Skin problems are the number one disorder that plagues our pet dogs. Modern medicine has actually confounded the issue by using drugs that merely suppress the inflammation and itching rather than finding the cause of the disorder.  

Toxicity is the dog's major underlying problem internally and externally: poor quality food, inappropriate ingredients in the food, environmental pollutants, pesticides, vaccinations, and untreated diseases. 

Finding the actual cause and approaching a treatment plan based on that specific problem is the best way to relieve your dog and prevent future outbreaks of skin problems. 

Apoquel® and Cytopoint® are medications veterinarians prescribe to manage itching and inflammation associated with dog allergies. However, they work in slightly different ways and have their own set of advantages and disadvantages. Natural remedies provide long-term relief and address the root cause of the allergies.

Apoquel® (oclacitinib tablets) is an anti-itch, anti-inflammatory medicine that is not an antihistamine or a cortisone-type drug. It targets certain enzymes involved in the allergic response, explicitly inhibiting the signaling pathways leading to itching and inflammation.

Apoquel® is administered orally in the form of tablets. If your dog responds to the medication, Apoquel® generally provides relatively fast relief, often within 4 to 24 hours after the first dose. Because the effects wane after 24 hours, daily dosing is required. However, depending on the dog's response, the dose can be adjusted to less frequent dosing.

Apoquel® is effective in approximately 50% of patients, partially effective in approximately  30%, and little to no effectiveness in approximately 20% of dogs. Over time, some dogs may develop reduced responsiveness to Apoquel®, which could necessitate increased doses or alternate treatments. When Apoquel® no longer seems to be effective, avoid sudden withdrawal. Strengthening the immune system while weaning your dog off of Apoquel® will help prevent a strong recurrence of pruritic dermatitis.

Because Apoquel® suppresses certain aspects of the immune response, your dog becomes susceptible to infections. Because it is an immunosuppressant drug, it can lead to secondary skin infections caused by bacteria or fungi. Prolonged use of Apoquel® can suppress the immune system, which may reduce the body's ability to respond to infections and other health challenges. If your dog is already immuno-compromised due to other diseases, you can be causing more harm than good by using Apoquel®. 

Because of the immunosuppression, your dog may become more prone to developing secondary skin or ear infections. Ear and skin infections caused by allergies are often the primary causes for initiating treatment. How frustrating is it for the medication to generate more of the same clinical manifestations as the original problem?

Clinical trials have shown that dogs on Apoquel® may experience gastrointestinal issues such as vomiting, diarrhea, or decreased appetite. There have also been reports of increased risk of certain cancers, including lymphoma, in dogs on Apoquel®. Long-term use of Apoquel® has also led to changes in liver enzymes and blood cell counts. These health risks must be assessed before you decide to use Apoquel® for your dog.

Cytopoint®, with the active ingredient lokivetmab, is a non-drug treatment with bioengineered antibodies similar to natural ones created within your dog's immune system. While the body normally produces antibodies to target bacteria, viruses, and other disease-causing pathogens, antibodies in Cytopoint® target a specific protein (IL-31) involved in the itch response.

Your veterinarian administers Cytopoint® via subcutaneous injection. If your dog responds to the medication, relief will be felt within 24 hours, lasting for four to eight weeks. However, Cytopoint®  is estimated to work in only 75% of the patients. For some dogs, the effect is very drastic and long-lasting itch relief, while the results are more modest and shorter in other dogs. 

The primary concern with using Cytopoint® is the potential for immunosuppression. Cytopoint® suppresses the immune response by targeting the IL-31 protein. As a result, the immune system's ability to respond to infections is reduced. This is particularly concerning if your dog is already immunocompromised from a different condition.

Dogs can experience localized reactions from Cytopoint® at the injection site, including redness, swelling, or discomfort. Although these reactions are usually mild and temporary, the site must be monitored for infection because your dog may be more prone to infections from the Cytopoint® injections.

There are a growing number of holistic veterinarians. Holistic medicine considers your dog's overall health and well-being, not simply the current clinical signs of disease. 

