In this episode, host Alice and co-host Janet welcome Dr. Alana Lisano, a specialist in veterinary allergy immunotherapy, to unravel the complexities of allergies in dogs and cats.
Discover the key differences between human and pet allergies, why some pets seem to suffer more as they age, and the importance of understanding your pet’s specific allergens. Dr. Lisano shares her insights on allergy testing, including blood tests and intradermal tests, and discusses the process and effectiveness of immunotherapy for pets.
You’ll learn about the challenges pet owners face when trying to identify allergens, the importance of patience during treatment, and how to recognize when it’s time to consult a specialist. We also explore practical tips for managing your pet’s symptoms while waiting for immunotherapy to take effect.
This episode is packed with real-life stories, expert advice, and a few surprising facts about allergies, even in exotic animals! Whether you’re a seasoned pet owner or a new puppy parent, this discussion will equip you with the knowledge you need to help your furry friends live their best lives. Tune in for a must-listen episode that could change the way you approach your pet’s health!
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Why Is My Pet Licking & Scratching? – Dr. Alana Lisano
Welcome to the show. I’m Dr. Alice Novotny Jeromin, a board-certified veterinary allergist and dermatologist.
I’m Janet Novotny King. I’m the doctor’s sister. I am not board-certified in anything. I’m a pet owner, lover, and rescuer. We’re here to share some good science-based information so that our pet owners can be better pet owners. I’ve learned a lot because I’m used to calling my sister at 2:00 in the morning because someone’s barfing or there’s blood somewhere. It’s nice to get all this info and be a little smarter about taking care of our pets. Who is on?
Definition Of The Expert’s Role And Background
First of all, vomiting and diarrhea aside. This episode is all about allergy, what your pets look like with allergy, how we diagnose it, and how we treat it. We’ve got my go-to allergy person, Dr. Alana Lisano, who’s a graduate of Colorado State College of Veterinary Medicine. Janet, you’ll find this interesting. She went to undergrad on a running scholarship, a Biology and Equine Studies major. She practiced in general medicine on the East Coast in New Hampshire and the West Coast of Colorado, then went to work for my favorite allergy company, Heska Antech, as their manager of the allergy assessment and treatment program.
She is and was my go-to person for any questions about how to interpret this blood test for allergy and what we put in the allergy solution. I’ve directed all my referring veterinarians to her because it’s a lot. When you don’t specialize in allergy, as a general practitioner, you have a lot of questions. She is my go-to person. I can’t wait to see her and talk to Dr. Alana Lisano again from Heska Antech. Welcome to the show. It’s all about allergy.
Welcome, Dr. Lisano. We are so happy to talk to you about allergies. As I said before, you are my go-to person. Not only for me, but for my referring veterinarians who had questions. It’s so nice to have somebody who can address those questions accurately and up to date because, as you know, allergy is morphing every day. It’s a dynamic process.
It’s constantly changing.
I feel like there’s going to be a lot of itching and scratching.
Are you ready for it?
Janet, that’s a very interesting thing because that marks the difference between allergy in humans and allergy in dogs and cats. We don’t tend to itch and scratch. We tend to have more upper respiratory. That’s why people have Dr. Lisano and my phone number on speed dial at 2:00 in the morning.
You can’t sleep. Dr. Jeromin, you outweigh me as a board-certified dermatologist. I respect you so much for talking about allergies every day. You have a hard job.
Stop because her head’s already big.
I definitely outweigh her. I can tell you that physically. Anybody who gets a running scholarship, I need to keep up with that. That was so cool.
Do you still run?
I do still run for two reasons. Stress relief is number one. Number two is it’s my time away from my kids.
I get it. I used to go to Target for fifteen minutes and feel better.
My stepdad always says, “How long do you have to run before you decide to turn around and come back?” It depends on the day.
When I was talking to Janet about your bio, you’re a runner and you have three kids and two cats but no dogs. I’m curious. The cats don’t want a dog? Did they vote or what?
It’s more like schedule and all of the other things. You can just leave alone cats. They’re good, and you’re good. You can go on vacation for a couple of days and they’re fine. With dogs, it’s a whole other responsibility. We took on the kid responsibility instead of the dog over the last few years. That being said, we are seriously considering getting a dog in the near future. We hope to add a dog to the pack. One of my friends works with guide dogs that may often have the fails. We might be in the allergy camp. You never know.
