Ep 20 - How to Get a Dog Even if You Have Pet Allergies (Allergist's #1 Tip) | Allergy Actually 

Amber: If you have pet allergies, you may have heard people say, "Just get a hypoallergenic dog." You might have seen lists online of dogs like Poodle, Schnauzers, even Portuguese water dogs being labeled as allergy-free.

But what does that mean? And is there really such a thing as a truly hypoallergenic dog? In this episode we're busting common myth and breaking down the science behind pet dander. We'll give you practical tips for managing pet allergies so you can finally stop asking, "can I get a dog?" And start answering, "Yes, I can." Welcome back to Allergy Actually.

Kara: Oh, I am just like loving living vicariously through your doggos, like through the screen. Because I grew up with dogs, I love them. I also do not have the bandwidth quite yet to keep another living thing fed and watered on the regular, but, oh.

Meaghan: I am just loving Amber's dog 'cause for those of you who aren't watching this and just listening, she is massive. Like massive. And so when she like lifts her up and then a minute ago she got scared when we did the clap and starts recording and she like ran off into the floor.

And I have a little itty bitty, mini dachshund and she is an English cream, so she's blonde, so she kind of looks like a baby golden retriever. And she's almost three years old. She didn't want to get in my lap. I offered, but she's perched above my chair, so she kind think she's a cat. We have a cat and so she wants be like her cat brother. But Yeah, this is something that comes up all the time with patients. 


The "Hypoallergenic" Dog Myth Busted
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Amber: They'll say to us like, oh, well. Or you know, if I say, "Do you have a dog at home?" "Yeah, but it's hypoallergenic." Or if they don't have a dog and they wanna get one, "Can you help me pick a hypoallergenic dog?" And hypoallergenic dog is a marketing term, you guys. We're gonna bust that myth today. There's not a real hypoallergenic dog. I think what people mean is getting a dog that maybe doesn't shed as much or has less dander. But all dogs have skin, which is where the dander comes from. All dogs have hair, so if you have a dog, you are exposed to the hair and the dander. There's no way to get around that or get away from it.


It's Not the Fur! The Real Cause of Dog Allergies
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Meaghan: One of the things patients say to me a lot is, "Well, my dog doesn't have fur." So these other dogs have hair. So I think sometimes in people's minds, that's a big distinction for them, and that's why they call things like golden doodles or whatever other dogs have hair versus, you know, in quotations, fur, that that is the big difference. And so there are times whenever, if the patient isn't being bothered by their dog, they're not allergic, I don't always go into a lot of detail and burst their bubble to be quite frank. But if they're truly saying like, "I have a dog allergy. Can I get a dog? I'm gonna get a hypoallergenic one. Definitely one that has hair instead of fur," we have to have this conversation. And so I always tell them the protein that we're allergic to is inside of dogs' bodies. And so it's also going to be in their saliva and it's going to come through their skin. And so that happens whether you have fur or hair or not. And so that is actually not a consideration for, I think, an allergist whenever we talk about hypoallergenic dogs, or dogs that you might tolerate. And the other thing that's weird about dog allergy is there are different proteins in dogs that humans can be allergic to, and it is very real that sometimes you can tolerate being around one dog better than you can another. So that's not your imagination. That is a real thing. 


An Insider's Guide to Dog Allergy Testing
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Kara: Well, we see that variability in the extracts that we get to test people. So for a bit of backstory, when we allergy test patients in the office and we do those little scratch tests with the little scratchers, not needles, right? The plastic scratchers, we are able to purchase purified allergen from one of several different distributors.

And there are some allergens that if you buy it from one distributor to the next, that that it's standardized, meaning it's exactly the same. But a lot of allergens, dog being one of those, are not standardized. And there is variability between how the ratio or how much of those different component proteins are a part of that allergen test mix So I know when I was at my previous office I worked at, we started with two different companies extracts that we would test to, so we would test everyone to dog twice. And it was not uncommon that you would sometimes see someone have both positive or one of each positive. And then at some point along the way, a third company came out with another extract that was supposed to be better. So we trialed all three for a little while and then decided to scale back to the two that gave us what we thought to be the most accurate results. 

Amber: And just to explain a little bit what standardized means, there's a reference that the FDA holds for certain standardized allergens, and I think we're at 19. There are some grasses, short ragweed, cat. So anyways, they're different species of grass, but don't quote me on the 19, guys, don't blow up our comments. Like "It's not 19, it's 21." I don't know. There are specific ones that the FDA holds certain standards of, and that's what the manufacturers have to match up against to say, yeah, we're distributing or selling the highest quality of extract. So, as allergists, if allergists are listening, you're like, oh, I know which one Kara was talking about that had the newer one that come out or that came out.