Working with a holistic veterinarian will offer alternative treatment options for your dog. The holistic veterinary approach will incorporate a plan supporting the immune system, including reestablishing balance in your dog's gut and skin microbiome. 

To find a holistic veterinarian near you, visit VetFinder – Find a Holistic Veterinarian – American Holistic Veterinary Medical Association (ahvma.org). Because there is a limited number of holistic veterinarians, many of them offer online consultations. 

A balanced and species-appropriate diet will support your dog's immune system and reduce inflammation and itchiness. An appropriate diet would include high-quality proteins, healthy fats, natural antifungal foods, prebiotics, probiotics, organ meats, and fiber from low-glycemic fruits and vegetables or fur. The Real Ancestral 6X Diet™ or the Real Ancestral Diet, contains the ideal ingredients to support your dog's immune system, skin, and gut microbiome.

Muscle meats from organically pasture-raised animals comprise 63-65% of your dog's meal—high-quality protein sources to support your dog's overall health and immune function. Feed a variety of protein sources, with the majority being red meats. Appropriate meat sources include:

Red meat: Beef, bison, lamb, pork, goat, elk, wild rabbit, venison, elk, ostrich, and wild birds

White meat: Chicken, turkey, farm-raised rabbit, partridge, pigeon, quail

Muscular organs and animal parts: Heart, trachea, aorta, gizzard, tongue, lungs, green tripe

Whole raw eggs, with or without the shell, up to three times per week

Raw meaty bones (RMBs) are critical to meeting a dog's nutritional needs. On average, dogs need about 10% bone in their diet, but some dogs may require up to 12%. Bone supplies a natural source of calcium, phosphorus, magnesium, and other trace minerals that support the immune system. RMBs include beef short ribs, pork ribs, poultry feet, necks, and wings. 

Seafood should make up about 10% of a dog's diet in the form of small, oily fish to supply Omega-3 fatty acids. Omega-3 is a natural anti-inflammatory that will help calm your dog's affected areas. Small oily fish and seafood to feed include anchovies, herring, smelt, sardines, mackerel, sprats, mussels, and oysters. For a complete look at feeding seafood to your dog, read Dive Into Seafood For Your Pup.

When feeding grass-fed beef, the seafood requirement can be reduced as there is more Omega-3 in grass-fed meat. Grass-fed beef is more nutrient-dense than grain-fed beef.

Organ meat, often known as offal, is essential for a dog's diet as it provides nutrients that may be deficient in muscle meat and raw meaty bones. Organs have high levels of B vitamins, including B1, B2, B6, folic acid, and B12. Minerals like phosphorus, iron, copper, magnesium, and selenium are abundant in organ meats. They also contain small levels of vitamin D and crucial fat-soluble vitamin A. 

The Real Ancestral 6X Diet™ calls for 5% of the bowl to be liver and 5% to be another secreting organ like kidney, spleen, pancreas, or testicles. 

Adding fur and fiber to your dog's bowl is another boost for your dog's immune system. It has been discovered that fiber is essential to colonocytes to maintain the health and proper operation of the entire GI tract. Feeding furred animal parts, the ears of cows, rabbits, and lambs or rabbit feet, or low-glycemic vegetables as 5% of your dog's meal will provide insoluble fiber to benefit the gut microbiome. 

The gut microbiome is likely imbalanced if your dog is prone to allergies that manifest as skin infections. Incorporating probiotics (beneficial bacteria) and prebiotics (fibers that nourish beneficial bacteria) can help restore a balanced gut environment. 

Kefir is an excellent food additive, especially when made from goat milk. It has both prebiotic and probiotic properties. Fermented foods such as Chaga and kimchi are also abundant in prebiotics and probiotics. However, the taste may be too tangy for your dog.

Larch Arabinogalactan is a type of soluble fiber that provides excellent prebiotic support. Look for high-quality larch that has at least 10 billion CFU. Follow the feeding directions for commercial products, but generally, the dosage is 1/4 teaspoon for small dogs, 1/2 teaspoon for medium dogs, and 3/4 teaspoon for large dogs. It is also important to rest your dog from larch occasionally, feed it for one month, and rest one week before providing it again. 