Alana, I have to tell you. Dr. Emily Rothstein, a fellow dermatology colleague of mine adopted one of the rejects from guide dogs. We talked to her about it on the show. Didn’t we, Janet?
My friend Melanie is on her third or fourth.
A reject?
Yes, because we have a place right over the border in New York. They’ve been great and fantastic dogs. She’s rosy now.
Janet, you might as well start, because we have not only questions from Janet, but also from our audience about allergies.
Defining What An Allergy Is And The Challenge Of Diagnosis
Why don’t we start at the very beginning? What is an allergy?
That’s a big question. An allergy is when there is an immune response that normally should be quite low, and the body should consider normal, but the body reacts abnormally to a substance in the environment, usually. It could be anything from grasses, trees, or dust mites to food. It’s often hard to pinpoint what.
An allergy is an abnormal immune response to something the body would normally ignore, often an environmental substance. Share on XIt’s something that, in tiny amounts, you overreact to. People who aren’t allergic to it tolerate it. Having said that, when people come to me and say, “I want to find out what my dog is allergic to.” I stop them in their tracks and say, “I can do that, but what are you going to do about it?” You can’t avoid it. Dr. Lisano will agree with me, dust mites are the most common allergen.
You can’t get rid of them.
Lower the amount. As Alana said, it’s when you’re that sensitive to even a teeny tiny amount. Finding out what they’re allergic to is okay if you’re going to do something about it. We’re going to talk about desensitization later. If you just want to know because you think you can avoid it, it’s impossible.
Dr. Jeromin, that’s so valid because every day, we see people running these panels, looking at what the pet might be allergic to, and then not doing anything about it. That’s not the intent. We want to make sure we do something about it to give them that relief. You can’t eliminate everything.
It’s regional. I grew up in Ohio, lived on the East Coast, and then moved to California. Every year for two weeks, this bright yellow tree called Acacia, I’d be a mess because I didn’t grow up with that. I had an allergy to it. How was I going to get rid of acacia trees? The allergist treated me with over-the-counter stuff. I’m sure it’s that way with pets around the country, like a desert environment versus the Midwestern or East Coast. It seems like every human and pet has an allergy. What is going on? Is it because we’re diagnosing better?
I do think that we’re more aware of it than we used to be. It also makes you wonder if there’s something else that’s changed. Dr. Jeromin, I don’t know if you have insight on that. I’m not sure what that might be.
Alana, I heard this years ago and it might not even be true now. If you remember in the old days, for example, one of the astronauts, Frank Borman, who’s deceased now. One of the Apollo and Gemini astronauts. He grew up out East. He had terrible allergies and asthma, if I’m not incorrect in saying that. The prescription then was, “Move out West. Move to Arizona.”
Change location.
Everybody with allergies from here moved to Arizona. Guess what? They took up residencies there. We moved all these seasonal plants out there. Allergies are just as common there now as it was in New York State, Pennsylvania, or the East when everyone made the mass migration. As humans, we’ve created more allergies now than there used to be, at least environmental.
For our pet owners, how do I know if my dog or cat is allergic? What’s going on that would be a sign?
It’s important not to think that it’s normal for a dog to scratch all the time or a dog to lick its feet all the time, or a cat to barber their hair coat down to where they have nothing. It’s things like that, that often, pet owners think are within the normal for their pet. Once you dig into it, you realize that it’s not. It’s having those recognitions and asking your vet if you’re not sure. You say, “After they come in from the yard, they sit there and lick their feet for ten minutes.” That’s a valid question to ask your veterinarian about. It’s same with ears. They shouldn’t normally shake their head or scratch their ears. That’s something to pay attention to as well.
Deciding When To See A Veterinary Specialist
My regular vet could treat if there’s something in the ears or a little paw-licking. How do I know when it’s time to go to a specialist? I’m not trying to pump up everybody’s business.
I’m retired, so it’s not going to affect me at all.
That is very much a personal preference for the first part of that. When I was in clinical practice, I had a lot of pet owners who wanted me to do as much as I could before they went to a specialist. You always have that occasional one who wants to go straight to the specialist. I would say, “Here you go. Please proceed.” The only challenge with that, and this is probably regionally dependent, too. We don’t have a lot of dermatologists. I live twenty minutes from Colorado State University, where we have an entire dermatology service. The wait is still six months to get in and see one. That can be a challenge, too.
