Advice on possible pet allergy please

[pepsimax]

Can anyone offer me advice regarding pet allergies?

I have a house bunny. Around the end of summer as he sheds his coat for his winter one I get very sensitive towards him. Its basically very itchy eyes and sneezing with runny nose. Once I get antihistamines in my system things settle down then go completely when he stop molting. He will be 8 in April and I've only suffered this for the last 3 years, getting worse each year.

Christmas day I spent with my parents and brother and his family at my parents. His family includes their chocolate Labrador. When I got home early evening I felt ok but was sneezing a little and slight runny nose. Didn't think anything of it at the time until over the next few days my eyes got itchy and felt like they had grit in them most of the time. They didn't get any worse, or better and I am due to see my doctor early next week so thought I'd mention it if they still felt sore. At the time they were not swollen or red.

Yesterday I went to my parents for a few hours (they also have a long haired cat but I go there a few times a week at least) and when I got home my eyes started itching worse than before. Woke up this morning with my eyes swollen and closed. Bathed them in cold water which helped but when looking at them I have a small rash in one corner. Funnily enough the same area I had this rash once before (see thread... http://www.dermatalk.com/showthread.php?t=3144 )

I suffer symptoms of GERD although Omeprazole usually controls it but the day after Christmas day and again this morning I have been very sick. I know this isn't a stomach bug as I know this feeling well and when I am sick it is just bile or what I have consumed in the last few minutes.
I've not eaten or drunk anything new and I don't drink alcohol or dairy, instead I have soya products. I've not rubbed my eyes but when they got sore yesterday I put a cold compress on them which relieved the itching.
The pictures below are from just after I got my eyes open, before I put any cream on them so they look and feel rough and sore. When this happened before I couldn't control the spread of the rash until I got Hydrocortissone cream, which I want to avoid if possible.

I do seem to have a weak immune system and if I cut myself I have both overactive and underactive scar tissue form on the same area. Sounds crazy but its true. Half the cut develops a nodule of skin and the other half can look fresh after a week of healing. Usually if I get ill in any way I get far worse before I get better.

I'm thinking it could be an allergy to animals and if it is I need help to control it as avoiding pets is impossible. I try and get my vitamins and minerals from my diet but I have a poor appetite and am borderline underweight.

Sorry for going on but I need to try and find what is causing this so I can avoid how I was this morning. Of course I will speak to my doctor but it helps getting input and advice from others.

2214

2215

[Dr.Saiyan]

Hi Nikki! We really feel sorry for you. You seem to have hyperactive immune system reacting to animals hairs producing antibodies against it. Do you have any history of eczema or atopic dermatitis during your early days? From your long history and rashes it seems like chronic airborne allergic contact dermatitis to me which may also be result of atopic eczema.

To determine the exact culprit allergen you are allergic to, you may seek patch or prick test including all the probable allergen you think have caused it. As you think the most probable cause may be animal hair and its impossible to separate you from your pets. You can think of all possible ways to avoids its hairs. There is also therapy called de-sensitization therapy ,you can try if you wish though the success rate is unpredictable for different persons. Yes as you already know antihistamines along with topical corticosteroid can provide temporary relief, in severe cases you can also use short course oral corticosteroid. As the condition is hyperactive immune mediated so some doctors also wanna try immunosupressive drugs (azathioprine).

If the trigger is not avoided you may develop chronic recurrent allergic contact dermatitis (ACD). As your condition seems bit severe please try to avoid contact with your pets for some time otherwise its not going to help your condition.

Since you are already visiting doctor, hope u will get to know the exact cause of your allergy. We are also very interested to know it. Until than please continue taking the antihistamines on regular basis and apply corticosteroid to to relief the symptoms.

[pepsimax]

Thank you so much for the advice Saiyan.
I remember as a child I had eczema on the back of my knees which I grew out of and around 5/6 years ago I got what I though was athletes foot but turned out to be if memory serves me right, Palmoplantar pustulosis on the soles of my feet. Started off in one spot but spread across the whole of my feet. I got this under control eventually after trying various creams and now after a couple of years free of it my feet are back to normal. When I had that I had odd spots of it on my palms but they came and went quickly.
I've had my rabbit for over 7 years now and have noticed the last few years I am getting severe hayfever type symptoms around september when he sheds his summer coat for his winter one. As soon as its through (can take a couple of months) it clears up. The only thing is due to medication I am on my doctor says I am limited to the antihistamines I can have. I asked her for stronger ones just last year but I'm sure she said they interfere with carbamazapine. I can confirm that when I see her.
Avoiding animals is impossible as pretty much everyone I know has a pet of one form or another and I will not part with my bunny so I'm trying to find ways to help prevent or fast treatment if I flare up like this.
The rash around my eye is much better now by just bathing that area with water and applying shea butter.
Can you explain antihistamines to me please. When I go into a pharmacy to buy them, one brand can sell a couple of different ones and although they say they are for the same the ingredients are different. Do you understand what I mean? I'm just wondering the best ones for me and I dont mind if they cause drowsiness.