Read Prebiotics And Probiotics Boost Your Dog's Health  for a comprehensive guide about prebiotics and probiotics. 

Quercetin is a flavonoid that is naturally found in fruits and vegetables. Its unique biological properties have been shown to improve mental and physical performance, reduce the risk of infection and disease, and act as an anti-inflammatory, anti-carcinogen, anti-viral, and antioxidant. 

When your dog is exposed to allergens, histamine is released from the inflammatory cells, which results in eye and skin irritation and itchiness. Quercetin's anti-inflammatory and antihistamine properties suppress inflammation and reduce the release of histamine, which is why it is often called nature's Benadryl. 

There is an overabundance of commercially available quercetin supplements, alone or with other nutritional supplements like vitamin C or bromelain. The dose of quercetin must be high enough to provide anti-inflammatory effects, approximately 5-10 mg/pound of body weight given twice a day. Quercetin with bromelain, the ideal combination, should be given at least 1 hour before feeding or 3 hours after to get the anti-inflammatory effects. If not provided on an empty stomach, the bromelain will be used for digestion by the body rather than preventing inflammation.

The combination of quercetin and bromelain is usually available in capsule form. If your dog refuses to take a capsule, you can safely put the powder on a small amount of food to encourage the consumption of the supplement. However, if this appears to cause a reduced appetite in your dog, add it to the whole meal. 

Chamomile, green tea, calendula, and black tea can cool irritated and sensitive skin. Cooled tea bags can be used directly on irritated skin, or cooled brewed tea can be put in a spray bottle and applied to the skin.

Cooled chamomile tea can clean around the eyes, soothe irritated skin, and remove dried discharge.

You can reduce the histamine levels in your dog by adding brewed decaffeinated green tea to your dog's daily meal.

Use only organic teas to avoid chemical contamination.

Processed dog food often contains too much Omega-6, which alters the ideal ratio of Omega-3 to Omega-6 in your dog's diet. An imbalance in the fatty acids leads to inflammation.

Omega-3 fatty acids improve the skin barrier to external pollen and irritants while reducing inflammation.  

Skin problems are the number one disorder that plagues our pet dogs. Modern medicine has actually confounded the issue by using drugs that merely suppress the <a href="https://feedreal.com/glossary/inflammation">inflammation</a> and itching rather than finding the cause of the disorder.  

<a href="https://feedreal.com/glossary/apoquel">Apoquel</a>® and Cytopoint® are medications veterinarians prescribe to manage itching and inflammation associated with dog allergies. However, they work in slightly different ways and have their own set of advantages and disadvantages. Natural remedies provide long-term relief and address the root cause of the allergies.

Apoquel® (oclacitinib tablets) is an anti-itch, anti-inflammatory medicine that is not an <a href="https://feedreal.com/glossary/antihistamine">antihistamine</a> or a cortisone-type drug. It targets certain enzymes involved in the allergic response, explicitly inhibiting the signaling pathways leading to itching and inflammation.

Because Apoquel® suppresses certain aspects of the immune response, your dog becomes susceptible to infections. Because it is an immunosuppressant drug, it can lead to secondary skin infections caused by <a href="https://feedreal.com/glossary/bacteria">bacteria</a> or fungi. Prolonged use of Apoquel® can suppress the immune system, which may reduce the body's ability to respond to infections and other health challenges. If your dog is already immuno-compromised due to other diseases, you can be causing more harm than good by using Apoquel®. 

Dogs can experience localized reactions from Cytopoint® at the injection site, including redness, <a href="https://feedreal.com/glossary/swelling">swelling</a>, or discomfort. Although these reactions are usually mild and temporary, the site must be monitored for <a href="https://feedreal.com/glossary/macrophages">infection</a> because your dog may be more prone to infections from the Cytopoint® injections.

To find a holistic veterinarian near you, visit <a href="https://www.ahvma.org/find-a-holistic-veterinarian/">VetFinder – Find a Holistic Veterinarian – American Holistic Veterinary Medical Association (ahvma.org).</a> Because there is a limited number of holistic veterinarians, many of them offer online consultations. 