Alana, I found that out here in Sanibel because I’m helping out the Golden Retriever Rescue, as I’ve emailed you. I’m seeing there are skin cases that they’re having problems with. I’m just doing it because I want to do it. There are not many. As you said, the wait is hard. It’s a long time to get in. Janet, to your point, an allergy in the dog or cat is forever. Humans outgrow theirs. Dogs and cats get worse as they get worse as they get older.
We want to get that pet on an allergy treatment at a young age so that their skin changes don’t advance to chronic changes that are harder to reverse. That is a main difference, besides the licking, chewing, rubbing, and scooting, between dogs and humans and cats and humans. The difference is that pets get worse as they get older. Janet, your son, who was on allergy shots, which we’re going to talk about. He is better now.
He also doesn’t live here anymore with the cats. I feed the cats that Purina, the one you told me to feed them. I’ve got to tell you, it works.
I heard great things about it. That’s awesome.
It’s supposed to reduce the allergenicity of the cat by 40%, which doesn’t sound like a lot, but it does.
That’s a lot.
I wanted to jump back, Alice, to what you said about that it’s forever. That six-month wait is probably worth it. If you have to wait, get on the list because you’re still going to need that help from the specialist if your pet is suffering. All for that.
Do they test dogs and cats for allergies like humans? I’ve had the prick test done. Do they do that to cats and dogs? Is it the same?
Similarities Between Human And Pet Allergy Testing
They do. It’s very similar. I’m not the one who’s doing that. That’s pretty much all the specialists who do that part. In intradermal testing, under the skin, with a little prick to the allergen is very much the same for dogs and cats. The main difference there is that they have to be sedated usually because they’re not going to want to sit still and tolerate that in most circumstances. Some pet owners are also not thrilled about having a big bald patch on their dog or cat for the next few months while the hair grows back. That’s a temporary situation, but that is an issue sometimes.
Janet, was your son skin-tested or blood-tested?
It was two panels. One is the environment, and one is the food.
I know, but did they do the prick in the skin?
On the back.
We do it on the side of the pet. We can also blood test for environmental allergies in the pet. As a specialist, I used to do both. It’s interesting. You’ll have some allergic pets that blood test positive and skin test negative, and vice versa. We want to get all the information we can. We usually combine those results.
As I tell people, when the kids are all in bed, sit down with those results and say, “Do these results jive with the time of the year the pet is affected?” It’s because the whole idea of allergy testing these pets is to make up an allergy solution to desensitize them. We call that immunotherapy, which we’re going to ask Alana more about. It has to make sense.
Say that my Golden, Annie, is licking, scratching, and chewing all year round. It’s not a food allergy because I’ve done that food trial with her. She’s dust mite allergic. Say the test just shows she’s ragweed allergic. That doesn’t mix. Ragweed is two months out of the year in Ohio. You’ve got to have, A) Accurate results, and B) Know what to do with those results. That’s where the consultation with Alana and Heska comes in. You can’t just take what’s on the paper and say, “This is it.” You’ve got to talk about it and think about it.
Let’s talk about immunotherapy. I know the human part of that because I have a son and a husband who would go for weekly shots. It starts weekly, then it goes to two weeks. I can’t even remember. It goes to monthly. They had their own little solution that they’d mix up for them. We do our homework in the waiting room. It becomes a habit, but it works. Can you tell us how it works? Is it the same as it is for humans?
Explaining How Immunotherapy Treatment Works
It’s similar. If you’ve been on the human side, you have a good comparison to the veterinary side of that. Immunotherapy for dogs and cats, and horses, for that matter, and sometimes other species, too. Although, there’s always that question of how feasible it is, the idea is very similar. As Alice said, it’s looking at that allergy test result, whether it’s just the blood or the blood and intradermal combination, or only the intradermal. I love practitioners who do both. That’s always the best. I’m with you. It’s all about looking at those results in the context of the individual, and then coming up with a solution that is what that pet needs to be desensitized to.
