Iris, house dust mites and a long road to comfort

About allergy in dogs, desensitisation, tailored treatment – and the question of whether working with an allergy is fair

When Iris started scratching more and more often, her ears became more sensitive and her skin simply would not settle, I quickly felt: this is not a “just put some ointment on it” problem.

The pattern did not make sense. It kept coming back. And above all – it was clearly getting in her way.

For an assistance dog, that is not a small detail.

You cannot learn properly, work reliably and remain stable when your body is constantly irritated, itchy or painful.

In Iris’ case, house dust mites eventually turned out to play an important role.

And that is how we ended up in a trajectory that, beforehand, you rarely have a realistic picture of: desensitisation.

This is our story. With everything that comes with it – including the searching, the fine-tuning, the temporary support and the ethical questions that inevitably arise.

What is house dust mite allergy in dogs?

With a house dust mite allergy, a dog’s immune system reacts excessively to proteins from house dust mites.

Those allergens are everywhere:

• in dog beds and blankets

• in sofas and upholstery

• in carpets

• in rugs and soft toys

That immediately means something important:

👉 this allergy is usually not seasonal.

Symptoms are often present all year round.

What exactly is desensitisation?

Desensitisation (allergen immunotherapy) is not medication against itching.

It is training for the immune system.

The dog receives:

• very small amounts of exactly those allergens

• that cause symptoms in that individual dog

• according to a fixed schedule via injections (sometimes via drops)

The goal is not a cure.

The goal is for the immune system to learn to respond less intensely.

What many people do not know: in dogs the dose remains the same

During the build-up phase, the dose is increased step by step.

But once the maintenance dose has been reached, that amount remains the same in dogs.

So you do not keep increasing the amount of allergen.

You keep repeating.

Not stimulating – but stabilising.

But… Iris is exposed to house dust mites all day anyway, isn’t she?

Yes. And that is exactly where confusion often arises.

Natural exposure:

• takes place via the skin and mucous membranes

• in areas where inflammation and hypersensitivity are already present

That exposure actually maintains the allergic pattern.

The injection is given:

• in a controlled way

• with a fixed, known dose

• in a different immunological context

So the difference is not in how much allergen is involved,

but in how the immune system learns to deal with it.

Why does the effect fade when you skip a dose?

Because with desensitisation you do not build permanent insensitivity.

You build active tolerance.

And that tolerance needs to be maintained.

If you stop for too long, only natural exposure remains – and that does not train tolerance.

What does the standard protocol usually look like?

It is important to be honest about this.

Build-up phase

• start with a very low dose

• the dose is increased step by step

• usually with intervals of several days to one week

This phase often lasts several weeks to several months.

Maintenance phase (standard)

• once the final dose has been reached

• the same dose is continued

• usually one injection every 2 to 4 weeks

👉 This is the average starting point.

And then reality

Not every dog fits neatly into that schedule.

Iris certainly does not.

Our practice with Iris

In Iris’ case, the standard protocol proved insufficiently stable.

After a great deal of fine-tuning, she ended up on:

0.08 ml per injection – twice per week.

So:

• a relatively small dose

• but a higher frequency

And that specific combination gives her skin and ears relief and stability.

And yes – finding the right setting took months

Adjusting the correct dose and frequency for Iris

took more than six months.

It was not a straight line.

It was:

• observing

• adjusting

• reviewing

• adjusting again

Only after months did it become clear what worked for her body.

Her body shows the right moment itself

With Iris we clearly see:

• more scratching

• more restlessness in her skin

• increased sensitivity

when the built-up tolerance starts to fade.

Not because she “decides” the dose,

but because her symptoms show how stable the tolerance is at that moment.

So the dog itself becomes an important measuring instrument.

And yes – in the beginning additional medication was needed

During the start-up phase, Iris temporarily needed support with anti-itch and anti-inflammatory medication.

At times she really scratched herself raw.

Unfortunately, that can happen at the start of this trajectory.

Desensitisation works slowly.

In that phase, the dog’s welfare always comes first.

Now that her schedule is stable, this is no longer necessary – and that is exactly why we are so satisfied with this approach.

Which other treatment options are commonly used for allergy?

Antihistamines

• ✔ relatively safe

• ✔ sometimes sufficient for mild symptoms

• ⚠ often limited effect

• ⚠ symptom-based treatment

Anti-inflammatory medication and prednisolone

• ✔ fast and powerful

• ✔ useful during severe flare-ups

• ⚠ clear side effects with long-term use

• ⚠ only suppress the reaction

Modern anti-itch / immune-modulating medication

• ✔ often effective

• ✔ usually fewer side effects than prednisolone

• ⚠ symptoms usually return after stopping

• ⚠ remain symptom-based

Supportive skin care and environmental adjustments

• ✔ important for comfort

• ✔ help to limit flare-ups

• ⚠ almost never sufficient as the only treatment

And desensitisation?

Advantages

• targets the dysregulated immune response itself

• works in a regulatory rather than suppressive way

• suitable as a long-term strategy

• often less dependence on ongoing anti-itch medication

Disadvantages

• effect develops slowly

• requires long-term commitment and monitoring

• does not work in every dog

• less suitable when there are many different allergies at the same time

• additional support is often needed during the build-up phase

  
  

But before you can stabilise, you first need to know what triggers your dog

However carefully you want to work with desensitisation –

you can only start training the immune system once you know what it actually reacts to.

