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Food Allergies
In Dogs
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Food allergy is where the immune
system reacts to one
or more ingredients within your pet's diet as if it isn't safe. Food
allergy typically causes
non seasonal itchiness (scratching, biting, chewing, licking, rubbing,
etc.).
Your pet may also exhibit hair loss and may be prone to developing
secondary
yeast and/or bacterial infections of the skin. Chronic ear infections
and
anal gland infections may also be seen. Some pets may also show
gastrointestinal
signs such as vomiting, diarrhea, burping, flatulence (gas) and/or have
a
sensitive stomach. \a severe allergy can cause a life threatening
reaction, such as anaphylactic shock. Blood and skin tests are
available for food allergy diagnosis,
however these tests are considered very inaccurate and are not
recommended
by most veterinary dermatologists/allergists. A strict food elimination
diet
trial is the best "test" for food allergy diagnosis.
Food intolerance does not
involve the immune system and isn't generally life threatening, but it
can make your pet feel ill and can affect their long term health.
Symptoms include vomiting and diarrhoea.
Food Allergies
Food Allergy Trials in Dogs
Food
Allergies
(Only some of the captioned signs are usually
present in a given animal, not necessarily all.)
Your Pet's Itchy Skin
Itchy skin in the
small animal is often more than just a minor annoyance. Red, oozing
bald patches, rashes, and
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The classical canine food
allergy lesion distribution includes signs of facial itching, foot or
limb chewing, belly itching, and recurrent ear infections
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large expanses of hair loss
are unfortunate markers of very real discomfort for which a cause
should be sought and specifically dealt with.
The food allergy is one of the itchiest conditions known to cat and
dog. Animals eat a variety of processed food proteins, fillers, and
colorings which are further processed inside their bodies. Proteins may
be combined or changed into substances recognized by the immune system
as foreign invaders to be attacked. The resulting inflammation may
target the GI tract or other organ systems but, in dogs and cats, it is
the skin that most often suffers from this immunologic activity.
Many people erroneously assume itching due to food allergy requires
a recent diet change of some sort. In fact, the opposite is true.
Food allergy requires time to develop; most animals have been eating
the offending food for years with no trouble.
What Kind of Allergy?
Sarcoptic mange and inhalant allergy (also known as atopy) are the two
conditions which must be distinguished from food allergy as the
treatment approach to each is markedly different. Much time and money
can be wasted pursuing the wrong the problem.
Please consider the following clues which contribute to pointing us
towards the food allergy as a diagnosis.
Your pet demonstrates:
Your pet has been treated for sarcoptic mange without any positive
change.
Your pet's itchiness is not and has never been a seasonal problem.
Your pet has responded poorly or only partially to cortisone-type
medications.
Your pet has had a skin biopsy demonstrating changes often associated
with allergy or, more specifically, food allergy.
A lesion distribution pattern which is common for food allergy (see
illustration at top of page)
Please note that three of the above four criteria relate to what you,
the owner, observe at home. Trouble results when the veterinarian must
speak to different family members about the pet and there is
disagreement
in their observation of the pet at home. It is best to have one person,
preferably the one who has the most contact with the pet, be the
spokesperson
and make the relevant judgments.
The Flea Factor
Some animals have many allergies. It would not be particularly unusual
for an animal with a food or inhalant
to also be allergic to flea bites, especially considering that flea
bite allergy is an extremely common allergy among pets. Because
allergies
add to each other, it is possible that a food allergic dog will not
itch
if its fleas are controlled. Since new technology has made flea control
safe and convenient, it is especially important (and no longer
difficult)
to see that fleas are not complicating a pet's itching problem.
Ensure immaculate flea control for any itchy pet!
For more information on flea biology and flea control, visit the
special site prepared by the Iowa State Veterinary College: http://www.vetmed.iastate.edu/services/vth/clinical/derm/flea/
How to Deal with the Food Allergy Suspect: The Hypoallergenic Diet
Trial
The Basic Principle
To determine whether or not a food allergy or intolerance is causing
the skin problem, a hypoallergenic diet is fed for a set period of
time. If the pet recovers, the original diet is fed for up to two weeks
to see if itching resumes. If we see recovery with the test diet and
itch with the
original diet, then food allergy is diagnosed and the pet is returned
to
either the test diet or another appropriate commercial food
indefinately.
What Is a Good Hypoallergenic Diet?
There are two approaches to this question. Obviously, the test diet
must be of a food source that the patient could not possibly be
allergic
to. The traditional method is the use of a novel protein and
carbohydrate
sourse; that is, something the pet has never eaten before. In the past,
lamb has been the protein source of choice as American pet food
companies
had traditionally failed to produce lamb-based pet foods.
Unfortunately,
recent production of lamb and rice-based foods have removed lamb from
the
acceptable hypoallergenic diet list.