Immunotherapy is about looking at test results in the context of the individual pet and creating a treatment plan tailored to what they need to be desensitized to. Share on XYou start at a low dose, so either an injection or an oral, sublingual solution that goes under the tongue. It’s one or the other, depending on the pet. I always say they’re fairly equal in effectiveness. You always pick the one that is the most feasible for the pet owner and the pet that you’re dealing with. Most cats don’t mind a quick shot, but don’t love stuff in their mouth. It depends on the dog. Some dogs might tolerate the shot quite well, but won’t tolerate the oral solution, or vice versa.
It’s an important consideration to look at what works for the pet and the pet owner. With all of that in mind, you’re going to slowly be increasing the amount of allergen that this pet is exposed to, with the idea that they then get desensitized with time. It’s not a quick process, as you probably experienced on the human side, too. It takes a while. We’re talking six months plus to get a good positive response. It does take some dedication, for sure.
You stick to it. Honestly, once you’ve desensitized your kid, the difference is amazing. He used to come down to the breakfast table, barely picking his head up because he couldn’t sleep. We’re like, “What’s wrong with you?” It was the allergies. I’m always like, “Take an Advil. You’ll be fine.”
You’re so sympathetic. “What’s wrong with you?”
It does work. It made a huge difference in his life.
Janet, I have to tell you personally. Dr. Lisano, Janet had a diabetic cat. I was so proud of her that she gave shots. Janet, you are living proof that it’s easier to give your cat a shot. You did it every day. These allergy shots are once a week, rather than a pill once or twice or three times a day. Pet owners, especially allergic cat owners, are so shocked when I teach them. First of all, I’d say, “I think the best thing would be to find out what he’s allergic to then we’ll put him on immunotherapy, which is a desensitization shot.” They would be like, “I give my cat a shot?”
You can.
We would show them, with some water sterile saline, how to give the shot. I’d be talking to them. They’d say, “When are you going to give the shot?” I’m like, “It’s done.” Another great story is that I had an owner of a chocolate Lab that was allergic. Back then, we weren’t doing the oral solution, the sublingual. We were just doing injectable. She was like, “I’m so afraid of needles. I can’t do it.” Do you know she went on to become a nurse because she overcame her fear of giving her dog the desensitization immunotherapy?
That’s amazing. I love it.
We gave it to the diabetic cat for five years. The challenge with giving your cat insulin is that they have to eat. It’s not like a dog. My tips for our readers are, we put her on top of the dryer, on a beach towel, because it was our level. We’d put the stinkiest, most disgusting wet cat food out, so she’d be eating. It got to the point where she’d raise her shoulders, “Here it comes.” I never thought I could do it. I had the whole family trained to do it because that way, if someone was home, you had to do it at even times during the day. Honestly, it was worth it to have the whole family trained. There was nothing to it.
Getting back to allergy shots. Janet, it’s my favorite way to treat allergies because it’s natural. You’re giving them what they’re allergic to. It’s not a drug. Secondly, it’s the only treatment for allergy that has the potential of curing the allergy. When can you cure a genetic disease? That is amazing to me. As Dr. Lisano said, it takes a while. This allergy’s going to be forever and get worse as they get older. Let’s get started.
I’m telling you. It worked for two humans in my life. Is it the same medicine for humans and for pets?
I love that question. It’s such a client question. It’s such a JQ public question. Dr. Lisano can take that one.
I’ll try. It should be very similar. The difference would be what allergen are common in humans. Honestly, I’m not a human allergist, so I can’t say for sure, but it should be similar to where you work up.
How long has immunotherapy been around?
Over 100 years.
At least for me, it’s been almost 30 years.
It’s one of the oldest treatments for allergy as well, which is pretty cool because it’s tried and true. We know that it works. We know that it’s effective. As Alice said, it can have the potential to go to the source. Not just treat the clinical signs and stop the itching, but prevent the itching in the first place. It’s amazing.
I was nervous about my son going on it because I think he was in 3rd or 4th grade. I remember sitting with the allergist, going, “Wait a minute.” As you said, Alice, there’s no drug in it. It’s the actual allergen, which he’s being exposed to in everyday life anyway. As a parent, I was like, “What’s the bad part about this?”
You’re thinking steroids and all the other things.
Addressing Potential Risks And Side Effects Of Immunotherapy
Are there side effects from immunotherapy?
There can be. If you think about that we’re treating an allergy, it’s ironic that they can have an allergic response to that, especially if you get too high a dose. One of my best examples of that was when I started a pet on the sublingual immunotherapy. It comes with two different concentrations of allergen for the first set, a bottle A and a bottle B. They’re supposed to start with bottle A. This client didn’t realize it and picked up bottle B first, and started treating.
