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Our Nina has had this happen on three or so occasions. We keep a bottle of Children's Benedryl on hand at all times because of this.
They have never been able to pinpoint the exact cause, in her case we are sure it was something she ate each time. One time she may have gotten a small piece of chocolate. Other than that we aren't clear as to what caused it.
She responds to one dose, that is 3 ml of the Benedryl, and we have never had to give her a second dose, or had to get her the cortisone shot. But I can always tell when it is coming. She starts to shake, then sometimes vomits, then the spots start coming out.
Very very scary times.
 

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Wanted to add..definitely get the liquid, and use a syringe or eye dropper. I fill it to a little past the 3 ml line, because she usually spits a good amount out..not her favorite thing by a long shot,lol. It usually takes two of us to give it, one to hold her still, one to put it in, but even though she hates it, it is way better than the alternatives.:(
 
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