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Best Treatment for Allergies to Cats

Interview with Lawrence DuBuske, M.D.

Boston Allergy Group in Newton, MA

Dr. DuBuske is a board-certified specialist in allergy and immunology. He has a long career in academic and private practice, has published over 600 allergy articles and abstracts, and served on many major allergy organization boards. 

In this interview, Dr. DuBuske answers important questions about dealing with cat allergies, including the symptoms, treatment, and costs.

If you know you’re allergic to cats, can you still get one?

My goal is to help people so they can live with a cat that brings meaning and happiness into their lives. Through allergy immunotherapy, also known as allergy shots, it's possible to become desensitized, allowing cat lovers with allergies to enjoy the companionship of their cats, usually without any allergic reactions.

What are the signs that you’re allergic to cats?

There are a number of possible signs that you are allergic to cats, including:

  • itching skin

  • watery, red or itchy eyes.

  • runny nose, itchy nose, nasal congestion

  • Skin rash or hives

  • coughing, sneezing, and wheezing

  • malaise and fatigue when encountering a cat

Usually people come in with nasal congestion, runny nose, post nasal drip, and a lot of sneezing. Sometimes their eyes feel itchy and are watery. The more troublesome and serious symptoms are respiratory, including coughing, lung congestion, and asthma. 

Do people recognize that they are allergic to cats?

It depends. If someone starts showing symptoms after moving in with their partner, they might suspect the cat. However, if they've lived with a cat for some time without realizing it's the source of their discomfort, they might mistakenly believe they're allergic to another person's cat or something else entirely. Often people who have had a cat for years no longer get acute sneezing or a runny nose near the cat but instead get nasal congestion and chronic sinus symptoms.

What tests do you use to determine cat allergies?

We conduct a few different tests. One involves applying a specific cat allergen extract to the skin and observing the reaction. Cat sensitized people will get a hive greater than 3 mm in size at the site of the test, known as a skin prick test. Additionally, we perform blood tests to measure levels of Cat allergen- specific Immunoglobulin E (IgE)  in the body. New testing called Component Resolved Diagnosis allows us to determine which specific cat allergens the patient is sensitized towards. From these results, we can create a detailed allergy profile.

Can you tell whether someone is mildly or moderately allergic to cats?

If you're experiencing symptoms associated with lower respiratory issues, like asthma, it might indicate a more intense allergic reaction, potentially leading to significant asthma episodes. Typically, patients can articulate the extent of their discomfort. We prioritize understanding your symptoms through listening, conducting necessary tests, and offering various treatment possibilities.

What is the treatment for allergies to cats?

Based on the intensity of the allergic reaction, we offer various treatment choices, ranging from medications to gradual desensitization through allergy shots. Medication options may encompass oral antihistamines, oral anti-leukotrienes, topical steroids, topical antihistamines, topical cromolyn and additional medications. These medications only provide temporary relief and only help when they are being used.

Given that cat allergens are found in their skin, saliva, and urine, the effectiveness of environmental measures is somewhat limited.  Bathing the cat only very transiently reduces their allergens as cats will continue to salivate and urinate after bathing. Keeping the cat out of bedrooms, confining the areas where the cat stays, and using HEPA air filters may limit the cat allergen exposure.

Desensitization therapy is highly effective, though it requires a year to achieve full efficacy. For example, Stuart K., a patient of mine, underwent a series of allergy shots for several years beginning with weekly injections then advancing to every other week injections then monthly injections for three years. Five years down the line, during the COVID Pandemic we had a telehealth visit where he demonstrated that he remained symptom-free, even with his cat curled up in his lap during the encounter.

Do all allergists treat allergies to cats the same way?

There are some differences in how allergists treat allergies to cats with desensitization. I use injectable allergy shots which are highly effective for cat allergy symptom relief. Cat allergy sublingual tablets are not yet available.  Sublingual  drops are not FDA approved, are generally not covered by insurance, and have not been shown to be consistently effective.

Does insurance pay for treatment?

Treatment with allergy shots is typically covered by insurance, but it's important to verify with your insurance provider to understand your deductible and copayments. Medicare and Medicaid generally cover these treatments.


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