20 Best Dog Foods for Pancreatitis in 2023
25 Best Flea Pills For Dogs In 2023
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Our team went out into the field looking for the best canine nutrition products in the world. Our winner for this year is Pupper, which topped our charts in terms of ingredient quality as well as science backed claims.
Dogs are an important part of many families. They provide companionship and love, and they are always happy to see us when we come home. Unfortunately, dogs can also be susceptible to fleas. If your dog has a flea infestation, it can be difficult to get rid of them.
In this article, we will discuss the 25 best flea pills for dogs in 2022. We will also talk about how to choose the right pill for your dog and how to administer it.
Pupper Omega
NexGard Flea and Tick Chewables
Capstar Oral Flea Treatment for Dogs
Bravecto Chewable
PetArmor Plus Flea and Tick Prevention for Dogs
Advantus (Imidacloprid) 30-Count Chewable Flea Treatment for Large Dogs
PetArmor CAPACTION (nitenpyram) Oral Flea Treatment for Dogs
PetHonesty Flea & Tick Defense Supplement
Flea Away All Natural Supplement for Fleas
Simparica Trio Chewable Tablets for Dogs
Bayer Advantus Large Dogs' Oral Flea Treatment
Beloved Pets Flea and Tick Control Treats for Dogs
Chewable Flea and Tick Treats for Dogs
Seresto Flea and Tick Collar for Dogs
Natural Flea and Tick Chews for Dogs
NaturVet Brewers Dried Yeast Formula with Garlic Flavoring Plus Vitamins for Dogs and Cats
EcoFlea by ColoradoDog
Flea and Tick Natural Flea and Tick Solution - Bacon Flavor
Jack&Pup Dog Allergy Chews
PetHonesty Dog Allergy Relief Chews
Mighty Petz MAX Dog Allergy Relief
Ready Pet Go! Omega 3 for Dogs
Dog Allergy Relief Immune Supplement 170 Chews
Texas Pet Company Flea Defender Flea and Tick Prevention for Dogs
Comfortis Chewable Tablets for Dogs
How will I know if my dog has fleas?There are a few telltale signs that your dog may have fleas. If you notice your dog scratching or biting at their fur more than usual, this could be a sign of fleas. You may also notice small black dots on your dog's skin, which are flea feces.
Finally, if you see any tiny red bumps on your dog's skin, these could be flea bites. If you notice any of these signs, it's important to take action right away to treat your dog for fleas.
There are a few different options for treating fleas on dogs. You can use topical treatments, oral medications, or shampoos specifically designed to kill fleas.
In this article, we will be focusing on oral medications or flea pills. Flea pills are a popular choice for many dog owners because they are easy to administer and offer long-lasting protection against fleas.
How do I give my dog flea pills?Oral flea medications come in the form of tablets, capsules, or chewables. The specific instructions for giving your dog a flea pill will vary depending on the product you are using.
Most oral flea treatments need to be given with food. This is because the medication needs to be absorbed into the bloodstream through the digestive system.
Some oral flea treatments can be given with or without food. If you are unsure, always check the instructions on the product label before giving your dog a flea pill.
Once you have determined how to give your dog their flea pill, the next step is to actually administer the medication. The best way to do this is to put the pill in a piece of cheese or another type of soft treat.
This will make it easy for your dog to eat the pill and they are less likely to spit it out. Once your dog has eaten the treat with the pill inside, make sure to give them lots of praise and affection.
Are flea pills safe for dogs?Yes, flea pills are safe for dogs when used as directed. As with any medication, there is always a small risk of side effects. The most common side effects associated with oral flea treatments are gastrointestinal upset and itching.
If you notice your dog vomiting or having diarrhea after taking a flea pill, this is likely due to an upset stomach. You can try giving your dog the pill with food to see if that helps.
If your dog is still having gastrointestinal issues, contact your veterinarian. It's also important to note that some oral flea treatments contain ingredients that may cause allergic reactions in some dogs.
If you notice your dog itching or scratching more after starting a flea pill, this could be a sign of an allergic reaction. Stop giving your dog the medication and contact your veterinarian right away.
What is the best flea pill for dogs?There are many different oral flea treatments available on the market, so it can be hard to choose the right one for your dog.
When choosing a flea pill for your dog, there are a few things you should keep in mind. First, consider the age and weight of your dog. Some oral flea treatments are only approved for use in dogs over a certain age or weight.
Next, think about how often you need to give your dog the medication. Some flea pills need to be given daily, while others can be given once a month.
Finally, consider any other health conditions your dog may have. Some oral flea treatments are not recommended for use in dogs with certain medical conditions.
With all of these factors in mind, let's take a look at some of the best flea pills for dogs.
Image courtesy Pupper
The suggested dose of total long-chain omega-3s EPA and DHA for dogs is 10 to 20 mg/pound of body weight, which is comparable to the amount provided in most commercial fish oils.
