Treatment Options for Cat Allergy
Avoidance of cat allergen is the most effective way to manage cat allergy, with complete removal of the cat from the home being the optimal approach for reducing symptoms and improving respiratory function. 1, 2
Understanding Cat Allergens
- Cat allergens, primarily Fel d 1, are found in cat skin/dander, saliva, and urine, and are common to all breeds of cats 1
- Cat allergen particles are small and low-density, remaining suspended in air for extended periods and disseminating widely throughout homes 1
- Cat allergen can be found in homes and locations where cats were never present due to passive transport on clothing 1
- Cat allergy is regarded as the third most common cause of human respiratory allergies and the second most common indoor cause 3
Primary Treatment Approach: Allergen Avoidance
Most Effective Measures:
- Remove the cat from the home completely - this is the single most effective intervention 1
- Pet removal leads to significantly better improvement in airway responsiveness compared to medication alone and enables reduction in inhaled corticosteroid use 2
Important Considerations for Cat Removal:
- Cat allergen can persist for an average of 20 weeks after removal, so short trial removals may be misleading 1
- Steam cleaning of carpets and upholstered furniture after removal offers little advantage over routine vacuuming with HEPA filter vacuum systems 1
If Cat Removal is Not Possible:
- Confine the cat to an uncarpeted room away from the bedroom 1
- Install HEPA or electrostatic air purifiers in the cat's confined area, which may reduce airborne allergen in the rest of the home by up to 90% 1
- Weekly bathing of the cat can temporarily reduce airborne allergen levels 1
- Place litter boxes in areas separated from the home's air supply 1
- Keep the cat out of the patient's bedroom 1
- Use high-efficiency air cleaners (central or portable) 1
- Remove carpet or other allergen reservoirs from the bedroom 1
Pharmacological Treatment Options
For Allergic Rhinitis:
- Intranasal corticosteroids like fluticasone propionate are effective for controlling nasal symptoms 4
- Adults: 2 sprays in each nostril once daily (total 200 mcg/day) or 1 spray twice daily
- Maintenance: May reduce to 1 spray in each nostril once daily (100 mcg/day)
- Children (4 years and older): Start with 1 spray in each nostril once daily 4
For Systemic Allergic Reactions:
- Oral corticosteroids like prednisone may be used for severe allergic states intractable to conventional treatment 5
Advanced Treatment: Allergen Immunotherapy
- Allergen immunotherapy is the only disease-modifying treatment available and may be the best therapeutic recommendation for patients with moderate to severe pet-induced perennial allergic rhinitis 6
- Depigmented, polymerized cat epithelium extract immunotherapy has shown favorable safety and effectiveness profiles in patients with allergic rhinoconjunctivitis due to cat allergy 7
- Immunotherapy with Fel d 1 (major cat allergen) has been developed in several forms, including hypoallergens and peptide immunotherapy 8
Environmental Control Measures
- Use mattress and pillow encasings (less than 10 μm pore, fine weave, or vapor-permeable covers) 1
- Wash bedding weekly in hot water (greater than 130°F) 1
- Vacuum clean weekly using a vacuum with high-quality bags (double-thickness or HEPA filter) 1
- Replace upholstered furniture with leather, vinyl, or wood when possible 1
- Replace carpets with polished wood flooring 1
- Replace draperies with washable shades or blinds 1
Common Pitfalls to Avoid
- Short-term trial removal of pets (days or weeks) may be misleading due to persistent allergen 1
- Relying solely on medication without environmental control measures limits treatment effectiveness 2
- Assuming that certain cat breeds are "hypoallergenic" - all breeds produce Fel d 1 allergen 1
- Underestimating the persistence of cat allergen, which can remain at significant levels for months after cat removal 1