Maya's Allergies Under Control and Lessons Learned

It's been a while since I posted here. The good news is, Maya's allergy has been under control for the past year. 

Cone free in the middle of summer!

I have been asked under several occasions for tips on dealing with allergies. I'd like to share some of our experience through this whole ordeal. 

Elimination food trial is a good start to rule out food allergies. There are no real scientific way to test for food allergies, but Glacier Peak (Maya's results) and Hemopet has "sensitivities and intolerances tests" which may be worth trying. I'd suggest using raw rabbit as main protein for the trial.

If the allergy is not food related, then you'll need to look into environmental allergens. Blood test (Maya's results) or skin test (Maya's experience and results) could help find the cause, and the vet can prescribe custom made allergy shots or oral sprays for immunotherapy treatment. This is the only possible way to really "cure" allergies. Unfortunately, for Maya, neither test was conclusive, so we tried RESPIT, which uses the common allergens in the area. After a year, it seems to help with her fall allergies, but not for spring.

If immunotherapy doesn't work or is not a possible solution, then there are two different types of medicine, Atopica and Apoquel. Sadly, both may cause long term side effects. Maya is currently on Atopica and so far it has been effective. Between the two meds, we opted for Atopica, because it has been out on the market for longer. Apoquel will be our last resort if somewhat Atopica fails. With a good understanding of Maya's seasonal routine, we were able to keep her dosage very low.

There are also many holistic methods you can find online. They may or may not work. Some are worth trying, but do keep the exceptions low. I have had my fair share of high hopes and big disappointments. 

She still made a small scratch mark on her face this year

And a few lessons I learned along the way:

1. Whether it's food allergy or not, keeping a healthy digestive system is important. Digestive enzymes and probiotics are helpful. Check the poop daily and try to keep it firm.
   
   Maya had very soft poop throughout her puppy days. The vet told us it's common for puppies and she'll grow out of it. It never gotten better till we switched her to raw. I often wonder if I had fed her better when she's young, perhaps things will be different. Well, I'll never know.
    
2. Use flea repellents. Monthly flea meds only works when the dog is bitten, which is too late. Repellents lower the chance to even get bitten. I make my own using this recipe.
    
3. Be careful with open wounds and infections. Open wounds lead to infections. Infections increase the itchiness. Increased itchiness causes more scratches. More scratches lead to more wounds. And the bad cycle goes on, extending the itchy duration beyond the allergy season. More than once, we had rely on steroid and antibiotics to end this bad cycle. This year with Atopica keeping her itchiness under control and not causing infections, we realized she was itchy for a much shorter period of time than before.
   
   For yeast infections, we found the Zymox products helpful. (See Maya's ear infections.) For bacterial infections, we used Douxo AntiSeptic Mousse (the mousse is a bit hard to apply though, I would suggest using a different product with same ingredients). You may need your vet's help to determine weather it's bacterial or yeast infection. For a long time, we thought Maya has yeast infections, but it was actually bacterial.
    
4. Keep a detailed journal. Write down meds taken, food eaten, activities, places visited and "itchiness level". We were able to conclude Maya's allergies is seasonal from our records, and also adjust her Atopica dosage accordingly. I use Day One app on my iPhone to keep Maya's journal. 

We hope no other dog ever has to suffer what she did

Disclaimer: The information above is solely from my own experience. Please do your research before trying anything someone suggested online and consult with your vet.  

Teeth Cleaning

Yesterday, Maya had an appointment for anesthesia-free teeth cleaning. 

In general, she has pretty clean teeth, except for her silver tooth (see the story about her fractured tooth). Maybe she chews with that tooth less, or maybe because the texture is different, it somehow always has plaque built up on it. A few months ago, I also noticed a chip in her other premolar. Although it looks fine, I really do want a profession opinion. 

Maya's dirty silver tooth before the cleaning

I have a few options, an office visit to the pet dentist will cost about $100+, which the doctor will likely suggest a teeth cleaning, which will be another $800+, and run the risk of putting her under anesthesia. Another option is to try the anesthesia-free teeth cleaning, which costs $175, and includes a checkup by the vet. If the cleaning isn't needed or not suitable, I will only need to pay $25 for the vet visit. Price-wise and risk-wise, it's a no-brainer.

However, I also heard that the procedure could be very stressful and painful for the pet, so we need to take that into consideration as well. Since Maya has always been good when I brush her teeth and the spots that needed cleaning is limited, I believed she would be able to tolerate it. 

On the day of the appointment, after filling out some paper work and briefly going through her broken tooth and chipped tooth issues, Maya was taken to the back of the room and I was told to come back in 20 minutes. When I came back, I was surprised to see Maya wrapped in a towel, lying calmly in between the hygienist's legs. She wiggled a bit once in a while, but no signs of struggling or trembling. When it's done, she jumped right up and greeted me with a wagging tail, so I guess she was fine. Not a great experience, but at least not traumatizing.

During the cleaning

After the cleaning, we got some good news and some bad news. The bad news is that besides the chipped tooth I noticed, Maya actually chipped like 10 teeth. We know she's a heavy chewer, but we didn't expect it to be this bad. The good news is that the chips are all on the surface so nothing harmful as long as we prevent further damage. Well, no bones for her anymore! They also said I did a pretty good job keeping her teeth clean, and the super expensive sliver tooth was nicely made.

