Why Is My Dog Itching So Much?

What Can I Put on My Dog to Stop Itching?

Our Bernese Mountain Dog, age 4, is healthy but has sporadic itching. He is our sixth Bernese, so we are used to the breed. We have had this problem before with two dogs. This dog, Kai, is itching, on average, three times a day. He does not have any marks on his skin. His flea and worm treatments are up to date. He is brushed every couple of days and checked for grass seeds, etc. Our vet has prescribed Apoquel, which we have had before, but I am reluctant to use it although it does work on him. I feel there might be a more natural treatment to deal with this small but obviously annoying problem for him. His diet is Royal Canin, with half human-quality cooked meat. I would be so grateful if you could suggest something to help.

Your dog is most likely itching secondary to an inhalant allergy.

Causes of Itching in Dogs

The other causes of itching and scratching in dogs include:

• Flea allergies
• Contact allergies
• Pyoderma (skin infection)
• Yeast infection
• Food allergies
• Dry skin

Knowing that he does not have fleas helps a lot. It also helps to know if he is an inside or inside-outside dog, if this is a seasonal or year-round problem, and if he has any other symptoms, like vomiting or diarrhea. All of these will help figure out which of these problems is causing the itching. In a Bernese of this age, summer allergies are one of the most common problems we see, however.

Using Apoquel for a Dog's Itching

You are correct in looking for an alternative to the Apoquel. The way that medication works is by altering the immune system. It does not cause a problem in most dogs, but in some cases, there can be serious side effects. The company that sells the drug reports that adverse effects are very rare, but in other research, about 5% of dogs (1) have one or more of the following side effects:

• Diarrhea
• Vomiting
• New ear inflammation and infections
• New skin infections
• Urinary infections

The most concerning problem, in my opinion, is that the company that sells the drug suggests that Apoquel can increase the chances that pre-existing cancer can get worse because of the way it affects the immune system. Since you have Bernese Mountain Dogs, this is a significant concern.

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Besides the side effects, one of the common complaints I hear about Apoquel is the cost. Especially when dealing with a giant breed, the monthly cost can be significant.

The reason it was developed, however, is that the alternatives sometimes do not help as much. Apoquel is very effective, and 44% of dogs responded quickly and within a week 86.4% of dogs had a significant reduction in itching. (2)

Alternative Treatments for Itching in Dogs

There are some great alternatives to keep your dog comfortable. I listed these here from the most benign to the most serious and recommend you start from the top. They include:

• Reduce allergen exposure: This is something you can do immediately at home. If your dog is mostly showing signs after he runs in a field, do not let him out. If he has signs year round and he is an inside dog, reduce the allergens in the house by changing your HVAC filters, vacuuming more frequently, getting rid of your house plants, and changing out your carpet for a hardwood floor. If you figure out that your dog has seasonal allergies, it is a good idea to keep him in when the pollen counts are high and use air filters when he is inside. Unfortunately, these suggestions will not get rid of the problem unless you can determine what your dog is allergic to, but they always help somewhat.
• Fish oil: Omega-3 fatty acids have been proven to control mild itching in dogs. I prefer to add this as part of a dog’s diet (sardines), but if you want to purchase a supplement, it is just as effective. The amounts vary according to the fish oil you purchase, but you can add about a teaspoon for each 25 pounds. This is so effective for most dogs that you may find he needs no other medications; build up to this amount, however. If you give the whole dose immediately, your dog can have diarrhea.
• Shampooing: Some dogs who suffer from grass or other contact allergies will do well with a simple shampoo, as long as their exposure to the allergen is limited. This is not always effective, as it is an inhalant allergy, so you will have to see how he responds. The most effective shampoo now available is Douxo, which sells with a mousse that contains ophytrium and is very effective. But if this is too expensive, some dogs respond to a simple cooling bath with colloidal oatmeal.
• Antihistamines: The next step would be to treat him with antihistamines if he has a severe bout of itching. This is not a great option, as only some dogs (less than a third) respond to antihistamines, and there is no way to determine which one of them, if any, is going to help.
• Cytopoint injections: This injection is not as expensive as Apoquel, but you will have to take your dog to the vet, so it can end up being just as much. It interferes in the dog’s itch response by blocking one of the proteins that causes itching. One study found an 87.8% response rate, but another study of dogs with moderate itching (similar to what you describe with your dog) reported 98% response within a month. (3) There can be some side effects, however, so I would not recommend this unless your dog is suffering and does not respond to the milder treatments like fatty acids and shampooing.
• Steroids: There are so many side effects to this type of treatment that I would not recommend it for your dog. If he was itching severely and had a severe reaction to the Apoquel and did not respond to the Cytopoint, it would be worth trying this.
• Immunotherapy: If you try the alternatives like shampooing and antihistamines and he is still having problems, the best suggestion would be to consult with a veterinary dermatologist so he can be allergy tested and you can start on allergen-specific immunotherapy. This is a potential cure, the only one available, and in 59.9% of allergic dogs, the signs of itching and scratching were reduced to less than half. (4)

It does not sound like it is that much of a problem at this time, based on your question, but if he is very uncomfortable and is not responding to the treatments at home, the only potential cure is immunotherapy based on what he is allergic to.

Sources

1. Cosgrove SB, Cleaver DM, King VL, Gilmer AR, Daniels AE, Wren JA, Stegemann MR. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease: safety, efficacy and quality of life. Vet Dermatol. 2015 Jun;26(3):171-9, e35. doi: 10.1111/vde.12194. Epub 2015 Feb 16. PMID: 25688708. https://pubmed.ncbi.nlm.nih.gov/25688708/
2. Cosgrove SB, Wren JA, Cleaver DM, Martin DD, Walsh KF, Harfst JA, Follis SL, King VL, Boucher JF, Stegemann MR. Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis. Vet Dermatol. 2013 Oct;24(5):479-e114. doi: 10.1111/vde.12047. Epub 2013 Jul 5. PMID: 23829933; PMCID: PMC4282347. https://pmc.ncbi.nlm.nih.gov/articles/PMC4282347/
3. Gober M, Hillier A, Vasquez-Hidalgo MA, Amodie D, Mellencamp MA. Use of Cytopoint in the Allergic Dog. Front Vet Sci. 2022 Jul 19;9:909776. doi: 10.3389/fvets.2022.909776. PMID: 35928119; PMCID: PMC9343842. https://pubmed.ncbi.nlm.nih.gov/35928119/
4. Fennis EEM, van Damme CMM, Schlotter YM, Sinke JD, Leistra MHG, Bartels RT, Broere F. Efficacy of subcutaneous allergen immunotherapy in atopic dogs: A retrospective study of 664 cases. Vet Dermatol. 2022 Aug;33(4):321-e75. doi: 10.1111/vde.13075. Epub 2022 May 30. PMID: 35635279; PMCID: PMC9544551. https://pmc.ncbi.nlm.nih.gov/articles/PMC9544551/

This article is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from your veterinarian. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

© 2024 Mark dos Anjos, DVM