Fortunately, many pet food companies have discerned the need for diets
using unusual protein and carbohydrate sources with a minimum of
additives. Foods can be obtained based on venision and potato, fish and
potato, egg and rice, duck and pea, and even kangaroo. Our hospital
generally recommends duck and potato based foods for dogs and duck and
pea based foods for cats. We have chosen these products because
they are available both as canned as well as dry formulas. (Most pet
owners prefer to feed a combination of dry and canned food.)
It is important that during the diet trial no unnecessary medications
be given. No edible chew toys (such as rawhides or bones) should be
given. Treats must be based on the same food sources as the test diet.
(Beware of rice cakes, though, as wheat is commonly used as a filler.)
Chewable heartworm preventives should be replaced with tablets.
Home cooking was originally the only option felt to be appropriately
free of allergens but for most animals these special commercial foods
are adequate. Occasionally home cooking ends up being necessary
after all.
The Hydrolyzed Protein Method
Recently a new approach has been introduced using therapeutic diets
made from hydrolyzed proteins. This means that a conventional protein
source is used but the protein is broken down into molecules too small
to excite the immune system.
How Long to Feed the Trial Diet
In the past, 4 weeks was thought to represent a complete trial period.
More recent work has shown that some food allergic animals require 8 to
10 weeks to respond. This may be an extremely inconvenient period of
time for home cooking. Our current recommendation calls for a recheck
appointment or phone call after four weeks of diet trial and then again
after eight weeks of trial. Eighty percent of food allergic dogs will
have responded to diet trial at least partially by six weeks. The
Labrador retriever and cocker spaniel appear to require up 10 weeks of
trial diet before showing a response. Some animals may even require a
longer period.
All commercial diets mentioned have a 100% guarantee. This means that
if your pet doesn't like the food, the food can be returned for a
complete refund (even if the bag is opened). This is especially helpful
for feline patients, as cats are famous for being choosy about what
they are willing to eat.
What to Do if the Diet is Successful?
To confirm food allergy, return to the original food; itching resumes
within 14 days generally if food allergy was truly the reason for the
itchy skin. Many people do not want to take a chance of returning to
itching
if the patient is doing well; it is not unreasonable to simply stay
with
the test diet if the pet remains free of symptoms.
It is possible to more specifically determine the identity of the
offending foods after the pet is well. To do this, a pure protein
source (such as cooked chicken, tofu, wheat flour or any other single
food) is added to the
test diet with each feeding. If the pet begins to itch within 2 weeks,
then
that protein source represents one of the pet's allergens. Return to
the
test diet until the itching stops and try another pure protein source.
If
no itching results after two weeks of feeding a test protein, the pet
is
not allergic to this protein.
What to Do if the Diet is Unsuccessful?
Generally, an unsuccessful food trial is strongly suggestive that an
inhalant allergy is really the primary problem but there are some other
considerations that should at least be mentioned: Are you certain that
the
dog received no other food or substances orally during the trial? Was
sarcoptic
mange ruled out? Your pet may require a longer diet trial. Are you
certain
regarding the factor that pointed us toward the food allergy? If your
pet
has not been biopsied, now may be a good time. If an inhalant allergy
has
risen to the top of the list, symptomatic relief either via medication,
special
baths, or allergy shots will likely be necessary. Chronic itchiness can
be
extremely uncomfortable and prompt relief is the goal.
Copyright
2007 - 2008 by the Veterinary Information Network, Inc. All rights
reserved.
This work was originally published by
Veterinary Information
Network, Inc. (VIN) and is republished with VIN's permission.
*************
Food Allergy Trials in Dogs
Dr. Donna M. Raditic, DVM
Objectives
What are some of the signs of a food allergy?
How does your veterinarian select a diet for a food allergy trial?
What diets are currently available for a food allergy trial?
What pitfalls can occur during a food allergy trial?
What Signs can be seen with a Food Allergy?
A food allergy is a reaction to food that involves the body’s
immune system. It is usually always a protein particle in the
food that is responsible for reactions. Your dog may itch, lick,
and chew paws, flank, groin, neck, and ears. The itching can be
during all seasons. A small percentage of food allergy dogs may only
have chronic otitis. The dog may also have some gastrointestinal
signs such as chronic vomiting, diarrhea, belching, and frequent bowel
movements. Food allergy dogs often have both varying degrees of
skin signs and gastrointestinal problems that persist.
How Does your Veterinarian Select a Diet for a Food Allergy Trial?
With this information an appropriate diet can be selected for the food
trial. Your veterinarian will first want a complete medical
history. The most important information you will need to provide
is a thorough history of what foods and treats your pet has
eaten. This includes table scraps and chew toys with food
flavorings.
