August is Itchy Pet Awareness Month. When it comes to itchy cats and dogs, the pets are not the only ones suffering. Caregiver burden is directly related to treatment complexity and treating allergies can be very complex. Dr. Meagan Painter, veterinary dermatologist, founder of The Allergic Dog and The Allergic Cat, and pet owner of her own allergic cat, talks about Stella and how managing her cat’s allergies has been a learning process for them both.
Dr. Meagan Painter, veterinary dermatologist
[00:01:05] Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. I’m joined, again, by the wonderful Dr. Meagan Painter, who is here to talk to us about her cat, Stella, as part of Itchy Pet Awareness Month. Welcome, Dr. Painter.
[00:01:19] Dr. Painter: Thank you so much. I’m happy to be back here.
[00:01:22] Dr. Lancellotti: I’m happy to have you back, too. Some of the other episodes that you’ve done for us have been amazing. If listeners want to check out some other topics that Dr. Painter has joined us for (ear infections, diet trials), there is really good information for those itchy pets out there. But today, we’re going to talk about your own pet, Stella. As a veterinary dermatologist, and an owner of an allergic pet, you’re also a very brilliant educator, who is doing an amazing job of improving how family veterinarians manage allergies. I wanted to invite you on the show to tell us your story and help bring some more awareness to allergic skin disease. Can you tell us a little bit about your background and how you came to be a veterinary dermatologist?
[00:02:06] Dr. Painter: What a great question. The other day, someone asked, “Why veterinary dermatology?” and I was like, “I don’t know. I just can’t imagine doing anything else.” And I feel so fortunate to find something that really fuels so many parts of my being. I love connecting with people. I love connecting with animals. I love the fact that dermatologists really focus on life quality and that, while we obviously have health as a priority for our patients, we really want them to live great lives and to have medication management that’s safe and effective. There are just so many little nuggets, every day, that I feel like I get to participate in this human-animal bond and promote it just by working individually (one on one) with my clients and my patients. And I absolutely love my job. It’s just the best.
[00:03:01] Dr. Lancellotti: That’s such a great description of what being a veterinary dermatologist entails. We really do talk a lot about quality of life and how the medications we’re using are impacting the pets that we’re seeing, and how each individual animal is treated in a very specific way. It really does involve a lot of communication with our clients to figure out all those little details to improve their quality of life.
[00:03:26] Dr. Painter: Exactly. I love thinking about each patient as an individual. That’s something that I really pride myself on. And I know a lot of my colleagues and dearest friends, such as yourself, do in the clinic. The reason it matters is because there are really no two animals that are exactly the same. You’re going to see similarities between different breeds or different situations, but in the end, the family and that pet are going to all be just so unique. It’s so important to listen to what people are telling you and what specific challenges they might have, and create a plan that just works for that patient and that family. And that’s something I absolutely love doing.
[00:04:07] Dr. Lancellotti: Absolutely. That’s something we talk about a lot on the show- here’s the information, the evidence, and the data that we’ve gotten from research studies, regarding these specific diseases and medications, but the best plan for a specific pet is to talk to the veterinarian that you’re working with and come up with an individualized treatment plan because no two animals are alike.
[00:04:29] Dr. Painter: Exactly.
Stella, the Allergic Cat
[00:04:30] Dr. Lancellotti: The goal of this show is to connect with pet owners and provide them with relatable, reliable information about each topic. For Itchy Pet Awareness Month, I wanted you to come on and talk about Stella. I think Stella is really special and I love her story. Can you tell us who Stella is and what she means to you?
