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. 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 said as 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 really 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 where I was being 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 therapeutic 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 to keep things in check.
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 insist on keeping 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 in individuals. I also know that it frustrates many doctors when they find that a good number their 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 asked for lifestyle changes. For many patients, such emotional factors can outweigh the unpleasantness of their physical symptoms.
The research which 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 years. The criterion for selecting this particular group of people was that they had been diagnosed as having allergies which were severe enough so that their doctors had specifically advised them to stop sharing their living quarters with their pets.
Because I know how strong the emotional bond is that people develop with their pets I expected that a good number of these people would not go along with their doctor's request. However, even though I had 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 extremely low. Only 21.4% (a bit more than one out of every five people) actually rid themselves of pets or stopped allowing them inside their homes. 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 were not complying with their doctor's instructions were probably reasoning something like "I'll just keep Fido around for as long as he lives, but afterward I won't get another dog in order to control my allergies."
I suppose that the real surprise to me was that my expectations turned out to be an underestimation the importance of pets in the lives of a lot of people. The bond between people and their dogs is simply too strong, and it appears that for the majority of people the idea that once a well-loved dog has passed might imply that they will not be able to have another dog to keep them company is simply unthinkable — even if there is a medical recommendation which says 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 dog allergies and the advice of their physician, the notable finding was that 70.5% (more than two out of every three patients, had actually replaced the deceased animal with a new dog. Apparently, pets are sufficiently important to the lifestyle of many individuals so that they are willing to ignore both chronic allergic symptoms and specific medical instructions in order 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 would make a good compromise choice since at least some of the allergic symptoms would be reduced. These include dogs with hair rather than fur. The difference is that 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 so that reduces the problem. 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 dog fur, and that means there will be less dander from them 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, namely the Coton de Tulear and the Havanese.
In the end, all that I could suggest to this woman was that she had to make an assessment as to whether the emotional gain from the companionship associated with living with her dog is sufficiently valuable so that it offsets the continued physical discomfort caused by ongoing allergic reactions. I pointed out to her that that is what I have done. That means that I sniffle and wheeze but still carry on my life with a pair of dogs to comfort and entertain me in my home.
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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.