And I don't know what your guys' kind of internal results were, but that company states that their process helps give you a more predictable, standardized amount of Can f 1, which is the major dog allergen. So just kind of a insider guide to when you're going to the allergist to get skin tested and then to get immunotherapy, we know the science behind how the different extracts are made, and that's how we determine which extract we purchase for testing and treatment. 

Meaghan: I can't find it right now. I tried to do a quick lit search, but there was a paper that was published by two notable authors in our field, but they looked at the different levels of Can f 1 and is it Can f 3? I can't remember the other Can f that we look at as far as proteins exactly, but they looked at different dog breeds and like the amounts of each of those proteins that they produced, essentially like to try to figure out if there really was, you know, a particular breed and, and it was a hot mess. Like there was no, it, it was all over the place. There was no difference. And so, I remember thinking that that was very interesting that we actually had some validated data for that.


The #1 Way to "Fix" Your Dog Allergy (Immunotherapy)
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Amber: That is interesting. 

Meaghan: Yeah. I'll have to send it to you guys whenever I refine it again, so you can take a little, it's just interesting background stuff. One thing I do tell patients though, who are allergic and want a dog or have a dog, so number one, we can, I always say fix it, but you know, we can make that much better with immunotherapy. And that can be the regular allergy shots. It could be something called ILIT, which is intra lymphatic immunotherapy. There are various methods that are very effective for dog allergy. And if you're wanting to bring a pet into your home and you have been tested for a dog and you know, had dog allergy, but you're not really ready to commit to shots or anything like that, I always tell people the best method to get a pet whenever you know that you're allergic or even if you're not sure that you're allergic, but suspicious, it's a good idea to try to spend time with it first. Because again, we can't say that getting this hypoallergenic dog isn't gonna work. We'd just established there's no such thing. But if there is a way for you to spend some time with the animal itself, and it's hard because when you spend time, you become attached and then you don't care if it makes you sneeze. But that is something that is a way to do it if you can do that and see. And you know, it may worsen over time, but still that can give you an idea about tolerability for that particular dog. 

Amber: Yeah, I give similar advice and I a 100% agree. Number one, if you want to get a dog and you know you're allergic to dog and are symptomatic, meaning when you're around dogs, you have your asthma flares or you get bothersome congestion, drainage that would, you know, disrupt your quality of life if you were living with a dog.

Just fix the allergy. That's the best thing we can do for you, rather than you trying to say, "okay, maybe I should the smallest dog that doesn't shed. So what are we looking at here, like a King Charles?

Yeah, what you have, Megan, those beautiful mini dachshunds, like you can make all these rationalizations to yourself about, "Well, I'm gonna pick the dog with the least fur or dander." But in the end, you don't really know, you're taking a gamble. And if you commit to adopting a dog, it's not fair to the dog to adopt it on a gamble to say, we'll see how it works out. You need to either fix it or like you suggested, Megan, test it out beforehand. See if you can do a test run of fostering for two to four weeks before you commit.

Meaghan: Yeah, absolutely. 

Kara: Yeah, I think, you know, one of the themes we've talked about a lot in our most recent episodes is this idea of the additive effect of inflammation. And if you think about if you are allergic to your fur baby, that is a []


Practical Tips: Creating a "Pet-Free Zone" & Managing Dander
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Kara: or kind of an element that is going to continue to drive inflammation over the long term. And so, it's echoing what you're saying, but it really does make a huge difference to be proactive about that. I think some other things you could do to set yourself up for success if you do have allergy, maybe you're undergoing immunotherapy at the time, but it, you know, it hasn't fully kicked in yet.

Making sure you have a pet free zone in your bedroom is huge. Sleep is a time for your body to rest, to recover, to repair. And so if you're, you know, able to keep that a lower allergen space, it's really important. So keeping the pet out of there, keeping an air purifier that's adequately sized for that room, super important. Making sure to wash your sheets on hot and dry on hot to get any allergen that's being carried along with you into the room or through the vents, right, to periodically be getting that off. And then being proactive about your medication regimen because we know that oftentimes, if we're able to use medication ahead of time and more proactively, we don't need as much to rescue, like keeping the horses in the barn.

Amber: Another way to minimize exposure to your dog is weekly bathing. There's been data looking at that. And I know some patients will say, "Well, my dog's skin is too sensitive for weekly bathing." Okay, well then do daily brushing or something like that. But anything you can do to reduce the amount of hair that is coming off of the dog, which takes hair and dander into your aero-environment can be helpful for reducing exposure. But I'm just a big believer if you are a dog person, I'm a dog person. If you love dogs, whether you're allergic or not, you should have the freedom to get the dog you want, because if you're like me and you love golden retrievers that are super hairy and they shed everywhere,

Kara: Tumbleweeds.

