At the present time, the only reliable way to diagnose allergies (pollen, dust, etc.) in dogs and cats is through intradermal allergy testing, commonly called skin testing. Although allergy blood tests for dogs and cats are commercially available, they are not recommended due to their less accurate results. Intradermal allergy (skin) testing allows us to pinpoint the exact nature of your pet's allergies and, more importantly, provides the information necessary to custom formulate an allergy vaccine to desensitize your pet. It is ideal, but not required, that corticosteroids and antihistamines be withdrawn for 1-2 weeks prior to testing to avoid negatively impacting the skin test results. Atopica (cyclosporine) and Apoquel may be continued. Please continue ALL other medications that were otherwise prescribed by your veterinarian.
The following is a brief outline of what an intradermal allergy test involves. A Skin Testing Consent Form will need to be filled out before the test can be undertaken. The form is available to download and fill out on each of our web pages. If the document does not display correctly, click on the upper right-hand box labeled "open with different view" and choose to open with Adobe Reader.
1. A mild intravenous sedative is administered to relax your pet. The sedative used is very safe and is completely reversed using an "antidote-like" drug after the procedure is finished. The sedative is not an anesthetic; your pet will be awake and responsive throughout the entire procedure. The sedative simply relaxes the animal so it will lie quietly on its side for 30 minutes while the test is administered. The entire procedure can be as short as 35 minutes or as long as 1 & 1/2 hours, depending on how quickly your pet sedates. Since an overly excited or frightened pet will not have meaningful test results, sedation is required for every patient undergoing intradermal allergy testing. Testing must be done in a quiet room without their owners to avoid sensory overstimulation that can be created by the sedative. Because a small percentage of dogs and most cats may become nauseated from the sedative, we ask that you withhold food 8-12 hours prior to the test, if possible, but it is not required. Water should be given as usual.
2. An area of skin approximately 4" x 8" is clipped in the armpit region, and 66 injections are made into the skin.
3. Positive reactions, which look like small red hives, will appear within minutes after the injections are made. Dr. Jeffers records the results and keeps one copy to generate the allergy vaccine, while a second copy is given to you for your records.
4. Once the information from the testing is recorded, effective symptomatic treatment is recommended to immediately control your pet's itching. Dr. Jeffers prefers oral medications that don't contain corticosteroids since the side effects are minimal; however, those who do not respond or are severely itchy may need to be given corticosteroids to prevent suffering from their allergies. If you must give your pet corticosteroids, make sure you use the lowest possible dosage and no more frequently than every other day if given for more than 2 weeks. Your pet will probably need some form of medication for at least 3-9 months following the initiation of the allergy vaccine program. Dr. Jeffers will work with you in determining the best type, dosage, and schedule of symptomatic therapy for your allergic pet.
5. Although usually unnecessary, you may apply a corticosteroid cream to the test site (given at the skin test appointment) for three days following the skin test. This will help reduce any irritation which may have been caused by the clipping and testing.
6. A vaccine will be custom formulated based on the results of the allergy test. The vaccine is almost always available at the time of the skin test. When refills are needed, please call ahead to place a vaccine order. Orders are usually filled within a week. You can pick up the vaccine at our office or have it shipped to your home or work via FedEx. If shipped, the vaccine should be refrigerated as soon as possible after it arrives to maintain maximum potency. If shots are given, the initial allergy vaccine includes three vaccine vials, while subsequent refills will include only one maintenance vial. If the oral (sublingual) vaccine is chosen, there will only be one vial but two different sized sprayers.
7. At the time of the appointment, you will be able to chose how you want to give your pet's vaccine (by injection or orally) and will be instructed on how to administer the vaccine to your pet. It is VERY helpful to watch the allergy vaccine instructional videos located either on the bottom left side of every web page or imbedded in this paragraph. Dr. Jeffers will recommend the injections as as they are more standardized and have been studied and used for decades, unlike the oral vaccine which is new. If you chose the injections, they are administered every other day for the first 25-29 days and afterwards are decreased to a frequency of once every 1-2 weeks. Click here and here to view instructional videos on how to administer allergy injections. If you chose the oral (sublingual) option, a dose is administered once a day. Click here to view an instructional video on how to administer an oral allergy vaccine. If beneficial, the vaccine will be continued for the rest of you pet's life. Approximately 60%-85% of pets placed on allergy vaccine treatment will benefit from them, to an appreciably degree. It typically takes 4-6 months of vaccine treatment before you will see any improvement, but it may be as long as 9-12 months before improvement is noticeable (see link). As mentioned above, medication must often be used during this period to keep the pet comfortable. If your pet has not appreciably improved after 1 year of allergy vaccine use, the program is abandoned and medications will be chronically needed.
8. The cost of skin testing is $260, and is in addition to the cost for the examination (the examination fee is NOT included in the skin test cost). The initial 3 vials of injectable allergy vaccine, which last almost 6 months, cost $144. A refill vial costs $140 and will last 20 weeks. The oral (sublingual) vaccine also costs $140 per vial and lasts between 11-15 weeks.