The diet selected will contain a “novel” protein and carbohydrate
source meaning that your dog has not eaten this protein source in the
past. Your veterinarian may recommend a food allergy trial based on
skin and possible gastrointestinal signs.
What Diets are Currently Available for a Food Allergy Trial?
Commercial diets sold “over the counter” may claim to be
“hypoallergenic” or “good for sensitive skin.” It is important to
realize these claims have no official meaning. These diets can be
misleading because the pet food companies do not have to list every
ingredient on the label. Close inspection of the label can identify
inappropriate proteins and the manufacturer can substitute other
ingredients as long as they meet the guaranteed analysis. It is
best to use the diet your veterinarian has selected for a proper food
allergy test.
Diets that are used in food allergy trials are in one of these
categories:
Prescription Diets
Low Antigen Diets
Home Made Diets
Prescription diets are made by pet food companies to specifically and
always contain the same ingredients. The protein source and
carbohydrate source never change in these food allergy diets.
These diets are only available through veterinarians. They are
formulated to treat a medical condition, in this case, food allergies.
The protein(s) in a diet that can be responsible for food allergy signs
are called antigens. Low antigen diets are also prescription
diets. In these diets, the protein has been formulated (hydrolyzed) to
be so small that it will not stimulate the immune system. The
diet may also have used small carbohydrates as well to avoid the
potential immune response to proteins in the carbohydrate component of
the diet.
Some of the current examples of these diets made by specific pet food
companies are listed below. Again your veterinarian will need to
carefully evaluate your dog’s dietary history and any other current
medical
issues to select the best diet for the food allergy trial.
Hill’s Diets:
Prescription diets:
D/D canned/dry- salmon & potato/rice
D/D canned/dry- duck & potato/rice
D/D canned/dry-venison &potato/rice
D/D dry – egg & rice
D/D canned-lamb & rice
Low Antigen diets:
Z/D Ultra Allergen Free dry and canned-hydrolyzed chicken and refined
starch
Z/D Low Antigen –dry and canned-hydrolyzed chicken and single source
carbohydrate (potato)
Purina Diets:
Low Antigen diets:
LA Limited Antigen dry-salmon and rice
HA hypoallergenic dry-hydrolyzed soy
Iams Diets:
Prescription diets:
Response FP dry and canned-fish and potato
Response KO dry-kangaroo, canola meal, and oat flour
Royal Canin:
Low Antigen diet:
Hypoallergenic HP 19 dry-hydrolyzed soy and rice
Prescription diets: (IVD)
Potato and Duck dry and canned-duck protein and potato (also has light
formula)
Potato and Rabbit dry and canned- rabbit protein and potato
Potato and Venison dry and canned- venison protein and potato (has
large breed formula-dry)
Potato and Whitefish dry and canned-whitefish protein and potato
If your pet will not eat one of the above diets, or has a concurrent
medical issue that prevents the use of these diets, then a home made
diet may need to be used. Home made diets usually contain a novel
protein source (for your pet) and a carbohydrate. A home made
diet recommended for your dog can not be fed long term. It can be
fed for the length of a proper food trial without any concerns. It is
not formulated to be a long term complete and balanced diet for your
dog because it is deficient in necessary nutrients.
Your veterinary may consult a veterinary nutritionist to formulate this
diet. The diet initially contains only two ingredients: a protein
source and a carbohydrate source. Some of the protein and
carbohydrate
sources a veterinary nutritionist may select from include:
Protein Source
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Carbohydrate Source
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Tuna
Salmon
Pinto
Beans
Rabbit
Game
Meats
Garbanzo (chick peas)
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Yams
Sweet potatoes
Pumpkin
Oats
Barley
Quinoa
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Common Food Trial
Pitfalls
The hallmark or a successful
food is feeding only the prescribed diet for the required period of
time. There are many pitfalls that can occur during a food allergy
trial. These pitfalls must be avoided or the food allergy trial
will be inconclusive. You and your veterinarian will be unable to
determine whether your dog does indeed have food allergies.
The most common pitfalls in food allergy trials include:
1. The client does not understand why the veterinarian
has recommended a feeding trial, how the feeding trial will be
conducted,
their role in completing the food allergy trial properly, and the
ultimate
goals of the trial.
IDEAS:
Your veterinarian must communicate the specific reasons for a
conducting a food allergy trial and outline how to complete a proper
food allergy trial. Expectations and goals should be clearly
expressed.
Schedule request recheck exams and/or phone progress reports
The veterinarian should provide other sources of current information
about food allergies and food allergy trials.
The owner should feel comfortable asking questions throughout the trial.
2. Feeding your dog any type of snack or chew toy with food
flavoring can affect the length and success of the food trial.
This mistake may not be just the owner, but can include visitors,
relatives, delivery men and children.
IDEAS:
Use pieces of the dry kibble (if a dry diet is used for the food trial)
in a Kong to provide snacks, entertainment and chewing.
