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Category Archives: PET ALLERGIES

Pork-Cat Syndrome

Pork-cat syndrome is a condition in which individuals become allergic to pork following exposure and sensitivity to cats.  It almost always occurs in individuals who have or have had cats.

Typically, if one is sensitized to cat allergen, the allergic symptoms one may develop are generally triggered by exposure to the cat allergen from the air.  These allergic rhinitis (i.e., hay fever) symptoms may include itchy eyes, red eyes, watery eyes, sneezing, nasal congestion, runny nose, post-nasal drip, itchy throat, sinus pressure, and/or sinus headaches.  Cat allergen may also trigger and/or aggravate asthma symptoms in some individuals and cause coughing, wheezing, chest tightness, and/or shortness of breath.  The treatment for classic cat allergies includes avoiding exposure to cats, medications to relieve the symptoms, and/or allergy immunotherapy (i.e., allergy injections, allergy shots, allergy desensitization, allergy hyposensitization).  Medications may include oral antihistamines, oral decongestants, leukotriene antagonists, nasal corticosteroids, nasal antihistamines, nasal anticholinergics, nasal mast cell stabilizers, ocular antihistamines, and/or ocular mast cell stabilizers.  The use of oral corticosteroids, nasal decongestants, ocular corticosteroids, and ocular decongestants are discouraged due to their side effects and/or “addictive” qualities.

What is common between cat and pork allergies?

Cat-allergic individuals are also more likely to develop food allergies, particularly to meat, than that of the general population.  The most common type of food allergy related to a history of a cat allergy is that of an allergic reaction to pork.  The symptoms generally begin within an hour after the ingestion of pork.  The usual symptoms may include generalized itching (i.e., pruritus) and/or breaking out in hives (urticaria).  These symptoms can be followed by abdominal cramping, nausea, and diarrhea.  Rarely, more severe reactions such as a sudden drop in blood pressure or throat swelling, which can cause a difficulty in swallowing or breathing, or life-threatening anaphylaxis may occur.  Needless to say, allergic reactions need to be quickly identified and treated with medications in order to stop them from progressing to anaphylaxis.  As meat allergies cannot be desensitized at this time, sensitized individuals should avoid exposure to meat at all times.

The reason that some cat-sensitized individuals are susceptible to pork allergies is that some individuals are not only allergic to the cat dander, but are also allergic to a protein found in cats called albumin.  Albumin is also found in meat from pigs and other animals.  The albumins share several common amino acid sequences.  This phenomenon is termed cross species cross-reactivity.  When albumin is consumed after eating pork meat, an allergic reaction may occur in some cat-sensitive individuals (i.e., in patients that are allergic to cat albumin).

The diagnosis is suspected when a person with a history of allergies to cat also reacts to pork.  It is confirmed by the demonstration of the presence of specific antibodies to both cat and pork allergens.  This is accomplished by skin prick testing and/or laboratory tests.  Skin tests with raw pork are usually positive but with baked meat can be negative since the heat often denatures the protein.  An oral food challenge to pork may sometimes be needed to establish the diagnosis.

This condition should be distinguished from the more common allergies to mammalian meat caused by antibodies to a carbohydrate called alpha-gal.  This condition, which is known as mammalian meat allergy, usually follows a tick bite which introduces the allergen into humans.  In this condition, the symptoms usually begin several hours after ingestion of mammal meat (e.g., beef, pork, lamb, venison) as a “delayed anaphylaxis.”  The diagnosis is confirmed by the detection of specific IgE antibodies to alpha-gal in a blood test.  Some individuals with this condition will have their sensitivity reduced after several years of avoiding the ingestion of mammalian meat.

The management of pork-cat syndrome entails reducing exposure to cats as well as avoiding of pork at all times.  Some individuals will be able to tolerate well-cooked pork, as high temperatures can denature the offending protein and render it less harmful.  Most patients with this condition also need to carry self-injectable epinephrine for emergency use in case of a severe reaction after the accidental exposure to pork.

The board certified allergy doctors at Black & Kletz Allergy have 3 office locations in the Washington, Northern Virginia, and Maryland metropolitan area.  The allergy specialists at Black & Kletz Allergy treat both pediatric and adult patients.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All 3 of our offices have on-site parking and both the Washington, DC and McLean, VA offices are Metro accessible.  In addition, the McLean, VA office has a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line.   For an appointment, please call our office or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  The allergists at Black & Kletz Allergy have been helping patients with food allergies, hay fever, asthma, eczema, sinus disease, hives, insect sting allergies, immunological disorders, and medication allergies for over a half a century.  If you suffer from any allergy, whether unusual or not, it is our mission to improve your quality of life by reducing or preventing your unwanted and bothersome allergy symptoms.

