Skin Care

Skin Care:

The skin is the largest organ an animal has and in some animals skin issues arise from many different causes, some of which are extremely difficult to diagnose. 

There are many different triggers that can lead to an inappropriate immune response whereby the animals skin develops an inflammation and the itch scratch itch cycle begins.

Some of these triggers include flea saliva, mange mites burrowing through the skin, contact allergies such as pollens, wool lino, sawdust, plant allergies such as Ivy or Wandering Jew or food allergies from different proteins found in the diet such as beef or chicken or pork.

In humans a common food allergy is known as Coeliac disease, where people are allergic to a protein called gliadin which is found in the gluten protein of wheat and similar grains.  Gliadin is a similar shape to the milk protein casein so many Coeliacs are also allergic to dairy products that contain casein.  Similar allergies occur in other mammals and diagnosis of these allergies is difficult, expensive and often unrewarding.

Irrespective of the cause of the skin irritation, there are different ways to approach this problem in your pet.  There are specialist referral centres that initiate testing of many allergens through injecting different allergens into the skin of your pet and seeing which one they react to.  This form of diagnosis is not commonly undertaken due to its high cost and mixed results regarding achieving a true diagnosis as to the cause of the skin irritation.

Another method is to eliminate potential causes over time.  For example, you could increase your flea treatment regime and treat for mange mites.  This would then rule out parasitic causes.  You could eliminate beef from the diet for at least 6 weeks and see if the skin calms down.  You could try a different diet completely such as Black Hawk, where the protein source and oils used to formulate the feed are sourced from outside New Zealand and therefore your pet is unlikely to have come across them before.

Addition of oils to the diet is always a good idea and treating for infectious diseases also is a good start to helping clearing up a skin condition. 

It is important to note that the skin is a large and dynamic organ and it is unlikely that you are going to get a magical cure from a single visit to the vet.  It has probably taken years to develop so will take a long period of time to sort out.

Products that Alleviate Itchy  Skin:

Itchy skin comes from an allergic pathway that has been stimulated by something as mentioned above.  There are hundreds of things that can cause this immune response and each immune response follows a pathway to produce itchy skin.

Preventing the itchiness can be achieved using drugs such as steroids (glucocorticoids (not anabolic steroids)), or non-steroidal products such as Cytopoint injection or Apoquel tablets.

The pathways followed by each immune response that cause skin itchiness are all different and not all drugs have an effect on every pathway, so some drugs may work in one dog but not in another due to the different immune response occurring in each animal.  This is the difficulty in treating itchy pets.....which drug to use?

Steroids:

Steroids are really good at stopping all itchy pathways as they have an effect on every pathway, stopping the itchiness and allowing your pets skin to recover.  They are usually started on a high dose rates which then decrease until it stops working.  At this point it is increased slightly to give an effective response for the animal over a long period of time.

Steroids do have negative side effects.  However, if managed correctly they can be successfully used long term for the treatment of skin conditions in animals.

Cytopoint injection:

This is an immune modulator drug in that it can prevent the pathway of itchiness for some causes but not others. 

This is why it works in some animals and not in others due to different primary causes occurring.  For this reason it may also only give 2 weeks effectiveness in one animal and up to 3-5 months in another. 

If used repeatedly its effectiveness has been known to decrease over time which is why rotation between anti-itch products is a good idea.

Apoquel tablets:

These are also an anti-inflammatory product that works yet another way and has a different activity on different causes of itchiness.  This again may work for one animal and not another due to different causes.

These are initially given at high doses reducing to a maintenance dose over time and again given to effect based on clinical signs of your pet scratching itself.

Anti-Histamines:

For all drugs to actually work, the animal taking them must have cells that have receptors on them that can actually receive the molecule in that drug.  If the cells do not have any receptors, the drug just passes by the cell which it cannot attach to and is excreted in the urine or faeces at  a later date, having had absolutely no effect.

Antihistamines work well in humans for things such as hay fever or pollen allergy due to the fact that most humans have cells that have anti-histamine receptors on them.  They take the oral antihistamine, it binds to the cell and turns the itchiness off.

Dogs do not always have antihistamine receptors, therefore in some dogs dosing them with an antihistamine tablet will have no effect. However some dogs do have these receptors and if your dog has say a grass allergy and has these receptors then an antihistamine would be great at preventing it itching when it goes for a walk.

As an aside, and to provide an example of why being able to bind to receptors is important for allergies / diseases to occur.  Viruses and bacteria cause disease by being able to bind to animal cells.  If they can’t bind, much like a pharmaceutical drug, then there can be little or no interaction with that cell.

 

 

For example; COVID-19 Vaccine;

The COVID-19 virus is a vasculytic virus in that it binds to cells within the blood vessel system and ruptures them.  As everything within our bodies requires a blood supply, having a virus invade and damage these blood vessels throughout the body can result in significant and long lasting disease, irrespective of whether or not it is fatal. 

The Covid-19 vaccine stimulates the human immune system to produce the spike proteins that the COVID-19 virus uses to bind to human respiratory and other body cells in the vascular system.  This results in natural antibody formation against these spike proteins which are then stored in advance of any infection.

When a COVID-19 virus enters our body, the stored spike protein antibodies that are already present, immediately bind to the spike proteins on the virus making it unable to bind to our body cells.  If the virus can’t bind then it can’t cause disease and is eliminated. 

Vaccination does not stop infection it just makes a vaccinated person a dead end host for the virus where it cannot replicate and mass produce itself.

Whereas, in an unvaccinated person where the virus can attach to cells, it can then invade them, replicate inside, rupture those cells and invade more cells and so on causing vascular damage and disease.  It then takes the body’s immune system 14 days to recognise the real viral spike proteins and the virus within our body and then makes the same antibodies to fight it off.

 If the virus within this two week period has damaged blood vessels in your brain (strokes) or heart (cardiovascular disease) or lungs, liver and kidneys, then by the time you make antibodies against it, it may be too late to prevent disease as it has already happened. 

That is why vaccinations are prophylactic – ie/ they are given before you need them ie/ before you get the disease, much like having house insurance.  We all pay our insurance premiums every year just in case our house burns down one day.  No point paying it after it has burned down as the insurance company is probably going to say no.

 

Back to the itchy pet.......

As an interim step, drugs such as steroids can be used to give your pet some respite from having itchy skin as all pets have receptors for steroids and these drugs are able to bind to the cells producing calmness.

You may also try Cytopoint injection or Apoquel tablets.  However, if there are no receptors for these products or they have no activity against the irritant that your animal is allergic to, then they will have no effect.  Using these later two drugs initially is a trial event to see whether or not your animal has receptors for these drugs to work or whether the itchiness is caused by an irritant pathway that they are effective against. 

Food Allergies:

If your pet is allergic to a food protein and you eliminate it from the diet it may take up to 8 weeks before the body responds.  You may require a prolonged course of steroids to help out as this period elapses.

There are many different allergy diets that can also be initiated to help rule in or rule out whether or not your pet’s skin condition is related to diet.  If they each take eight weeks to complete, you can see that this process can be a long one.

If you have a skin issue with your pet, please call us sooner rather than later as the skin is a complex organ to treat and the sooner treatment protocols are initiated the better for the animal.

If you have any queries please call us to see a veterinary surgeon and we will initiate a programme of treatment that we feel best suits your pets individuals needs – 06 3503950 or centralvetsandpets@gmail.com