Venom immunotherapy gains ground as a preventive option for sting-allergic dog

With the UK’s only canine VIT service reporting rising demand, first-opinion teams are starting to play a part in delivery, and cases are being identified in horses and cats as well as dogs.

Hymenoptera venom immunotherapy (VIT) could move from a niche specialist procedure towards a more mainstream option for dogs at risk of anaphylaxis from bee and wasp stings, according to the clinician leading the UK’s only service.

The University of Glasgow Small Animal Hospital, one of a handful of centres worldwide offering the treatment, has so far treated a small number of dogs successfully. Professor Ana Rostaher, who leads the programme, says enquiries are increasing from both UK and overseas vets and owners, and she expects the therapy to become far better known and more widely offered in the coming years.

Why recurrence is the real concern

Sting allergy is among the most serious acute allergic conditions in dogs. Signs can appear within minutes and, in a minority of cases, progress from urticaria and vomiting to collapse, respiratory compromise and death.

The bigger issue for clinicians is what happens next time. A 2024 study involving the Glasgow team found that almost two-thirds of dogs with a severe systemic reaction had equal or more severe signs after later stings, while more than 40% of dogs with only local reactions progressed to a systemic reaction on re-exposure. Dogs under two years old, those under 10kg, purebreds and dogs stung in the mouth were at greater risk.

Separate data also challenge the idea that this is purely a summer problem: reactions have been recorded in every month except December and January, so vigilance is needed for most of the year.

How VIT works

Adapted from an established human therapy, VIT is the only disease-modifying treatment for venom allergy. Controlled, gradually increasing doses of the relevant venom are given to build tolerance and reduce the chance of a further severe reaction.

Treatment begins with allergy testing to confirm whether bee venom, wasp venom or both are implicated. A closely supervised induction phase follows, then maintenance injections that may continue for several years, and in some cases for life.

Because the approach targets the underlying immune response rather than managing each episode as it occurs, it offers something that antihistamines, corticosteroids and adrenaline cannot: a lasting reduction in risk for patients with confirmed venom allergy.

Evidence so far

Prof Rostaher was lead author of a 2023 prospective study in Animals assessing the safety and efficacy of VIT in allergic dogs. The university reports that published research and its own clinical experience indicate many treated dogs gain strong protection against repeat anaphylaxis, with a favourable safety profile when therapy is overseen by specialists.

Wider access on the horizon

Although Glasgow remains the only UK provider, the team has already supported a vet and owner in the south of England so that treatment could be given closer to home. This shared-care approach could make VIT a realistic option for patients living far from Scotland.

Access may broaden further, as a major pharmaceutical company is understood to be developing venom allergen products, which could raise awareness among practitioners and make treatment easier to obtain.

Not just a canine problem

Dogs appear to be affected most often, but sting-allergic horses and cats are also being identified. Prof Rostaher has worked with clinicians in Hungary on what is believed to be the first use of venom immunotherapy in a horse.

To better understand the scale of the problem, the Glasgow team is working with a diagnostic laboratory to map how widespread venom allergy is across Europe and across species.

What it means for practice

For first-opinion vets, VIT is worth raising with owners of dogs that have had a severe systemic reaction, or reactions that are escalating in severity. Recording the suspected insect, clinical signs and speed of onset will help specialists judge whether a patient is suitable for testing.

Owners should understand that treatment is a long-term commitment, with frequent visits during induction and regular maintenance injections thereafter, so cost, travel and compliance are worth discussing at the outset. Emergency planning and education on the early signs of anaphylaxis remain essential, whether or not a patient is referred.