Allergy shots are an ineffective treatment for some patients, due to lack of efficacy, difficulty in administration, or adverse reactions. Sublingual immunotherapy is an effective treatment for many patients who fail to respond to allergy shots.
In addition to offering immunotherapy injections to relieve the painful conditions of atopic dermatitis, Heska is the first to introduce a proprietary sublingual immunotherapy. Administered beneath the tongue, ALLERCEPT® Therapy Drops provide a simple way to provide effective relief.
Sublingual immunotherapy allows specific antigens placed under the tongue to induce immunologic tolerance. Multiple mechanisms are involved and include the production of anti-inflammatory cytokines such as IL-10 and the induction of regulatory T-cells.
The mucosal area under the tongue is a privileged immunological site with unique characteristics. It consists of:
- A physical barrier (mucosa)
- Local immune cells
— High concentration of dendritic cells and T-cells
— Low concentration of mast cells, basophils and eosinophils
This allows for:
- Differentiation of pathogens from harmless antigens
- Muting of immediate and delayed allergic responses
- Tolerance of mucosally-delivered allergens
When starting a new patient on immunotherapy, should you advise shots or drops? Because both methods are effective, the decision often lies in the client’s own preference for administration and other factors like the pet’s temperament. If the pet has significant mold allergy, drops may be preferred, since mold extracts can be mixed in with other allergens in the same treatment set. Dosing for sublingual immunotherapy gradually increases in concentration.
- Patients start with the “A” dilution–using the entire contents of the bottle.
- Next, the patient is escalated to the “B” dilution.
- The patient is then escalated once more to the “C” dilution – the maintenance dose.
Each bottle is used until empty (lasting approximately 10 weeks) before progressing to the next dilution. The volume of allergen serum dispensed into the oral cavity is always the same–two “pumps” twice daily, every day.
Dispensing the Drops
Rest the dispensing arm of the pump on the lower teeth, anywhere near the front or side of the mouth, with the tip of the arm over the edge of the teeth (Figure 1). To administer, fully depress the pump firmly and quickly so that the dose is released into the mouth, preferably under the tongue. Repeat a second depression of the pump for a total of two pumps per dose. It is important to keep the bottle in an upright position while depressing the pump. It may be helpful to gently hold your pet’s mouth closed while administering the dose (Figure 2).
Do not mix the drops with food or on a treat. The drops are highly palatable for most pets. Avoid giving food or water for 10 minutes after dosing to allow the drops to remain in the mouth as long as possible.
Administer the 2-pump dose twice per day, for example, morning and evening. The doses do not have to be given at the same time every day. If you miss a day, do not try to “catch up” by giving additional doses; just continue treatment the next day. Each bottle will last approximately 75 days. Order refill bottles through your veterinarian approximately 2–3 weeks before needed.
Safety and Efficacy
Allergy drops have been used around the world in humans for more than 70 years and numerous studies validate both the safety and effectiveness. In fact, the World Allergy Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy in humans. The Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, recently concluded allergy drop immunotherapy significantly reduced allergy symptoms and use of allergy medications. See RESEARCH
section for more information.
Heska’s proprietary technology for sublingual administration was developed as a veterinary-specific variation based on a unique, time-tested and highly efficacious human protocol. In efficacy trials with hundreds of atopic dogs treated by veterinary dermatologists in varying geographic areas of the U.S. over the past 3 years, approximately 60% of dogs demonstrated substantial improvement in their clinical signs. Approximately 50% of dogs that showed no improvement or could not tolerate allergy shots, showed improvement when treated with allergy drops.
ALLERCEPT Therapy Drops can even be used safely in dogs that have experienced a prior anaphylactic reaction to allergy shots. If the patient has a history of prior anaphylactic reaction to allergy shots, please contact Heska’s Medical & Technical Consultants at 1-800-464-3752, option 5.