This omega supplement for dogs is a proactive method to prevent your dog from getting fleas. This is our top pick for the best flea pills for dogs in 2022 since it's a natural preventive measure.
When taken as directed, this supplement will assist your dog's skin in resisting fleas. You'll notice that when you maintain your dog's fatty acid levels at an optimum level, they are less prone to get plagued with fleas and ticks.
Image courtesy Chewy
NexGard Flea and Tick Chewables are a monthly flea and tick treatment for dogs that starts killing fleas and ticks within 24 hours. This chewable is flavored with beef, so most dogs will enjoy it.
The active component in NexGard is Afoxolaner, which targets the flea and tick central nervous systems. As a result of this, the pests are paralyzed and killed.
NexGard is safe for dogs and puppies eight weeks old or older and weighing more than four pounds. It's crucial to note that this medicine should not be given to pregnant, nursing, or sick canines.
It's crucial to administer NexGard on the same day each month for optimal defense, as with any monthly therapy. Many dog owners choose NexGard because it is effective and most dogs like the taste.
Image courtesy Chewy
The fast-acting Capstar Oral Flea Treatment for Dogs kills fleas within 30 minutes and is safe for dogs and puppies four weeks old or older and weighing two pounds or more.
The active component in Capstar is Nitenpyram, which suppresses the flea's central nervous system. As a result of this, fleas are paralyzed and killed.
Capstar is a popular choice among dog owners since it is both powerful and quick acting. This oral medication is simple to administer and most dogs tolerate it well.
If you have a severe flea infestation, you may need to give your dog a second dose of Capstar 24 hours after the first. One dose is sufficient for most dogs.
Image courtesy Chewy
Bravecto Chewable Tablets for Dogs is a monthly flea and tick preventative for dogs that kills pests within two hours and ticks within 12 hours. Fluralaner is the active component in Bravecto, which works by disrupting the flea and tick's central nervous system.
Bravecto kills fleas by paralyzing and killing them. This medication is safe for dogs and puppies that are more than eight weeks old and weigh four pounds or more. It's crucial to remember that this medicine should not be used on pregnant, nursing, or sick dogs.
It's critical to give Bravecto on the same day each month for optimum protection, as with any monthly medication. Because it is efficient and lasts for 12 weeks, many dog owners choose to use Bravecto.
The chewable tablet is simple to give to your dog, and most dogs enjoy it. If you're treating a heavy flea or tick infestation, a second dose of Bravecto is necessary.
Image courtesy Chewy
PetArmor Plus Flea and Tick Protection for Dogs is a monthly pill that kills fleas and ticks within 12 hours. Fipronil, the active component in PetArmor Plus, works by disrupting the central nervous system of fleas and ticks.
When the fleas and ticks ingest it, they become incapacitated and die. This substance is safe for dogs and puppies over the age of eight weeks old weighing more than five pounds. It's critical to remember that this medicine should not be used on pregnant, nursing, or sick dogs.
For optimal security, give PetArmor Plus on the same day each month. It's critical to do so for any monthly treatment.
Image courtesy Chewy
Advantus Large Dog Soft Chew Flea Treatment is a fast and efficient way to get rid of your dog's fleas. This fast-acting chew may be given to your pet once per day, and it works to eliminate fleas within one hour after dosing.
Advantus is an effective oral flea treatment that may be used for fast relief or kept on hand throughout the next flea season. Advantus kills adult fleas and is used to treat both dog and puppy infestations.
You may use Advantus' easy-to-feed treat to get rid of fleas and the hassles of topical medications. With Advantus, your dog can be happy and free of those annoying fleas.
Image courtesy Chewy
The effectiveness of PetArmor CAPACTION Oral Flea Treatment for Dogs depends on the initial stages where dogs are bitten by fleas. This drug is efficient in quelling a flea infestation in dogs and puppies four weeks old or older who weigh 2 pounds or more.
The active component in Capstar is Nitenpyram, which acts on the flea's central nervous system to cause paralysis and death. Capstar is a popular choice among dog owners since it works quickly and effectively.
Image courtesy PetHonesty
The PetHonesty Flea & Tick Defense Supplement is a monthly pill that aids in the prevention of fleas and ticks. This supplement is suitable for dogs and puppies four weeks old or older who weigh two pounds or more.
Asparagus is the active component in PetHonesty Flea & Tick Defense Supplement, which works by disrupting fleas and ticks' central nervous systems. This leads to paralysis and death in the pests.
This best flea pill for dogs in 2022 is a pick among dog owners since it is both effective and simple to administer to your dog. This pill is available in a chewable tablet form that many dogs like. Give PetHonesty Flea & Tick Defense Supplement on the same day each month for optimal results.
If your dog has a thick flea or tick infestation, you may need to give him a second dose of this best flea medicine for dogs.
