Allergy to the cat - from diagnosis to management

Background: In allergology practice, efficient counselling of cat owners is often frustrating because the topic of allergen avoidance is mostly a “no-go” and there are only few studies on allergen immunotherapy that prove its efficacy. In the end, what patients are mostly offered in allergy consultations are allergen reduction measures and symptomatic therapy. Results: Sensitisation to the main cat allergen Fel d 1 occurs more frequently in atopic conditions and then represents a risk for allergic rhinitis and asthma. Current guidelines are therefore cautious about the first-time acquisition of a cat in the first months of life in atopic families. However, sensitisation occurs in many cases even without contact with an own cat at home. Conversely, it has been observed in adult patients that in the case of high Fel d 1 exposure immunological tolerance can also develop through the induction of specific IgG4. The fact that many cat allergic patients keep their animals despite diagnosis is, however, partly due to the psychological phenomenon of coping. Conclusion: In this review, we present current literature and facts that should make everyday life easier for patients, even without giving up the animal. We also review best practices in the management of cat allergy and present new management options and concepts from the development pipeline that our patients are eagerly awaiting.