Their dog’s belly got bright red, horrible, itchy, red belly. They called. Sure enough, they were using the wrong concentration. If that concentration’s not quite right, certainly, you can end up with an exacerbation instead of improvement. The good news is that’s something that can easily be corrected and be adjusted, for sure.
It happened with me, with the kid in the back seat in the car seat.
Tell her your story.
I’m driving, dropping off twenty kids with soccer practice in the suburban. I got the kid in the back seat. He’s in 2nd or 3rd grade. He couldn’t explain it. He goes, “It’s like I can’t swallow.”
They had been to the doctor for the allergy shot.
You sit for twenty minutes to see if you have a reaction. They had switched brands or something. It wasn’t A or B, that vial thing. I called the allergist’s office. They said, “You have two choices. Go to ER, or come to us.” I’m like, “I’m going to them because it will be faster than ER.” I called Alice. I’m like, “He’s in the back seat. It’s not good.” It was interesting because they took us into the room, and they gave him whatever the other shot was. They said, “You’re going to shake lock,” because I think it was adrenaline or something.
It’s epinephrine.
At least they told us that because that would have freaked me out. It passed. Everybody was fine.
Janet, if I remember this call when you called me. Her son was mold allergic. We should say this immunotherapy is for environmental only in pets. It’s not for food. Janet, I remember you told me he was mold allergic. It was mold season and they increased the dose. To me, one plus one equals four in that situation. In practice, I can tell you, let’s take the ragweed allergic dog. In Ohio, it’s August through October.
The season’s getting longer because it’s getting warmer longer. I sometimes would have clients back off a little bit on the dose during their current allergic season. You need an observant owner. It’s not a matter of taking that list and giving 0.1 cc or 0.2. You have to keep your eye on how that pet did that week. The pets that are most successful on it, A) Have the most observant owners, and B) Have had allergic kids because they know what they’re watching for.
One of the biggest things I’ve had in cases that were referred to me is that people just sped through the whole sheet, 0.1, 0.2, 0.3, or 0.4, without watching the pet or being told they need to watch the pet. They bring the allergy solution and the paper, set it on the exam table, and say, “This didn’t work.” I’m like, “Let’s back it up. Let’s talk about this because you might have gone past the dose that it took to desensitize your pet.” It’s a lot of observation. To be honest, Alana, I wouldn’t want your job because you’re not seeing these pets, and yet they’re asking you questions.
Alice, you have another challenge because they’re often the worst cases that make it to the specialist, the most challenging cases. That being said, compliance is potentially better by the time they get there because they are that desperate for a solution. My struggle when I was in practice was having people give up too soon. It was challenging to get them to stick with it long enough. They say, “I did it for two months, and it didn’t work.” There’s no time to explain to them because it can take longer and to stick with it.
It’s our impulsive society. Everything’s got to be like that.
That’s a true way to human dermatology. I’ll go to my derm for something. He’ll be like, “Be patient. It’s going to take 4 to 6 weeks because your skin is regenerating.” It’s not going to happen overnight.
I know, but I can understand that because if you’ve got a pet that’s licking its feet or scooting its butt, and it’s 2:00 in the morning. You’re like, “This isn’t working.”
You need another solution.
I tell people, “Let’s give it a year to be fair.” I will say this. There’s no proof of this. This is anecdotal to me and a couple of other veterinary dermatologists. For some reason, yellow Labs can take up to two years to respond to those shots. I don’t know why. It’s their genetic makeup. They’re also more sensitive to certain medications. It’s like the blonde-haired and blue-eyed child.
What impresses me about that is that you waited it out for two years to find this out.
Having said that, Dr. Lisano, I’m going to do a shout-out to one of our readers. If the dog is tuning in, it’s Cheddar Bay. Cheddar Bay is owned by Miss Malivuk, who is a reader of ours. Cheddar Bay was preceded by Big Christmas, a yellow Lab, before that. You can imagine Cheddar Bay is a yellow Lab. Cheddar Bay’s mom is a great mom because she is on the ball with these allergy shots. She’s a wonderful client to work with. I miss her. We still stay in contact via the show.
Those are the clients that keep you going.