You first need an answer to a simple, but decisive question

What is my dog allergic to?

For Iris, that was also an essential starting point.

Not to create a list, but to be able to treat in a targeted way.

Desensitisation only works with allergens you actually know.

You cannot build tolerance for something that is not identified.

That is why, before we could start her desensitisation trajectory, we first carried out testing.

Not only for environmental allergens –

but also for food.

Precisely because itching, ear problems and skin reactions are often influenced by several factors at the same time.

For Iris, therefore, a food allergy blood test was performed in addition to the environmental allergy test.

Not because that test can prove everything, but to avoid overlooking anything and to narrow the field.

Only once we had a better picture of her main triggers could we start a trajectory that truly suited her.

Allergy testing – how did we do this?

In Iris’ case, a blood test for environmental allergens was performed.

This measures specific IgE antibodies against, among others:

• house dust mites

• storage mites

• pollens

• moulds

The results are used to compose a personalised immunotherapy preparation.

👉 This test is a tool, not a diagnosis on its own.

The dog’s clinical signs always remain leading.

And the food blood test?

We had that performed as well.

Such a test usually contains the most common food sources, such as:

• beef

• chicken

• lamb

• turkey

• pork

• fish

• egg

• grains and rice

Exotic proteins (such as ostrich or camel) are usually not included.

Such a test can:

• ✔ give direction

• ✔ help to select suspected ingredients

But:

• ⚠ it cannot reliably confirm a food allergy

• ⚠ and it cannot reliably rule it out

Mild food reactions and food intolerances are usually not visible in blood tests.

With severe food allergy, a reaction is seen more often – but even that is not guaranteed.

The only reliable way to assess food allergy remains:

a strict elimination diet with controlled re-introduction.

From test to a personalised product – and only then to self-injecting

Once it is clear what a dog reacts to, the process is not finished yet.

The desensitisation medication is custom-made for each dog based on the test results.

It is not a standard vial kept in stock, but a personalised allergen preparation.

In practice this means:

• first formulation in the laboratory

• then delivery

• and only then can you start or continue your schedule

That takes time.

And that also means:

👉 you must always reorder well in advance.

Especially when – as in Iris’ case – the standard protocol is adjusted and injections are given more frequently.

At first, I found this quite stressful.

Not medically, but logistically.

Because this is not medication you can simply collect the same day.

Only once this whole process was running smoothly –

test → formulation → delivery → stable schedule –

did it become logical to take the next step:

not constantly going to the clinic,

but injecting in her own, calm environment.

I administer the injections myself

Before I started giving all injections at home, I first administered one myself in the clinic – under supervision.

So the veterinarian could see that:

• I inject correctly

• I work hygienically

• and Iris accepts it calmly

Only after that did we start giving the injections structurally at home.

For Iris this means:

• no constant visits to the clinic

• no additional stress

• a fixed and predictable moment in her own environment

For me this means:

• control over her schedule

• and being able to adjust quickly when her body indicates it is needed

For an assistance dog, that predictability is extremely important.

And why “Little Boss” is learning this too

Little Boss is not learning this in order to ‘help’.

He is learning this because it is realistic.

Because of my own health, it is possible that I may suddenly be admitted to hospital.

And at such a moment, someone must be able to take over Iris’ care safely and correctly.

Not only feeding and walking –

but also:

• her medical care

• her daily routine

• and her desensitisation injections

We discussed this together first.

Whether he wanted to do this.

Whether he felt able to.

Whether he found it stressful.

And whatever his answer would have been – that would have been decisive for me.

I do not care how long it takes him to learn this.

What matters to me is that there is someone who knows:

• what Iris receives

• why she receives it

• and what happens if a dose is missed

Otherwise, every time I am unexpectedly hospitalised, Iris would have to go to the clinic twice a week for an injection.

That would mean:

• extra stress for her

• losing her routine

• and more strain for a dog who actually needs stability

This is not an emergency solution.

This is consciously thinking about continuity of care.

Is it ethically responsible to let a dog with an allergy work?

For me, the answer does not lie in the word allergy.

It lies in:

• how well the symptoms are controlled

• how much discomfort the dog actually experiences

• how much medical intervention is required

• and how stable the dog can function

A dog with an allergy who:

• constantly itches

• regularly develops inflammation

• repeatedly needs time to recover

• and can only function with heavy suppressive medication

has, in my view, a serious welfare problem.

But a dog with an allergy who:

• is stably managed

• has hardly any symptoms

• is comfortable in her body

• and does not have to push beyond her limits

can – with good guidance – work responsibly.

For Iris, my core question was not:

“Can she still perform her tasks?”

but:

“Is she comfortable in her body?”

Only when that question could genuinely be answered with yes did it feel ethically right to me.

With assistance dogs, the bar should always be higher than merely functioning.

In conclusion

Desensitisation is not an easy path.

It requires:

• time

• observation

• fine-tuning

• patience

• and realistic expectations

But when the most important allergens have been properly identified and the number of triggers remains manageable, this is one of the few treatments that truly aims to address the problem at its source.

Internationally, allergen immunotherapy is also regarded as an important long-term treatment for environmental allergies in dogs, among others within the guidelines of the

World Small Animal Veterinary Association.

For us – and for Iris – this path ultimately provided something that may be the most important thing for an assistance dog:

comfort in her body.