This is my allergy protocol with pets. It is a frustrating process, and time consuming, but I have had good luck.:
For pets with severe flea allergies I recommend ALL the animals in the household be on oral flea preventatives (Comfortis, Trifexis, Bravecto, Nextguard). Topicals, IMHO just don’t cut it anymore. House MUST also be treated to make sure there is not a constant source for re-infestation.
Then try a course of antibiotics alone for 3 weeks. If they respond to just antibiotics (no steroids) as will be the case with secondary staph infections due to allergies then I manage these pets on “pulse therapy” of antibiotics life long.
If no response to antibiotics alone then I try a 30 day course of ketoconazole. If they have an underlying yeast infection they will usually respond. If they have a positive response to this trial then I will start food trials and topical shampoos to see if we can reduce the “root cause” of the allergies.
I prefer Hill’s Z/D for food trials. I think it has better palatability than Purina HA. Food trials MUST be a minimum of 8 weeks and other than water NOTHING else enters his mouth (Bravecto is a great flea/ tick product for these guys as it is hydrolyzed so will not interfere with food trials).
If all that has failed then I go to allergy testing. There is so much controversy to testing (skin versus blood, injections versus lingual drops). Having said that I do have pets that have done amazingly well on allergy shots.
If allergy shots do not work then I go to Atopica (have yet to have access to Apoquil). It can be a life saver for these guys. Often I will use Atopica while starting allergy shots to help manage the pet while giving time for the allergy shots to start working (can take up to 6 months).
Now this is assuming the owner is on board for the long road of “trial and error”. Also remember that allergies are almost always multifactoral…meaning your dogs is most likely not ONLY allergic to fleas. He may be 50% fleas, 30% food, 20% environment. The hardest to control is environment as you can control what they eat and we have great flea products today that can generally control flea issues when used properly. So in my example above if you controlled the fleas that is 50%, controlled their diet that is 30%, leaving only 20% and at that point sometimes allergy shots, antibiotics, Atopica or even infrequent use of steroids can be used.