Can we just say how cute that name is, Cheddar Bay?
I love it.
I want to ask Dr. Lisano to address the cost factor because people want to know. This is scientific and technical.
How does that work?
Evaluating The Cost And Long-Term Value Of Therapy
That’s a great question that comes up all the time. My top recommendation is, if you’re looking at the cost, don’t just look at the test. Look at the test and at least six months to a year of immunotherapy when you’re considering that cost. To Alice’s point, if you’re not going to pursue immunotherapy, then don’t bother testing. You have to look at both together when you look at the cost.
If you're not going to pursue immunotherapy, then don't bother testing. Share on XThe alternatives to immunotherapy are very expensive as well. If we’re looking at other treatment recommendations that might help your pet. Things like Apoquel, Cytopoint, and Prednisone all have pros and cons. Prednisone is cheap, but it also has a lot of side effects. When we’re talking about a lifelong disease, that’s a tough pill to swallow.
Excellent point. All these are drugs that you need to do blood work routinely on. To Alana’s point, that’s true. It’s probably the cheapest in the long run way to treat, and the safest and most effective. I’ll tell you something else. In my practice, the majority of allergic cats were either gold, a calico, or a tortoiseshell. That gold color to me must somehow be linked with an allergy.
What’s tortoiseshell?
It’s like tortoiseshell glasses, that color, Janet.
I’m looking that up.
It’s a golden brown and black combination.
It’s a triple color.
It’s orangey. It’s orange and black.
Cats do even better on immunotherapy than dogs do. I don’t know. I’ve had 80-year-old clients with very arthritic hands, giving their cats their once-a-week or every two-week allergy shot. I couldn’t be happier with how they were doing.
Cats often manifest in different ways for those allergies, too. My cat was circling my feet, but I have a perfect example right here. She chews her hair coat out. Sometimes, you think they don’t have a true skin lesion, but they’re chewing their hair down. You can hear her. Sometimes, they’ll have an actual lesion where people think that they have a wound from something, but it’s an allergy. It’s a different kind of presentation sometimes.
Cats don’t like to do anything by the book.
If the cat’s licking their hair off, then I’m assuming a hairball’s coming up at some point.
Yes.
If I’m a pet owner, it sounds like I have two choices. I can go on immunotherapy, which is owner-dependent, or I could choose one of those other drugs that you brought up. To me, as a pet owner, if you’re doing the allergy test, figuring out what’s wrong, and then doing the immunotherapy, you’re getting to the root of it.
That’s the foundation.
In the long run, your pet’s going to be better. I’ve seen it with two humans, but if you go on the other drugs, you’re masking it. I’m not a professional, folks.
It’s very true. A lot of those drugs you can’t even use on cats. They’re only labeled for dogs. That’s a whole other challenge for cats.
If I’ve got the dog with itchy paws, and I’m treating them, doing the immunotherapy, and waiting for him or her to get better. Is there a topical to calm that down?
You can use those other drugs to support as well while they’re getting accustomed to the immunotherapy and building up that desensitization. It’s a great idea to use other medications to support them because you don’t want them to be miserable for six months while you’re waiting for the immunotherapy to take full effect. Remember that it’s worthwhile to continue the immunotherapy, even if you’re supporting them with other medication, and that you’re saving them from that lifelong time on that.
To Dr. Jeromin’s point, you have to monitor blood work with Apoquel and make sure that there are no other things that are going on, as well as drug interactions. If they end up with another diagnosis, it’s having that in mind. If they have another diagnosis that you have to address, you don’t have to worry about that interacting with the immunotherapy, which is nice.
I know my friend David has Rosie. She was a wonderful puppy and excellent. She hit three and a half or four years, and it was her paws, then her belly. It became an environmental allergy. Does it happen at a certain time when owners should be a little more aware?
Younger to middle-aged. Two to six years is pretty typical, but it can be anytime. I’ve seen it in puppies. I’ve seen it in seniors. It can span all of that. It’s just that younger middle age is most common.
Janet, the other thing, we have a red tide at the beach. When you inhale that in, it’s horrible. You get an allergic reaction, but dogs and cats inhale it, but they absorb it where there’s not much hair. That’s why their feet are involved, the insides of their ears, tummies, and butt. When they come in from outside, it’s nice to rinse them off, but not soak them because if you have wet skin, you absorb better across the skin what you’re allergic to. Rinse them off and pat them dry. Don’t soak their feet. That’s an old wives’ tale. “I soaked their feet for five minutes.” You know how when you’re pruney in the tub, then you’re told to put your moisturizer on.
