Dietary trials with a commercial chicken hydrolysate diet in 63 pruritic dogs

The owners of 63 pruritic dogs were instructed to feed them a chicken hydrolysate diet exclusively for six weeks as part of diagnostic investigations into non-seasonal pruritus. Ectoparasitism and microbial infections were eliminated during the dietary trial. The dogs' skin lesions, gastrointestinal signs and frequency of defecation were assessed and scores for pruritus were assigned before they started the diet and before and after they resumed their original diet. An adverse food reaction was diagnosed if the pruritus resolved while they were on the diet, but recurred when they resumed their original food regimen. Seventeen of the 63 dogs were withdrawn from the trial, including four which found the diet unpalatable; however, its palatability was reported to be good or excellent in 48 of the dogs. An adverse food reaction alone was diagnosed in nine (19.6 per cent) of the 46 dogs and another nine had an adverse food reaction and atopy. There were gastrointestinal signs in six of the nine dogs with an adverse food reaction, which resolved on the trial diet but recurred when they resumed their original diet.     

Validity of skin testing for diagnosis of food allergy in dogs.

One hundred suspected allergic dogs were skin-tested with 9 food extracts, in addition to other inhalant and insect allergens. Forty-eight of the dogs had +2 or greater intradermal reactions to 1 or more food extracts at concentration of 1,000 protein nitrogen units/ml. Thirty of the food extract-positive dogs were fed a restrictive hypoallergenic diet. Of these 30 dogs, 3 improved, then allergy signs worsened when they were challenge-exposed with the original diet. Fifty-two dogs did not have skin test reactivity to any of the 9 food extracts. Of these 52 dogs, 35 were fed a restrictive diet. Six improved, then allergy signs worsened when dogs were challenge-exposed with the original diet. Skin-testing with selected allergenic food extracts was not useful in identifying food-sensitive dogs.     

Diagnostic testing of dogs for food hypersensitivity

Thirteen food-allergic dogs were studied to evaluate the efficacy of feeding a commercially available egg and rice diet, intradermal skin testing, and serologic testing by ELISA for diagnosing and/or characterizing food hypersensitivity. Feeding of a home-cooked whole lamb meat and rice diet for 3 weeks, followed by challenge with each dog's regular diet, served as the standard for diagnosing food hypersensitivity. Each dog underwent provocative testing with 6 individual ingredients to determine as many of its dietary allergens as possible. Prior to skin testing and serologic testing by ELISA, most dogs had been recently exposed to the offending diet and subsequently manifested clinical signs of allergy. All dogs that tolerated the aforementioned commercial diet were exposed to it for at least 7 weeks; 84.6% of food-hypersensitive dogs ate the commercial diet with impunity. Of the 2 reactors to the commercial diet, only 1 became pruritic in response to provocation testing with chicken eggs. Low sensitivity and high specificity were found for skin testing and the ELISA, indicating a lack of true- and false-positive reactions. Neither the positive nor negative predictive values adequately predicted positive and negative reactions, respectively, for either test. On the basis of these results, the commercial diet, skin testing, and anti-IgE ELISA cannot replace an owner-prepared food elimination diet for food hypersensitivity testing in dogs.     

P-58 Three cases of pathological dermal deposits associated with internal diseases in dogs (xanthomatosis, calcinosis and amyloidosis)

Intestinal parasites have been anecdotally associated with pruritus in dogs. A relationship was proposed when the elimination of a specific parasite resolved the pruritus, and re-infection with a parasite caused the pruritus to recur. Ascarids, coccidia, hookworms, tapeworms and whipworms have all been incriminated. Recent reports in the human and veterinary literature have suggested that there may be a relationship between Giardia infection and the development of pruritus and other allergic signs. In order to determine if there is an association between infection with Giardia and pruritus in dogs, faecal samples were collected from 71 pruritic dogs and 101 clinically normal dogs. Three faecal samples from each animal were analysed using a zinc-sulphate concentration technique for the presence of Giardia cysts, and one randomly selected faecal sample from each dog was analysed with an ELISA for Giardia -specific antigen. Ten of 101 dogs (9.9%) in the clinically normal group tested positive with the ELISA, and Giardia cysts were detected in the faeces of seven of these antigen-positive dogs. No Giardia cysts were found in the dogs that tested negative with the ELISA. None of the dogs in the pruritic group tested positive for Giardia by either method. The results indicated a negative association between Giardia infection and pruritic skin disease ( P  = 0.006). Cephalexin was commonly used in the pruritic group, but not in the control group, and may therefore be an explanatory variable.
Funding: Ontario Veterinary College Pet Trust.     

