How families can mitigate a child's pet allergies

Pets are often treated like a member of the family. However, when another member develops an allergy, where do you draw the line?

This dilemma can leave families with pets whose children develop pet allergies to face a tough decision—deal with the allergies or get rid of the pet.

“Very frequently families do not want to remove pets from the home environment,” said Sandra Hong, MD, director of the Food Allergy Center at the Cleveland Clinic in Ohio.

Numerous studies have shown that early exposure to pets may actually help prevent allergy and asthma symptoms, Hong said. However, when allergies do develop, families then have to try and reduce exposure to pet allergens—especially when those allergies have a genetic component. Having a pet can make this more difficult.

Protecting children from pet allergens isn’t always as easy as getting rid of a pet, either. Pet allergens can stick around for a long time and exposure can still happen outside the home, Hong explained.

“You are being exposed every single day to cat and dog allergens,” she said.

Pet allergens are particularly strong, Hong added, explaining that even just passing by someone carrying these allergens can cause a reaction in some people. Even if you choose to get rid of your pet, it might not fix the problem for some time, she added. It can take months to clear a home of pet allergens, even with intense cleaning, Hong said.

“When someone has cats, in particular, that cat protein doesn’t degrade or break down for up to 4 to 6 months,” she explained.

Rodents are another pet that is particularly allergenic, Hong said.

The first step in addressing pet allergies is to pinpoint what is causing the problem—especially in a home with multiple pets or in people with multiple allergies. Additionally, people with seasonal allergies may face mixed sources of exposure from pets that go outside and then come in the house covered in pollen. There can also be other unlikely sources of exposure, like when pets are fed peanut-containing treats and someone in the home has a food allergy. In the case of snakes, these are great hypoallergenic pets, but they are often fed rodents which are highly allergenic.

Hong said she begins an assessment for pet allergies with a detailed history, investigating what symptoms the child is having, when it started, and how long a pet has been in the home, and anything else that may have changed.

Typically pet allergies include symptoms like:

• Hives at bite locations
• Shortness of breath
• Itching
• Stuffiness
• Sneezing
• Postnasal drip
• Asthma exacerbations

Anaphylaxis is not common with pet allergies, Hong added, so if this is occurring, additional testing is needed. Either way, it can be helpful to perform blood work or skin testing to confirm sensitivity to particular allergens, she said.

For families who want to try treating allergies instead of getting rid of pets, Hong said she starts by suggesting the following measures in addition to any medications.

1. Limit pets to a particular room
2. Ideally, rooms with pets are free of carpeting and upholstery that can trap allergens
3. Don’t allow pets in bedrooms
4. Use high efficiency particulate air filters to pull proteins from pet allergens from the air
5. Wipe pets down that go outdoors to reduce exposure to additional outside allergens
6. Brush and groom pets often, and do it outside
7. Keep windows open for ventilation unless you have seasonal allergies

Avoidance and mitigation strategies can be very helpful, but Hong said medications can provide relief, too.

Over-the-counter antihistamines can be used to relief symptoms of pet allergies, and nasal steroids are the preferred medication, Hong said. Second-generation oral antihistamines are the next choice, she said, adding that diphenhydramine and other first-class antihistamines are short-acting and sedating so they are not usually recommended.

Immunotherapy injections are an option, too, Hong said, but only for cat and dog allergies. This type of treatment is more effective for cat allergies than dog allergies, she said, adding that all varieties of immunotherapy are only about 80% effective overall. On top of that, treatment is frequent, costly, and may take a long time to take effect.

There are no sublingual options for pet allergy immunotherapy, she said, and injections must be given weekly for about a year. After that, monthly injections are required for another 3 to 5 years. On top of this frequency, Hong said patients usually have to stay in the office for observation for about 30 minutes following their injection.

No solution is perfect when it comes to managing pet allergies, and Hong said families need to examine what works best for them.

“I think that very frequently families are hesitant to remove pets from their home environment,” Hong said. “This can be fine as long as they’re not having asthma symptoms or frequent infections.”

Pediatricians can help offer initial advice on medications and allergen avoidance, but a referral to an allergist is ideal, she added.