MICHAEL M. MILLER, M.D., F.A.A.A.I. 3
ALLERGY, ASTHMA & IMMUNOLOGY, P.C.

Allergic reactions to animals may constitute a minor problem for patients or can be a very significant cause of severe allergic diseases. The allergens from animals include skin scales and proteins found in their urine and saliva. The animal allergens are so small they cannot be seen. These permeate the household environment, including the rugs and bedding, and become a household cause of allergic reactions. The animal fur (because it is insoluble) is not the major cause of allergy.

The symptoms resulting from allergy to animals are nasal, ocular, and/or pulmonary. The nasal symptoms are like those of hay fever, and the pulmonary symptoms are usually asthma. Patients may have very minimal symptoms such as mild nasal problems which are of no great significance to them. By contrast, they may have severe asthma occurring after animal exposure. One of the major problems that we see is the individual who is allergic to animals and initially has low grade asthma that becomes progressively more severe. The asthma may persist for hours or even days after being away from the animal. At times, the patient may have chronic, low-grade asthma due to animal exposure that is made extremely severe only when the patient has a coincidental respiratory infection. This latter asthma may be so severe as to require hospitalization. As in other types of allergies, diagnosis is made by correlation of history with confirmation by skin testing.

In cases where the animal causes significant disease, elimination of the animal from the home may be the only sound medical approach. An animal that is kept totally outside of the house is entirely acceptable. Allergy injection therapy, which is successful for pollen, mold and dust inhalant allergies, is generally not indicated in animal dander allergy where the most appropriate therapy is total avoidance of the allergen. In rare instances (as in a veterinarian physician allergic to animals), injection therapy may be necessary as a trial program. Animal dander allergy, particularly due to cats, may be far more important than the patient can recognize. This is because the animal protein has become such an important part of the environment that it produces continuous, chronic symptoms. We recognize that individuals may become extremely fond of their pets, and our advice to remove the pet from the home is given only after due consideration of the impact on the patient and his/her family. Because our obligation is to deal as effectively as possible with a problem such as asthma, at times it is necessary for us to emphasize this approach because of our goal to provide the best possible care for our patients.

Individuals or their families who have demonstrated a tendency to be allergic by the development of multiple allergies to pollens, molds, and dust should not acquire "indoor" animals because of the future possibility of developing such a sensitivity. A person who is not allergic to an animal may become allergic after the intense exposure which occurs after the pet is obtained, and it is far more difficult to remove a pet from the home after an attachment has developed than to avoid getting one in the first place.

ANIALL-MMM 183A-@ 9/97