A balanced and species-appropriate diet will support your dog's immune system and reduce inflammation and itchiness. An appropriate diet would include high-quality proteins, healthy fats, natural <a href="https://feedreal.com/glossary/antifungal">antifungal</a> foods, prebiotics, <a href="https://feedreal.com/glossary/probiotics">probiotics</a>, organ meats, and fiber from low-glycemic fruits and vegetables or fur. The Real Ancestral 6X Diet™ or the Real Ancestral Diet, contains the ideal ingredients to support your dog's immune system, skin, and <a href="https://feedreal.com/glossary/gut-microbiome">gut microbiome</a>.

Muscle meats from organically pasture-raised animals comprise 63-65% of your dog's meal—high-quality protein sources to support your dog's overall health and immune function. Feed a variety of <a href="https://www.feedreal.com/articles/understanding-protein-in-your-dogs-diet">protein sources</a>, with the majority being red meats. Appropriate meat sources include:

Raw meaty bones (RMBs) are critical to meeting a dog's nutritional needs. On average, dogs need about 10% bone in their diet, but some dogs may require up to 12%. Bone supplies a natural source of <a href="https://feedreal.com/glossary/calcium">calcium</a>, phosphorus, magnesium, and other trace minerals that support the immune system. RMBs include beef short ribs, pork ribs, poultry feet, necks, and wings. 

Seafood should make up about 10% of a dog's diet in the form of small, oily fish to supply <a href="https://feedreal.com/glossary/omega3">Omega-3</a> <a href="https://feedreal.com/glossary/fatty-acids">fatty acids</a>. Omega-3 is a natural anti-inflammatory that will help calm your dog's affected areas. Small oily fish and seafood to feed include anchovies, herring, <a href="https://feedreal.com/glossary/smelt">smelt</a>, <a href="https://feedreal.com/glossary/sardines">sardines</a>, mackerel, sprats, mussels, and oysters. For a complete look at feeding seafood to your dog, read Dive Into Seafood For Your Pup.

Organ meat, often known as offal, is essential for a dog's diet as it provides nutrients that may be deficient in muscle meat and raw meaty bones. Organs have high levels of B vitamins, including B1, B2, B6, <a href="https://feedreal.com/glossary/folic-acid">folic acid</a>, and B12. Minerals like phosphorus, iron, copper, magnesium, and selenium are abundant in organ meats. They also contain small levels of <a href="https://feedreal.com/glossary/vitamin-d">vitamin D</a> and crucial fat-soluble <a href="https://feedreal.com/glossary/vitamin-a">vitamin A</a>. 

Adding fur and fiber to your dog's bowl is another boost for your dog's immune system. It has been discovered that fiber is essential to colonocytes to maintain the health and proper operation of the entire GI tract. Feeding furred animal parts, the ears of cows, rabbits, and lambs or rabbit feet, or low-glycemic vegetables as 5% of your dog's meal will provide <a href="https://feedreal.com/glossary/insoluble-fiber">insoluble fiber</a> to benefit the gut microbiome. 

<a href="https://feedreal.com/glossary/kefir">Kefir</a> is an excellent food additive, especially when made from goat milk. It has both prebiotic and probiotic properties. Fermented foods such as Chaga and kimchi are also abundant in prebiotics and probiotics. However, the taste may be too tangy for your dog.

<a href="https://feedreal.com/glossary/larch">Larch</a> Arabinogalactan is a type of <a href="https://feedreal.com/glossary/soluble-fiber">soluble fiber</a> that provides excellent prebiotic support. Look for high-quality larch that has at least 10 billion CFU. Follow the feeding directions for commercial products, but generally, the dosage is 1/4 teaspoon for small dogs, 1/2 teaspoon for medium dogs, and 3/4 teaspoon for large dogs. It is also important to rest your dog from larch occasionally, feed it for one month, and rest one week before providing it again. 

Read <a href="https://feedreal.com/articles/prebiotics-and-probiotics-boost-your-dogs-health">Prebiotics And Probiotics Boost Your Dog's Health</a>  for a comprehensive guide about prebiotics and probiotics. 

