Am I allergic to my pet? Dog & cat hair dander allergy
TGIF folks! Welcome back to Dr Euan's Blogposts.
Today we are looking at our pets (cats 🐈 & dogs 🐩 ) and how their fur / dander may provoke an allergic response in us!
Q: What is a pet allergy?
Do you have a pet at home? Do you start sneezing or itching when you play with your pet?
Pet allergy is an allergic reaction to proteins found in an animal's skin cells, saliva or urine. Signs of pet allergy include those common to hay fever, such as sneezing and runny nose. Some people may also experience signs of asthma, such as wheezing and difficulty breathing.
Most often, pet allergy is triggered by exposure to the dead flakes of skin (dander) a pet sheds. Any animal with fur can be a source of pet allergy, but pet allergies are most commonly associated with cats and dogs.
If you have a pet allergy, the best strategy is to avoid or reduce exposure to the animal as much as possible. Medications or other treatments may be necessary to relieve symptoms and manage asthma.
Q: What are the symptoms of a pet allergy?
Pet allergy signs and symptoms caused by inflammation of nasal passages include:
Itchy, red or watery eyes
Itchy nose, roof of mouth or throat
Facial pressure and pain
Swollen, blue-coloured skin under your eyes (allergy shiners)
In a child, frequent upward rubbing of the nose
If your pet allergy contributes to asthma, you may also experience:
Chest tightness or pain
Audible whistling or wheezing sound when exhaling
Trouble sleeping caused by shortness of breath, coughing or wheezing
Some people with pet allergy may also experience skin symptoms, a pattern known as allergic dermatitis. This type of dermatitis is an immune system reaction that causes skin inflammation. Direct contact with an allergy-causing pet may trigger allergic dermatitis, causing signs and symptoms, such as:
Raised, red patches of skin (hives)
Q: When you should see a doctor
Some signs and symptoms of pet allergy, such as a runny nose or sneezing, are similar to those of the common cold. Sometimes it's difficult to know whether you have a cold or an allergy. If symptoms persist for more than two weeks, you might have an allergy.
If your signs and symptoms are severe — with nasal passages feeling completely blocked and difficulty sleeping or wheezing — call your doctor. Seek emergency care if wheezing or shortness of breath rapidly worsens or if you are short of breath with minimal activity.
Cats and dogs
Allergens from cats and dogs are found in skin cells the animals shed (dander), as well as in their saliva, urine and sweat and on their fur. Dander is a particular problem because it is very small and can remain airborne for long periods of time with the slightest bit of air circulation. It also collects easily in upholstered furniture and sticks to your clothes. Pet saliva can stick to carpets, bedding, furniture and clothing. Dried saliva can become airborne. So-called hypoallergenic cats and dogs may shed less fur than shedding types, but no breed is truly hypoallergenic.
Pet allergies are common. However, you're more likely to develop a pet allergy if allergies or asthma runs in your family.
Being exposed to pets at an early age may help you avoid pet allergies. Some studies have found that children who live with a dog in the first year of life may have better resistance to upper respiratory infections during childhood than kids who don't have a dog at that age.
Ongoing (chronic) inflammation of tissues in the nasal passages caused by pet allergy can obstruct the hollow cavities connected to your nasal passages (sinuses). These obstructions may make you more likely to develop bacterial infections of the sinuses, such as sinusitis.
People with asthma and pet allergy often have difficulty managing asthma symptoms. They may be at risk of asthma attacks that require immediate medical treatment or emergency care.
If you don't have a pet but are considering adopting or buying one, make sure you don't have pet allergies before making the commitment.
Q: How to test for pet dander allergy? Allergy skin test
Your doctor may suggest an allergy skin test to determine exactly what you're allergic to. You may be referred to an allergy specialist (allergist) for this test.
In this test, tiny amounts of purified allergen extracts — including extracts with animal proteins — are pricked into your skin's surface. This is usually carried out on the forearm, but it may be done on the upper back.
Your doctor or nurse observes your skin for signs of allergic reactions after 15 minutes. If you're allergic to cats, for example, you'll develop a red, itchy bump where the cat extract was pricked into your skin. The most common side effects of these skin tests are itching and redness. These side effects usually go away within 30 minutes.
In some cases, a skin test can't be performed because of the presence of a skin condition or because of interactions with certain medications. As an alternative, your doctor may order a blood test that screens your blood for specific allergy-causing antibodies to various common allergens, including various animals. This test may also indicate how sensitive you are to an allergen.
Q: what can be done to manage my pet allergies?
Current recommendations for controlling clinical symptoms caused by dog and cat allergens primarily includes avoidance to exposures. Bathing animals at least twice per week reduces allergens and can eliminate reactions. Immediate removal of the pet from the household will not alleviate symptoms particularly if the owner has carpeting in their home. Mammalian allergens are very stable and persist in house dust up to 6 months.
Symptomatic management with the use of anti-histamines and localised (intra nasal) steroids are used when avoidance strategies have been utilised but symptoms still continue. Data on dog allergen subcutaneous immunotherapy (SCIT) show evidence of effectiveness, but is clinically less effective than for cats.
