Diabetic Dogs and Allergy Issues | Ask Dr. Joi

By Dr . Joi Sutton|2018-03-01T09:14:54-05:00Updated: March 1st, 2018|Pet Care, Pet Diabetes, Pet Grooming, Pet Newsletter|13 Comments
  • Miniature Schnauzer playing in the Grass

I get some great questions from clients. They inspire me with article ideas and keep me in tune with diabetic pet owners. I enjoy interacting with our readers, and sometimes the questions are worthy of a newsletter. I bet if one person has this question and takes the time to write me, there are likely lots of folks with a similar question. Todays question is about a Diabetic sweetie and her allergy issues.

My sweet 10 year old miniature schnauzer has diabetes and severe allergies. Apoquel does not work, nor does the new shot Cytopoint. She is on a specialty diet and really likes it. I have tried changing her foods multiple times but she wouldn’t eat it. What other food should I try? She had food allergies before she was diabetic and changing her food really helped. Any suggestions would be greatly appreciated. Thank you!

How disappointing that neither Apoquel nor Cytopoint worked for your pet! Now as a refresher, the are 3 big categories of allergies for dogs and cats. There is atopic dermatitis, which is also referred to as atopy, environmental allergies or more simply “hay fever”. There is food allergy. And there are parasitic allergies, most commonly flea allergy. Flea allergy and atopy are the most common, particularly down where I live in tropical south Florida. Nonetheless, they must all be considered if you have an itchy pet!

Veterinarians usually try the holistic approach as much as possible when we have an allergic pet. This includes avoidance of the allergic trigger, weekly baths, omega 3 fatty acids, antihistamines and so on. Sometimes, despite these efforts we may yet still have a flare up of itch, a hot spot, or a secondary infection. Allergies can be extremely frustrating. At times we even run allergy tests on pets to determine what is triggering the itch. Allergy tests for environmental allergies have gotten pretty good, but testing for food allergy testing lapses behind. For food allergies we are usually left with an elimination diet. Yes, there are tests available for food allergies, but they aren’t as accurate as testing for environmental allergens.

I’ve been in the vet biz for a long time. For decades, we only had steroids as our rescue drugs when a pet had an allergy flare up. We still use steroids, but the use of steroids for allergic dermatitis has gone down in the last few years when a new drug, called Apoquel, came on the market. Apoquel is a cytokine inhibitor. Cytokines are proteins in our bodies that cause itch. I love Apoquel, and yet, I treat it with caution. Again, Apoquel has only been on the market a few years and we don’t yet know the long-term effects until we have a few more years worth of studies and reports of adverse effects, just as with any new drug. One fear is that it could increase the incidence of cancer over years of usage. I explain it like this: Our bodies have an amazing surveillance system. We make goofy cells all the time, but our immune system takes them out. If we suppress our immune system, for example with Apoquel, particularly if used over long spells of time, it might increase the risk of cancer cells in these pets. It’s a minor risk, but should be considered. I’d much rather have a pet on Apoquel than on steroids long-term. Or, we might use Apoquel on an alternating day dosage. And of course, since your sweetie is diabetic we should not reach for steroids.

What came next in the world of cytokine inhibition is fantastic – Cytopoint. Cytopoint came on the market earlier this year. I adore this drug! It is a monoclonal antibody that targets and takes out just one cytokine, but it is the most important cytokine for atopic dogs. I’ve had some atopic dog patients have phenomenal results on Cytopoint. I sometimes even use it as a diagnostic aid for itchy patients. If a pet become much less itchy after an injection of Cytopoint, then I know it has atopy. It might also have flea allergy or food allergy, but if it responds to Cytopoint, I know there is atopy involved. Cytopoint works only for atopy whereas Apoquel is broad spectrum and helps pets with food allergy, hay fever and parasitic allergy. Perhaps the best thing about Cytopoint is that it is a monoclonal antibody. Monoclonal antibodies are a very safe class of medication. Cytopoint can be used in puppies. It can be used in diabetics. It can be used if there is liver or kidney disease. We inject a dose into the dog at the vet clinic. The injection scavenges up the cytokine, and a single injection lasts for 4 to 8 weeks. I’m a huge fan.

Now, if your pet truly has allergies and yet did not respond to either Apoquel or Cytopoint, we need to consider reasons for treatment failure. Is there really an underlying allergy? Perhaps it is a parasite rather than an allergy. Are you certain there isn’t also a secondary skin infection as well such as a yeast or bacterial infection? Secondary infections can be intensely itchy and are a big cause of apparent failure of Apoquel or Cytopoint. Next, how often are you bathing her? A good oatmeal bath can help decrease the itch, and regular medicated baths may help decrease the incidence of secondary skin infections. Nonetheless, I’m guessing if she had food allergies in her past that food allergies may yet continue to play a role.

