RESPIT™ | Regionally-Specific Immunotherapy

Background

Allergy immunotherapy (also known as “desensitization,” “allergy vaccination,” or “hyposensitization”) is the process of administering injections to a pet in order to make them more tolerant of allergens. Common allergens are house dust mites, grass pollens, weed pollens, tree pollens, and fungal spores. Veterinarians have used immunotherapy for over 30 years to treat pets with skin allergies (atopic dermatitis or “AD”). Immunotherapy provides significant relief from itching to most pets with allergies (about 75% respond to treatment). The selection of ingredients is traditionally based on either a blood test or an intradermal test (“skin test”). To perform an intradermal test, pets are sedated or anesthetized and 50-70 different allergens are injected into the skin. A red swelling is interpreted as meaning the pet is possibly allergic to that allergen.

Limitations of allergy testing

• Allergy testing is costly.

• Allergy tests (intradermal and blood) are not as reliable as is desired of laboratory tests.1, 2

• The interpretation of intradermal tests is subjective.

• The season during which the pet is tested may influence the results.3, 4

• There is often poor agreement between intradermal and blood allergy tests.2

• The accuracy of allergy tests is questionable. A positive reaction (intradermal or blood test) does not necessarily mean that the allergen is truly causing the pet’s allergy signs.4 There is not a perfect test available for comparison to use as a “gold standard.”5

• The success of immunotherapy is similar no matter whether the pet undergoes blood testing or skin testing, even though the tests often don’t agree with each other or with themselves.1, 3, 6, 7

• A double-blinded study reported by Garfield in 1991 found that there was not a significant difference in the response rate of dogs treated with (a) immunotherapy based on individual allergy tests and (b) those treated with a standardized allergen mixture.

The innovative and cost-effective SkinVet Clinic solution: RESPIT™

Putting together the results of numerous studies leads to the conclusion that allergy testing results are often not specific and are not critical to the success of immunotherapy. There is significant cross-reactivity between certain allergens within a group (weeds, trees, and grasses). By selecting the allergens that are most likely to be causing your pet’s allergies, RESPIT avoids allergy testing, while providing an equal benefit to your pet. Building upon 20 years of experience with immunotherapy, Dr. Plant pioneered RESPIT in order to make allergy relief available to more pets.

Immunotherapy has traditionally been recommended to continue for the life of your pet. Our goal at SkinVet Clinic is to discontinue RESPIT after 3 years if your pet has remained comfortable for an extended period of time.

Of course, as with any medical therapy, each pet’s individual response is unique. Approximately 75% of pets will eventually respond to immunotherapy. Since the response is gradual, pets usually require additional forms of therapy to remain comfortable at first.

1. Ferrer-Canals G, Plant JD, Beale KM, Fadok V. Reliability of intradermal allergy tests in dogs with atopic dermatitis. Veterinary Dermatology. 2009; 20(3): 228.
2. DeBoer DJ, Hillier A. The ACVD task force on canine atopic dermatitis (XVI): laboratory evaluation of dogs with atopic dermatitis with serum-based "allergy" tests. Vet Immunol Immunopathol. 2001; 81(3-4): 277-87.
3. Zur G, White SD, Ihrke PJ, et al. Canine atopic dermatitis: a retrospective study of 169 cases examined at the University of California, Davis, 1992-1998. Part II. Response to hyposensitization. Vet Dermatol. 2002; 13(2): 103-11.
4. Reedy LM, Miller WH, Willemse T. Allergic skin diseases of dogs and cats. 2nd ed. London; Philadelphia: W.B. Saunders, 1997.
5. Griffin CE, Hillier A. The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy. Vet Immunol Immunopathol. 2001; 81(3-4): 363-83.
6. Schnabl B, Bettenay SV, Dow K, Mueller RS. Results of allergen-specific immunotherapy in 117 dogs with atopic dermatitis. Vet Rec. 2006; 158(3): 81-5.
7. Park S, Ohya F, Yamashita K, et al. Comparison of response to immunotherapy by intradermal skin test and antigen-specific IgE in canine atopy. J Vet Med Sci. 2000; 62(9): 983-8.
8. Garfield R. Injection immunotherapy in the treatment of canine atopic dermatitis: comparison of 3 hyposensitization protocols. 8th Annual Members Meeting of the American Academy of Veterinary Dermatology & the American College of Veterinary Dermatology; 1992; 1992. p. 7-8.