelly Pitlinsky?
It is from Cincinnati, Ohio. We have Miriam and Anne. We have a lot of folks. We know that Anne had her Molly cross over the Rainbow Bridge as well at only age four, sadly, with a brain tumor. She was a love bug and was lucky enough to live with Anne. She was spoiled rotten. The beauty of it is that we were able to enjoy Molly for the time we had her.
Please, everybody, send us pictures of your new rescues. We’d love to feature them on the show. I’ve got one right here. She won’t jump up on me, but she must’ve heard we’re wrapping it up because I heard her run down from upstairs down here.
Thanks for tuning in. This is Janet Novotny King from Cleveland, Ohio, saying thanks for tuning in. Thanks for learning. Take good care of your pets and give them an extra biscuit for us, with my sister.
This is Dr. Alice Novotny Jeromin. We’re so glad you tuned in. We’re Cleveland gals. The Cavs’ season is over, but Go, Guardians. They need all the help they can get.
PS. the Browns.
It looks good for the Buckeyes. We will be having Dr. Rustin Moore, the vet school Dean. He’s in South Korea lecturing. He came out with a new book, which I have. It’s lovely. It is Unleashing the Bond. Please look it up on Amazon. It’s so wonderful. I was tearing up because of the stories. There are a lot of good tips on pet care. As we call him, Rusty.
Thanks for tuning in.
Kiss the pets for us.
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