All About The Itch: Atopy

Before we start, a small side note: Hey guys! I want to apologize for missing Thursday’s blog update. Since I’ve started actively blogging, meeting a twice-weekly schedule has been one of my top priorities. I hope to deliver relevant, informative content on a timeline that my readers can expect and rely on. Thursday, I failed to do that- I was sick with the stomach bug. In the future, I hope to have each post written a few days in advance so that I can be a more reliable blogger for my audience. Thanks for sticking with me!

Today, we’re going to be talking about something called atopy.

Atopy (also known as atopic dermatitis) is a condition that results in chronic dermatitis (skin inflammation), and is associated with allergies, usually from the environment. Atopy is in full bloom here around the tristate. I’ve been seeing itchy dogs (and even itchy cats) left and right. Unfortunately, atopy can be a very difficult problem to diagnose, and can be even more difficult to manage.

Here are 5 things you should know about atopy in dogs and cats;

  1. Allergens invade your pet’s immune system through the skin- not the respiratory system. It was once thought that, much like humans, dogs inhaled their allergens, which then caused a skin reaction. We now know that the allergens that cause skin inflammation break directly through the skin barrier. Because of this, keeping your pet’s coat healthy with topical shampoos and essential fatty acids is extremely important in treating this disease.
  2. Atopy can only be ‘definitively diagnosed’ when all other causes of itching and skin inflammation are ruled out. Atopic dermatitis is what veterinarians call a “diagnosis of exclusion.” That means that we cannot say for certain that skin disease is caused by environmental allergies unless we rule out all other causes of skin inflammation. These causes include mites and other topical parasites, food allergy, bacterial infection, ringworm- the list keeps going. If your vet is suggesting diagnostic tests, don’t get frustrated! Remember that your vet is just trying to make sure that a different problem isn’t going undetected.
  3. A wide variety of allergens can play a role in atopic dermatitis. Dogs can be allergic to seemingly ridiculous things- even cat dander! Common allergens associated with atopy include animal dander, dust and dust mites, feathers, fleas, grains, cleaners, insects, mold spores, plants, pollen, and wool. Because many of these allergens are ubiquitous in the environment (meaning: everywhere, no matter what), eliminating them from the atopic pet’s environment is often not possible. However, if you can find out what the cause of the reaction is- eliminating or reducing exposure to the allergen is a good place to start.
  4. There is no cure for atopic dermatitis. But it can be managed. Usually, long term management involves allergy testing and immunotherapy (small doses of the allergen that are given to desensitize the pet to its effects). In the last few years, products such as apoquel and atopica have been developed to act as immune suppressants, which decrease a pet’s immune response to an allergen. Recently, a product called Cytopoint has launched that is a biologic aimed at preventing the itch signal from being released in dogs. These products are impressive and have very few side effects compared to traditional treatments (such as steroids), but they can be expensive, and patients usually require them at least periodically for life.
  5. Symptomatic treatment can help some pets. Some pets may benefit from using anti-histamines, topical anti-itch medications, and short courses of steroids (long-term steroid use is no longer advised due to the high risk of dangerous side effects). However, these treatments may not be enough in severe cases of atopy. Some pets may do well for most of the year on antihistamines, and only need apoquel (or the other products listed above) during flare ups. Which treatment is best for your pet depends on many factors, and your veterinarian is the best person to ask for advice!

If you think that your pet may be having signs of atopic dermatitis (such as inflamed ears, head shaking, licking the paws, gnawing the legs or forearms, scooting his back on furniture, and otherwise itching excessively), talk to your vet about the short and long-term options for treatment. Remember that atopy is a complicated disease and that there is no permanent cure. However, you can substantially improve your pet’s comfort level and quality of life by communicating well with your veterinarian and by being dedicated to life-long management.

Question for readers: Has your pet ever been diagnosed with atopy or “allergies?” What steps did you and your vet take to improve his or her quality of life?