It will absorb.
In dogs, we want to keep their skin rather dry as opposed to macerated and wet. I always tell people, “When you bring them in, maybe have a little pan of water, dip, dip, wipe, wipe, and go on your way.” That’s why it’s usually underneath most allergies in dogs. You’ll see how red their feet are. They come in. While they’re doing that, they’re inhaling some of that.
They’re making it worse because then their skin barrier is even more upset as they lick and chew at it.
Do zoo animals, like exotics, have allergies?
They do.
I can tell you. I skin tested a clouded leopard at the Cleveland Zoo. That was when we didn’t do any blood testing. It was early in my career, probably in the early ‘90s. The thing about zoo medicine is you go in there, and everything’s already sedated and laid out on the table for you. This was a beautiful, breathtaking animal. We shaved it. We allergy-tested it. Alana, I was so worried. It was going to be dust-mite-allergic because it’s an outside animal. It wasn’t. It was very pollen-allergic.
We made up the solution. The solution is supposed to go under the skin, the injection. The curator, once a week, would lure the clouded leopard over to the edge of the outdoor cage while he was getting the meat. Pop them with the shot and I’m sure it went into the muscle or under the skin. Sadly, that was part of their breeding stock, and allergy is hereditary.
I love that question about exotics because Heska Allercept has been used on a variety of exotics. I always recommend consult for the veterinarian before considering that option for an individual. Ferret, rabbit, and those other small exotics are the most common just because that’s what gets seen the most, but certainly zoo exotics as well.
Janet, horses are pretty allergic. They get heaves.
That’s a lot of space to itch.
You can’t put horses on a lot of cortisone because they do something called founder, where they get lame from it. There’s not much coming back from foundering.
Horses often have more insect allergies too, which is a challenge when they’re in a barn environment or even outside, or a combination of the two. That’s a challenge to address those insect allergies.
Janet, it’s like your no-see-um allergies when you come to Florida.
Come hang out with me because they’re going to attack me.
What is it about certain people that they work with? My mother-in-law is the same.
I think it’s hormones. It’s the scent. I go home and I’ll be, “Are you kidding me? Are they in the luggage?”
She has the delayed hypersensitivity.
Was that what it is? I think they come home.
I don’t think so.
It’s horrible. I found whatever product that is that I send down to Florida when I go. I’m a toxic waste dump. I coat myself. It’s Ranger Ready.
Janet, right after the hurricane, it was horrible. They swarmed. That spray was not doing anything.
Probably because of standing water, I would assume.
Yes, I think so.
Even here, mosquitoes come to find me immediately.
We should also ask Dr. Lisano what the success rate is for the oral immune sublingual or the injectable. People aren’t going to do this if it’s only a 20% success rate.
You’re right. The success rate is between 60% and 80%, depending on the study that you look at. It’s pretty decent. Certainly, not every pet is going to respond, but it’s worth a try. It’s a lifelong disease. You want to know if they’re the ones that would respond. I’ve had so many clients tell me that the immunotherapy ended up saving them so much money, heartache, and trouble over the long run.
Many of my clients tell me immunotherapy saved them money, heartache, and countless frustrations. Best of all, their pets are finally comfortable again. Share on XWhen their dog or cat does respond, it saves them not only the medication, but also their pet isn’t uncomfortable anymore. Also, vet visits. We love seeing them, but we only want to see them for good things if possible. If we can save them all those ear infections or skin infections and the other things that come with an allergy, it’s worthwhile.
You’re not up as a pet owner listening or hearing that scratching.
Maybe not everybody.
You bond with this pet because you’re watching how they’re doing. You’re giving the shot. It’s a loving way to treat. It’s not just, “Here, take this drug. Guess what? We’d better do some blood work because it could be adversely affecting you.” I would tell clients, if you’re into natural, it doesn’t get more natural than this.
If you’re one of those who like to have your dog or cat in, lying on your bed when you sleep at night, you want them to smell good. You don’t want them to smell like yeast. You don’t want them to be scratching or licking all night. It’s worthwhile.
That’s true because, as Alana said, not only are ear infections accompanying these yeast infections, and we all know what that smells and bacterial infections. It’s the start of snowballing and allergies at the base of that. It’s hard for people to realize that. The other thing too is I’ve also seen the opposite, where, unfortunately, a pet has been blood tested for allergies. Maybe they’re thirteen years old.
They’re scratching like crazy. They never did this before, yet it’s mange. It’s scabies mites. The thing is, as a veterinarian, as a doctor, you have to weed out the things that look like an allergy because I don’t want to spend somebody’s money on allergy testing a pet when maybe they’ve got scabies. Both those diseases are itchy.
On that note, sometimes, it takes more than one test to get your answer. Even with things like checking for mites. I’ve had it as a vet where I scraped one time and didn’t find any. We come back a month later. We scraped again, and we found them. It’s persistence and perseverance when you’re trying to figure out, being a detective through that whole process, which is challenging sometimes.
What about the time of the year? Is that important in testing an allergic pet?
It is, especially blood tests. When we’re looking at those IgE antibodies, they’re going to be the highest when the pet is exposed to whatever they’re allergic to. You don’t yet know what they’re allergic to, but you can see the clinical signs when they’re showing the symptoms of allergy. That’s the ideal time to test.
Dr. Lisano, I got to ask you our questions that we ask all of our guests. What about your work motivates you and keeps you going?
Discussing Motivation And Impact In Veterinary Medicine
I’ve been in clinical practice for eleven years before I came over to product management with Antech. I was with Heska originally. I will admit that I had a little bit of a crisis initially because I was so used to seeing right in front of me the difference I was making, the difference for the pet, and the difference for the pet’s family.
That’s what motivated me in clinical practice. When I moved over to the industry, it took me a little bit of time to figure out how I am impacting the veterinary community. That’s the pet. I realized with time that I can have an even broader impact, an even global impact now. What motivates me is truly making this a better world for those families.
Thank you so much, Dr. Lisano. I learned an awful lot. I knew the human part of it because I’ve experienced it, but not with a pet. This is helpful.
I love to talk to her again.
Likewise. I was so excited you reached out because I’ve tuned in to your show. It’s so much fun. You guys are great.
That’s one. No, we’re kidding. We have a lovely audience.
I’m so glad to hear that. Please stay in touch. Let me know when you’re at conferences and such.
It was great seeing you again. I hope we always keep in touch.
Thank you, Dr. Lisano. This was informative. I appreciate the good work you do. Thank you.
Thanks for having me.
This was a great session. I can’t thank Dr. Lisano enough. It’s always fun to get together with her. I always learn so much. I hope you all have learned a lot in this hour about allergy and immunotherapy. Ask your vet about it. See a veterinary dermatologist if you need to. Go to the ACVD website. Click on Find a dermatologist and there’ll be one in your region. I promise you. This is Dr. Alice Novotny Jeromin.
This is Janet Novotny King, saying thanks for tuning in. Don’t forget to love up your pets and extra biscuits from us.
Kiss the pets.
Important Links
- Antech Diagnostics
- Pet Allergies Unleashed | SOP Ep. 49 – Dr. Emily Rothstein on YouTube
- American College of Veterinary Dermatology
About Dr. Alana Lisano
Alana Lisano, DVM grew up in the foothills west of Fort Collins, Colorado, where she spent her childhood on a small acreage surrounded by a menagerie of animals. She attended Truman State University in Missouri on a running scholarship, graduating with a degree in Biology and Equine Studies. Alana went on to earn her Doctor of Veterinary Medicine from the Colorado State University College of Veterinary Medicine and Biomedical Sciences in 2011.
Following graduation, Alana began her career in a mixed-animal practice in western Colorado and later worked in a variety of small-animal practices across New Hampshire and Colorado for more than a decade. In 2022, she made a major career shift by joining the marketing team at Heska (now Antech), where she managed the ALLERCEPT® Allergy Assessment and Treatment Program for two years. In 2024, she transitioned into Research and Development as a Technical Product Manager, where she discovered a passion for product innovation, development, and advancing diagnostic solutions for veterinarians.
Alana is married to a fellow veterinarian, and together they share their home with three children and one Siberian cat. Outside of work, she enjoys running, baking, spending time in the mountains, and exploring the outdoors with her family.