Diagnosis and management of food allergy and intolerance in dogs and cats

SUMMARY This paper reviews food allergy and intolerance in dogs and cats. Adverse reactions to ingested food components can affect many systems and can produce signs involving the skin, gastrointestinal tract, respiratory tract and central nervous system, and these clinical signs are reviewed. Most basic food ingredients have the potential to induce an allergic response, although most reactions are caused by proteins. In particular, dogs and cats can become sensitive to cow's milk, beef, fish or cereal. Food allergy and intolerance is rare in dogs and cats, although the incidence in practice is difficult to establish. Clinical signs are quite variable, depending on the individual response, although the major clinical sign is pruritus. Diagnosis can be difficult, as there is no single test available to help the clinician to confirm or refute the presence of food sensitivity. Diagnosis is based on dietary investigation in the form of elimination diets and test meals. Elimination diets for dogs include lamb, chicken, rabbit, horse meat and fish as sources of protein, with rice or potatoes. Successful elimination diets for cats include lamb, chicken, rabbit or venison, with rice. Improvement in clinical signs while on the elimination diet is suggestive of food allergy. The diagnosis should be confirmed by feeding the original diet, with the development of clinical signs within 7 to 14 days of feeding.     

A blinded randomized controlled trial evaluating the usefulness of a novel diet (aminoprotect care) in dogs with spontaneous food allergy

Aminoprotect Care (APC) is a novel diet composed of aminoacids, potato proteins and corn starch. The objectives of this study were to determine whether Maltese-Beagle atopic (MBA) dogs hypersensitive to corn exhibited clinical signs and changes in immunological markers after being fed APC. The study was designed as a blinded randomized controlled crossover experiment. Ten MBA dogs with signs of allergy within five days of ingesting corn were selected. Dogs were randomized to be fed either their maintenance diet with corn or APC for five days. After a washout of two weeks, diets were switched. Before and daily during each intervention, skin lesions were graded by an investigator while pruritus was assessed by another. Before and at the end of each intervention, the percentage of circulating CD4+CCR4+, corn-activated CD4+ T-lymphocytes and serum corn-specific IgE levels were measured and ratios of post:pre values calculated. During this trial, pruritus and skin lesions increased significantly in MBA dogs when ingesting corn while no such increase occurred when fed APC. Total, median and maximal pruritus values were significantly higher in MBA dogs ingesting corn compared to APC. There were no significant differences between interventions in the immunological parameters assessed. In summary, even though APC contains corn starch to which corn-sensitive MBA dogs often react, the ingestion of APC did not lead to significant increases in skin lesions or pruritus. Aminoprotect Care might prove valuable for management of food allergies. These experimental observations must be validated in large field studies.     

A retrospective analysis of case series using home-prepared and chicken hydrolysate diets in the diagnosis of adverse food reactions in 181 pruritic dogs

The purpose of this retrospective study was to compare home-prepared and chicken hydrolysate diets in the diagnosis of canine adverse food reactions (AFR). Seventy-two dogs were fed home-prepared diets and 109 were fed hydrolysate. Owners chose the type of diet at presentation, and ingredients of home-prepared diets were selected depending on each dog's dietary history. Ectoparasitic infestations and microbial infections were treated during the trials. Cutaneous and gastrointestinal signs and pruritus scores were recorded before starting the diet, 6 weeks into the trials and after provocation with the original diets. AFR was diagnosed if pruritus resolved during the trial and recurred on dietary provocation. The dropout rate was lower for home-prepared diets although not statistically significant (18.1% home prepared; 24.7% hydrolysate, P=0.377). AFR alone was diagnosed in 10 dogs (17%) using home-prepared diets and in 15 (18.3%) fed the hydrolysate. Gastrointestinal problems were more frequent in dogs with AFR than in dogs without AFR (P=0.001). Another 11 dogs (18.6%) in the home-prepared diet group and 20 (24.4%) in the hydrolysate diet group had AFR concurrent with other pruritic diseases, mainly atopy. The similar frequencies of AFR diagnosis in the two groups (P=0.837 AFR; P=0.416 concurrent AFR) indicate that the chicken hydrolysate diet may be a valuable alternative to home-prepared diets in the diagnosis of canine AFR. Prospective cross-over studies are warranted to confirm these findings.     