[00:04:50] Dr. Painter: Absolutely. I love coming on the show to flip the coin a little bit, and not come on here as a dermatologist, but as a cat owner. Stella absolutely creates the cat owner in me. It’s funny because I’ll share a little bit about the challenges of being a veterinarian and a dermatologist, and then have an itchy cat in my house. It’s pretty much, “Here I am. I’m just a normal person (like your listeners) who is struggling with the challenges of living with an allergic cat. Stella came to me as a patient. She was owned by this awesome girl who was really just doing everything that she possibly could for Stella. She (the girl) had come to us, the dermatology service at Angell in Waltham, maybe one or two times before I started seeing her (Stella). Then, I took her on as a patient, seeing her again for two or three separate visits. It was quite a lot of investment by this person who you really loved Stella. She got her as a kitten from a friend’s litter and right away, she was like “This was the best cat,” and “Oh my God. I love her so much.” Just like everyone feels with their cat. Then, Stella started to have really severe head and neck dermatitis, which is one of the four presentations that we can see of feline allergy, and much like most cats with this type of presentation, it was very severe. She was scratching her face to the point of bleeding. She had lesions around her head, eyes, and her neck that were totally impacting her life. She was absolutely miserable, so her previous owner really wanted to help her. She sought our care and we tried to do all of the things- she did a diet trial at home, allergy testing, and medication- nothing helped. And honestly, Stella is a very spicy cat.
[00:06:42] Dr. Lancellotti: That’s a very diplomatic way of saying that.
[00:06:48] Dr. Painter: Yeah. I’m sure a lot of people are like, “Oh yeah. I have one of those.” There are cats out there who are very laid back and will do anything, but the grand majority of cats absolutely hate being medicated. So, Stella’s previous owner was having a lot of trouble medicating her, and she talked to me about potentially finding Stella a new home. And I absolutely wanted this cat to be in a situation that was good for her and encouraged her previous owner to surrender her over to our adoption center- which she did. About a week later, Stella was in the shelter. Fast forward to me saying, “I’ll foster her,” of course, because she was my patient and I really wanted to continue my care for her. In the shelter, she was having a lot of trouble. She just very aggressive with the staff there, so she came and stayed with me- and she never left. She was what you call a ‘foster failure,’ and it was truly because we really love this cat. She’s a very unique cat. I’ve never met a cat who can jump as high as Stella. She loves to play with little feather toys on the stick, and she’s just very fun and athletic and always out and about. And she trusts us. One thing that was very clear from the beginning is that she never tried to bite or scratch me. She knew, in some weird way, that I was trying to help her. And still, to this day, I’m the main medicator in the home (actually the only one who gives her her medicine). She still follows me around and sleeps on my legs at night. I think she just has this bond with me, knowing that I am trying to help her. But she’s still very spicy with some strangers who come over. Sometimes, even with people that she knows, like my dad. She gives him a run for his money. It’s very funny. We think it’s funny now, but of course, it wasn’t funny when she was in the shelter environment.
[00:08:52] Dr. Lancellotti: Do you have pictures of Stella, from when you were first treating her as your patient?
[00:08:55] Dr. Painter: I do. Yeah. There’s one picture that I have of her on the day that her previous owner said, “I think I have to give her up.” She was sitting in her little carrier looking absolutely miserable, and I remember texting that picture to my husband, saying, “This might be our new cat.” She didn’t look like a really great cat. She looked miserable. She was messy. Her face was bloody. I just remember being like, “I love you.” You know? I was like, “This is okay.” But you just feel so badly for these animals. And that’s part of the reason why I’m a vet. I just want to help them. And thank God my husband is a cat lover. He was like, “Whatever. She needs help. We can help her.” I’m glad, because in the end, she ended up picking him as her favorite, so I think that really helped her cause.
[00:09:50] Dr. Lancellotti: Oh, for sure. And I think a lot of veterinary professionals who may be listening can sympathize with your situation, because I think a lot of us have texted our significant others, at some point, like, “Um… I think we’re going to have a new pet?” This is not an uncommon occurrence among veterinarians and veterinary technicians.
