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Immunotherapy

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Allergic diseases, which are considered chronic and progressive, require a lifetime strategy of continuous symptom control. Using steroids and other medications may reduce the allergy symptoms but can also cause serious side effects that may decrease the quality and length of your pet’s life. During the past few decades, the allergen-specific immunotherapy (ASIT) has been the preferred veterinary medical treatment for allergies that helps to avoid these complications. This treatment is based on building up resistance to the specific allergen by exposing patients to increasing amounts of the same allergen. The formulation of ASIT depends on the identification of the offending allergen through serological or skin allergy testing. ASIT helps modify and boost the immune system by improving clinical signs, at times even halting the progression of the disease, better than traditional pharmaceutical treatments. ASIT is available as subcutaneous injections or sublingual drops. The drops may be preferable to owners who are less comfortable using needles. Pet Preferred Diagnostics offers subcutaneous and sublingual allergen-specific immunotherapy as a powerful tool that can significantly improve the lives of allergic pets.

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Safety of allergen-specific immunotherapy

Allergen-specific immunotherapy is a safe and effective treatment to prevent the progression of allergy in pets. Immunotherapy can be administrated in two different ways, subcutaneously or sublingually.  Both types of immunotherapies are formulated based on the allergy test results and help to decrease the usage of long-term anti-allergy medications.

For Subcutaneous immunotherapy (SCIT - allergy shots or allergy vaccine), pet owners should be guided on how to give the injections to their pets. If pet owners fear giving allergy shots to their pet themselves, they can bring the pet to a veterinarian to get the allergy injections. The shots are not painful and do not require a lot of time for recovery. Adverse reactions to allergy shots are very rare (less than 1% of patients). However, the pet should be monitored for about 30 to 60 minutes after the injection to watch for any reactions. Reactions should be reported to the veterinarian before providing the next injection to adjust the protocol for avoiding the negative effect.

Sublingual immunotherapy (SLIT), or “sublingual drops," can successfully replace traditional subcutaneous immunotherapy due to its easy and safe administration under the pet’s tongue. This technique is helpful for pets that do not respond to injection with allergen extract, and it reduces the risk of even mild adverse reactions. SLIT is formulated with 50% glycerin, which increases uptake through the oral mucosa, and many dogs associate these drops with a treat because of the sweet taste of glycerin. SLIT is very well tolerated by pets. However, mild adverse local reactions to SLIT can occur locally in the mouth or throat. Therefore, a pet should remain under observation for about 30 minutes following the administration of the first few doses of SLIT. Systemic reactions to sublingual drops are rare, but if any adverse symptoms continue, the dosing schedule should be altered to help manage side effects, similar to subcutaneous immunotherapy. Thus, SLIT, as well as SCIT, are the preferred treatment forms for controlling non-food-related allergies with the highest effectiveness and rare side effects.

Efficacy of Subcutaneous and Sublingual Immunotherapies

About 70%-80% of pets treated with SCIT respond positively to the treatment without any adverse side effects or damage to the organs. Some symptoms can even be completely cured by allergy shots. SCIT is also a cost-effective treatment option for long-term use in comparison to medications that only temporarily control the symptoms. If this therapy works, it can be long-lasting or permanent, with the high improvement of symptoms seen a few months after treatment. Notably, 50% of dogs respond better to sublingual therapy than subcutaneous injections and nearly 78% of pet owners expressed satisfaction with SLIT. Among dogs that previously failed subcutaneous injections, 60% showed significant improvement with sublingual treatment. Studies have revealed that clinically SLIT performed similarly or better than SCIT. Sublingual immunotherapy has been shown to improve the symptoms of allergic diseases with an 80% success rate even after discontinuation of active treatment.

Allergen-specific immunotherapy is more effective than topical therapies and less harmful for pet health than Apoquel or Cytopoint. These medications only suppress the symptoms and never take care of the root cause of an allergy.

Duration of treatment and doses

With SCIT, a pet should be injected with the extract of allergens that was formulated based on their allergy test results. In the initial vials, the allergen doses are the lowest. Over time, a pet will receive an increased amount of allergen mixture until they get to a maintenance concentration. Pet owners should follow the protocol provided by their veterinarian. The majority of pets may have improvement after 6 to 9 months of injectable therapy. However, some of them need just weeks to show progress. In other cases, the improvement could take one or two years. During the treatment, an anti-allergy medication can be used to control the symptoms. Any doses of additional medication can be gradually reduced due to the positive effect of allergy injections.

SLIT is customized for each patient and formulated based on a pet’s allergy test results as well. The therapy protocol starts with a build-up phase, during which the amount or concentration of specific allergens is gradually increased until an effective daily maintenance dose is reached. This usually takes from 15 to 30 days. The effectiveness of the maintenance dose depends on the pet’s response to the build-up phase dosage and individual allergen sensitivity. The maintenance dose is continued on a regular basis until the symptoms improve. Although most patients have demonstrated noticeable improvement within the first 1–6 months of therapy, it is recommended that they continue treatment for at least 10-12 months. After this time, if the patient is stable, the treatment can be discontinued. If the allergy symptoms are still not substantially improved, immunotherapy can become a possible long-term management option. At least one year of SLIT treatment is highly recommended.

Allergen-specific immunotherapy provides protection against life-threatening allergic symptoms associated with regular exposure to allergens. While ASIT does not usually provide quick results, it is largely effective in the long term. SCIT and SLIT will be formulated for each individual patient based on that patient's allergy test results. It must be prescribed by a licensed veterinarian. Pet Preferred Diagnostics will process the order immediately after receiving the prescription. SCIT/SLIT solutions will be sent to the veterinary clinic indicated in the prescription form.

Administering immunotherapy

SCIT: The first injection is usually performed by a veterinarian who will train the pet owner on how further injections should be administered. Pet owners must follow their veterinarian’s instructions and use Pet Preferred Diagnostic’s allergy treatment notebook and dosing schedule guidance. A new needle should be used for each application.

SLIT is administered via a pump dispenser directly under and around the tongue.

The dispenser pump must be primed once before the first use. SLIT cannot be

taken with food or drink. It is important that patients do not eat or drink at least

30 minutes before and after receiving a dose. Pet owners must follow their

veterinarian’s instructions and use Pet Preferred Diagnostic’s dosing schedule

guidance.

SCIT and SLITS do not require a cooling pack for transportation. However, they

must be refrigerated after being received by a veterinary clinic or pet owner.

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