Double-blind evaluation of two commercial hypoallergenic diets in cats with adverse food reactions

The aim of this study was to evaluate two commercially available selected-protein-source diets as maintenance diets in cats with dermatological manifestations of adverse food reactions. Twenty cats with a confirmed adverse food reaction were tested in a double-blind manner. An adverse food reaction was diagnosed when, after recovery with a home-cooked elimination diet, the signs relapsed after a challenge with their previous dietary components, and re-disappeared on a second elimination diet period. Hereafter the cats were blind and randomly challenged with two commercial hypoallergenic diets. Relapse of the clinical signs was seen in eight cats (40%) on a lamb and rice diet and in 13 cats (65%) on a chicken and rice diet (P>0.05).Neither one of the commercial diets was as effective in controlling the skin problems as the home-cooked elimination diet. The study confirms that commercial hypoallergenic diets are adequate for maintenance.     

P‐56 Evaluation of the association between Giardia infection and pruritic skin disease in dogs

Intestinal parasites have been anecdotally associated with pruritus in dogs. A relationship was proposed when the elimination of a specific parasite resolved the pruritus, and re‐infection with a parasite caused the pruritus to recur. Ascarids, coccidia, hookworms, tapeworms and whipworms have all been incriminated. Recent reports in the human and veterinary literature have suggested that there may be a relationship between Giardia infection and the development of pruritus and other allergic signs. In order to determine if there is an association between infection with Giardia and pruritus in dogs, faecal samples were collected from 71 pruritic dogs and 101 clinically normal dogs. Three faecal samples from each animal were analysed using a zinc‐sulphate concentration technique for the presence of Giardia cysts, and one randomly selected faecal sample from each dog was analysed with an ELISA for Giardia‐specific antigen. Ten of 101 dogs (9.9%) in the clinically normal group tested positive with the ELISA, and Giardia cysts were detected in the faeces of seven of these antigen‐positive dogs. No Giardia cysts were found in the dogs that tested negative with the ELISA. None of the dogs in the pruritic group tested positive for Giardia by either method. The results indicated a negative association between Giardia infection and pruritic skin disease (P = 0.006). Cephalexin was commonly used in the pruritic group, but not in the control group, and may therefore be an explanatory variable. Funding: Ontario Veterinary College Pet Trust.     

Evalution of a Commerical Canned Lamb and Rice Diet for the Management of Adverse Reactions to Food in Dogs*

Abstract— A commercial canned lamb and rice diet was fed to 20 dogs with previously diagnosed determatologic problems due to adverse reactions to food. Fifteen of the 20 dogs had concurrent atopy and flea allergy which were being treated with hyposensitization and agressive flea control. Palatability and acceptability were good in most of the dogs. Recurrent of previous dermatologic signs did not occur in 75 per cent (15/20) of the dogs while they were fed the diet. Gastrointestinal side effects, specifically diarrhea, caused the owners to stop feeding the diet in four dogs. Overall, 60 per cent (12/20) experienced some gastrointestinal signs during the diet trail.     

Effect of diet on markers of intestinal health in dogs

The effects of two popular commercial pet foods on faecal markers of microbial metabolism were investigated. Adult dogs were fed a dry, extruded diet and a moist, canned diet in a randomly assigned crossover design. Fresh faecal samples were collected for chemical and enzyme activity assays. Relative to the canned diet, the dry food resulted in decreased faecal pH and faecal indole, sulphide and ammonia concentrations and increased total short-chain fatty acid, acetic and propionic acid concentrations. Faecal beta-glucosidase, beta-glucuronidase, beta-galactosidase and nitroreductase activities were decreased in dogs fed the dry diet. These changes in microbial metabolic activity are consistent with beneficial effects of the dry diet on colonic health.     

Role of feeding in the treatment of dogs with pancreatic degenerative atrophy

Fourteen dogs with pancreatic degenerative atrophy (PDA) were fed their original diets or a special diet for 2 periods of 4 weeks to compare the severity of clinical signs in relation to different types of diet. During the first period, the dogs were given ordinary food, and in the second period, the dogs were given only the special diet that consisted of a commercial moderate-fat, low-fiber, highly-digestible food. In addition, equal amounts of pancreatic enzymes were added into the food during highly-digestible food. In addition, equal amounts of pancreatic enzymes were added into the food during both periods. The owners were given a questionnaire covering 9 typical signs of PDA. They were asked to assess the severity of signs daily for the 2 periods using a scale provided with the questionnaire. The general well-being of the dogs was significantly (p less than 0.05) better during the period when the dogs were fed a special diet. Of the individual clinical signs associated with PDA the severity of flatulence, borborygmi, volume of faeces and frequency of defecation were significantly (p less than 0.05) decreased on the special diet. There were no significant differences in appetite, drinking, colour and consistency of the faeces or in coprophagy between the 2 feeding periods. The costs of the special diet were almost double compared to the ordinary diets.     

