Today's Veterinary Practice

MAY-JUN 2018

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19 MAY/JUNE 2018 ● TVPJOURNAL.COM ESSENTIALS WHAT ABOUT RAW DIETS? Owners are motivated by "it's what's fed in the wild" and "it's natural." What is not understood by owners is that dogs have evolved over wolves to digest plants and carbohydrates. There are 36 regions of the genome that differ between dogs and wolves, 10 of which play a role in digestion and metabolism. These diets may not be optimal for domesticated dogs and cats living in our homes hoping to live a long life. Contamination rates in dry pet foods are still markedly lower than in raw pet foods. Raw or freeze-dried diets carry the same risks of pathogen contamination as freezing and freeze drying does not destroy all pathogens. 21-44% of chicken for human consumption was found to harbor Salmonella with commercial raw pet foods containing 20-48% Salmonella contamination. Overall rates of Salmonella contamination in raw diets was 15/96 (15.6%) vs. 1/480 (0.21%) in commercial dry diets. In a 2001 U.S. study, all 5 raw diets tested had calcium: phosphorus ratio, Vitamin A, D, & E imbalances with one diet containing twice the amount of Vitamin D recommended by AAFCO. When owners make their own raw diets, 60% were found to contain nutritional imbalances. WHAT IS THE RELATIONSHIP BETWEEN FOOD ALLERGY AND ATOPIC DERMATITIS (AD)? Atopic dermatitis has historically been used in relation to environmental allergies. Food-driven skin disease may look indistinguishable from pollen-driven allergy. AD and food allergy are felt to no longer be separate! A patient's microbiome includes skin flora and GI flora (combination of microorganisms and their genetic material), which helps define their skin and mucosal barrier.7 Any alteration can result in clinical disease. In some dogs with clinical AD, food allergens trigger their disease, which is termed "food-induced" AD. Predisposed breeds to food-induced AD include: West Highland Terriers, Boxers, Rhodesian Ridgebacks, Pugs, and German shepherds. Clinical signs usually start at < 12 months of age in 60% of dogs, with GI issues seen in 31% and Malassezia seen in 43%. This young age of onset in dogs is very much like in humans. Human studies show that food sensitization occurs across an inflamed skin barrier. Food protein in dust samples in the home predisposes to early food allergy especially if excoriation (ie, an altered skin barrier) is present. The question exists as to whether food allergy exists first or AD, then promotes food sensitivity. 8 AD and food allergy in dogs are almost impossible to distinguish clinically as both may be present in the same dog. Cross over syndromes such as "oral allergy syndrome" in humans occur in dogs with worsening of AD by ingesting inhalants such as storage mites. 8 HOW WE CAN HELP OUR ALLERGIC PATIENTS Use a prescription hypoallergenic novel protein diet in our atopic patients—many may be food allergic as discussed. Remember that with hydrolysate diets, there can be cross reactivity with chicken, soy, or cornstarch in those patients with those sensitivities. Cooking a hypoallergenic diet is also an option. Visit balanceit.com for a completely nutritionally balanced hypoallergenic diet. References 1. Tsakok T, et.al. Does atopic dermatitis cause food allergy? A systematic review. J. Allergy Clin. Immunol. 137(4), April 2016: 1071-1078. 2. Olson J, Taurine deficiency induced dilated cardiomyopathy in Golden Retrievers, www.vetcardiologist.com 2017. 3. Raditic D, ELISA testing for common food allergens in four dry dog foods used in dietary elimination trials. J An Physiol An Nutrition. 95(1), February 2011: 90-97. 4. Bizkova P, Olivry T, A random double blinded crossover trial testing 2 hydrolyzed poultry diets in dogs with chicken allergy. Veterinary Dermatology 27, 2016. 5. Olivry T, et. al. Food for thought: pondering the relationship between canine atopic dermatitis and cutaneous adverse food reactions. Veterinary Dermatology. 18(6), December 2007: 390-391. 6. Mueller R, et.al. Evaluation by patch testing with single protein, single carbohydrates and commercial foods. Veterinary Dermatology 28(5) October 2017: 473-e109. 7. Jansen-Jarolim E, et.al. Outstanding animal studies in allergy II. From atopic barrier and microbiome to allergen-specific immunotherapy. Current Opinion in J. Allergy Clin. Immunol. 17(3), June , 2017:. 180-187. 8. Pucheu-Haston C, et.al. Review: The role of antibodies, autoantigens and food allergens in canine atopic dermatitis. Veterinary Dermatology, 26(2), April, 2015: 115-123. Alice Jeromin Alice Jeromin is a pharmacist and veterinary dermatologist in Cleveland, Ohio. She is a 1989 graduate of the Ohio State University College of Veterinary Medicine, 1977 graduate of the University of Toledo College of Pharmacy and an adjunct professor at Case Western Reserve University's College of Medicine. Alice is also an at-large member of AVMA's Council on Biologics and Therapeutics.

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