Recently, I was asked to look into sublingual immunotherapy by our friend Jana Rade, and to be honest, I’d never heard of it.
Since I assume you’ve never heard of it either, as you’re reading this blog, let’s all learn together!
Sublingual means under the tongue. Immunotherapy in this case refers to administering high doses of allergens to your pet, so their body stops seeing those allergens as foreign and stops reacting to them – in short, addressing the core cause of seasonal allergies in dogs and cats instead of just masking the symptoms.
Sublingual immunotherapy, then, means putting high doses of allergens under your pets tongue to stop them from being allergic to those allergens.
Used to be, veterinarians had only one real way to diagnose and treat the core cause of seasonal allergies, and as it turns out, referral to a veterinary dermatologist is still the gold standard for allergy testing, since they use the human style skin prick testing method that has been proven more effective than blood testing.
Blood tests for seasonal allergies, then, are less ideal to diagnose what exactly it is your pet is allergic to, but if you can’t afford a referral to the derm people, blood testing may be a good “better than nothing” approach.
So with that being said, we are now seriously considering offering this combination of allergy testing and treatment for our four legged friends:
ALL PRICES ARE SUBJECT TO CHANGE.
STEP 1: Greer Aller-g-complete Blood Testing, Midwest/Prairie Region – $200
This single blood test includes 48 environmental allergens specific to our region, including pollens (from weeds, trees and grasses), molds and mites. We draw your pet’s blood here in the clinic, send it off to the lab, they get back to us in a few days with a list of everything your pet is allergic to. Cool, eh?
STEP 2: Heska Sublingual Immunotherapy Vials A and B – $210
Here’s where the magic happens. Heska corporation will make up a little squirt bottle of whatever it is your pet is allergic to. You then squirt a little of it under your pet’s tongue twice a day (see picture, above). Once you go through Vial A, you switch to Vial B, which is a stronger concentration of the same stuff. Vial A and Vial B take about five months to go through.
STEP 3: Heska Sublingual Immunotherapy Vial C qty 2 – $210
After the first five months of Vials A and B, you place a re-order through our hospital for two vials of Vial C, which is the highest concentration of allergens. Two bottles of Vial C take another 5 months to go through, and you keep doing it foreverandeverandever (unless you’re brave and decide after a few years to see if your dog isn’t allergic anymore – most humans can stop their sublingual immunotherapy after 2-5 years). So basically, you’re looking at $210 every five months for immunotherapy, given twice daily.
My experience with the injectable forms of immunotherapy suggest that no dog or cat is ever 100% cured of seasonal allergies with immunotherapy, but every patient feels at least a little bit better – fewer days on prednisone, less severe symptoms. And ideally, any therapy that means we can give your dog or cat less prednisone is OK with me, let alone seeing fewer hot spots, ear infections….
QUESTIONS YOU MIGHT ASK (and I did too!)
QUESTION 1: DOES IT WORK?
ANSWER: Why yes, yes it does. There’s only been one real study done so far, by Mary Morris, M.D. and Douglas J. DeBoer, D.V.M. at the School of Veterinary Medicine, University of Wisconsin, Madison, WI, but long-term studies is currently underway. Sublingual immunotherapy has been used in humans for 40 years, and seems to be working pretty darn well in dogs too.
Read the initial paper here: Sublingual-Immunotherapy-for-Dogs
QUESTION 2: IS IT SAFE?
ANSWER: Way safer than injections, yes! Reports of anaphylaxis (acute allergic reaction) in humans using sublingual immunotherapy are pretty much nonexistent. There’s no reason to think dogs or cats will react any worse than humans in this case, but again, studies are ongoing.
QUESTION 3: CAN I DO INJECTIONS INSTEAD?
ANSWER: Sure you can! Injections have the benefit of less frequent administration (often going to once weekly/monthly after a few months) so that may be a consideration. Having offered injectable immunotherapy in years past, I can safely say that most clients were turned off by having to inject their pets, and compliance was… lacking. Since this oral stuff apparently tastes pretty good, initial reports are that compliance is not an issue – and no therapy works if you don’t put it inside the pet!
QUESTION 4: CAN’T I JUST SQUIRT IT ON MY PET’S FOOD?
ANSWER: Well, no. There’s something about the delicate tissue under the tongue that allows for quick absorption of medications like these allergy drops, so the stuff needs to be put in the proper place under the tongue or it won’t work. If your pet won’t tolerate you putting stuff under her tongue, consider injections instead.