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 Dogs)

Hi guys! Now that you know how important flea prevention is for your dog, you are probably feeling a little bit overwhelmed trying to figure out which product is the best. In this post, I am going to tell you which products are worth every penny- which to me means that they are highly efficacious, safe, and science based. I hope you enjoy the list. Check back on Sunday, where we will be talking about my five favorite flea preventions for cats, and next Thursday for my five LEAST favorite flea preventions.

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 underlined have been given to me as free samples by company representatives.

I only recommend products that are scientifically based, effective, safe, and that I would feel comfortable using on my own pets.

My Top 5 Favorite Flea Preventions for Dogs:

  1. Trifexis*
    Trifexis is my absolute favorite antiparasitic product on the market. It is a one monthly prevention that is given orally with a meal. It protects against fleas, whipworms, hookworms, roundworms, and heartworms. It must be purchased with a valid prescription from a veterinarian and an up to date heartworm test. Animals that have had seizures before should not take this (or any oral flea preventatives). This product should always be given on a full stomach, as rare GI upset can occur. My dog, Gemma, is on this every month and has been since she was 5 months old. She looks forward to taking her special “treat” and has never had a problem with it.
  2. Revolution*
    This product is a heartworm and flea preventative (it also protects against one species of ticks, and is effective against mange mites). It is applied topically. Animals should have a heartworm test before purchasing this, and this should be purchased from a vet. Revolution is one of the safest products on the market. I’ve used it “off label” in very small pets such as neonatal puppies and kittens, guinea pigs, ferrets, and rabbits. The newest addition to my family, Franklin, is on this preventative as he is currently too small for anything else.
  3. Nexgard*, Bravecto* Chewables
    These are some of the newer preventatives out there. Simparico is another comparable product, but it is not on this list as I am not familiar with it. These products are given orally, and are flavored chewable tablets that most dogs actually love to take. Like other oral products, don’t use them if your pet has seizures. These products also kill ticks, but do not protect against heartworms or intestinal parasites. Nexgard lasts for one month and Bravecto lasts for 3 months. You do not need a heartworm test to purchase these, although they should be purchased from your vet. My oldest dog, Willow, takes Nexgard (and heartgard) every month. She is very picky about pills, but she loves them!
  4. K9 Advantix II
    K9 Advantix and Seresto (below) are made by Bayer Health and are the only OTC products that I trust. K9 Advantix is highly effective at killing and repelling fleas, ticks, and mosquitos. It is applied topically. You can get this product at many pet stores, and you don’t need a prescription from your veterinarian. Be very careful with this product if you have cats- if a cat is exposed to the product while it is still wet or if it is accidentally put on a cat, it could be fatal.
  5. Seresto Collars
    Seresto collars are the only collar you’ll ever hear me (and probably most other veterinarians) recommend. How are they different from other collars on the market? For one, they aren’t greasy, smelly, or gross. It lasts for a whole eight months and has been extensively researched and found to be very safe. The product has been rigorously tested- and is safe even if the collar is chewed on or ingested. Most other collars aren’t efficacious, are smelly and greasy, last for a month or less, and can be toxic if swallowed. My dog, Gemma, wears a Seresto collar in the summers (and also takes Trifexis) to protect her from ticks.

Question For Readers: Are you familiar with any of these products? Which are your favorite? Why?

If you liked this post, please comment, subscribe, or share to help us reach more pet owners!


One Thing You Can Do To Make Your Vet’s Life Easier

The practice where I work is a walk-in only, extended hours practice. Because of this, it often feels like I’m working in an emergency clinic. We see all sorts of emergencies; from dog fights, to animals hit by cars, to accidental (and sometimes purposeful) poisonings.

Sometimes I feel like I’m doing mental and emotional gymnastics at work- I may go from vaccinating a litter of happy, healthy 6-week-old puppies to euthanizing an animal or seeing a critical patient within seconds.

There is one thing that you could do to help me win gold in these mental gymnastics: always tell me the truth.

I spend a lot of time trying to get a straight answer from clients about what happened to their pet. This would all be so much simpler if we didn’t have to go in circles- I could spend less time deciphering code and more time helping your animal.

