My GOD, I am allergic to my cat, or “the dilemma of pet allergy” – thoughts and reflections from an allergy doctor   Leave a comment

Today the Swedish newspaper Expressen is posting articles about the “cat allergy dilemma”.

today: http://www.expressen.se/nyheter/dilemmat/1.2321744/dilemmat-del-2-kattallergi

yesterday: http://www.expressen.se/nyheter/dilemmat/1.2320390/dilemmat-del1-kattallergi#comments

Scenario:

What happened? My eyes are red and itchy, my nose is blocked, I sneeze all the time, and sometimes I get wheezy and have difficulty to breathe. My doctor tells me I am allergic to my cat. ARGH! What does this mean? What can I do? How do I deal with this? I love my cat, I don’t want to get rid of my cat! STOP THIS, I AM ANGRY. I DON’T WANT TO BE ALLERGIC, CURE ME NOW, I LOVE MY PET!!

This is a very common problem, and a perfectly normal psychological reaction, occurring every day in every country of the world. People that have a furred pet suddenly develop symptoms of allergies, and the doctor coldly and bluntly state “you have to get rid of your cat or dog”.

This is clearly not an easy situation to deal with as a patient and as a doctor, and involves complicated issues such as allergy diagnosis, complications of allergies, psychology of the individual becoming allergic, and the welfare of the animal.

Research is unequivocal. If you are truly allergic to a pet, and maintain exposure to that pet, chronic allergic symptoms develop. The nasal mucosa is more swollen than normal, eyes are red and inflamed, and some individuals develop symptoms of asthma. The allergic symptoms become chronic, influencing everyday life and quality of life, and can make you more tired. The risk of developing difficult asthma is obvious.

The tricky detail is that many patients say “I am NOT allergic to my own pet, only other people’s pets”. This is not so strange actually, but the fact is that the cat at home is hugely responsible for chronic symptoms, but not for the immediate symptoms. What happens is that long-term exposure to an allergic stimulus, such as cat, reduce immediate reactions, but the chronic inflammation becomes more enhanced, causing chronic daily symptoms also away from the pet. Scientifically, this has been shown by repeated low dose allergen exposure increasing allergic inflammation (http://bit.ly/fW9WTl), but reducing allergen responses (http://bit.ly/fkxXza). That chronic blocked nose and itchy eye, and that chronic asthma, is still caused by the cat at home.

Can I take medicines to remove my allergy? Medicines such as inhaled and nasal glucocorticoids can reduce the inflammation. But they are seldom sufficient to remove symptoms totally, except in those with really mild allergy. But in the end, if this allergy is perpetuated, the efficacy of medication is often inefficient to eliminate the allergic symptoms. And the medication is fairly short term, and if you forget a dose the effect is more or less gone (http://bit.ly/glA0qJ )

What is the general advice if you have a furred pet allergy in a skin-prick test, but do not have or have ever experienced any symptoms? Well, there is no or very little evidence to say what is best. If the sign of allergy on the test is strong, it is likely that symptoms will develop, but it is not universal.

Can I be vaccinated against cat? If you have a cat, it is not recommended that cat allergy immunotherapy should be performed. This treatment is usually reserved for those exposed to cat allergens indirectly, for example teachers at school exposed to cat dander from the clothes of children.

Can I have another type of pet if I am allergic to another? Thus, can I get a dog, if I am not allergic to dogs, but to cats. Clinicians avoid giving advice on matters like these. It is possible that a new allergy will be developed, but the likelihood that it will not happen is probably greater.

Are there some pets that spread less allergens? The answer is yes, but the importance is really nothing. Allergy is usually an “all or nothing” response, and small reductions in exposures are seldom sufficient. Elimination is required to achieve significant effects on symptoms. There is one company that has claimed to have developed a “hypoallergentic cat”, which they sell at very high prices, but there is controversy how true and effective this is for allergic individuals http://abcn.ws/ezDySP .

If I am allergic to pollen, and the prick test says I am allergic to pet, should I avoid getting a pet, even though I have never felt any symptoms? There is no real reason to argue either way. If you have one allergy, you have a greater risk of developing a new allergy.

How about the psychology and thoughts when dealing with this dilemma? It is easy to understand the emotional distress and even anger when the doctor’s advice is to “get rid of your pet”. Health is important, allergy is difficult, allergy makes the sufferer more tired and less productive, and increases the risk of asthma.

I sometimes ask “what do you think your pet would advice you, had he or she understood the dilemma”.

Posted February 8, 2011 by Jan Lötvall in Allergy, asthma, behaviour, EAACI, medicine

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