Practice parameter for allergy to furry animals

Here are some excerpts from the new practice parameter for allergy to furry animals:

Patients with allergic disorders should be evaluated for sensitization to cat and dog allergens by skin prick testing or in vitro testing for cat and dog specific IgE.

Avoidance

Avoidance is the most effective way to manage cat and dog allergy. Patients should be advised to consider removing the cat or dog from the environment, if present, to improve respiratory health.

To reduce exposure to cat allergens with the cat still living in the house, a combination of measures, such as removing reservoirs, keeping the cat out of the bedroom, washing the cat, air cleaning with a HEPA room air cleaner, improving ventilation, and mattress and pillow covers, may be helpful.

Exposure to cat allergen

Complete removal of all cats is necessary to minimize cat allergen exposure in a home.

Cat characteristics, such as length of hair, sex, reproductive status, and time spent indoors, are not associated with levels of Fel d 1 in the environment.

To reduce transport of cat allergen, people should consider changing their clothes when traveling from a high cat allergen environment to a low cat allergen environment.

Hypoallergenic cats

Because 1 or more cat allergens are present in all cats, patients should not be advised that it is safe to obtain a hypoallergenic cat.

Exposure to dog allergen

Dogs should be excluded from rooms in which reduced exposure is desired.

Because 1 or more dog allergens are present in all dogs, patients should not be advised that it is safe to obtain a hypoallergenic dog.

Washing cats and dogs

Washing cats or dogs at least weekly can reduce airborne cat Fel d 1 or dog Can f 1; however, the clinical benefit is yet to be proven and the effect of washing is not sustained.

Primary prevention to avoid IgE sensitization

Although exposure to elevated cat or dog allergen concentrations before 3 months of age may reduce the likelihood of developing cat or dog sensitization, the risk reduction is not sufficient to justify a decision to get a cat or dog to avoid IgE sensitization.

Secondary prevention to avoid disease in IgE sensitized individuals

Cat and dog exposure should be minimized in cat sensitized individuals to reduce the likelihood of developing asthma.

Tertiary prevention to treat furry animal allergy

Exposure to cat and dog allergens should be minimized to reduce the likelihood of an asthma exacerbation in cat and dog sensitized schoolchildren and adults who already have asthma.

List of measure that are not proven efective to reduce clinical symptoms:

- washing the cat
- dry heat
- dust cleaning with vacuum cleaners
- air cleaning with a HEPA room air cleaner
- improving ventilation
- chemical treatments, such as tannic acid or hypochlorite bleach
- mattress and pillow covers


Animal Dander Avoidance (click to enlarge the image).

References:

Environmental assessment and exposure control: a practice parameter—furry animals. Annals of Allergy, Asthma & Immunology, Volume 108, Issue 4 , Pages 223.e1-223.e15, April 2012.
Image source: Wikipedia, GNU Free Documentation License.

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