Diabetic dogs do well with a variety of diabetic foods. In general, since many diabetic pets became diabetic secondary to pancreatitis (schnauzers in particular are prone to pancreatitis), we usually suggest low-fat foods. I usually aim for a fat content less than 10 percent for most diabetic pets, for chubby pets and for pets with a history of pancreatitis. Lots of diabetic pets are also chubby as well. The low fat, high complex fiber nature is a good choice for diabetic dogs, but if she is itchy while eating we should consider a new diet!

Perhaps you should think back to what she was eating when her skin was in tip top shape! You said your vet diagnosed food allergy and that she improved on that food. How about feeding that food again? Or, if you know what the main protein and carbohydrate sources were of that successful diet you could make a home cooked diet with similar ingredients.

I think a chat with your veterinarian is in order. And perhaps a consult with a nutritionist or dermatologist.

Have a question or comment? Then post below! I always enjoy hearing from my readers!

NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

About the Author: Dr . Joi Sutton

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida. Connect with Dr. Joi on LinkedIn


  1. Abigail September 4, 2022 at 6:15 am - Reply

    hi there, my Snow Ball is a chihuahua x papillon mix and she’s 12 and she’s been itching her entire life, but recently she’s started itching her face and her stomach…..before it used to be her back and her feet mostly she would itch and bite, we did do food trials and changed her diet, which she is now on a home cooked (sweet potato, pigeon peas, eggs/fish, and carrots)……i haven’t been bathing her as often as before either so i’m not sure if it’s environmental allergies and food allergies she has…because my neighbour has a shepherd, one that itches like crazy her face, stomach and feet (the same way mine does now)….but she was itching for her whole life….and my neighbour has another dog that doesn’t itch at all…and both sleep in the same kennel and eat the same thing….so that made me feel it isn’t environmental. Also my dog has recurrent UTI’s which is annoying to say the least because i know it’s uncomfortable for her…and she wakes me up all hours of the night. She was on a prediabetic watch before, so now i’m thinking she has diabetes….but also she’s old so can it maybe be old-age related? Also she did have a corneal ulcer before that was repaired……and with her scratching and rubbing her face everyway i am afraid she’ll get another one despite her daily cyclosporine treatment.
    so basically her history of treatment for her pruritus is from tick and flea treatment (because when i got her she was covered in ticks….so we thought maybe it was a residual allergic reaction to that…..but she’s been tick and flea free for 11 years….so i’m doubtful that’s the issue); then it was food allergies that took us over 4 years to perfect (she was very good very few bouts of itching) then ………it was environmental concern (because she kept licking her paws…..and i had to do a salve foot bath for her twice a day)…….and then it was bacterial because she started itching her ears a lot so they though maybe an ear infection (but nothing was found…and antibiotics didn’t make a difference)…….the with the diabetes scare….her food had to change from rice to the sweet potato…..and she was good again ….and now she’s back itching with a rage. So is she just becoming allergic to every food she gets after a while?

    • Dr . Joi Sutton September 10, 2022 at 4:25 pm - Reply

      It sounds like Snowball needs a trip to your veterinarian pronto! Perhaps even a dermatologist is in order.

  2. Christa November 16, 2020 at 9:04 am - Reply

    My dog is diagnosed with diabetes. He struggle with eye infection at the moment. Do you think that he got a allergy and what can i give him for that. He is on a special diet food. Thank You

    • Dr . Joi Sutton November 22, 2020 at 5:47 pm - Reply

      I hope you have taken him to your veterinarian to assess the eye.
      Pets can get allergic conjunctivitis, but that is a diagnosis we back into after ruling out other issues. If other issues have been ruled out your vet might try an antihistamine.
      Diabetic dogs are very at risk for cataract s, dry eye, retinal disease and uveitis. If I had my way, I’d have all diabetic dogs consult with a vet ophthalmologist to catch these things early. Certainly good blood glucose regulation is critical to m8 I I’ve the risk of these diseases.
      Be sure to follow up with your vet.
      Best, Joi

  3. Steve Hovanesian April 11, 2019 at 10:34 am - Reply

    One of my breeding females, Lucky was diagnosed with gestational diabetes 3 years with her last litter. We spayed her hoping that it would resolve. Took a long time to regulate but have successfully done so. I now do random glucose checks 6 hours after her 6am dose. She was on 8u in am, 7u qpm. Readings were 60 twice. I decreased her to 7/6 units (vet aware). Last 2 readings were 64 and 45. Decreased her to 6u/5u. Question is: after 3 years could her diabetes (if still gestational) resolve herself? Thank you.

