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Bites and Stings
The A-Bee-C’s of Acute Allergic Reactions
Recently, Pickle (the puffy-faced puppy) suffered an acute, but not life-threatening, allergic reaction.

I kicked off my Saturday morning shift by treating the cutest puffy-faced puppy; he was experiencing his first acute allergic reaction. Like many dog owners, this puppy’s mom had never witnessed this kind of sudden reaction, and arrived at our ER in a panicked and perplexed state exclaiming, “he was normal just a minute ago!”

Acute allergic reactions are a common emergency, and the culprits are generally bees, wasps and spiders. This typically happens when our curious canines can’t resist a good sniff and inspection of the interesting creature moseying along the ground or floor.

Bites and stings can cause clinical signs that range from mild to life-threatening reactions. Mild reactions are generally limited to a swollen or puffy face, swelling and redness around the eyes, lumps and bumps over the skin, redness of the skin, head shaking and itchiness.

Severe reactions are called anaphylactic reactions, which are nearly immediate and can lead to life-threatening alterations in the body. These symptoms can include vomiting, diarrhea, staggering, pale gums, swelling of the larynx leading to difficulty breathing, and sudden collapse. Most pets that I see for anaphylaxis are reported to have vomited once followed by collapsing, and when I perform my physical exam, I generally observe pale gums and a poor pulse indicating a state of shock.

Veterinary attention is required if your pet is showing any signs of an allergic reaction. While seeking medical care, follow these steps:  

What to Do:

A” is for assist: If your pet was stung, see if the insect and stinger are still attached. If so, try to remove the stinger by scraping it out with a credit card or other stiff material. Alternatively, use tweezers by grasping the stinger, which is located below the venom sac.

When a honeybee stings, its stinger becomes detached from its body and the bee then dies. What’s left in the pet’s body is the stinger and a tiny piece of fleshy looking tissue, which is the venom sac. (Here’s a short video demonstration.) Wasps or bumblebees, on the other hand, can sting over and over again because their stingers do not become detached from their bodies.

B” is for baking soda: To help neutralize some of the acidic venom, apply a paste mixture of baking soda and water to the sting area.

Cis for cool compress: Apply a cool compresses to the area to help reduce the swelling and pain, as well as to help with constricting the blood vessels to “slow” the spread of the insect venom.

Have your pet examined immediately by your veterinarian if there are any signs of facial swelling, vomiting, breathing difficulty or collapse. Mild clinical signs can progress to severe clinical signs in a short period of time and early treatment will generally prevent continued progression of the reaction

What NOT to Do:

  • Do not administer any medications without first contacting your veterinarian or a veterinary emergency hospital. A veterinarian will need to examine your pet before recommending medications.
  • If the sting just happened, be careful not to put pressure on the venom sac during its removal, as this will inject more of the venom into your pet.

Can Anaphylaxis be Prevented?

In general, there is no way to predict which animals will have an allergic reaction, whether it will be mild, or whether it will progress to life-threatening anaphylaxis. Some pets have no reaction to a sting one time, and then have a severe reaction the next. The  “Bee Gods” are not kind to my own baby girl, and one hones in on her bald little butt at least three or four times a year. Luckily, she has yet to develop a reaction.

For animals who do have an established history of being allergic to insect bites, I often get asked about giving Benadryl, which is part of the treatment protocol in allergic reactions. In the hospital setting, Benadryl is given by injection into the muscle, which works much faster than giving the medication orally. However, owners who are out on hikes and away from veterinary care often raise the concern about needing more immediate treatment. In these cases, you can carry with you, and give if needed, one milligram of Benadryl for every one pound of body weight (for example, a 50-pound dog can get 50 mg of Benadryl). This is not a substitute for veterinary care, but it can be helpful at “buying time” as you make your way to your veterinarian for evaluation. 

You can also ask your veterinarian about getting a prescription for an “epi-pen” if your pet has experienced a true anaphylactic reaction in the past. This is a special syringe and needle filled with a single dose of epinephrine, and is similar to the type used for people who are highly allergic. You can carry this with you on trips or hikes and use if your pet experiences another severe reaction. 

If you suspect your pet is experiencing a reaction from an insect bite, whether it is mild or severe, please contact your veterinarian or local emergency hospital for guidance and advice. 

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Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.

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Submitted by Frances | September 15 2011 |

Very helpful article - but I thought wasp stings were alkaline, and therefore need an acid - such as vinegar - to neutralise them.

Submitted by Shea Cox | September 16 2011 |

Hi Frances! Thanks for the comment! With regards to your question:

Wasp stings can very loosely be considered "alkali," but the venom actually contains up to 13 different antigens, making it unlikely that the small alkali component is the single active ingredient in the venom that causes the pain. Therefore, neutralizing a wasp sting with vinegar doesn't really work when you consider the multiple components of the venom.

If we get into the nitty-gritty technicalities, a similar "argument" can be made for bee stings as well, but the use of topically applied baking soda/water is actually listed in the veterinary medical literature, and I have found it to work on myself as well. I have not found any such references for wasp stings.

Thank you for your thoughtful question and I hope this helps :)

Submitted by fredcredible | September 21 2011 |

Great advice. I love your passion for dogs!

Submitted by Shea Cox | September 29 2011 |

Wow! Thanks, Fredcredible! You just made my day :)

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