My 5 Favorite Flea Preventions (For Cats)

Hi Y’all! Last weekend, I confessed my feline flea prevention faux pas. On Thursday, we talked about my 5 favorite flea preventions for dogs. Today, we’re going to give the cat people some love. Flea prevention is just as important for cats (even if they are indoor only) as it is for dogs. Cats often have fleas with few symptoms or signs- they are fastidious groomers and an owner may see their cat itch and be unsure why.  However, many flea products available on the market can be harmful or deadly to cats, and so it is important to know which products are best for your kitty.

Although this article will focus mainly on flea products, many of the products I list below are also heartworm preventatives. Heartworm disease in cats results in respiratory distress and can even be fatal. Your cat won’t need a heartworm test to get started on heartworm prevention, but it must be purchased from a vet or with a veterinarian’s prescription, so talk to your vet today about getting on flea and heartworm prevention.

Disclaimer: I have not been sponsored or paid to write about these products by anyone. These opinions are my own and are based of 2 years of experience as a veterinarian and a combined total of nearly 10 years of working in the veterinary medical field. My opinions do not necessarily represent the views of my employer or of the veterinary medical profession as a whole. To ensure complete transparency, products listed below that are followed by a star are sold in the veterinary practice where I work. Products that are italicized have been given to me as free samples by company representatives.

Please note that I only recommend products that are safe and effective. I would never recommend anything that I didn’t feel comfortable using on my own pets.

Now, without further ado, here are my 5 Favorite Flea Preventions For Cats

  1. Revolution* 
    Revolution is a very safe, gentle, and effective flea and heartworm preventative. It is applied topically on the back of the neck and lasts for a month. It also protects against ear mites, roundworms, and hookworms. I use this product frequently on my two cats. This is also the product I use on many small mammal species, such as ferrets, guinea pigs, and rabbits (although this is considered “off label” use).
  2. Advantage Multi
    This product is also a topical flea and heartworm prevention that protects against ear mites, roundworms, and hookworms. The biggest difference between this product and revolution is that Advantage Multi has been tested and is labeled for use on ferrets. This product is only available through your vet, but another product marketed by Bayer (and available over the counter) is Advantage II, which is essentially Advantage Multi without the heartworm and intestinal parasite component.
  3. Bravecto for Cats*
    This is one of the newer products on the market, and it is quickly becoming one of my favorites. Like the others, It is a topical that is applied to the back- but it only has to be applied every three months. The only downside is that you must apply a larger volume of product compared to Advantage or revolution, and the solution is somewhat greasy until it dries. It protects against fleas and ticks, but does not protect against heartworms or intestinal parasites. I recommend using a monthly oral heartworm prevention, such as Heartgard, if you’re using this product.
  4. Comfortis*
    Comfortis is a prescription product that is also available for dogs. We didn’t talk about it for dogs as I prefer Trifexis for dogs, which is essentially comfortis plus heartworm prevention. There isn’t a trifexis for cats, unfortunately, so you should pair comfortis with a monthly heartworm prevention. It is a tablet you must give once monthly, by mouth. The biggest downside is that this tablet is somewhat large, and can be difficult to give to cats as they can be significantly harder to give medicines to than dogs.
  5. Seresto
    Seresto for cats is an over-the-counter collar that prevents fleas and ticks for 8 months. I really like this product. It is very safe, effective, and has a safety release mechanism in case you cat gets caught on something. I don’t recommend any other type of flea collar for cats- seresto is different from other collars because it is safe and effective, isn’t greasy or smelly, and doesn’t contain chemicals that are highly toxic to cats.

Question for readers: Are you guilty on skimping on your cat’s monthly flea and heartworm prevention? Have you ever had a good or bad experience with a product? Share below!

If you liked this post, please comment, subscribe, or share to help us reach more pet owners! Don’t forget to stop by on Thursday, where we will break down my 5 LEAST Favorite Flea Preventative for Dogs and Cats.

P.S. Happy Easter!


Photo cred for Easter Bunny and Orange Cat Picture:

“Help! My Cat is Peeing Everywhere!” What to Do if Your Cat isn’t Using Their Litter Box

Did you know that inappropriate urination is one of the leading reasons why owners leave their cats at shelters?

Sometimes the symptoms happen gradually, and sometimes all at once. Maybe fluffy was peeing in the bathtub for a while, and that was tolerable, but now she’s started peeing in the clothes hamper, and your spouse is ready to kill both of you. Other times, the cat is meowing loudly inside the litter box, and then he goes and squats in a corner instead. No matter how it presents, it is important to recognize this could be more than your cat just trying to spite you. In fact, he or she may need your help!

Before we go any further: If you have a male cat that is straining to urinate, and is producing little to nothing, take him to the vet immediately. He could have a urinary blockage, which can be fatal if not rapidly treated in male cats.

Behavioral and medical problems can cause your cat to avoid his litter box. These causes are often closely related. Behavioral stress can lead to a medical condition known as FIC (feline idiopathic cystitis) and sometimes called FLUTD (feline lower urinary tract disease). The exact pathway of this disease is unknown, but it is believed that the behavioral stimuli cause inflammation of the lower urinary tract, leading to the clinical signs that you are seeing at home.

Medical causes also include serious organ or metabolic diseases such as diabetes, kidney disease, or hyperthyroidism, which can cause cats to drink and urinate excessively. Less serious causes include a urinary tract infection or bladder stones/ urinary crystals, which can be very irritating to the inner lining of the bladder and tract. These medical conditions can be diagnosed easily by your veterinarian through a urine analysis, some bloodwork, and imaging to look at the bladder.


Once you’ve visited your veterinarian and your pet has the “all clear,” here are some things you can do at home to help:

  1. Make sure you have the right number of litter boxes

    The “magic number” of litter boxes given by veterinary behaviorists is “N+1,” where N equals the number of cats in the household. For example, if I have one cat, I need two litter boxes. If I have two cats, I need three litter boxes (and so on). It is also important to mention that, regardless of the number of cats in the household, you should at least have 1 box on every floor of your house. These boxes should be easily accessible and meet the criteria listed below.

  2. Make sure you’re using the right type of litter boxes and cat litter

    Cats prefer clumping clay litter, and tend to use it more readily. It is recommended that you scoop the litter box once daily. If your cat has clumping litter and is not using it, I recommend using Dr. Elsie’s Cat Attract Litter, which worked miracles for a cat that I had with FLUTD. Cats prefer large boxes that are easily accessed and do not have a lid, which may trap odors inside the box. A kiddie pool would be the perfect box, but realistically this isn’t possible for most pet owners. Instead, look for a big, wide, simple box. Fill it with at least 2 inches deep of cat litter, and place it in ideal locations. Viola! You may be surprised at what a difference this makes.

  3. Provide environmental enrichment

    Boredom has been associated with FLUTD/FIC. Make sure your cat has plenty of things to occupy his highly intelligent mind. Play with him a couple of times a day, get him a cat tree, let him look out of some windows or walk him outside on a leash. This will lower his stress, which can reduce the signs and reoccurrence of FIC.

  4. Use pheromone diffusers

    This is especially helpful when aggression between multiple cats may be playing a role. There are several pheromone diffusers, sprays, and collars that can help cats relax. My preferred brand is Feliway. Use them in rooms where the accidents usually happen, or in areas where there is a litter box.

  5. Change your pet’s diet

    Most vets will recommend this the first time they see your cat for urinary tract disease, regardless of the cause. Some prescription diets are specially formulated to dissolve stones. My favorite diet for FLUTD is C/D Multi-care Stress, made by Hill’s science diet. However, if a prescription diet is out of your budget, try an over-the-counter bag of food for urinary health. Purina Pro Plan makes a “Urinary Tract Health Formula” that you can order online or at Petco.

If you do those steps and your cat is still having accidents, talk to your vet or a veterinary behaviorist to discuss other treatment options and to make sure a health problem was not missed!