Overall, it was a good experience and the price was reasonable. I hope I can keep up with the cleaning and pay extra attention to the silver tooth, so we no longer need this type of service. If she ever do need teeth cleaning again, I will definitely pick this over putting her under anesthesia. However, I still want to point out that this may not be suitable for every dog. Especially those who don't like to be handled, hate teeth brushing, or have lots of cleaning needed. 

Anyways, very proud of my little girl!   

Her silver tooth after cleaning

Skin Test Details

Since a few people asked about what was included in Maya's skin test. Here's a copy of the test results. There are quite a few 1s and 2s, but the vet said those are fine.

On the bright side, the patch of fur that got shaved off is growing back in. If I didn't mention it myself, no one actually noticed it.

Pet Insurance - Year 2

This is a follow-up post to my previous one about pet insurance. Sadly, it's not as positive.

After a year without any claims, Maya's 2nd year premium increased from $580 to $793. I was really shocked when I saw the quote, especially since Maya wasn't even 5 years old.

A nice Shiba owner, who originally recommended PetPlan to us, helped contact their customer service and voice our complaints. They were quick to respond, but said there was nothing they can do to lower the price unless we pick a plan with less reimbursement level. Well, that kind of defeats the purpose, right?

After some debate, we still paid the high premium. Since we got some discounts the first year, I hope the big increase is just a one time thing. If the price keeps going up at this rate, I will seriously have to reconsider whether it's really worth having the insurance. We'll see in a few months.

To be clear, I have read posts online about which insurance will be "worth it", as in whether their expected "return" will be more than the money they paid. Like I mentioned in my other post, insurance companies are not charity and they are here to make money, so for most of us, it will never be "worth it", and I am totally fine with that. If Maya can grow old without ever needing to file a claim, I am totally fine as well. What I don't like, is the steep price increase that caught me by surprise. Perhaps if the insurance company can lay out a price projection for next 10 years, I would have been a much happier customer.

Anyhow, Maya was not impressed.

Link to my previous post: Pet Insurance (Jan. 10, 2014)

Skin Test Results and Atopica

After the round of steroid and antibiotics treatment, Maya was feeling much better. Around mid-April, we took Maya back to the dermatologist for an allergy skin test. Well, that was one of the fastest way to waste $$$$$. 20 minutes after they sedated Maya and shaved off a patch of her beautiful fur, the result came back all negative. So we were back to where we were 3 years ago.

Customized immunotherapy is no long an option. As for RESPIT (another type of immunotherapy that uses general allergens in the area, so no need to pin point the allergens causing troubles), the doctor thinks that's just adding random allergens in Maya's body, and blew off the idea. Then, she denied giving us Apoquel. She said the meds hasn't been out long enough and there could be unknown side effects. Somehow I feel like she said so only because she was out of stock.

Once again, Maya was put back on Atopica, which I hate. The possible side effects really worries me. However, on the other hand, I need to consider her quality of life. Pure holistic treatment was not taking us anywhere, and we just couldn't let her suffer anymore. It feels giving in and taking the easy way out, but we've spent 3 years trying to find something that works. How many more 3 years will she have to let us "experiment"?

So far, Maya's on Atopica once every 3 days for almost 2 months. She has been doing well, but May and June were always her "good months", so we'll have to wait till August to see. Meanwhile, I still haven't given up on finding a more natural approach. And hopefully, the "good things" we are providing her and the good mood she's in, can help combat some of the negative effects of the drugs.

Revisiting the Dermatologist

Due to various reasons, we decided to give the dermatologist another try. The one we went to 3 years ago is the only one in this area, so we didn't have much choose, but we did pick a different doctor this time.

Before we headed over, I have two plans in mind. One is to put Maya on Apoquel, a new drug that seems to have helped many itchy dogs, but was out of stock due to high demand as soon as it came out in 2013. Two is to start Maya on RESPIT, a sublingual immunotherapy that targets common regional allergens and doesn't require allergy tests.

Well, of course nothing went as I planned. Apoquel is still out of stock till April, and even then, they are not guaranteed to have enough supply for new patients. As for RESPIT, the doctor thinks the success rate is low by just targeting random allergens. She suggested us to do a blood test or skin test first to identify the causes and customize the immunotherapy to Maya's needs. Since we've already done a pretty useless blood test, I wanted to go straight for a skin test.

Unfortunately, unlike blood test that can be done right away, Maya can't do the skin test now. We have to get Maya's itchiness and infections under control, or the result will not be accurate. So we were sent home with steroids and antibiotics again. Great! To make things even more interesting, she can't do her skin test while she's on the steroids either, so we need to put her on the meds for 2 weeks, take her off for another 2, then do the tests. Nothing can be done till a month later, and whether she'll be itchy again when she's off the meds is unknown. Uhh!!

Oh well, at least for now, the meds did stop the itch and she's out of her Thundershirt. It is kind of nice that we can all sleep through the night.

Bad Behaviors

A few days ago, when we were in the elevator, Maya stuck her head in the grocery bag, smelling the meat, the fruit, the yummy Cheese cake. For a split second, I thought about stopping her. This is not a behavior I normally allow. Then I questioned myself. Spring allergies has been brutal and she has been so uncomfortable in the past two weeks. Why take away this little happiness?

I noticed I have been letting her get away with some mischief lately, especially when she's sick. When she's pulling on leash, she won't be sitting in the middle of the street scratching. When she's begging for food, she won't be noticing the tingling sensation on her butt. When she's chewing on my blanket, she won't be licking her own feet. I believe a dog deserves all the happiness in the world. If only I can figure out how.

We will be going to the dermatologist again next week. Hopefully, we will find better solutions this time. Wish us luck.