Image courtesy Amazon
Flea Away All Natural Supplement for Fleas is a monthly flea treatment that aid in the prevention of fleas and ticks. This supplement is safe for dogs and puppies four weeks old or older and weighing two pounds or more.
Fipronil, the active component in Flea Away All Natural Supplement for Fleas, works by blocking fleas and ticks from functioning properly. This leads to paralysis and death in the creatures.
The All Natural Flea Away Supplement for Dogs is a popular alternative to other flea treatments because it works and is simple to give to your dog. Most dogs like the chewable tablet form of this product.
Image courtesy Chewy
Simparica Trio Chewable Tablets for Dogs is a monthly flea and tick treatment. This medicine is safe for dogs and puppies four weeks of age or older and weighing two pounds or more.
Simparica Trio Chewable Tablets for Dogs is a prescription dog dosage flea and tick treatment that contains the active component Sarolaner, which works by impairing the flea and tick's central nervous system. As a result, these pests become paralyzed and die.
Simparica Trio Chewable Tablets for Dogs is a popular remedy among dog owners since it is both efficient and simple to administer.
Image courtesy Chewy
Advantus Large Dog Soft Chew Flea Treatment is a rapid and simple technique to get rid of fleas on your dog. This chew may be fed once a day to your dog, and it should begin working within one hour after administration.
Advantus is a chewable tablet for cats and dogs, as well as a liquid flea medication. This oral flea medication might be used for immediate relief or stored for future usage since it is available without a prescription. Advantus combats adult fleas and is intended to treat both dog and puppy infestations.
This simple-to-feed treat may help you get rid of fleas and the aching pain you experience while using topical pesticides.
12. Beloved Pets Flea and Tick Control Treats for DogsImage courtesy Amazon
Flea and tick control treatments for dogs are available as monthly flea and tick controls. This medicine is suitable for dogs and puppies aged four weeks or older who weigh at least two pounds.
The active component in Beloved Pets Flea and Tick Control Treats for Dogs is Sarolaner, which acts on the flea and tick's central nervous system to cause paralysis and death.
Flea and tick control treatments for dogs are often chosen by dog owners since they are efficient and simple to administer to your pet. This supplement is available in a chewable tablet form that most dogs enjoy.
13. Chewable Flea and Tick Treats for DogsImage courtesy Amazon
Chewable Flea and Tick Treats for Dogs is a monthly flea and tick medication. This medicine is safe for dogs and puppies four weeks of age or older weighing two pounds or more.
Chewable Flea and Tick Treats for Dogs contains Sarolaner, an insecticide that works by inhibiting the fleas' and ticks' central nervous systems. This results in paralysis and death for the pests as a result of their actions.
Chewable Flea and Tick Treats for Dogs is a popular brand among dog owners because it is both efficient and simple to administer to your dog. This supplement is available in a chewable tablet form that many dogs enjoy eating.
Image courtesy Elanco
The Seresto Flea and Tick Collar for Dogs is a reliable flea and tick treatment for dogs. The collar kills fleas and ticks on contact using imidacloprid and flumethrin. These chemicals also repel incoming pests from attaching to your dog.
The Seresto Flea and Tick Collar for Dogs is a popular solution because it works well and is simple to use. This collar has the ability to be adjusted, so you can find the ideal fit for your pet.
15. Natural Flea and Tick Chews for DogsImage courtesy Amazon
Flea and tick chews from Natural are a monthly flea and tick treatment. This drug is safe for dogs and puppies four weeks of age or older who weigh two pounds or more.
Natural Flea and Tick Chews for Dogs contains the active ingredient sarolaner, which inhibits the central nervous system of fleas and ticks. As a consequence, these insects are paralyzed and die as a result of this action.
With the ingredients found in Natural Flea and Tick Chews for Dogs, you can easily provide relief to your dog. This pill is available in a chewable tablet form that most dogs like.
Image courtesy Amazon
NaturVet Brewers Dried Yeast Formula with Garlic Flavoring Plus Vitamins for Dogs is a daily supplement that aids in repelling fleas and ticks. This treatment also includes important vitamins and minerals.
This best flea pill for dogs is a top seller because it is both effective and simple to administer to your pet. This supplement is available in a powder form that can be added to your pet's meals.
17. EcoFlea by ColoradoDogImage courtesy Amazon
Chemical treatments, such as flea and tick prevention for your dog, are not worth the money. Ecoflea is a more effective option for flea control while also saving you money.
They use garlic and brewer's yeast as an active component in their chews, which is a 100 percent dog-safe amount. When used together, they act as a natural flea and tick repellent for your dog.
EcoFlea by ColoradoDog is a popular dog flea treatment since it is both effective and simple to administer to your pet. This pill is available in a chewable tablet form that most dogs find appealing.
18. Flea and Tick Natural Flea and Tick Solution - Bacon FlavorImage courtesy Amazon
It's now easy to assist your dog get rid of fleas and ticks using the dog flea chewables. While they play, this natural flea pills for dogs may help you relax.