Amber: We can help you get your dream dog by treating your dog allergy. 


Why We'll NEVER Tell You to Get Rid of Your Pet
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Meaghan: Yeah. That's absolutely true and something that as far as some allergists are, you know, at least in the past for unclear reasons, would always say you have to get rid of your pet. And that's the first thing I tell my patients is, I'm not gonna tell you to get rid of your pets. There was a great study done by a fellow at Cleveland Clinic now about 10 years ago that said people would rather get rid of their allergist than they would their pet. So would I. 

Yep. 

Yeah, it's really, it was really good data. I remember I actually walked by the poster, I think at, I was either one of the, one of the national meetings, the College of the Academy for Allergy. But it was so funny and I was like, you know, that's real. That is absolutely real.

So if you have an allergist that says your only solution is to get rid of your dog, just please know that there are more things out there that can be done to help you out. And something people really underestimate is the emotional benefit of having an animal, you know? I mean. I'm not a psychiatrist or a psychologist, but I'm sure there's data out there. And I just know, personally for me, you know, it really enhances my life to have my little, you know, Ragamuffin. So

Amber: I think it enhances my life to see your beautiful dog. 

Meaghan: She's being shy today. She's not really participating. She's just ignoring all of us. 

Amber: To your point about allergists in the past telling people to get rid of dogs and like, I feel like nowadays, allergists are not taught that way. They're taught like, okay, no, our patients are gonna get rid of us. I saw the most wonderful patient the other day. 82-year-old woman who had an allergy to, I think it was a cat for her, but she had had allergies her whole life.

And she told me a story about how when she was in her twenties, she went to an allergist to see if what they could do about her cat allergy because she loved her cat and the allergist told her to get rid of it. I think they offered her get rid of it or do immunotherapy. And at the time she didn't wanna do immunotherapy and she was like, "Well, I guess I'm not doing anything." And she never went back. And she finally, like 60 years later, was coming full circle and she was like, "I'm ready to do immunotherapy." I was like, let's go lady. Let's enjoy this cat. And maybe you get a dog too.

Kara: It's so cute and so wonderful. I am thinking back to a few years back I was proctoring exams for medical students. So, one of my roles in my previous life as an academic physician was to be behind the curtain, so to speak, behind the secret screen where medical students would be interacting with standardized patients.

So they're actors that have a script and they are going through a particular scenario in order to show that the medical student has competency in getting that story from a patient doing a physical exam and thinking through the problem. So if I remember correctly, this particular scenario, it wasn't allergy specific, but it was related to a patient who is immunocompromised and there were particular recommendations that they needed to make related to pet care. Because if someone has a severe immunodeficiency, they're at increased risk for infections from their pets. So this student pretty much just told the patient in their counseling that they needed to get rid of the pets. And so in the feedback I was like, as an allergist, if I told patients this, they wouldn't come see me anymore.

So here's what I would suggest next time, that they wear gloves and a mask and wash their hands if they're changing the litter box. But it just made me, you know, think about like, yeah, that doesn't fly.

Amber: Nope.

Meaghan: And it's very paternalistic way to practice medicine now, whenever you say "you have to" because something like having a pet, I think that obviously that's a collaborative decision. You know, the patient to buy in. And that's sometimes you ever get disappointment when people really want, like as a parent, they really want some, like their kid to test positive or, you know, because I get a lot of divorce situations with that and there's a lot of battle where they're like, well, I wanna see if they're positive to cat or dog. And you know, we all know that there's the existence of something called non-allergic rhinitis, which is when you get symptoms like nasal, sinus type symptoms from irritants and, you know, pet dander and pet protein can be an irritant. Cats in particular are very irritating. I always explain we can do the test, but this isn't something that, you know, I never will recommend that you have to get rid of the pet so that if you're hoping, I'm gonna stand with you in court to say you must get rid of your dog. I'm, 

Kara: Not gonna do it. 

Amber: So just to summarize, if you're looking for a hypoallergenic dog, that's not a real term. If what you're really looking for is a companion and you're allergic to dogs and you really want a dog, find a local allergist. Get tested. If you're allergic, truly allergic, we can treat that with immunotherapy so that you can have the joy of living with and loving a pet for the rest of your life if you choose to. So, with that we're gonna wrap up this episode of Allergy Actually. Don't forget to comment, maybe comment with your favorite kind of dog or something about, you know, why your dog is the best kind of dog. And I'll, I'm gonna make sure to comment about Golden Retrievers. Now, hit the notification bell. Subscribe and stay tuned for our next episode of Allergy Actually. 

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