Quercetin is a flavonoid that is naturally found in fruits and vegetables. Its unique biological properties have been shown to improve mental and physical performance, reduce the risk of infection and disease, and act as an anti-inflammatory, anti-<a href="https://feedreal.com/glossary/carcinogen">carcinogen</a>, anti-viral, and antioxidant. 

There is an overabundance of commercially available quercetin supplements, alone or with other nutritional supplements like <a href="https://feedreal.com/glossary/vitamin-c">vitamin C</a> or bromelain. The dose of quercetin must be high enough to provide anti-inflammatory effects, approximately 5-10 mg/pound of body weight given twice a day. Quercetin with bromelain, the ideal combination, should be given at least 1 hour before feeding or 3 hours after to get the anti-inflammatory effects. If not provided on an empty stomach, the bromelain will be used for <a href="https://feedreal.com/glossary/cellulase">digestion</a> by the body rather than preventing inflammation.

Use only <a href="https://feedreal.com/glossary/organic">organic</a> teas to avoid chemical contamination.

Processed dog food often contains too much <a href="https://feedreal.com/glossary/omega3">Omega-6</a>, which alters the ideal ratio of Omega-3 to Omega-6 in your dog's diet. An imbalance in the fatty acids leads to inflammation.

They can be ingested orally or applied directly to dry or irritated skin. Use therapeutic-grade, organic oils that do not have artificial fragrances, especially when applying the oils directly to your dog's skin.

Adding fresh, small, oily fish to your dog's daily diet, such as smelt, sardines, anchovies, and <a href="https://feedreal.com/glossary/capelin">capelin</a>, is a delicious way to increase your dog's Omega-3 levels!

Lavender, chamomile, and peppermint oil all calm irritated red skin. Myrrh helps to repair damaged skin. It has <a href="https://feedreal.com/glossary/analgesic">analgesic</a> properties that can reduce pain associated with severe skin disorders and self-induced damage caused by scratching.

When applying the oils directly to the skin, try a single drop on a tiny area first to ensure your dog tolerates it. Not all dogs react the same way to oils.

As with the Omega-3 oil, use therapeutic grade, organic oils that don't have artificial fragrances. If you have a cat in the household, refrain from using an essential oils diffuser, as many oils can cause adverse effects in cats.

When your dog suffers from environmental allergies, a <a href="https://feedreal.com/glossary/adenosine-triphosphate">water</a> rinse after a walk can remove allergens from the skin and fur, especially on the underside and the paws. Some pet parents use a t-shirt during a walk to prevent allergen contact on the skin. The t-shirt can also prevent excessive scratching.

If your dog is prone to self-mutilation or excessive chewing on an affected area, try using a donut cone around the neck. These cones are not as cumbersome as the traditional E-collars used post-surgically.

Fleas are a potent allergen for many dogs. A topical flea repellent made from essential oils and <a href="https://feedreal.com/glossary/coconut-oil">coconut oil</a> will prevent complications with flea allergies. If your dog has itchy areas and hot spots, use a mild, all-natural shampoo to provide relief.

Light dusting powders that are scent-free, talc-free, and made of organic products only can keep rashes dry, especially in humid climates.

Good oral health will prevent the transfer of bacteria from your dog's mouth to the skin. Feeding your dog a natural diet that includes raw meaty bones is beneficial in preventing <a href="https://feedreal.com/glossary/plaque">plaque</a> and <a href="https://feedreal.com/glossary/tartar">tartar</a> accumulation on its teeth.

Trimming and filing down your dog's nails reduces the damage caused by scratching. Keeping the nails and paws clean can also reduce the chance of bacterial infections. 

When trying to find the right combination of diet, supplements, and other treatments, make sure you make one change at a time to know what is actually making a difference. You will not know what changes to maintain if you create multiple variables. 

You must be patient and allow each change time to make a difference. Again, you cannot discern which variable to maintain if you make changes too quickly. Total remission from skin issues and rashes can take weeks, months, or even years.  

Allergies in Dogs: Treatment Alternatives Beyond Apoquel® and Cytopoint®

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