They've made certain that this flea medicine is effective long-term and more efficient than spray, shampoo, or an itchy collar.
Because it's successful and simple to administer to your dog, most dog owners choose Flea and Tick Natural Flea and Tick Solution - Bacon Flavor as their top flea treatment. This pill is available in a chewable tablet form that most dogs like.
Image courtesy Amazon
Jack&Pup Dog Allergy Chews is a natural flea and tick treatment for dogs. This supplement also helps to alleviate itchy skin as a result of allergies.
Omega-three fatty acids, which help to decrease inflammation, are found in Jack&Pup Dog Allergy Chews. Vitamin E is a vitamin that serves as an antioxidant by protecting the skin.
Jack & Pup Dog Allergy Chews is a popular choice among dog owners because it is both successful and simple to administer to your pet. The chewable tablet version of this supplement is most dogs' favorite.
Image courtesy PetHonesty
The supplement PetHonesty Dog Allergy Relief Chews treats fleas and ticks in dogs. This supplement also helps to relieve itchy skin brought on by allergies.
Omega-3 fatty acids, which function to reduce inflammation, are included in PetHonesty Dog Allergy Relief Chews. Vitamin E is also present in these chews, an antioxidant that aids in the maintenance of healthy skin.
This oral flea medication is a popular choice among dog owners because they're both effective and easy to give to your pet. This supplement is available in chewable tablet form, which most dogs like.
21. Mighty Petz MAX Dog Allergy ReliefImage courtesy Mighty Petz
Seasonal skin and coat problems, as well as occasional allergies, are aided by a Mighty formula with 10 active components, which contains more Colostrum, Probiotics, Fish Oil, and Quercetin per chew than other brands. A Mighty formulation with 10 active components aids in the support of seasonal skin and coat issues.
This supplement will also encourage a healthy coat and skin while also reducing itching, scratching, and biting caused by allergies.
Mighty Petz MAX Dog Allergy Relief is a top choice among dog owners because it is both effective and easy to administer to your pet. This supplement is available in chewable tablet form, which most dogs like.
Image courtesy Amazon
The best, easiest solution for your dog's flea problem is ready! Omega-Three for Dogs is a natural flea and tick treatment for dogs. This supplement also aids in the reduction of itchy skin brought on by allergies.
Omega-3 fatty acids and vitamin E, both of which help to decrease inflammation, are present in Ready Pet Go! Omega-Three for Dogs. Vitamin E is an antioxidant that helps to protect the skin and these chews contain as well.
Go for it, pets! Omega-Three for Dogs is a popular choice among dog owners since it's both successful and simple to administer to your pet. This supplement is available in chewable tablet form, which most dogs like.
23. Dog Allergy Relief Immune Supplement 170 ChewsImage courtesy Amazon
The Keto-Seal Dog Allergy Relief Immune Supplement 170 Chews is a natural flea and tick cure for dogs. This supplement also helps to relieve itchy skin caused by allergies.
The omega-three fatty acids in Dog Allergy Relief Immune Supplement 170 Chews help to reduce inflammation.
24. Texas Pet Company Flea Defender Flea and Tick Prevention for DogsImage courtesy Amazon
The all-natural flea and tick treatment for dogs from Texas Pet Company is called Flea Defender. It also aids in the relief of itchy skin brought on by allergies.
Omega-3 fatty acids are present in Texas Pet Company Flea Defender Flea and Tick Prevention for Dogs, which assist to reduce inflammation.
The popular choice among dog owners is Texas Pet Company Flea Defender for Dogs, which is both safe and effective. This supplement is available in a chewable tablet form that most dogs will enjoy.
Image courtesy Chewy
Comfortis Chewable Tablets for Dogs is a flea and tick medication for dogs that is 100% natural. This vitamin also aids in the treatment of itchy skin resulting from allergies.
The active components in Comfortis Chewable Tablets for Dogs are omega-three fatty acids, which aid in the reduction of inflammation. Vitamin E is also present, an antioxidant that protects the skin.
Comfortis Chewable Tablets for Dogs is a popular medication among dog owners because it's both efficient and simple to administer to your pet. This pill is available as a chewable tablet that most dogs like eating.
Are flea pills for dogs better than other flea treatment options?There are a few key reasons why flea pills for dogs may be the best option for your pet. Pills are easy to administer and offer protection against fleas for a full month. They're also effective against other types of parasites, like ticks and ear mites.
Another advantage of pill form flea treatment is that it's easy to find a generic version of many popular brands. This can save you money, as generic flea pills cost significantly less than name-brand options.
Do I need a prescription from my vet for these best flea pills?The best flea pills for dogs in 2022 featured here today do not need a prescription from your vet. That being said, we always recommend that you speak with your veterinarian before starting any new medication, even if it's over the counter.
This is especially important if your dog is pregnant or nursing, as some flea pills may not be safe for use in these cases.
Final Thoughts on 25 Best Flea Pills for DogsIn conclusion, finding the best flea pills for dogs can be essential to keeping your pet healthy and free of pests. Fleas can cause a range of problems for dogs, including skin irritation, anemia, and disease transmission. Fortunately, there are many flea pills available on the market that can help prevent and eliminate these pests. One of the top choices for flea pills for dogs is Capstar Fast-Acting Oral Flea Treatment for Dogs. This product has a 4.4-star rating on Amazon with over 11,000 customer reviews and provides rapid relief from flea infestations. Another popular option is Comfortis Chewable Tablets for Dogs, which also has a 4.4-star rating on Amazon with over 1,500 customer reviews and provides a month-long protection against fleas. When choosing a flea pill for your dog, it's important to consider their specific needs and any potential health concerns they may have. It's also crucial to follow the product's instructions carefully and administer the correct dosage. In addition to flea pills, there are other preventative measures you can take to help protect your dog from fleas. Regular grooming and keeping your dog's environment clean can help reduce the risk of infestations. It's worth noting that while flea pills can be effective, they may not be a cure-all for pest infestations. Some situations may require professional extermination services to fully eliminate the pests. It's also important to be aware of the potential side effects of flea pills, which can include vomiting, diarrhea, and allergic reactions. If you notice any unusual symptoms in your dog after administering a pill, it's essential to contact your vet immediately. In conclusion, by prioritizing your dog's health and well-being, you can find the best flea pills to protect them from these pesky pests. With so many options on the market, it's important to do your research and consider your dog's individual needs before making a decision. By taking preventative measures and administering flea pills as directed, you can help keep your furry friend healthy and happy. Statistics show that flea infestations affect up to 60% of dogs, highlighting the importance of taking steps to prevent and treat these pests. With the right care and attention, you can protect your dog from the harmful effects of fleas and improve their overall quality of life.
Allergic To Your Pet? This Immunotherapy May Help
It's a nightmare for any dog or cat owner: suddenly developing an allergy to their pet. Belly rubs and cuddles bring red eyes and a runny nose. Some people can no longer even be in the same room as a pet without their respiratory system sounding the alarm.
Medical professionals' advice in such cases is unanimous: it's best to find the animal a new home because the odds of an allergy disappearing are extremely low. In fact, living with the animal increases the risk that allergic rhinitis, commonly known as "hay fever," will turn into more serious allergic asthma.
But saying goodbye to an animal friend is an unbearable thought for many allergy sufferers. And for some, it's not just an emotional problem but also an existential one. This is the case for people who need a guide dog, for example, or have a job in which they can't avoid contact with animals.
The good news: there is a therapy that can significantly alleviate or even cure allergies. The bad news: the treatment is laborious and not entirely risk-free.
An allergy sufferer's immune system acts like an overzealous security guard that keeps mistaking harmless visitors for dangerous intruders. If an innocent visitor fits a certain pattern, the guard automatically detains them and sends messengers to alert the entire security apparatus of an apparent threat.
In this analogy, the classic allergy drugs—antihistamines—take over various security posts, where they prevent the messenger substances—histamines—from raising an alarm. But this only temporarily relieves symptoms. The security guard still thinks harmless visitors are dangerous.
Retraining the Immune SystemFor more than 100 years, however, there has been a procedure that can address an allergy's root cause: specific immunotherapy, also called hyposensitization. As early as 1911 pathologist Leonard Noon used it to successfully relieve hay fever. To this day it remains the only known treatment that can permanently reeducate the immune system.
Hyposensitization works like this: An allergy sufferer's body is exposed to very small—and then gradually larger—amounts of the harmless visitors (allergens), and the immune system learns over time that they are not really dangerous. But if too much is introduced at once, the guards panic. And the immune system learns slowly: retraining it takes at least three years.
In this process, there are two ways to introduce allergens into the body in a controlled manner: injections under the skin (subcutaneous immunotherapy) or drops or tablets dissolved under the tongue (sublingual immunotherapy). The injections, or allergy shots, require visiting a doctor, say, weekly at the beginning of treatment and later, say, about every four weeks. The tablets or drops are taken under medical supervision the first time, then daily at home. (Allergy shots for animal dander are available in the U.S. Allergy tablets are only approved by the Food and Drug Administration for ragweed, grass pollen and dust mites. Drops are not approved by the FDA. Europe has approved more subcutaneous and sublingual treatments, including injections, drops and tablets.)*
Specific immunotherapy has proved effective for tree and grass pollen, and experts assume in principle that it also works for allergies to animals. "The effect of both methods is about the same, for cats as well as dogs. In 70 to 80 percent of people who finish the therapy correctly, complete success occurs in the sense that they hardly notice any symptoms," says Karl-Christian Bergmann, an allergist at the Institute of Allergology at Charité University Medicine Berlin.
The first improvements are usually seen after three or four months, Bergmann says, "and then they can take a cat on their lap, and it's very likely that they won't have a cold or watery eyes anymore." Once a three-year treatment is completed, the effect usually lasts for several years. "But that doesn't mean the allergy is cured forever. It's possible that the symptoms will come back after a few years," Bergmann says. No one can say how likely that is.
Preventing the Spread of Severe Allergy SymptomsThe best argument for hyposensitization is that it reduces the risk of the potentially dangerous spread of allergy symptoms from the upper to the lower respiratory tract—from allergic rhinitis to allergic bronchial asthma, for example. The first signs that such a change has occurred are often chest discomfort and an irritating cough. In severe asthma, the bronchi become chronically inflamed and constricted. There is a risk of shortness of breath or even life-threatening respiratory distress.
In principle, this spread of allergies can be prevented by specific immunotherapy. But the study record for animal allergies, unlike for plant pollen allergies, is modest. Reports of success come only from very small studies, and the covered time periods are short. For dog allergy sufferers, there are no large studies at all. The 2022 German guidelines on specific immunotherapy mention "limited evidence" for efficacy in allergies to cats and "insufficient" evidence in dogs. They therefore call for critically weighing the benefits and risks.
This is because there is evidence that serious side effects occur more frequently with treatment involving animal allergens than with other types, warns Helmholtz Munich's allergy information service. One example is severe anaphylactic shock, a life-threating bodily shutdown. The first signs can be harmless, similar to mild side effects that usually pass quickly: after a shot, the skin around the injection site reddens; after taking drops, the oral mucosa itches. But if the larynx swells up or the circulatory system collapses, the situation quickly becomes dangerous: there is a risk of respiratory distress, unconsciousness and organ failure—an emergency that must be treated immediately.
This risk is the main reason immunotherapy is often not recommended for pet allergies, says Margitta Worm, an allergist also at Charité University Medicine Berlin. "Compared with immunotherapy against pollen, intolerance reactions occur disproportionately often," she says, adding that deaths are extremely rare and that the danger of a reaction such as anaphylactic shock is likely highest for those who already suffer from asthma or other risk factors. Still, Worm says, "you simply can't rule it out" in anyone. And treatment is especially difficult if patients continue to live with their pets because their exposure to allergens is not controllable.
Ear, nose and throat specialist Adam Chaker of the University Hospital rechts der Isar at the Technical University of Munich agrees. But he draws a different conclusion. The risk of a life-threatening allergic shock from immunotherapy for a pet allergy is one in a million, Chaker says. It is conceivable but highly improbable that a person could die in such a case if one can exclude risk factors such as cardiovascular diseases. He says specific immunotherapy is "extremely safe" if contact with the animal and its allergens can be minimized—the allergy must be under control.
Chaker is confident that hyposensitization works when it is used correctly. He and his team are researching the molecular mechanisms behind allergies, and they are currently focusing on various biomarkers that indicate—at the outset of specific immunotherapy—whether it will be successful after three years. There is no evidence that treatment is less effective for one respiratory allergen than another, he says.
The therapy can be more difficult, however, if it requires several different allergens from one species. That's because the extracts used come from the animals themselves—and their compositions can vary. For cat allergy sufferers the issue is usually negligible as more than 90 percent of them react to the main cat allergen. For people with dog allergies, however, the problem tends to be spread across different allergens. Hyposensitization—as well as diagnosis—of dog allergies is therefore often more complicated.
There's also less demand for immunotherapies against dog allergies, compared with those for cat allergies. "Allergies to dogs usually do not cause symptoms as severe as those to cats," Worm explains. "Those affected are more likely to opt for symptomatic therapy with antihistamines and to banish the dog from the bedroom." She advises against permanent treatment of the symptoms with cortisone because of side effects. Allergy sufferers who continue to live with their dog, however, do have a higher risk of developing asthma—albeit lower than they would with a cat. "The therapy of choice, therefore, is always to find the animal a new home," Worm says.
Chaker agrees and says it would be even better not to get into this situation in the first place. He adds that people often tell him, "I want a dog, but I already have other allergies. Is that possible?" or "My child has neurodermatitis. Can we still get a cat?" In such cases, Chaker says, his answer is that this is "not a good idea. Anyone who is already allergic is in a high-risk group for further allergies and allergic asthma."
The situation is different when contact with the animal is difficult to avoid, as with visually impaired people who need guide dogs. In such cases, Chaker recommends specific immunotherapy with the necessary precautions: At the beginning of the treatment, the symptoms must be reduced as much as possible, especially in the case of asthma. This is particularly crucial in the first weeks of therapy, when as few allergens as possible should be allowed in from the outside. In the case of a pollen allergy, the treatment should ideally start in the pollen-free season. This reduces the risks and increases the chances of success. "If you manage to keep the allergen exposure low and control the symptoms well with medication," Chaker says, "you can also treat allergic asthma with immunotherapy."
Additionally, Chaker sees a great need in a different population: people who do not have an animal in the house but suffer from the allergens that pet owners carry into the public. "These are the people we could do well to help with specific immunotherapy," he says.
Say, one tablet a day for three years—that certainly seems manageable for those willing to take the risks. But there's no guarantee of success. Symptoms are likely to lessen but not disappear completely, and they may return after a few years. Whether that prospect is enough to try it is something every pet owner must decide for themselves.
Tips for Allergies under One RoofThough not a permanent solution, steps can be taken to reduce the amount of allergens in a dog or cat household. Experts recommend:
This article originally appeared in Spektrum der Wissenschaft and was reproduced with permission.
*Editor's Note (5/4/23): This paragraph was updated after posting to provide clarifying information on what allergy immunotherapies are currently approved and available in the U.S. And Europe.
Cats, Peanuts, Bee Stings… The Irritating Truth About Allergies
When Theresa MacPhail was four, her brother was killed in an accident. When she was 14, her mother died in a car crash. And when she was 24, her father died from anaphylactic shock after a bee flew in through the open window of his truck and stung him in the neck. For anyone else, these devastating experiences would almost certainly have been psychologically catastrophic. "I have several friends who are psychology professors, and they're always saying, 'No offence but, by rights, you should be a drug addict, or have severe emotional issues,'" she says, smiling, over Zoom from her home in New York, wearing a cheerful sweatshirt covered in luminous kittens.
Photograph: Stefan Sollfors/AlamyInstead, MacPhail decided to use what she'd been through as the bedrock for her PhD at UC Berkeley, and then her career as a medical anthropologist. She laughs. "I'm like the doyenne of death. I have been thinking my whole life about the things that make people ill and pass away, because of my history. These are the waters I've been in since I was a kid. Rather than ignoring it, I decided to go at all my fears and insecurities about mortality. And then I basically made it my profession."
Much of MacPhail's anthropological research has been into our collective fear of viruses, but six years ago and in her late 40s, repeated chest infections led to her unexpectedly being diagnosed with respiratory allergies. "When you're 24, you think you're invincible, so the only time I thought about whether I had the same allergy as my dad was when a bee came near me. But after I was diagnosed, I told all my friends about trying to figure out what I'm allergic to, and it turns out everyone has an allergy story. And then I thought, 'Wait, just how prevalent are allergies?' I had questions about whether this is just happening to us now, or was it the same in the past? I found academic articles but nothing accessible. I was complaining to a friend who is also a medical anthropologist. And that conversation is now famous in my mind, because he said to me, 'Hey, aren't you a researcher?'"
The result is a brilliantly comprehensive and highly readable book, Allergic: How Our Immune System Reacts to a Changing World, five years in the making and the first ever to track both the history of allergies and the state of modern allergy science, while also trying to get to the bottom of how, almost 30 years ago, her father came to be unknowingly and fatally allergic to bee venom, and whether she might be, too. If that sounds outrageously complicated, it was. "Every allergist I interviewed told me it couldn't be done. They were all like, 'What are you trying to do? And I said, 'I'm trying to do the whole story.' And they said, 'All allergies?' And I said, 'Yeah', and they said, 'Good luck.'"
Hard to crack: peanut allergy now runs at 1 in every 70 kids, versus 1 in 250 in 1997. Photograph: Craig Cutler/Trunk ArchiveIt's startling that this is the first popular science book of its sort. "Culturally, people have self-trained that allergies are not a big deal. But allergies are a signal that your immune system isn't happy with the world you live in. And I think that's a conversation we should all be having."
Despite interviewing practically every top allergist and allergy researcher in the world and being comprehensively tested, it is very unlikely MacPhail will ever know exactly what she is allergic to, unless she is unlucky enough to have an extreme and therefore very obvious reaction. Her experience mirrors that of many allergy sufferers. My six-year-old daughter has a respiratory allergy and, even after testing, we have no idea why. Because it's mild and far from life-threatening, we haven't been able to get a referral to an NHS allergy specialist, even though it makes life miserable. She also had cow's milk and soy protein allergies as a baby, making her one of the 48% of allergic people who have more than one allergy.
"The only way to know for sure if you have an allergy is to see someone who specialises in it," says MacPhail. "But I don't want to be glib about that, because lots of people just can't: there aren't that many allergists and it's not a popular speciality. And if your allergies don't qualify, you'll be paying out of pocket." Other factors affect access to services, too. "For instance, with skin allergy, for years they only trained people on white skin, so eczema can be under-diagnosed on brown skin," says MacPhail. In the UK, getting a referral or a prescription can depend on the amount of training your particular GP has voluntarily undertaken – allergies were only made a compulsory part of the GP curriculum in 2019, meaning many GPs may have no allergy training at all, despite allergies being the subject of 8% of all GP appointments. There are only 40 adult allergy consultants, and even fewer paediatric specialists working in the NHS, according to the charity Allergy UK, which is currently calling for specialist allergy nurses to be placed in all GP practices, following a trial in which 95% of allergy patients were successfully treated in their doctor's surgery.
'I'm like the doyenne of death. I've been thinking my whole life about the things that make people ill and pass away, because of my history': Theresa MacPhail. Photograph: Benedict Evans/The ObserverAnecdotal evidence has long suggested that our allergy problem is getting worse, but until recently it's been hard to be sure. We are better at diagnosing allergies than we were two centuries ago, say, and the theory has always been that back then, people were more worried about tuberculosis or any of the myriad other things which could kill you or your children in the pre-antibiotic and antiseptic age. A runny nose, itchy rash or upset stomach would barely register, meaning that while fatal reactions to bites and stings certainly happened, if respiratory, dermatological or food allergies did exist, no one took much notice. (On the other hand, diarists like Pepys recorded every niggle, so if chronic allergies had been common before the Industrial Revolution, debilitated sufferers would surely have left clues behind?)
MacPhail, however, has gathered a raft of data which conclusively shows that yes, we are becoming more allergic. There's the study by the Food Allergy and Anaphylaxis Network showing that peanut allergy now runs at 1 in every 70 kids, versus 1 in 250 in 1997. In the US, on average, someone now arrives in A&E every two hours with a severe allergic reaction. A study by Imperial College London suggests food allergy anaphylaxis increased by 5.7% between 1998 and 2018. US hospital admissions for asthma tripled between 1970 and 1990, and asthma rates continue to climb in developing countries.
I asked every expert, what is the cause? They simply said everything, it's everything we're doing
It's trickier to measure either national or global rates of less catastrophic allergies, such as hay fever, which was first observed in the 1800s, or allergies which cause localised reactions, in part because so many people self-diagnose – sometimes accurately, sometimes not – and because GPs don't always recognise or record allergies. MacPhail's conservative estimate, after wading through global datasets of highly variable quality, is that 10% of the world's population – 800 million people – will have a respiratory allergy at some point in their lives. But she says it's impossible to know exactly how many people have other allergies, because there is so much variation in how a person is diagnosed, if at all. Allergy UK says one in three Britons will experience an allergy during their lifetime and that currently 50% of British children have an allergy. Research by the European Academy of Allergy and Clinical Immunology suggests that up to half of Europeans may be affected by allergy by 2025. We may not have precise numbers, but it's clear that allergies are a big problem, getting bigger.
Another problem with the data – which often relies on self-reporting – is the public's misunderstanding of the difference between intolerances and allergies. "Most of us do not understand what the results of a scratch test show," says MacPhail, of the tests done by breaking the skin and applying a tiny amount of possible allergens, then waiting to see if a skin reaction occurs. "They're just telling you if you have a sensitivity. The difference between sensitivity, intolerance and allergy is the number one thing all allergists wish we could understand."
Straw poll: 48% of allergic people have more than one allergy. Photograph: Rob Shaw/ShutterstockCan she help us? "This is why it's so important to get access to better care, because it's almost impossible to know without seeing an allergist. The best example is lactose intolerance versus milk allergy. They can seem similar, but the difference is that when you have an intolerance, you don't produce the enzyme that breaks down the milk protein, which gives you an upset stomach and really does not feel good. It also does not feel good if you have a milk allergy and you ingest milk, but the difference is that you are activating mast cells, basophils, T-cells and IgE antibodies and your whole system is going into effect. But it's really difficult at a symptom level – unless you go into anaphylaxis – to know which is an intolerance and which is allergy."
When it comes to scratch tests, it's even more confusing. "If someone thinks they have a milk allergy and they react every time they drink milk, but they have a blood test showing normal antibody levels and their skin test is negative, then the likelihood of allergy is slim to none. On the other hand, your scratch test could leave you with a huge welt on your arm, but you've never had a reaction to milk in real life." Without an allergist to do your case history and family history and combine your various blood and skin results, the welt just means you have a sensitivity – which might never result in symptoms, and doesn't necessarily mean you need to change your behaviour.
It's also easier to get taken seriously when you call your symptoms an allergy. "I want to stress that intolerances are terrible and I understand why it's confusing. On Reddit, there's a subreddit for allergies, and people post pictures of the welts on their arms or backs after a scratch test, saying, 'Look at all these things I'm allergic to.'
"These poor people are then going to be avoiding all these things, when they don't have to. And here's the rub: if you avoid something, you can actually accidentally trigger an allergy because you are denying your immune system the training it needs to tolerate it. You think you're allergic to milk, you don't drink milk, and your body forgets what milk protein looks like. The next time you ingest it, you might have given yourself an allergic response."
Blowing in the wind: climate change is causing higher levels of pollen. Photograph: Levi Brown/Trunk ArchiveSo why are we getting more allergic? "No one knows what the smoking gun is. It's multifactorial. That's quite overwhelming and to think about
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