What People Do When the Doctor Says "Get Rid of the Dog!"
When doctors tell allergic patients to get rid of their dogs, most don't comply.
Posted Oct 25, 2018
I was walking across campus when I heard someone call my name. I turned to see a woman in her mid-20s approaching me with a midsized black Labrador retriever on a leash beside her.
"I recognized you from something which you did on television and was wondering if I could ask you a question," she said. "Just a couple of days ago I was at my doctor's office and he told me that my respiratory allergies were sufficiently bad that his recommendation was that I would be better off if I were no longer living with a dog in my house. But Emma is my soulmate." She nodded in the direction of the dog. "Letting her go would be like abandoning a family member, and I really can't tolerate the idea of living in a house without a dog. My husband says that he will stand by whatever decision I make, but the doctor is insistent, and he is the doctor. What do other people do when they are faced with a similar situation?"
I know exactly what that woman is going through, since it turns out that I have respiratory allergies myself, namely to dogs and dust — and of course the former bring a lot of the latter into the house. I went through a number of years of treatment when I was given shots of serum in an attempt to desensitize me to these allergies. The allergist actually went on a year longer than is usually recommended for such a regime; however, the effects were still minimal and I continue to wander around my dog-and-dust-filled house with a runny nose, occasional bouts of coughing, and a pocket full of antihistamines.
Perhaps it was due to my own condition that a number of years ago I did some research to look at people who are allergic to dogs but keep them anyway. Physicians often suggest lifestyle changes to their patients as part of medical treatment. Such changes are particularly important when confronted with certain conditions, such as controlling exposure to known or environmental factors that trigger allergic responses. I also know that it frustrates many doctors when they find that a good number of patients fail to comply with their instructions about eliminating such potential sources of allergens. Psychologists know that failure to comply with a physician's recommendations on such matters can be understood when there are emotional consequences to making the prescribed changes. For many patients, such emotional factors can outweigh the unpleasantness of physical symptoms.
The research I undertook involved some data collection during the course of a much larger study on the health consequences of particular lifestyles. I managed to isolate a sample of 341 adults who had been diagnosed as being allergic to dogs. Their average age was around 38. The criterion for selecting this particular group was that they had been diagnosed as having allergies severe enough that their doctors had specifically advised them to stop sharing their living quarters with their pets.
Because I know the strength of the emotional bond that people develop with their pets, I expected that a good number of these people would not go along with their doctors' requests. However, even with that expectation, I was extremely surprised to find how few people actually complied. The percentage of individuals acting upon their doctor's instructions to remove their pets from their household was only 21.4 percent. Of course, this low level of compliance might be explained by the fact that there is such a large emotional investment in their currently owned dog. There is a lot of evidence which suggests that a pet dog is often viewed as equivalent to a family member. It seems reasonable to think that many of the people who did not comply with their doctors' instructions were probably reasoning, "I'll just keep Fido around for as long as he lives, but afterward I won't get another dog, to control my allergies."
I suppose that the real surprise to me was that my expectations turned out to be an underestimation of the importance of pets in many people's lives. The bond is simply too strong, and it appears that for the majority of people the idea that the passing of a well-loved dog might imply that they will never have another dog to keep them company is simply unthinkable — even if they have a medical recommendation that they should not be living with a dog. This was confirmed in my data. In my sample of participants, I found a subset of 122 individuals for whom the diagnosis of a dog allergy had been made sufficiently long ago so that the animal that they were living with at that time had, by then, died. In this group, despite the presence of allergies and the advice of a physician, the notable finding was that 70.5% had actually replaced the deceased animal with a new dog. Apparently, pets are sufficiently important to the lifestyle of many individuals that they are willing to ignore both chronic allergic symptoms and specific medical instructions to continue to live with them.
Unfortunately, I did not have data on the specific type of dogs that these individuals replaced their late pet with. There are dogs that are relatively hypoallergenic which could make a good compromise choice, since at least some allergic symptoms would be reduced. These include dogs with hair rather than fur. (Fur grows to a particular length and is then shed, and when that happens it brings a bit of dander with it. It is the dander which is the principal allergen. In contrast, hair grows continuously and does not shed.) Dogs with hair include Poodles, Portuguese Water Dogs, and Irish Water Spaniels. Terriers with double coats (a hard outer coat and a softer inner coat which tends to trap the dander) are also less likely to trigger allergic symptoms. These include the Airedale, Bedlington Terrier, Cairn Terrier, Fox Terrier (wire-haired), Kerry Blue Terrier, Scottish Terrier, Sealyham Terrier, Silky Terrier, Soft Coated Wheaten Terrier, Welsh Terrier, West Highland White Terrier, and Yorkshire Terrier.
In general, smaller dogs are preferable, since a smaller dog means less fur, and less dander when they shed. Even among small dogs, some breeds are known for being particularly hypoallergenic including the Bichon Frise, the Maltese, and two breeds derived from it — the Coton de Tulear and the Havanese.
In the end, all that I could suggest to this woman was that she make an assessment as to whether the emotional gain from the companionship with her dog is sufficiently valuable that it offsets the physical discomfort of her allergic reactions. I pointed out to her that that is what I have done. I sniffle and wheeze but still carry on my life with a pair of dogs to comfort and entertain me.
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Coren, S. (1997). Allergic patients do not comply with doctor's advice to stop owning pets. British Medical Journal, 314, 517.