[Dr.Saiyan]

Yes Nikki, you have very hypersensitive body with tendency to develop allergic reaction to different allergens. As you already mentioned you had atopic dermatitis (childhood eczema) during earlier days,which cleared away then, but that has changed its form into adult type of allergic contact dermatitis. This is also hypersensitive reaction to substances to which normal people do not react.

Histamines are released from mast cells present in different parts of body (skin,lungs,nostrils etc), in response to allergen the body is sensitized to forming IgE antibodies. when body comes in contact with these allergen again, the mast cells releases histamines which is ordinarily a defense mechanism of body to save body from foreign substances, but this becomes troublesome mechanism in hypersensitive person reacting to ordinary substances to which normal person do not react. when the histamines are released they causes the affect like sneezing,running nose, itching, swelling, eye irritation, hypo-tension asphyxia etc. Antihistamines (H1 blockers) blocks the affect of histamines preventing symptoms by binding to their receptors on different parts of body (nerves, vascular smooth muscle, gandular cells, endothelium and mast cells).

There are two types of antihistamines first is conventional sedating type (first generation) antihistamines and the second is newer non-sedating antihistamines (second generation). The first type includes the short acting sedative antihistamines like pheniramine (25mg), chlorpheniramine (2-4mg), hydroxyzine(25-75mg),
promethazine (10,25mg), diphenhydramine (10mg) etc. These have tendency to cause extreme drowsiness as they act by supressing the central nervous system. They are very good in controlling the acute cases of allergy and can be repeated 2-3 times daily . Another is newer second generation long acting antihistamines which includes cetrizine, levocetrizine, fexofenadine, loratidine, desloratidine, mizolastine, ebastine etc. They causes less drowsiness as they do not cross blood brain barrier but are not so good in controlling acute reactions and can be taken as single dose. Thus these two types of antihistamines can be taken in combination using the non-sedating antihistamine during the day time and sedative antihistamine during night time to give the best result. Also the minimum dose necessary to control the reaction should be taken.

For chronic cases like yours these antihistamines in combination can be continued on regular basis for at least one month and can slowly decrease the dose and tapered over three months period. Again the antihistamines can be started during high risk period (when your bunny sheds his coat) for the preventing the possible allergy. Taking antihistamines on regular basis for long period of time can help to decrease the sensitivity of the body to the allergens but sometimes may be tolerant to the regular dose and may require to increase the dose.

I hope i am able answer some of your questions. If you have any doubt please feel free to ask i will try my best to help you.

[pepsimax]

That helps a lot thank you. Also explains why some antihistamines work better than others. I also think I stop them too soon. If I have a few days without symptoms I stop them but sometimes the symptoms return within a day. I have noticed that since Christmas day I am getting more sensitive towards my bunny again so have been continuing them.
Thanks again you've been a great help.

[Dr.Saiyan]

You are welcome Nikki! I would also like to suggest you to continue with your antihistamines for at least one month and than tapper it over 3 months period. Hope this would help develop resistivity to the pet allergy.

[pepsimax]

I've kept up the antihistamines and the rash around my eye has completely gone. Actually went faster than the last time I had it which kept spreading daily until I was (reluctantly) given a steroid cream from my GP. My regular doctor has been off this week so I am booked in to see her next week when I'll speak to her about an allergy test. Just hope I'm able to get referred for one without too much fuss.

[Dr.Saiyan]

That's really good news Nikki, we were also worried about you. Just be careful to avoid foods and drinks easy to cause allergy for sometime like seafoods, eggs, milk, peanuts, alcohol and medication you are prone to allergy. Hope you will get to know the real cause of your allergy and share with us.

[pepsimax]

Thanks Saiyan I will. Although I have always been a slow healer, I seem to be getting more sensitive to things as I'm getting older. In the last few years I have given up dairy as it inflamed my GERD.
I recently had a flu type virus that lasted over 4 months and only went after repeat antibiotics treatment. I also had a blood tests which showed a large increase in my liver reading but thankfully all follow up tests were clear.
And now more recently this (suspected) pet allergy.
The joys of growing old. :p

[Dr.Saiyan]

Yes Nikki, probably can also say experiencing all the new things and growing more experienced everyday is the joy of growing old :p. As we grow old our body changes and we also gradually start understanding our body and learn to take care of it.

[pepsimax]

Its a shame we don't get these warning signs when we are younger or so many more people would improve their health. I can't believe the amount of junk food I used to eat in my 20's. Due to working really long hours cooking was a chore so I grabbed what food I could, when I could, although I never gained weight. Over the last 15 or so years I have improved my diet and general health and now love cooking using ingredients, especially spices, which I didn't have growing up.

Hopefully the younger members of the group can learn something and improve things while they can so they don't get complications later in life. :p