Monday, June 06, 2005

Pet Allergies

As you can see from this post, I was recently adopted by Precious. The person Precious previously owned had to be traded in because of her asthma.

Of course, as physicians, especially those of who take care of kids, are well aware of the problems with pet allergies and asthma. Many people are allergic to the dander of their pets.

We can have an allergic reaction to the proteins from the hair, saliva or urine of household pets. These allergies can present as hay fever type symptoms (runny nose, itchy eyes, sneezing), asthmatic/bronchitic symptoms (wheezing, coughing, shortness of breath) or skin symptoms (atopic dermatitis, rash.)

Don't jump to the conclusion that your allergic symptoms are due to your pet. Many allergic patients are not allergic to their pets. Allergy to dust mites are much more common.

You may want to request specific testing to pet allergens. Allergens are proteins to which the body produces an immune response. The result of this response is the release of a chemical called histamine. This release causes the symptoms described above.

The tendency for this type of immune response can be hereditary. If you are allergic, your parents, siblings and children may be as well. It is routine to take a family history regarding "atopy," or allergic type symptoms, when presented with a patient whose symptoms we suspect are allergy related.

If it turns out that you are allergic to your pet, there are multiple options. However, all allergy treatment begins with controlling/decreasing allergen exposure. It can be very traumatic, for the physician and the patient, to have to advise someone to get rid of their pet(s). I have had more than one patient flatly refuse to do this and decide the symptoms were worth it.

Even if you get rid of your pet, you may still be exposed to the allergens through people at work/school. It can be very difficult to get rid of all the allergens remaining in your home.

Of course, through the benefits of direct to consumer (DTC) advertising, we all know about the antihistamine medications that are available. The "first generation" meds, such as diphenhydramine (Benadryl) and chlortrimeton, have been available over the counter (OTC) for many years and we have probably all been on them at one time or another. However, they can be very sedating (diphenhydramine is the active ingredient in most OTC sleep aids) and are not good for use in school children.

The "second generation" meds are the "non-sedating" or "less-sedating" meds like Claritin, Allevert, Zyrtec, etc. These are gradually becoming available OTC. If one of these each day controls your symptoms this may be preferable to losing your pet. With these new options, we often will treat before doing testing. If these meds control symptoms, you are done.

For those with respiratory symptoms, there are inhaled medications that can be used to control symptoms. As you escalate therapy, the cost and risk of side effects goes up.

Options for reducing allergen exposure, whether pet or dust mite related:

  • Use a dehumidifier or air conditioner to maintain relative humidity at about 50% or below.

  • Encase your mattress and pillows in dust-proof or allergen impermeable covers.

  • Wash all bedding and blankets once a week in hot water (at least 130-140 degrees F) to kill dust mites. Non-washable bedding can be frozen overnight to kill dust mites.

  • Replace wool, flannel or feathered bedding with synthetic materials and traditional stuffed animals with washable ones.

  • If possible, replace wall-to-wall carpets in bedrooms with bare floors (linoleum, tile, hard wood) and remove fabric curtains and upholstered furniture.

  • Use a damp mop or rag to remove dust. Never use a dry cloth since this just stirs up mite allergens.

  • Use a vacuum cleaner with either a double-layered microfilter bag or a HEPA filter to trap allergens that pass through a vacuum's exhaust. Avoid sweeping as much as possible, even on non-carpeted floors, as this just stirs up dust and allergens. Use a damp mop or a hard floor cleaner.

  • Wear a dust mask while vacuuming to avoid inhaling allergens, and stay out of the vacuumed area for 20 minutes to allow any dust and allergens to settle after vacuuming.

  • Utilize air filtration systems to remove allergens 24/7. Be sure to change the filters in your air conditioning system as recommended, more often if you have a dusty environment.

  • If pet related, restrict the pet from the bedroom of the patient, from the house, or even adopt the pet out.