If your pet is ill, the best thing that you can do for it is to bring him to a vet, and recount exactly what happened or what you think happened- even if it’s something embarrassing or illegal. Animals can’t speak for themselves, and so the “history” I get from the owner is just as important as my exam and lab findings in making a diagnosis.

If your pet could’ve eaten drugs, you can tell me. I won’t tell on you or judge you. In fact, I can’t. In Kentucky (and most other states), clients are protected by a confidentiality clause. In section 321.185 of the Kentucky State Practice Act, it states:

“A veterinarian shall not violate the confidential relationship between the veterinarian and the veterinarian’s client.”

The section even goes on to say that a subpoena or written consent from the owner is required to release any confidential information. So, rest easy knowing that what you tell me won’t leave the clinic. Even if your pet has eaten drugs, ate your mistress’s underwear, or you gave it chicken bones because you weren’t thinking (even though your husband told you not to), my lips are sealed.

I just want to know what, when, and where. I don’t care nearly as much about the how or why- that’s your business.

Before we wrap up, here’s a great video from Kelsey Beth Carpenter. Remember- we just want to help your dog!

Question for readers: Were you ever in a situation where you were tempted to lie to your veterinarian? How did things turn out?


7 Questions To Ask Yourself Before Breeding Your Female Pet

“Should I breed my female pet?”

If you have to ask yourself that question, it is probably a sign that you should not. In fact, I don’t recommend breeding any animal unless you are an experienced breeder who is dedicated to that breed and wants to help improve upon it.

Don’t get me wrong- I can understand wanting to breed your female pet- you love her, and feel like she has great genetics. Plus, wouldn’t it be cool to have one of her offspring, or grandchildren, once she’s gone? And puppies and kittens are adorable! Those ideas may seem attractive, but I recommend that you consider the following questions before you get serious about this.

  1. Do you want to breed your pet to make money? If the answer to this question is yes, you may need to do some more research. It is very difficult to make money breeding most species unless you are “cutting corners” and not doing the proper genetic testing or recommended care for your breeding stock. Breeding is, essentially, an expensive hobby for individuals who are fanatical about one or two breeds.
  2. Are you willing to put your pet’s health at risk? Just like in humans, pregnancy can be dangerous for many pets. If your female pet is a family pet, I would not recommend risking her health to produce offspring. Health problems can arise during and after pregnancy, and even years later if she is never spayed.
  3. Do you have the financial ability to pay for an emergency c-section or other pregnancy complications? Remember how I said that it was difficult to make money breeding animals? This is especially true if there are complications or if your pet is a breed that will likely require a c- section, such as Persian cats or bulldogs. These bills can easily pile up, coming to hundreds- and sometimes thousands- of dollars to save the mom and her babies. Remember that most veterinary clinics require payment at time of service, so you should have at least $1000 saved in case of emergency prior to breeding your animal.
  4. Is your pet a purebred animal with papers? Please consider that thousands of mixed breed animals die annually in US shelters. I beg you- please don’t add to that number. Please only breed an animal that has been registered with a legitimate breed organization or kennel club.
  5. Is your pet a breed commonly found in shelters? The top three dog breeds euthanized annually in shelters (behind mixed breeds) include pit bulls, Labrador retrievers, and chihuahuas. Other popular pure-bred dogs, such as dachshunds, beagles, and poodles, are only a little further down the list. Remember economics class? Don’t add to the supply if there is not enough demand!
  6. Does your dog have genetic traits that should not be passed down to offspring? The list of possible genetic traits that your pet may be carrying may surprise you. This could include anxiety, behavioral problems, skeletal or joint problems (such as hip dysplasia), environmental allergies, ocular disease, or heart problems. Not sure if your pet has genetic problems? Talk to your veterinarian and get her genetically tested prior to breeding her.
  7. What will you do if you’re left with extra puppies or kittens? The best breeders have waiting lists for litters that are yet to be born. They will also keep extra puppies, and even take back puppies that don’t work out with their new homes, if need be. If you don’t have a plan that allows you take responsibility for the lives you help to create, you should not breed your pet.

