Dermatology For Animals Blog
The Science and Art of Desensitization (Part 1)
Allergy shots which is also known as immunotherapy or desensitization, has been one of the safest, non-drug method to treat allergies in people and animals for many years. It also remains one of the more challenging aspects of dermatology to master. Even though at D4A we feel the intradermal allergy (skin) test is the best way to identify what the pet is allergic to, there are many more factors to consider when deciding what to include for the process of desensitization. Our current skin test panel includes 70 different allergens.
Allergen specific immunotherapy is most definitely not a “one size fits all” program. If a veterinarian wants to become proficient at administering immunotherapy, she or he should first become familiar with the regional pollen producing plants, when they bloom, how long they bloom, and how prevalent the plant (and allergen) is in the area. An awareness of the prevalence of indoor, potentially year round allergens, such as house and storage mites, mold spores, animal and human dander and insect particles is also necessary. This requires advanced training beyond what can be learned in Veterinary school. The first critical step in achieving success with allergy shots is determining accurately and completely what the patient is allergic to. Some veterinarians, clients, and drug companies spend a lot of time discussing the pros and cons of different types of allergy testing. At D4A we utilize intradermal skin testing almost exclusively pinpointing the allergic triggers. We find we get the most accurate results from intradermal testing. This also allows us to customize the list for which we are testing based on specific location, not just region. When blood (serology) testing is performed, the testing is performed by various regions. Does it really make sense to lump Southern Arizona in the same region as northern Montana when considering what allergens to test for? Intradermal allergy testing is expensive to set up and maintain, and requires practice and skill interpreting results and is therefore mostly performed only in a specialty setting. If intradermal testing is not available, then serology testing must be utilized. It should be emphasized that the only reason to perform any type of allergy (blood or skin) testing is to follow up with immunotherapy.
Written by: Thomas P. Lewis II, DVM, DACVD