The treatment of dog and cat allergies with immunotherapy depends on reliable and consistent allergen extracts. Unlike cat allergen extracts, differences in the manufacturing of dog allergen extracts exist even today. In the United States, allergens are typically manufactured in an aqueous solution. In Europe, products used for SCIT are usually prepared with aluminum hydroxide which forms a complex with the active allergens and is thought to act as a depot thereby releasing the allergens more slowly.
Without adequate standardisation, the amounts of different specific protein allergens vary enormously, thus making assessment of therapeutic improvement impossible. Safety of SCIT is also an issue, if a patient is highly sensitive, different manufactured lots even from the same manufacturer with different amounts of component allergen proteins can lead to adverse reactions when those individuals are suddenly exposed to high levels.
So dear friends, if you are troubled by pet allergies, do contact us today for a review, and further recommendations. Have a restful weekend 😊
Here are some updated references for those who are keen to read more.
1. Park HJ, Kim EJ, Yoon D, Lee JK, Chang WS, Lim YM, et al. Prevalence of self-reported allergic diseases and IgE levels: a 2010 KNHANES analysis. Allergy Asthma Immunol Res. 2017;9:329–339. [PMC free article] [PubMed] [Google Scholar] 2. Hellgren J, Cervin A, Nordling S, Bergman A, Cardell LO. Allergic rhinitis and the common cold--high cost to society. Allergy. 2010;65:776–783. [PubMed] [Google Scholar] 3. Lamb CE, Ratner PH, Johnson CE, Ambegaonkar AJ, Joshi AV, Day D, et al. Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr Med Res Opin. 2006;22:1203–1210. [PubMed] [Google Scholar] 4. Ownby DR. Pet dander and difficult-to-control asthma: the burden of illness. Allergy Asthma Proc. 2010;31:381–384. [PubMed] [Google Scholar] 5. Perzanowski MS, Rönmark E, Platts-Mills TA, Lundbäck B. Effect of cat and dog ownership on sensitization and development of asthma among preteenage children. Am J Respir Crit Care Med. 2002;166:696–702. [PubMed] [Google Scholar] 6. Takkouche B, González-Barcala FJ, Etminan M, Fitzgerald M. Exposure to furry pets and the risk of asthma and allergic rhinitis: a meta-analysis. Allergy. 2008;63:857–864. [PubMed] [Google Scholar] 7. Celedón JC, Litonjua AA, Ryan L, Platts-Mills T, Weiss ST, Gold DR. Exposure to cat allergen, maternal history of asthma, and wheezing in first 5 years of life. Lancet. 2002;360:781–782. [PubMed] [Google Scholar] 8. Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. In: Shiohara T, editor. Pathogenesis and management of atopic dermatitis. Basel: Karger; 2011. pp. 1–34. [Google Scholar] 9. Mandhane PJ, Sears MR, Poulton R, Greene JM, Lou WY, Taylor DR, et al. Cats and dogs and the risk of atopy in childhood and adulthood. J Allergy Clin Immunol. 2009;124:745–750. [PubMed] [Google Scholar] 10. Kim M, Oh JH, Park CY, Lee SW. Dry eye disease and allergic conditions: a Korean nationwide population-based study. Am J Rhinol Allergy. 2016;30:397–401. [PubMed] [Google Scholar] 11. Senanayake MP, de Silva R, Jayamanna MD, Jayasinghe JA, Ratnayaka D, Jayasuriya V, et al. Identification of aero-allergen sensitization in children seeking treatment for bronchial asthma at a tertiary care hospital for children in Sri Lanka. Ceylon Med J. 2014;59:89–93. [PubMed] [Google Scholar] 12. Qi J, Zhao Y, Li W, Wang J, Zhang Y, Zhang Y. Analysis of allergens spectrum in children with allergic rhinitis in Zhengzhou district. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015;29:404–406. [PubMed] [Google Scholar] 13. Qiu Q, Lu C, Han H, Chen S. Clinical survey and analysis of allergic rhinitis patients' allergens in Guangdong developed and developing regions. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013;27:928–931. [PubMed] [Google Scholar] 14. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733–743. [PubMed] [Google Scholar] 15. Rönmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundbäck B. Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden. J Allergy Clin Immunol. 2009;124:357–363. 363.e1-15. [PMC free article] [PubMed] [Google Scholar] 16. Salo PM, Arbes SJ, Jr, Jaramillo R, Calatroni A, Weir CH, Sever ML, et al. Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134:350–359. [PMC free article] [PubMed] [Google Scholar] 17. Suh M, Kim HH, Sohn MH, Kim KE, Kim C, Shin DC. Prevalence of allergic diseases among Korean school-age children: a nationwide cross-sectional questionnaire study. J Korean Med Sci. 2011;26:332–338. [PMC free article] [PubMed] [Google Scholar] 18. Lee SL, Wong W, Lau YL. Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood) Pediatr Allergy Immunol. 2004;15:72–78. [PubMed] [Google Scholar] 19. Kim C. Pooch protection and profit: South Korea to overhaul pet sector [Internet] London: Reuters; 2016. Jul 06, [cited Oct 10, 2017]. Available from: http://www.reuters.com/article/us-southkoreaeconomy-pets-idUSKCN0ZN05V. [Google Scholar] 20. Patelis A, Gunnbjörnsdottir M, Malinovschi A, Matsson P, Onell A, Högman M, et al. Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness. J Allergy Clin Immunol. 2012;130:397–402. [PubMed] [Google Scholar] 21. Munir AK, Einarsson R, Schou C, Dreborg SK. Allergens in school dust. I. The amount of the major cat (Fel d I) and dog (Can f I) allergens in dust from Swedish schools is high enough to probably cause perennial symptoms in most children with asthma who are sensitized to cat and dog. J Allergy Clin Immunol. 1993;91:1067–1074. [PubMed] [Google Scholar] 22. Sakaguchi M, Inouye S, Irie T, Miyazawa H, Watanabe M, Yasueda H, et al. Airborne cat (Fel d I), dog (Can f I), and mite (Der I and Der II) allergen levels in the homes of Japan. J Allergy Clin Immunol. 1993;92:797–802. [PubMed] [Google Scholar] 23. Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372:803–813. [PMC free article] [PubMed] [Google Scholar] 24. Rondón C, Campo P, Togias A, Fokkens WJ, Durham SR, Powe DG, et al. Local allergic rhinitis: concept, pathophysiology, and management. J Allergy Clin Immunol. 2012;129:1460–1467. [PubMed] [Google Scholar] 25. Chinoy B, Yee E, Bahna SL. Skin testing versus radioallergosorbent testing for indoor allergens. Clin Mol Allergy. 2005;3:4. [PMC free article] [PubMed] [Google Scholar] 26. Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100:S1–148. [PubMed] [Google Scholar] 27. Linden CC, Misiak RT, Wegienka G, Havstad S, Ownby DR, Johnson CC, et al. Analysis of allergen specific IgE cut points to cat and dog in the Childhood Allergy Study. Ann Allergy Asthma Immunol. 2011;106:153–158. [PMC free article] [PubMed] [Google Scholar] 28. Martínez A, Martínez J, Sanz ML, Bartolomé B, Palacios R. Dander is the best epithelial source for dog allergenic extract preparations. Allergy. 1994;49:664–667. [PubMed] [Google Scholar] 29. Curin M, Reininger R, Swoboda I, Focke M, Valenta R, Spitzauer S. Skin prick test extracts for dog allergy diagnosis show considerable variations regarding the content of major and minor dog allergens. Int Arch Allergy Immunol. 2011;154:258–263. [PubMed] [Google Scholar] 30. Heutelbeck AR, Schulz T, Bergmann KC, Hallier E. Environmental exposure to allergens of different dog breeds and relevance in allergological diagnostics. J Toxicol Environ Health A. 2008;71:751–758. [PubMed] [Google Scholar] 31. van der Veen MJ, Mulder M, Witteman AM, van Ree R, Aalberse RC, Jansen HM, et al. False-positive skin prick test responses to commercially available dog dander extracts caused by contamination with house dust mite (Dermatophagoides pteronyssinus) allergens. J Allergy Clin Immunol. 1996;98:1028–1034. [PubMed] [Google Scholar] 32. Ohman JL, Jr, Lowell FC, Bloch KJ. Allergens of mammalian origin: characterization of allergen extracted from cat pelts. J Allergy Clin Immunol. 1973;52:231–241. [PubMed] [Google Scholar] 33. Wood RA, Phipatanakul W, Hamilton RG, Eggleston PA. A comparison of skin prick tests, intradermal skin tests, and RASTs in the diagnosis of cat allergy. J Allergy Clin Immunol. 1999;103:773–779. [PubMed] [Google Scholar] 34. Adinoff AD, Rosloniec DM, McCall LL, Nelson HS. Immediate skin test reactivity to Food and Drug Administration-approved standardized extracts. J Allergy Clin Immunol. 1990;86:766–774. [PubMed] [Google Scholar] 35. Niemeijer NR, Fluks AF, de Monchy JG. Optimization of skin testing. II. Evaluation of concentration and cutoff values, as compared with RAST and clinical history, in a multicenter study. Allergy. 1993;48:498–503. [PubMed] [Google Scholar] 36. Gleeson M, Cripps AW, Hensley MJ, Wlodarczyk JH, Henry RL, Clancy RL. A clinical evaluation in children of the Pharmacia ImmunoCAP system for inhalant allergens. Clin Exp Allergy. 1996;26:697–702. [PubMed] [Google Scholar] 37. van Ree R, van Leeuwen WA, Bulder I, Bond J, Aalberse RC. Purified natural and recombinant Fel d 1 and cat albumin in in vitro diagnostics for cat allergy. J Allergy Clin Immunol. 1999;104:1223–1230. [PubMed] [Google Scholar]