Grass roots

We have a four-year-old JRT, Molly, who has an allergy to grass. We have fields at the back of our house and every morning she rubs her face along the kitchen mats and is constantly chewing at her feet.
She's on ZD dried food, Courtevance spray and a porridge oats bath. I feel that the ZD is a waste of money. Is there anything else we could try? I feel so helpless and even if we don't go for a run over the fields she is still the same. Can anyone help?
Nick Page, by email

Time to go back to your vet! The fact that Molly is on a prescription diet and a POM-V spray means that she is under the care of a vet so let him or her know that Molly is no better or else he or she will have assumed that Molly has responded well.
Your description of Molly chewing her paws is a classic for a dog with atopic dermatitis or itchy allergic skin disease. For the vet in practice, the complicating factor is that there can often be a food allergy as well, which will be why your vet put Molly onto Hill’s z/d, as a dietary trial. The thinking behind z/d is that it is balanced nutrition and hypoallergenic because the protein has been hydrolysed and reduced to such a small size of molecule that it should not be detected by the immune system.
If Molly is no better when being fed z/d, do first check that she is being fed exclusively on this food. A dietary trial is pointless if the patient is still having a rawhide chew or sneaking table scraps, for example. If she really has eaten no other food at all, and she has been fed just z/d for at least six weeks, then this suggests that she does not have a dietary allergy (and ruling that out is a positive result). There are rare occasions when a dog with a food allergy does not improve on z/d (if allergic to potato which is found in z/d, for example) but common things are common!
Cortavance is a steroid preparation as a spray which is applied to alleviate itchiness. It is not absorbed so many disadvantages of steroids are avoided, but it is really addressing the effects and not the cause of the itchiness. Also, it will have limited effect if Molly is simply licking off it off again. This can be avoided by distracting her with a meal or exercise immediately after spraying the area.
The porridge oats bath conjures up a great vision in my mind but I think that you mean an oatmeal shampoo which does again help ease itchy skin. There are however other shampoos which may be more effective, such as a shampoo containing ceramides which will help to improve the barrier function of the skin.
A suspicion that Molly is allergic to grass needs further work-up because immunotherapy can be very successful. There are two ways of testing a dog to identify allergies: intra-dermal skin testing, or serology which involves submitting a blood sample to a specialist laboratory. (Incidentally, the food allergy component could be finally ruled in or out with serology as well if requested on the laboratory submission form.) Based on the findings, a hyposensitising vaccine could then be requested containing those environmental components to which Molly is allergic. If serology did reveal foods to which she was allergic, then it would simply be a matter of avoiding them through careful scrutiny of labels on dog foods, or home-preparing her diet.
A successful course of hyposensitisation involves sub-cutaneous injection of the specifically formulated vaccine at increasing concentration over a schedule of increasing time-length between injections. The results can be spectacular!
Finally, do remember to ensure that Molly does not have fleas. If she has a grass allergy, then she is very likely to also be allergic to fleas which will simply complicate the picture. Strict flea control on Molly, all other dogs, cats and rabbits living with her and also addressing the environment should minimise the chances of her being bitten by a flea.
Molly is still young, which is generally the case with atopic skin disease, so I would definitely go back to your vet for further help. Best of luck!

Alison Logan, vet