If a canned diet is fed, take slices of the canned diet and bake them
into dry snacks.
Inform visitors that your dog is on a strict diet and cannot be given
any other foods except the diet that has been prescribed. Give
visitors prescribed kibble or your baked can treats to feed.
When visitors crate the dog or put the dog in a place with no access to
visitors.
Family members must understand the food allergy trial and realize the
importance of absolutely no snacks.
If senior relatives are home with the dog, send the dog to play groups
or take the dog to work if possible. Give the relative only
acceptable treats. Again, relatives must be a part of the effort
to complete the food allergy trial
3. In a multiple pet house you must prevent the patient
from eating the other dog’s food. If there is a cat in the
household, eating the cat food will disrupt the food trial.
IDEAS:
Stand over the dogs or separate the dogs when they are fed.
Feed the other dogs(s) a very palatable diet that they will eat
immediately. This may limit left over food for the patient to get
into. Still, remember the feces will need to be picked up
immediately. Even a small lick of an inappropriate food can potentially
be a pitfall in a food allergy trial.
If possible, put all the dogs on the new diet.
Put the cat food up out of the dog’s reach. Place the cat food in
a room a small enough entrance that only the cat can gain access to the
food.
Avoid or stop free feeding all pets in the household so inappropriate
food access in controlled.
4. The dog is given flavored medication such as chewable
heartworm pills, flavored antibiotics or anti-inflammatories. The
dog may also be given a flavored vitamin mineral supplement, joint
supplement or coat supplement.
IDEAS:
Flavored heartworm preventatives will be replaced by an acceptable
nonflavored pill, topical. or possibly an injection.
Be sure to ask your veterinarian before giving any supplements or
medications during a food allergy trial.
If your dog is treated at an emergency clinic where the veterinarian is
not familiar with your dog’s history, be sure to let them know the dog
is currently on a strict food allergy trial. Inform them what
diet the dog is eating.
5. The dog is not confined and wanders. This patient will
be able to get into the garbage, compost piles or the neighbor may feed
him treats.
IDEAS:
Keep your dog inside.
Be sure your own garbage is not within the dog’s reach.
6. You do not want to continue with the feeding trial because
you do not see any improvement in you dog’s condition.
IDEAS:
Schedule an examination with your veterinarian to discuss your
concerns. Your veterinarian has recorded the initial signs and
reasons for starting the food trial. Your veterinarian may note
and document improvements in your dog. These improvements may be slower
than you would prefer or expected. Your veterinarian can give you more
information and the encouragement you need to complete the food trial.
Take photographs of your dog before you start the feeding trial and
then biweekly to monitor your dog’s progress. You can also keep a diary
if the dog has had gastrointestinal reactions to food.
You must be aware that a complete food trial can take 12 to 16 weeks so
your patience and persistence are needed.
7. You read or were told by a friend that there is a blood test
for food allergies in dogs.
Currently these tests are not accurate and are not reliable. They can
not be used to select an appropriate diet for your dog. A food
allergy trial is the only way to determine if your dog has food
allergies.
A positive food allergy trial can improve your dog’s itching and/or
gastrointestinal signs. This means your veterinarian now has a
way
to treat and manage your dog with an appropriate diet and treats.
After the trial you will have the option of continuing the prescription
diet. If a home made diet has been used in the food trial, and
you
and your veterinarian would like to continue that feeding plan, the
diet
must be balanced. Your veterinarian will confer with a veterinary
nutritionist to balance the diet. When the trial home made diet
is
complete and balanced, it can be your dog’s diet forever.
If you elect to try and find an “over the counter” dog food rather than
the prescription or homemade food trial diet you and your veterinarian
conduct a food challenge test. A new ingredient is added to the
successful diet and the dog’s response is followed. If there is
no return of the original skin or gastrointestinal signs, the dog is
not allergic to that
ingredient. After testing several new ingredients, your
veterinarian or a veterinary nutritionist can select a commercial diet
you can safely feed
your dog.
Food allergy trials are the only available means to determine if your
dog has food allergies. Current diet options are listed above. The
trial can be long and difficult. Outlined are many of the common
pitfalls and ideas to avoid them. With a team approach, you and your
veterinarian
can successfully complete a food allergy trial. If a food allergy
trial works, then the long-term treatment for the health of your dog is
an appropriate diet.
Copyright
2007 - 2008 by the Veterinary Information Network, Inc. All rights
reserved.
This work was originally published by Veterinary Information
Network, Inc. (VIN) and is republished with VIN's permission.
The above information is simply
informational. It's intent is not to replace the advice of a
veterinarian nor to assist you in making a diagnosis of your pet.
Please consult with your own veterinarian for confirmation of any
diagnosis. Your pets life may depend on it.