Questions for Readers:
Has your pet ever had this problem? What worked for him or her?
If you try these tips, please comment below on what worked (or didn’t)!

Resources & References: 

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”



Veterinary Myth Busters: Part One (an overview)

Greetings, earthlings! Welcome to the first post in a mini series I am doing called:

Veterinary Myth Busters

I tweeted over the weekend, asking my veterinarian friends what common veterinary medicine myths (#VetMedMyths) annoy them the most. Today, we’ll go over the top 3 from the list and briefly go over why they are not true. Later on, we will unpack each topic in a little more detail to break the cycle of misinformation that permeates the internet. Stay tuned so that you can be the most informed pet owner at the dog park!


“Grain free food is better for dogs, because most are allergic to corn.”

Submitted by: Me, @KatieHoganDVM

I hear this one daily in practice, and it drives me nuts. Most dogs with food allergy are not allergic to the grain in the diet, but to the protein (the beef, chicken, turkey, etc) in the diet. Grain free diets often come coupled with novel protein sources (proteins that your dog’s immune system hasn’t seen before), and so when they make the switch to grain free they see an improvement because they changed the protein, not the grain.

The “corn is bad for dogs” myth has been perpetuated by the excellent marketing strategies of certain pet food companies. These guys claim to sell “premium” products fit for the wolf living in your living room. Sorry, people, but your pug mix is not a wolf! Even if he was, corn would still not be bad for him. Corn is quite nutritious for dogs and other species. I encourage you to talk to your veterinarian, do your research and feed a high-quality food with meat as the first ingredient on the list. Some dogs do well on grain free food- but for most dogs (80-90%), you’re wasting your money.


“I don’t need heartworm and flea prevention because…”

Submitted by: @BalyBoo

You would not believe some of the ways people finish this sentence! The people who say this think that their pet is immune to the need for parasite prevention because they live in a gated community, their dog never interacts with other pets, they spray for mosquitos, they have hardwood floors, they’ve never had a problem before…. The list goes on and on! Later in this series, we’ll break down the many excuses and bust each one of them individually. But, for now, we’ll keep it short and sweet: Heartworms are spread by mosquitos, who can quite literally survive anywhere. Unless you keep your dog or cat in a plastic bubble…. he needs heartworm prevention!

As for fleas, they are extremely resilient, and can be spread by wildlife and feral/outdoor cats. In my practice, I see as many animals suffering because of fleas in the winter as I do in the summer. If your pet has fleas, you need at least four months of flea prevention to get rid of the current infestation. And if your pet goes outside or you have other pets that go outside? All pets in the household need flea prevention. Remember the old saying- an ounce of prevention is worth a pound of cure!


“Spaying my dog will make her sick”

Submitted by: @TiffanyHeaton

I hear this one a lot. In fact, it is 100% the other way around! Spaying your female dog before her first heat cycle reduces her risk of mammary cancer to a 0.5% chance compared to the 25% chance (1 in 4 dogs) for females who are not spayed or spayed after their second heat cycle. Breast cancer accounts for over half of all cancers in female dogs, and by spaying early you nearly eliminate this possibility!

Another common condition in older, unspayed female pets is pyometra- a serious infection that can be life-threatening and requires immediate (and very expensive) emergency surgery. We see this condition (as well as mammary cancer) in feline patients as well. Simply put, you will greatly increase your pet’s life expectancy and quality of life if you spay her before she is 6 months old!

Thanks for joining us for part one of the #VeterinaryMythBusters series. Check back on Sunday, where we will be investigating the grain free food myth!

Do you have a myth you’d like to submit? Want to get in on the conversation? Comment below or tweet @KatieHoganDVM



Resources and References:
Photo of dogs book Photo by Lisa Fotios from Pexels
Photo of dog eating fruit by Rarnie McCudden from Pexels
Photo of little girl and dog by Kai-Chieh Chan from Pexels
Photo of dog with bow by Caio Resende from Pexels
Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”