[00:10:12] Dr. Painter: And we actually tried to find her home. She was live on their adoption website. We had several people come over to our house to meet her- some of them, she played with, and some of them, she just flat-out swatted. I was like, “Okay. There’s no way this cat’s going to find another home.” Then, we went on vacation (about a year ago) and we had her stay at my work. When I brought her up to work, I set her up in her little spot and we really missed her. When we came back home that night, we were like, “Gosh, we just really miss Stella,” and that’s when we decided, one hundred percent, that we were going to keep her. She is just such a cool presence in the home, and we really are glad that she came into our lives. And I think she’s glad that I came into her life, as well, despite the fact that I’m medicating her on a pretty regular basis.
Caregiver Burden and Medicating Allergic Cats
[00:11:05] Dr. Lancellotti: Let’s talk about that. Because it’s different having an allergic animal as your own pet, compared to treating an allergic animal as your patient. So what are some of the specific things that you’ve learned since having an allergic cat as your own pet? We talk a lot about caregiver burden, in relation to the frustration that a lot of pet owners feel when they’re trying to make an allergic pet more comfortable. All of this while dealing with the treatment, tests, vet visits, medications, etc. Can you talk a little bit about caregiver burden and what you’ve experienced that you haven’t expected?
[00:11:39] Dr. Painter: I have so many thoughts on this. And it’s really important for people who are going through this on their own to talk with their vet and say, “Listen. This is hard for me.” If you don’t tell us that something’s hard for you, then we’ll never know, so it is really important to know you’re not alone and that it’s not easy. One of the challenges that I’ve noticed is that allergic disease is a chronic relapsing condition, meaning that every now and again, you’re going to have flareups. The goal with medication is to reduce the frequency and severity of those flareups, but they’re still going to happen unless you’re curing allergy and that is really difficult. And as we know, we can use immunotherapy for that, but it doesn’t always help one hundred percent. Here we are living life, things are good, and then all of a sudden, seemingly out of nowhere, Stella will have a flare up. And that’s really difficult because suddenly, you have to go back to daily medication if you had reduced medication frequency. Or you wonder, “Gosh, is this medicine even working?” and you just feel lost. You know? It’s really just overwhelming. You might feel like you are calling your vet all the time. It’s important to just feel as if I have a plan. What is the plan? And is this plan working? I actually email myself. I say, “Dear Dr. Painter. I just wanted to let you know that Stella had a flare up last night.” It’s just something that helps me because now, I can tell someone else and make sure that what I’m doing is actually what I would tell someone that I’m not connected to. It’s really hard to treat your own pets. That really helps to ground me, but it is a message that’s important to hear. As a pet owner, listening to this, you just have to tell your vet how frequently things are either going awry or going well. That way, we can adjust the plan from there. So with caregiver burden, it’s exhausting. I always have to like run and catch this cat. Finding a place where she’ll accept medication has been a huge bonus. One thing that I learned, very early on, is that she loves to drink water from the sink in our bathroom. I actually paired her medication with that treat. So the reward of getting water from the sink is met only after she gets her medication. And giving Stella her medication, since figuring out that little combo, has been much, much easier. And because she loves drinking water from the sink so much, she’s usually in the bathroom, ready for it, which has been huge. But I have spent five extra minutes of my morning (which I don’t usually have to give) trying to find this cat in the basement, because she sees me coming or she hears the freezer open (which is where I keep her Atopica capsules). She runs away from me. And I’ve heard a lot of pet owners say how frustrating that can be, and they feel bad, and they don’t want to chase their cat, and those kinds of things. It can be really difficult, and you just have to except that this is reality and this is what you’re doing.
[00:14:49] Dr. Lancellotti: I love that you’ve discovered that the water is a high value reward for her. That’s honestly not something that I’ve ever thought of and will actually mention to cat owners now. Thinking back to when I was growing up and had cats in the household (before I got married to a husband who goes into anaphylaxis around cats), my cats loved drinking from the faucet in the bathroom, as well. And if that’s high value enough for them, it doesn’t always have to be food. What is that high value thing that’s going to help you to create a positive association? For Stella, it’s the drinking from the faucet, but it could be things like playing with a certain toy, getting a little bit of catnip, or a certain type of food (if that’s okay for your allergic pet). Finding whatever it is for that specific animal will really help you towards making that caregiver burden less.