Allergy Shots – A Brief Overview

Allergy shots are synonymous with other terms such as allergy immunotherapy, allergy injections, allergy desensitization, and allergy hyposensitization. The allergy shots Gainesville, VA residents rely upon are the same allergy shots that have been given in the U.S. for over 100 years. They have been an important method of preventing and/or diminishing allergy symptoms in tens of millions of individuals over the last century.

Allergy shots can be given to almost any person and are given to any individual over the age of 2. Usually, however, most children do not begin allergy injections earlier than 4 years of age. They can be given to children, teenagers, adults, and the elderly. They can be continued in a pregnant individual as well as in a person who is nursing, as long as it is confirmed by the patient’s obstetrician and/or pediatrician of the nursing baby.

Allergy injections are given to patients with allergic rhinitis (i.e., hay fever)allergic conjunctivitisasthma, and venom hypersensitivity (i.e., allergy to stings of bees, wasps, hornets, yellow jackets, and/or bites from fire ants). The idea behind them is to get to the root of the problem, as opposed to treating the symptoms of allergic rhinitis, allergic conjunctivitis, and asthma. By receiving allergy injections, one’s body develops antibodies that help prevent the allergen (e.g., dust mites, molds, pollens, pets, cockroaches, venom) from causing the unwanted allergy and/or asthma symptoms.

Allergy immunotherapy is useful and may be considered when one is allergic to substances that cannot be avoided. They are also used in individuals that have failed over the counter therapy and/or prescription medications. There are other individuals that do not want to take medications on a daily basis. Others have very severe symptoms and develop secondary problems (e.g., sinus infections, ear infections, bronchitis, asthma) from untreated or sub-par treatment from medications. Many people cannot deal with the side effects of many of the allergy medications. Still others would like to treat the cause of the allergy rather than just treat the symptoms of allergy and/or asthma.

During allergy immunotherapy, very small doses of the allergens that the individual is allergic to are administered subcutaneously (i.e., just under the skin into the fat) of the arm(s) either once a week or twice a week, depending on the patient’s choice. Obviously, if the individual receives the injections more frequently (i.e., twice a week vs. once a week), he or she will get through the build-up process twice as fast. Each dose is increased in strength over the build-up period which at Black & Kletz Allergy is usually 18 doses. Therefore, the maintenance dose (i.e., top dose) is reached in 9 or 18 weeks depending if the individual gets his or her build-up shots twice a week or once a week respectively. Once the maintenance dose is reached, the individual can spread out the frequency of the injections to up to every 4 weeks. Note that many people get their shots more frequently throughout the year depending on their “bad” seasons, such as Spring and Fall which in the Washington, DC, Northern Virginia, and Maryland metropolitan area is very common. Others need their injections more frequently throughout the year since they have perennial symptoms which may require them to get the injections more frequently, depending on their severity of allergy and/or asthma symptoms. The average length of time someone is on the allergy shots Gainesville, VA residents receive from Black & Kletz Allergy ranges between 3-5 years. It is important to note that allergy shots to venoms have a different build-up and maintenance schedule.

The effectiveness of allergy injections is excellent. They have been shown work in 80-85% of individuals taking them. Venom immunotherapy is effective in over 90% of patients receiving them. Allergy injections may also prevent the development of asthma in children with allergic rhinitis. They help to prevent the inflammation that occurs in a typical allergic encounter. Normally when an individual is exposed to a known allergen, many chemicals such as histamine and leukotrienes are released into the bloodstream of the patient. These chemicals are responsible for producing the miserable symptoms of allergies, and in addition, cause inflammation to occur. The allergy shots Gainesville, VA patients receive help the body naturally produce antibodies that will help prevent this process from occurring and thus the individual suffers much less or not at all and has much less or no development of allergic inflammation.

There are essentially no side effects of allergy shots, however there are two risks. The first being the chance of having a local reaction at the site of the injection which may include localized itchiness, redness and/or swelling. The second risk is that of a systemic reaction such as developing generalized itching, hives, swelling, wheezing, abdominal cramps, drop in blood pressure, which potentially can be serious. For that reason, although very rare to occur, it is important to wait 30 minutes in our office after an allergy injection, so that we could treat you with epinephrine and/or Benadryl if necessary. Despite the rarity of a systemic reaction, it can occur and it is necessary to wait the 30 minutes after an injection. A longer wait time is needed for individuals receiving venom immunotherapy.