    • Dr . Joi Sutton April 13, 2019 at 6:01 pm - Reply

      When pets have gestational diabetes it usually resolves once spayed. If there were other factors such as obesity at play it could last longer. Essentially the progesterone causes insulin resistance.
      Clearly based on your spot checks her insulin dose at this time is too high. Chat with your vet about backing off further. If you ever get numbers like 45 and 65 again you will likely skip a dose and check the blood glucose closely before giving any more insulin.
      Do you run blood glucose curves? Curves are checking the glucose every 2 hours from one injection until the next, 12 hours later. If it goes below 150 you should check hourly til it goes over 150. We don’t know with a spot check where it really bottomed out. It could have been even lower! The scary thing is that the most common sign of hypoglycemia is nothing at all. Hypoglycemia often goes unnoticed by pet owners.
      Do chat with your vet. You will clearly need to back off the dose. 🙂

  4. Renee Anglin November 30, 2017 at 5:50 pm - Reply

    I have an eight year old shepherd mix – he has had weird allergies off & on since he was around two. They would come and go with the fall seasons up until 2016 when the allergies changed from bumps to dry scaly type skin events. Instead of the allergies going away they hung around until approx. May 2017. We treated him with an hydrating shampoo every four days or so and also tried some Apoquel which seemed to help. He mysteriously cleared up right before being diagnosed with Diabetes, July of this year.

    Question is: Is it possible that allergies are linked to Diabetes and that the use of insulin may help with his previous allergies? He has not had a return of allergy symptoms since he cleared up earlier this summer. Has not been on medication or had a special bath, just insulin.
    Thanks Renee

    • Dr . Joi Sutton December 5, 2017 at 8:53 pm - Reply

      I cannot think of a reason for his atopic dermatitis to improve once starting Insulin. As it has a seasonal pattern in the fall, atopic dermatitis (a fancy term for hay fever) is most likely.

      Pets can grow out of allergies. Or, perhaps there was something in the environment that is no longer in the environment? Short of allergy testing (which has become quite affordable in recent years), we won’t know. An allergy is an inappropriate reaction to something in the environment. Typical allergy panels test for antibodies to grasses, pollens, trees, weeds, fleas, dust mites and other mites, etc. bathing is a great help for pets with atopic dermatitis. I’m so glad your pet isn’t itchy at present! If the signs recur, apoquel and/or cytopoint are both good options that are appropriate for diabetic pets.

  5. Elaine November 30, 2017 at 2:39 pm - Reply

    I also have a diabetic but no allergies. I would still recommend a homemade diet which is what I had to do, mainly because of the cost of the RX can food. I googled homemade diabetic dog recipes for my dog. I prepare half of a recipe and for a 40lb dog it usually lasts two weeks and I could make this in my sleep!! Her BG was gradually getting higher and higher and was prescribed 20 units of insulin. She is down to 16 units and although the BG bounces all over the place I think this diet has helped keep it down most of the time. I hope you find something that works for your baby. I also test her BG before breakfast and dinner to keep a close watch on it. Ask your Vet if you are not already testing because this has taken a lot of stress from me always knowing and not having to take her for curves. Good Luck, I know your baby loves you for everything you do!!!

    • Io September 25, 2021 at 9:30 am - Reply

      My little tilly(tt) has really itchy skin which always starts in April till about October. This year it worse then ever, it’s been a very dry September, could this be part of it. Also could it be the start of diabetes?

    • Ruth Duff September 25, 2021 at 9:30 am - Reply

      My little tilly(tt) has really itchy skin which always starts in April till about October. This year it worse then ever, it’s been a very dry September, could this be part of it. Also could it be the start of diabetes?

      • Dr . Joi Sutton September 26, 2021 at 10:12 pm - Reply

        Hi, Ruth!
        If your pet has a recurrent seasonal allergy, there is a good chance it is hay fever. It could be a tree or grass during that season, a weed, lots of things. Food allergies typically subside in the wintertime. Be sure of course to use a good flea preventative as that is also flea season in most areas.
        Chat with your vet about cytopoint. It’s a monoclonal antibody for the most important cytokines for hay fever in dogs. It is very safe. (My joke is that the on’y side effect is your pocket blood as it can be a bit pricey as there is no generic yet.). You could also try. Course of apoquel which is a pill for allergies. Cytopoint is my fave, but both are great meds. Have a chat with your veterinarian. 🙂

  6. Tony Sparks November 30, 2017 at 1:08 pm - Reply

    My yorkie is a diabetic and has allergies too. My vet put her on Royal Canin Hydroyxed Protein food, it has done wonders with her skin…..might be worth a try

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