Intestinal permeability testing in dogs with diet-responsive intestinal disease

Fifteen dogs with signs of small and, or, large bowel disease that responded clinically to an exclusion diet were studied, using differential sugar absorption as an objective parameter of the mucosal response to the diet. Intestinal permeability and function were assessed by determining the urinary excretion ratios of lactulose/rhamnose and xylose/3-O-methylglucose, respectively, following oral administration of a mixture of these four sugars. Five dogs, all retrievers, were tentatively diagnosed as having dietary hypersensitivity, based upon resolution of clinical signs and normalisation of high intestinal permeability following an exclusion diet and recurrence of signs (in four of five dogs) upon challenge with the original diet. The fifth dog did not become symptomatic when challenged, but intestinal permeability increased. The remaining 10 dogs were diagnosed as having food intolerance, based upon clinical improvement on an exclusion diet, relapse on challenge with their original diet, but lack of improvement in intestinal permeability. These findings suggest that a differential sugar absorption test may be useful to determine the reasons for clinical response to exclusion diets. Demonstration of increased intestinal permeability with subsequent normalization following an exclusion diet may be useful in the diagnosis of dietary hypersensitivity, while persistent abnormalities in intestinal permeability are suggestive of underlying intestinal disease and food intolerance.     

Food allergy and dietary intolerance in dogs: A report of 25 cases

Food allergy or dietary intolerance was diagnosed in 25 dogs. A screening diet of home-cooked chicken and rice was used in all cases except in those dogs which were regularly fed chicken. If an improvement was noted, dogs were then challenged with their original diet and, if relapse occurred, they were suspected of having a diet-related dermatosis. After remission was achieved by again feeding the home-cooked screening diet the animals were provocatively challenged with dietary components. The offending component was a single constituent of the original in 13 of the animals. The age of onset of clinical signs ranged from three months to 10 years and the median age at onset of clinical signs was significantly different from the median age at the hospital. All animals responded to the screening diet within three weeks and none required a period of more than two weeks to respond to provocative challenge. The duration of time between challenge and the onset of clinical signs was significantly different between dogs with intolerance to cereal and those intolerant to dairy products.     

Use of a restricted antigen diet in the management of idiopathic canine colitis

Eleven dogs diagnosed as having idiopathic chronic colitis were treated for four months with a commercial hypoallergenic diet. Ten clinical parameters were evaluated monthly for each dog. Within one month, four key signs associated with colitis (straining, faecal blood, faecal mucus and faecal consistency) were significantly improved and remained so for the subsequent three months. Sulphasalazine was also used in the initial stages of management to control presenting signs. However, within one month 60 per cent of the dogs required either no sulphasalazine (or less) than when originally presented; within two months 90 per cent were stabilised with no drug therapy.     

Effects of modified protein diets in dogs with chronic renal failure

A maintenance diet containing 44.4% dry weight protein and 2 reduced protein diets containing 17.2% and 8.2% dry weight protein were studied in dogs with induced chronic renal failure to determine effects on their (1) clinical status, (2) renal function, (3) electrolyte and acid-base balance, (4) divalent ion balance, (5) nutritional status, (6) hematologic status, and (7) hemostasis. A cross-over design of feeding was utilized so that the effect of diet could be studied in each dog at a known state of renal dysfunction and so that reversibility of effects could be determined. The inulin clearance rate was higher when the 44.4% protein diet was fed than when the 8.2% or 17.2% protein diets were fed. However, consumption of lower protein diets was associated with greater physical activity and reduction in serum urea nitrogen concentrations, compared with consumption of the 44.4% protein maintenance diet. Varying degrees of hyperchloremic metabolic acidosis developed in dogs fed the 8.2% and 17.2% protein diets. Reduced total serum protein and albumin concentrations, and hypercholesterolemia developed in dogs fed the 8.2% protein diet. All effects were reversible after diets were changed. It was concluded that diet-induced alterations in renal function associated with moderate dietary protein restriction did not adversely effect clinical and biochemical status of dogs with renal failure. It was unclear whether the clinical and biochemical changes observed with more severe protein restriction resulted from diet-induced changes in renal function.     