Remember, I am not here to judge you. I will be cheering for you and helping you and your pet live your best lives, even if puppies or kittens are in your future. However, I encourage you to think through these questions and consider multiple angles. If you can answer the questions above honestly and conscientiously, then you may be in a situation where it would be acceptable to breed your pet.

As always, before making any big decisions, I encourage you to discuss the pros and cons with your family veterinarian. They’ll assess your pet and help make the best recommendation for her and your family.

Like this post? Please comment below, subscribe, or share with friends on Facebook or twitter! 

Questions for readers: Has your female pet ever (purposefully or accidentally) had offspring? What was the hardest part of trying to care for her and her babies? What did you learn? 

Resources for pet owners:


“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: Yes, Your Pet DOES Need Heartworm Prevention

Hello, friends and pet owners!

Welcome to the second episode of a mini-blog series I am hosting called Veterinary Myth Busters. Today, we will be talking about heartworm prevention, and how most veterinarians in the US recommend it for all dogs, monthly, year-round.

I have this conversation at least once a day:

“My niece has been around dogs all of her life, and she told me that she’s never had a problem with heartworms and that I don’t need to spend money on heartworm prevention. Do I really need to be giving my dog that pill every month?”

The short answer: Yes, unless you feel like gambling. 

This subject is a big matter of debate. Between veterinarians, dog people, and snake oil salesmen who spout “holistic” remedies and preventions, it can be hard for well-meaning pet owners to decipher the truth. Different areas of the country have different levels or risk, but heartworm disease has been diagnosed in all 50 of the United States. So, the truth is: no matter what state you live in, heartworm disease is a real threat to your pet, and you can prevent it for less than $10 per month.

heartworm incidence map

“Well, I don’t need heartworm prevention because…”

These excuses are endless (and infuriating)! The pattern and spread of heartworm disease is highly variable and unpredictable based on a myriad of factors. I’ve seen indoor dogs, outdoor dogs, small breed dogs, large breed dogs, pets with rich owners, pets with poor owners, and even cats come up positive for heartworm infection. The fact is- weird, improbable things sometimes happen. If you have an indoor pet, he is unlikely to get heartworm disease, but he is not immune. Heartworm disease is easy to prevent, and difficult to treat and predict. Don’t gamble with it!

“But I don’t want to put toxic chemicals in my pet’s body…”

Heartworm prevention medications are safe, effective, and extensively tested before they hit the market. These products have been licensed by the FDA and have been through testing as rigorous as the testing human medications must go through. Health problems due to heartworm disease are much more likely to cause illness in your dog. Once an animal gets heartworm disease, the treatment is a course of expensive and painful injections. These injections must be given deep in the epaxial (back) muscles, and can come with significant side effects. Personally, I would much rather give my dog a meat flavored chewable (that she enjoys taking) once a month than subject her to a series of three painful injections, over two months of “cage rest,” and possible life-long side effects from having heartworm disease.

“But, Doc, I can’t remember to give a pill every month!”

You’re in luck! There is even an injection licensed to prevent heartworm disease. One injection, given by your vet, under the skin of your dog every 6 months is all that is needed. If you’re dog doesn’t like taking pills, there are even topical products which prevent heartworms (as well as intestinal worms and fleas).

In summary, there is really no good excuse for your pet to not be up to date on heartworm prevention! The benefits definitely trump the risks, as heartworms (much like the mosquitoes that harbor them) SUCK! 

Thanks for reading this blog post. Join us on Sunday, where we will be busting myths and talking about all the reasons why YOU need to spay your dog.

Want to get in on the conversation? Tweet @KatieHoganDVM or comment below:

Have you ever had an experience with heartworm disease?

Do you feel like your veterinarian has thoroughly explained WHY your dog needs heartworm prevention? 

Disclosure of Material Connection: I have not received any compensation for writing this post. However, I am an employee of Noah’s Ark Animal Clinics, which sells heartworm test and prevention products to pet owners. Regardless, I strive to only recommend medical services and products whose indications are evidence based and that are necessary to ensure the health of your pet. 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.”

Resources for pet owners: