A holistic veterinarian's approach to itchy skin in dogs

By Dr Edward Bassingthwaighte, Holistic Veterinarian

Allergies in dogs (and cats) are complex, hard to treat, and often a source of a LOT of frustration for everyone - the itchy dog, the dog’s human, and the vet who is trying their best to find something that works!  

First up, let’s talk about what an allergy is. Allergies happen when your dog’s immune system overreacts to substances (allergens) in the environment. Allergens may be inhaled, may come into direct contact with the skin, or may be ingested or eaten.   

Many different substances can be allergens, and include:  

• Pollens
• Mould
• Dust mites
• Storage mites
• Grass or other plants
• Foods (proteins or other ingredients)
• Insects (fleas, mosquitoes, sand flies, etc)
• Other substances such as fabrics, cleaners, plastics, cleaning products
• Medicines and parasite prevention chemicals

If your dog’s allergies display a seasonal pattern, that makes it more likely that they are suffering from an inhalation allergy, with pollen being the trigger. If they have an all-year-round pattern, then things like house or dust mites or food are more likely to be the problem. 

The most common kind of allergy we see in dogs is itchy skin. Your dog will scratch, lick, chew and bite at their skin, and you’ll often see redness, irritations, saliva staining, and sometimes broken skin, scabs, or even infection and hot spots. There may be skin rashes or hives (itchy lumps).

Chronic ear or foot infections are common with skin allergies. These tend to be secondary infections because the allergies make the skin hot and moist, the perfect environment for yeast and bacteria. There may be hair loss, or bald patches.

Dogs may also experience runny noses, and itchy, watery eyes, with or without sneezing. Rarely, allergic dogs may experience breathing difficulties/wheezing.

Food allergies may cause gut issues, including diarrhea, vomiting, reflux, or gas. All these symptoms may lead to behavioural issues, increased anxiety, or general unwellness/depression.

The most severe form of allergy (thankfully rare) is anaphylactic shock, which can be life-threatening. Symptoms include sudden weakness, collapse, vomiting, and diahrrea. This is a medical emergency.

Allergies, especially itchy dogs, are very common. And they are quite strongly heritable - if one or both parents are itchy dogs, chances are their pups will be itchy too!   

In my experience, it’s not uncommon for vaccinations to trigger allergic issues anything up to 6 months after a vaccination. So always Titer test before re-vaccinating! Want to know more about Titer testing? Listen to this podcast episode here.

And sometimes they just happen, with nothing to blame.

My holistic approach to treating allergies in dogs is… 

Step 1: Understanding

Gain the strongest possible understanding of what the trigger allergens are by taking a detailed history, and testing. 

You can do a blood test or refer to a skin specialist for intradermal testing. However, I’ll often do my best to narrow down what type of allergy it is through the history first, and gauge response to treatment before going to testing, especially if the problem is not too severe. This is because the tests are expensive!

Step 2: Diet

Make sure the dog is on a healthy fresh whole foods diet with little or no carbs, and especially no grains. Kibble is a huge no-no, and most itchy dogs I get off kibble show reductions in itchiness from this alone. BARF or home-cooked are fine!

If there is suspicion that food sensitivities may be involved, we may do an elimination diet to work out what foods are hot triggers, so we can avoid them. 

Step 3: Holistic Treatments

‍Then I’ll try a broad range of holistic supplements, treatments, and interventions. 

• CBD is often helpful
• Medicinal mushrooms are a great support for the immune system (I love the Teelixer Immune Support blend)
• Homeopathy can unwind these complex, chronic diseases
• Probiotics can support the gut
• Local raw honey can help naturally desensitise dogs to pollen
• Acupressure/acupuncture can help
• Herbal medicine (TCM and/or Western) can be effective
• Energy healing may be helpful
• Reducing anxiety is a great support
• A faecal transplant can be very effective!
• And of course getting rid of insects like fleas, or allergens like house mites is important.

Step 4: Testing

If a more generalised holistic approach isn’t working, I definitely want to get real information about what allergens are hot triggers. I’ll send off blood tests and/or refer to a dermatologist for intradermal allergen testing. 

Step 5: Allopathic Medicine

‍There is a place for prescription medicines, though I avoid the suppressive ones unless they are needed as a last resort for quality of life. 

I do like the specialist intervention of allergen testing and desensitisation - where they blood test and intradermal allergen test to discover which allergens are the hot triggers, and then make a special injection with very low levels of these allergens that is then regularly injected under the skin. 

This teaches the immune system to stop over-reacting. It’s often very effective and has little or no side effects. Also, it’s not suppressing the immune system, which is VERY important. 

It’s important to understand that right across the board, you’ll be lucky to get a 60-70% success rate with any allergy treatment. If you get to a place where nothing has worked, and your dog is chewing and scratching holes in themselves, then suppressive medications may be necessary for adequate quality of life. 

I would avoid Cytopoint most of all, closely followed by Apoquel. If I do need to use a suppressive medication, I tend to use cortisone, at the lowest possible effective dose. Some dogs can’t tolerate cortisone, if so, I’d use Apoquel as a second choice. 

I always begin with the most holistic options available, and if they don’t work, I then move into the least harmful allopathic, before going to palliative care with immuno-suppressive medicines as a last resort. 

Cytopoint is the last thing I would try, and I’d only use that if nothing else worked, and the dog was chewing holes in themselves. 

It’s important to note that if there are secondary bacterial or yeast infections (hot spots, ear infections, skin infections, pyoderma etc) then appropriate antibiotic therapy under the supervision of your vet is a necessity. 

Remember that allergies are tough to diagnose and treat, and please be kind to your vet. If you don’t have a holistic vet locally, give me a hoy and I can help you with a Zoom consultation.  

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About the Author - Dr Edward Bassingthwaighte.

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Dr Edward Bassingthwaighte is a holistic veterinarian, and a world-leading expert in silent pain in pets. Dr Edward is passionate about fresh raw whole foods for dogs. He is the founder of the Whole Energy Body Balance method- a profoundly healing bodywork modality for pet parents and pet wellness professionals to relieve silent pain, anxiety and trauma in pets. Join Dr Edward's free masterclass on silent pain in pets here.

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