Itching is the single most common reason dogs come to see us, and it is a symptom, not a diagnosis. A scratching dog, a dog with hot spots, and a dog with an ear infection every spring are very often the same dog with the same underlying problem.
Seattle Doesn’t Give Them a Break
In places with a hard winter, allergic pets get a few months off. Here they often don’t. Our mild, wet climate means mold and grass are in play most of the year, tree pollen starts early, and fleas never get a cold snap long enough to break their cycle.
That’s why “it’s only seasonal” is less true in the Pacific Northwest than the phrase suggests, and why a pet who itched for six weeks last year can itch for six months this year.
The Three Causes, in the Order We Rule Them Out
Fleas. First, always, even when you’re certain there are none — and most owners are certain. A flea-allergic dog reacts to a handful of bites, and you will never see a flea on a pet who grooms. This is also the only one of the three we can take off the table in a fortnight, which is why we start here. Year-round prevention is the test and the treatment at the same time.
Environmental allergy (atopy). Pollen, grass, mold, dust mites. This is the biggest group by far. It usually starts between one and three years old, it tends to show up on the feet, belly, armpits, face, and ears, and it gets worse year on year if it’s left alone. It can be managed extremely well. It cannot be cured.
Food. Less common than the internet believes — it’s a minority of itchy dogs — but worth finding, because it’s the one you can fix completely. It’s usually a protein the animal has eaten for a long time, not a grain. “Grain-free” is a marketing category, not a diagnosis.
Ears Are Usually Not an Ear Problem
A dog with recurrent ear infections is an allergic dog until proven otherwise. The allergy inflames the ear canal, the inflamed canal grows yeast and bacteria, and the infection is what you notice. Treat the infection alone and it comes back in eight weeks, every time, forever.
Treat the allergy and the ears quietly stop being a problem. That’s the whole trick, and it’s the thing owners most often haven’t been told.
One thing to please not do: don’t put leftover ear drops, oil, or a home remedy into a painful ear before we’ve looked. If the eardrum is ruptured — and with a bad infection it may be — some of the drops that help an intact ear can damage hearing permanently. Let us look first. It takes a minute.
Cats Hide It Differently
Cats rarely scratch in front of you. They overgroom, usually at night, and what you see is the result: a bald stripe down the belly or the back legs, scabs around the neck and chin, or hair that looks “broken” rather than thin. Owners often come in worried about hair loss. It’s almost always licking.
What We Actually Do
Allergy work is unglamorous and it’s mostly about not skipping steps.
- A proper look at the skin, including the feet and the armpits, and the ears with a scope.
- Cytology — a sample from the skin or ear, stained and read under the microscope here, usually while you wait. It tells us whether we’re dealing with yeast, bacteria, or neither, and it changes the treatment completely.
- Skin scrapes when mites are on the list. Mange is treatable and is sometimes missed for months.
- A strict diet trial, if food is a real suspicion: eight to twelve weeks on one prescription or novel diet and nothing else — no treats, no table scraps, no flavored chews, no flavored medication. One biscuit from a neighbor restarts the clock. This is the step that fails, and it fails at home, not in the clinic.
What Stops the Itch
There is more available now than there was ten years ago, and it’s a great deal better than steroids every spring.
- A daily tablet (Apoquel) that switches off the itch signal within hours.
- A monthly injection (Cytopoint) given here, which suits dogs that are hard to pill and dogs whose itch is seasonal.
- Medicated shampoos and ear flushes, which do more than people expect and cost less than anything else on this list.
- Steroids when something needs calming down fast, used short-term and then stepped off.
- Treating the infection that’s sitting on top, because an itchy dog with a yeast infection won’t improve until both are handled.
Most allergic pets end up on a combination, adjusted over the first few months. The goal we aim for is a comfortable animal with normal skin, not a perfect one — and it’s a goal we usually reach.
Worth an Appointment Rather Than Waiting
- An ear that smells, or a head your dog keeps shaking
- Paws stained rust-brown from licking
- A hot spot — these go from a small patch to a hand-sized raw wound in a day
- Scabs you can feel along a cat’s back or neck
- Any itch that’s keeping either of you awake