PET ALLERGIES: ASK THE DOCTOR: CAN WE KEEP THE FAMILY CAT WHEN OUR TODDLER IS ALLERGIC?

Q: Our toddler seems to be developing an allergy to our family cat. We've been told that the best solution is to get rid of the animal, but our pet is a part of our family. We cannot bear the thought of finding her a new home. What other options are there? Is there a way to keep our pet with us and keep the allergies under control?

A: I share your concern about finding a new home for a member of your family. As a pet owner myself, I understand that dogs and cats are members of the family.

First, the good news: Your toddler is actually too young to have developed an allergy to things in the air like cat allergen. Most experts agree that it takes a child's immune system two to three years of continuous exposure to an allergen to provoke the immune system to make allergic antibodies, and the immune system is too immature to respond to allergens in a child less than 6 months old.

Based on your question, I'll assume your toddler is experiencing symptoms of nasal allergies (such as sneezing or a runny nose). At this point, I would refer to your toddler's symptoms as a pre-allergic condition. The not-so-good news - if your child is genetically predisposed to have allergies, it is likely they will develop between the age of 4 and 5. If both parents have allergy or asthma symptoms, the odds are greater than 50 percent that your child has the genes to develop allergies as well. If neither of the child's parents have nasal allergies, perhaps other exposures, such as those found in day care, are causing your child's "allergy" symptoms.

The person giving you the advice to get rid of the cat likely knows that cat dander is a very potent allergen, but that is only part of the story. Statistics show 90 percent of animals that are removed from a home at the direction of a physician are eventually euthanized. Unfortunately, most physicians, when they advise a family to remove a pet from the home, do not realize this. In addition, finding your pet a new home would only take care of part of the problem. Cat allergen remains at unabated levels for six to 18 months after a cat leaves the home, and routine cleaning, steam cleaning and shampooing the carpets does not rid a house of cat allergen. In fact, the best way to remove cat allergen after a cat leaves is to remove the carpeting, curtains and overstuffed furniture. Tannic acid solution is commercially available and has been shown to accelerate the decline in cat allergen in homes, but tannic acid is the same chemical used to stain and weatherize boots, and it tends to make items look and smell like a boot.

Here is my advice to parents of children who suspect their family member may be allergic to a cat. First, see a board-certified allergist who will not only perform accurate testing, but also collect a complete medical history. Allergists specialize in diagnosing and treating allergies, and can perform skin testing, a special type of allergy testing that can provide very accurate results when interpreted with your child's symptoms.

If your child is confirmed to have cat allergy, there are options other than getting rid of the cat. First, if at all possible, the cat should become an outside pet; this will substantially reduce the cat allergen levels in your home. If it isn't possible for your cat to become an outside pet, absolutely keep the cat out of your child's bedroom. Bathing the cat weekly has been shown in research studies to reduce the cat allergen in homes. Most cats will tolerate bathing if you begin bathing them when they are kittens. If it is too late for that option, there are commercial cat-bathing devices available, which have the water rise slowly from the bottom, allowing the cat to tolerate the bath better.

I also recommend high efficiency vacuum cleaners for people who are allergic to cats but have one in their house. Unlike other allergens that go to the ground within 30 minutes of turning off a vacuum cleaner, cat allergen may remain in the air for several hours after turning off the vacuum cleaner, so your child should stay out of the house during this period. I would suggest a vacuum cleaner with a HEPA filter and avoid a water trap vacuum cleaner since water does not trap microscopic allergens, only dirt.

Next, absolutely do not allow any additional cats into your home. When the current cat goes to "kitty heaven", don't replace "Fluffy" with another pet. I followed this bit of my own advice after one of my children developed an allergy to a feline member of my family.

A variety of medications and treatments can be used to control allergies. Typically, nasal allergies are controlled with prescription nose sprays such as Nasonex (approved for children 2 and older), Flonase (approved for children 4 and older) and Nasacort AQ. (Oral antihistamine medicines tend to be relatively ineffective in controlling nasal allergies.) Patients with asthma will need to be treated with inhaled cortisone as well, to control symptoms. Immunotherapy or allergy shots to cats are quite effective. At least initially, injections would need to be given on a weekly basis in a physician's office, and the shots would need to be maintained for a minimum of two to three years.

However, even if all cat allergens are removed from your home, your child will still be exposed to cat allergen on a daily basis. Significant quantities of cat allergens are found in many places where cats have never been, including hospitals, schools and doctor's offices. If a child has a cat allergy, it is likely — even if living in a new home that has never been shared with a cat — symptoms will continue and some form of treatment will be needed.