Gaining Trust With Your Allergic Cat
[00:15:42] Dr. Painter: Another really interesting thing I’ve noticed is that if I attempt to give Stella her medicine when she’s sleeping on a place that’s special to her, she will put up way more of a fight than she ever will if she’s in the bathroom. If someone came and said, “Oh, you’re going to go to the dentist right now” while I was sleeping, I’d be like, “Are you kidding me?” But if you get in the car and you go to the dentist, you know that’s where it’s going to happen. The bathroom’s kind of like this neutral ground. It’s also a good height for me because she’s standing on the sink platform. Then, I can give her medication a lot more easily than if I’m bending over, or sitting on the couch and don’t have as much leverage. Little things like this can make it just so much easier. One of the things that I always reiterate to pet owners (with allergic cats, especially) is that “allergies are forever.” We’re going to be dealing with this forever. On some level, we’re going to have to make this work. And it’s been a journey. You know? It didn’t happen overnight. I certainly wasn’t like, “Oh, day one. Look, the water! This is amazing!” It was just that over months of time, things got a little easier. And those two things- giving a water reward and not giving her medicine in her own personal space- have been the two most important factors for that.
The Allergic Dog and The Allergic Cat
[00:16:59] Dr. Lancellotti: I want to talk about another journey that you’ve gone through- the courses that you’ve created, The Allergic Dog, and now, The Allergic Cat. The Allergic Dog has been a fantastic resource and support for family veterinarians, who are looking for a better understanding of how to treat allergies. Can you tell us a little bit about how this course came about and what it means to you?
[00:17:20] Dr. Painter: I love my course. It’s been such a journey to create something that is meaningful- to provide a resource for family veterinarians who want to learn more about treating this incredibly common problem. We all know that ear infections, itchy skin, diarrhea, and even food related issues are definitely the most common reasons why pet owners, like yourselves, are going to seek veterinary care. And the knowledge that veterinarians have, in general practice, is just incredible. They have to know a little bit about every single thing. And when it comes to skin management, there are so many updates and things that are changing all of the time about new medications, ways to do things, or how to solve problems. In the medication master’s course, I put together the most up-to-date review of how to utilize medication in practice for different presentations of canine allergy. Then, of course, I wanted to flip that and make sure we didn’t leave cats out. It’s so important to make sure that if we can treat allergic dogs, we want to be able to treat allergic cats very well. The biggest challenge with cats is that they love to be mysterious. Right? And that’s part of the reason why we love them. There’s a lot of mystery. There’s a lot less that is known. The parallels between them and dogs (and even humans) just isn’t as obvious, so coming up with therapeutic targets and medication for cats is proving to be pretty difficult. But for The Allergic Cat course, it’s putting together information on how to recognize the disease, some basics on how to treat it, and then managing some of the complicating factors, most of which are whether this cat is going to accept the medication and how to get around that.
[00:19:13] Dr. Lancellotti: Beautiful. What a great resource for family veterinarians. If they want to check out The Allergic Dog or The Allergic Cat, where can they go to do that?
Support for Pet Owners with Allergic Cats
[00:19:31] Dr. Lancellotti: Beautiful. So we’ve talked a lot about Stella and having an allergic cat. What would you like other pet owners with allergic pets to know? What have you learned from your experience?
[00:19:42] Dr. Painter: The most important thing to know is that this is a challenging problem that’s always going to keep you on your toes. Just when you think things are going really well and you’re in a groove, something might change. To be open to that, and to recognize that your veterinarian is here to help with those changes, is the single most important thing that you can hear from me. If your family veterinarian is overwhelmed and you want to seek advice from a veterinary dermatologist, that is exactly why we’re here. We really do want to help you and your pet achieve the best life quality that we possibly can, given the resources that we have available for medications and immunotherapy options, at this time.
