Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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ESSENTIALS 17 MAY/JUNE 2018 ● TVPJOURNAL.COM ESSENTIALS NOVEL PROTEIN A thorough diet history must be asked of the owner inquiring which proteins the pet has been exposed to previously. Hippocrates said, "let food be your medicine and your medicine be food." Wouldn't it benefit our allergic patients to be able to control their symptoms with diet and less, if any, medications? Clinically, presentations of food hypersensitivity appear the same as food intolerance, but immunologically they are different. Food allergy in pets has been described as early as 1920 yet the diagnosis is often elusive as it coexists 20-30% of the time with other allergies. FOOD ALLERGY—DOGS The old belief of food allergy not being steroid responsive is not necessarily true. The incidence is anywhere from 10-49% with the age of onset being extremely variable. In one-third of dogs, the age of onset is < 1 year old. Other reports claim 48% of patients are < 1 year of age with 83% being < 3 years of age. The symptoms are nonseasonal with variable response to steroids. Areas of the body affected include the face, feet, axillae, perineum, inguinum, and ears. In one study, 25% of dogs showed only ear involvement, some of which was unilateral. Skin lesions can vary from papules, erythema, excoriations, hyperpigmentation, seborrhea, and recurrent bacterial/fungal infections. Unusual manifestations of food allergy include erythema multiforme, seizures (10% of dogs), lupoid onychodystrophy, vasculitis, and pemphigus. Severe reactions may include angioedema — an example of which in humans is "oral allergy syndrome" where inhalants from the environment cross react with food allergens. 1 Breeds more commonly seen with food allergy include Shar pei, German Shepherds, Boxer, Pug, West Highland Terrier, Rhodesian Ridgeback, and Labrador Retriever. Irish Setters are a breed used in gluten enteropathy research for humans. Gastrointestinal problems may occur in up to 50% of food allergic dogs and affect the stomach, small bowel, or colon. Be sure and ask the owner about any bowel symptoms such as increased stools (up to 3x daily), flatulence, poor stool quality, vomiting, bloating, or anorexia as these symptoms can suggest food allergy. Bowel biopsies of food allergic dogs may include lymphoplasmacytic +/- eosinophilic gastroenteritis. Depending upon which country performs the studies, beef, dairy, and wheat are the most common food allergens but corn, wheat, egg, chicken, soy, dairy and any other previously fed protein sources the dog has eaten should be avoided. FOOD ALLERGY—CATS The incidence is anywhere from 10-49% with the age of onset being extremely variable anywhere See Ya Later, Alligator! The Hypoallergenic Diet to Aid Patients Alice M. Jeromin, RPh, DVM, DACVD Veterinary Allergy & Dermatology, Inc., Richfield, Ohio NUTRITION NOTES shutterstock.com/Jaromir Chalabala

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