In summary, allergy shots are a very effective treatment modality for individuals with allergic rhinitis, allergic conjunctivitis, asthma, and/or venom hypersensitivity. As mentioned above, they have been given in the U.S. for over a century and can be given to all ages from young children to the elderly. The board certified allergists at Black & Kletz Allergy have been administering allergy shots for over 50 years. We have one office location in Washington, DC and 2 offices in Northern Virginia with one office in McLean, VA (Tysons Corner, VA) and another in Manassas, VA. We have on-site parking at all 3 office locations and the Washington, DC and McLean, VA offices are Metro accessible. There is a free shuttle that runs between the McLean office and the Spring Hill metro station on the silver line. If you suffer from allergies, asthma, sinus problems, hives, swelling episodes, and/or immunological conditions, please call our office to schedule an appointment or you can click Request an Appointment and we will respond within 24 hours by the next business day. Black & Kletz Allergy prides ourselves in providing high quality allergy and asthma care in a professional, inviting, and friendly environment.

Pet Allergy: What You Should Know

The two most common pet allergies in the United States are cats (20% of the population) and dogs (10% of the population).  Dogs, however, are the most common pet, followed by cats.  There has been an upward trend in the U.S. in the number of household pets with almost 70% of households having at least one pet.  Of course, besides dogs and cats, other common pets include birds, rodents (i.e., hamsters, guinea pigs, gerbils, chinchillas, mice, etc.) reptiles (i.e., lizards, snakes, turtles, etc.), rabbits, ferrets, horses, hermit crabs, spiders, and fish.  Horses, unlike the other pets mentioned above, do not live in people’s homes, but can be quite allergenic.

One can be allergic to any animal, but clearly the most common indoor pet allergies are cats and dogs.  For the purpose of this blog, we will talk exclusively about cats and dogs.  If you would like to see more information about allergies to other types of pets, please visit our website, www.bkallergy.com , click “SERVICES,” and then click the 4th bullet which is a link entitled “Pet Allergies.”

When an individual is “allergic” to a pet, they are in fact “allergic” to particular proteins that are produced by that animal.  For example, the proteins that cause most of the misery suffered by people who are allergic to cats are designated “Fel d 1” and “Fel d 4.”  Likewise, in individuals that are allergic to dogs, the major protein involved is called “Can f 1.”  Most proteins that cause allergies in any household pet tend to be concentrated in the pet’s dander, urine, saliva, and/or feces.

The dander (from the skin of an animal) tends to be a big problem with most pets.  In cats, the dander tends to “stick” to things such as clothing, walls, carpeting, bedding, etc. and therefore can and is “transported” from the home to other places that people go to, such as their workplace.  If Fel d 1 protein is measured on a cat owner’s clothing or their upholstered chair at work, it is likely to be found.  In addition, since the proteins stick to the walls of the cat owner’s home, it takes months for the proteins responsible for causing an allergic reaction to diminish to non-detectible levels, despite a thorough cleaning of the home.  Since the protein is also found in urine, cat litter boxes are a rich source of the proteins.  In dogs, luckily the protein Can f 1 is not as “sticky” as the cat proteins, but still can stick to clothing, bedding, etc.

As a general rule, it is advisable not to have a pet if one is allergic to it.  However, despite common sense, most people still opt to either acquire a pet or to keep an existing pet that they have had even if they cause bothersome allergy symptoms.  Even though this is not advised, it is understandable since a pet can cause great joy in one’s life and becomes a member of the family!

One major misconception is that there are “hypoallergenic” cats and dogs.  While some people feel that

they do better around short-haired cats or around dogs that do not shed like poodles, most scientific studies do not support this phenomena.

One can take some measures to reduce their exposure to the allergens that cause pet allergies.  Brushing your cat or dog frequently and bathing your cat or dog often will help reduce the levels of cat and proteins.  It is also advisable to prevent the cat or dog from entering your bedroom.

The symptoms of pet allergies are similar to any other type of environmental allergy.  The symptoms can include any or all of the following:  sneezing, runny nose, stuffy nose, itchy/watery/red puffy/eyes,

post-nasal drip, itchy skin, hives, wheezing, chest tightness, coughing, and/or shortness of breath.

The board certified allergists at Black and Kletz Allergy can help you diagnose whether you have a pet allergy by simple tests which involve a thorough history and physical examination as well as skin tests and/or blood tests.  In addition to avoidance measures, there a number of medications that can be tried to try to alleviate your symptoms of pet allergies.  These medications can be in the forms of tablets, nasal sprays, eye drops, creams, inhalers, and/or injections.  Since pet allergies are a perennial (year-round) problem, many patients find allergy shots (allergy immunotherapy) extremely effective in preventing and/or diminishing their pet allergy symptoms.  Allergy shots can be administered to children, pregnant women, and adults and have been used for over a century.

If you would like to have a consultation with us regarding your pet allergies (or other type of allergies), please call us or use our website to “Request An Appointment” and we will get back to you by the next work day.  Black and Kletz Allergy has been serving the Washington, DC metropolitan area including Maryland and Northern Virginia for more than 50 years.