[00:20:26] Dr. Lancellotti: Yeah. A lot of family veterinarians are comfortable managing pets with allergies, but if you would like to consult with a specialist, the link to find a veterinary dermatologist near you is under the resources tab on yourvetwantsyoutoknow.com. If you’re looking for a community of pet owners who are struggling with their itchy and allergic pets, you can join our Facebook group Your Vet Wants You To Know. There’s a lot of really good discussion on there, regarding what people are going through, sharing stories, commiserating, and everybody likes to post cute pictures of their pets too- which I just love. You can join us there to connect with more listeners.
Scratching the Itch
Dr. Lancellotti: Dr. Painter, we end each episode of the show with a segment called Scratching The Itch. It is designed to highlight something- whether it’s a human interest story, a product, or a website- that just provides relief or makes you feel good. Hence, scratching the itch. Do you have a ‘scratching the itch’ for our listeners, today?
[00:21:21] Dr. Painter: I do. And it’s your show.
[00:21:24] Dr. Lancellotti: Oh, stop it. You can’t do that!
[00:21:26] Dr. Painter: Yes, I can, and I’m going to right now. I’m taking the mic. I really thought hard about my ‘scratching the itch,’ because now I’ve had to come up with a few. The other day, I sent you this story and posted it in the group– I had a woman who works with special needs adults, and she talked to me about how she was blown away that I offered her a podcast, with a transcript, that she could both read and listen to after the appointment. Also, I have handouts for people that pretty much mirror the information, like how the diet trial handout mirrors the information from that podcast. So providing people with different ways of learning, and creating this environment where (along with learning the information in the exam room with your veterinarian) you have this resource that’s a trustworthy, wonderful, fun, happy, and great resource is so incredible. And it is such an honor to be able to promote it and to say, “Please listen to this because it’s great information.” I see the traction that this podcast is gaining, and I’m just really excited about that, and proud of you, and it really scratches my itch every time. I can say, “Go ahead and listen to this,” because it’s just that much more information. As a dermatologist, I use it every single day, and it really just fills this gap that is so needed. So, thank you for that. And yes, that is my ‘scratching the itch’ and no, you can’t take it back.
[00:23:02] Dr. Lancellotti: Thank you very much. That means the world to me and your support has been so incredibly invaluable. I do have to shout out to my editor, Dave. He edits the show beautifully, but he also goes through and does the transcripts. The fact that we have another resource for people who do better with reading than listening, and having that resource available on the website, is very much due to Dave’s commitment to making the show as fantastic as it can possibly be. Thank you very much, Dave. And thank you, Dr. Painter, for making the show your Scratching The Itch. That’s very sweet.
[00:23:37] Dr. Painter: You’re welcome. But also- Dave, one more thing- that “Pet Rocks” episode– if you need some laughs, everyone should go and check that out right now. It was the April Fools episode and it is SO good. I actually have a QR code link to that one, as well. When I give out my handouts and say, “Go check out this podcast,” I make sure that people listen to that one because it’s so good. It’s just so lighthearted and wonderful. Dave, you are such a comedian. It’s just amazing.
[00:24:11] Dr. Lancellotti: Yeah, we had a lot of fun doing that one. We’ll have to come up with something for April Fools, next year.
[00:24:15] Dr. Painter: Honestly, just do a rerelease. Just rerelease it. It can’t be better.
[00:24:21] Dr. Lancellotti: That was really fun.
[00:24:23] Dr. Painter: It was so good. So, that’s awesome. And you guys are awesome. I hope this show helped. I think that there are just a lot of challenges, but you’re not alone. There are lots of resources and tons of ways to do things, when it comes to medicating and finding a solution that’s stable for you and your cat. So, good luck out there!
[00:24:44] Dr. Lancellotti: Well, thank you very much for sharing Stella’s story. I really appreciate your time, Dr. Painter.
[00:24:48] Dr. Painter: You got it.
[00:24:49] Dr. Lancellotti: And for everyone listening, I look forward to your next visit with Your Vet Wants You To Know.