Effects of topical administration of an aldose reductase inhibitor on cataract formation in dogs fed a diet high in galactose

OBJECTIVE: To determine effects of a topical formulation of an aldose reductase inhibitor (ARI) on the development of sugar cataracts in dogs fed a diet high in galactose. Animals-Ten 6-month old Beagles. PROCEDURES: Dogs were fed a diet containing 30% galactose, and after 16 weeks, 6 dogs were treated topically with a proprietary ARI formulation and 4 dogs were treated with a placebo. Cataract formation was monitored by means of slit-lamp biomicroscopy and fundus photography. Dogs were euthanized after 10 weeks of treatment, and lenses were evaluated for degree of opacity, myo-inositol and galactitol concentrations, and concentration of the ARI. RESULTS: All dogs developed bilateral cortical opacities dense enough to result in a decrease in the tapetal reflex after being fed the galactose-containing diet for 16 weeks. Administration of the ARI arrested further development of cataract formation. In contrast, cataracts in the vehicle-treated dogs progressed over the 10-week period to the mature stage. Evaluation of the isolated lenses after 26 weeks of galactose feeding indicated that lenses from treated dogs were significantly less optically dense than lenses from control dogs. Lenticular myo-inositol concentration was significantly higher in the treated than in the control dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that topical application of a proprietary ARI formulation may arrest or reverse the development of sugar cataracts in dogs fed a diet high in galactose. This suggests that this ARI formulation may be beneficial in maintaining or improving functional vision in diabetic dogs with early lens opacities.     

Dietary hyperthyroidism in dogs

Objectives: Evaluation of dogs with elevated plasma thyroxine concentration fed raw food before and after changing the diet. Method: Between 2006 and 2011 all dogs presented with an elevated plasma thyroxine concentration and a dietary history of feeding raw food were included. Thyroxine (reference interval: 19·3 to 51·5 nmol/L) and in many cases also thyroid-stimulating hormone concentrations (reference interval: <0·30 ng/mL) were measured initially and after changing the diet. Results: Twelve dogs were presented with a median age of five years. The median plasma thyroxine concentration was 156·1 (range of 79·7 to 391·9) nmol/L; in six dogs, thyroid-stimulating hormone concentration was measured and was <0·03 ng/mL in five dogs and 0·05 ng/mL in one dog. Six dogs showed clinical signs such as weight loss, aggressiveness, tachycardia, panting and restlessness while six dogs had no clinical signs. After changing the diet eight dogs were examined: thyroxine concentration normalised in all dogs and clinical signs resolved. Clinical Significance: Dietary hyperthyroidism can be seen in dogs on a raw meat diet or fed fresh or dried gullets. Increased plasma thyroxine concentration in a dog, either with or without signs of hyperthyroidism, should prompt the veterinarian to obtain a thorough dietary history.     

Evaluation of selected-protein-source diets for management of dogs with adverse reactions to foods.

OBJECTIVE: To evaluate 3 commercially available selected-protein-source diets as maintenance diets in dogs with pruritus caused by adverse food reactions. DESIGN: Randomized crossover trial. ANIMALS: 40 dogs > 6 months of age with pruritus caused by adverse reactions to foods. PROCEDURE: Diagnosis was confirmed by use of diet elimination and provocation studies. Subsequently, dogs were fed 3 commercial diets for 3 weeks each in a randomized, blinded, crossover trial. Dogs were evaluated for pruritus, vomiting, diarrhea, and flatulence. RESULTS: Pruritus recurred in 52.5% of dogs fed a chicken-rice diet, 47.5% of dogs fed a catfish-rice diet, and 85% of dogs fed a venison-rice diet. Overall 95% of the dogs could be managed successfully with at least 1 of the 3 diets. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that commercially available limited-allergen diets with selected protein sources may be appropriate for long-term management of pruritus caused by adverse food reactions. Testing of various protein sources is usually required.     

Comparison of a commercial limited-antigen diet versus home-prepared diets in the diagnosis of canine adverse food reaction

The objective of the present study was to compare the efficacy of a commercial limited-antigen diet (Eukanuba Veterinary Diets Response Formula FP/Canine, The Iams Company) with home-prepared diets in the diagnosis of adverse food reaction in dogs. The study was conducted in two phases. The first phase utilized 28 dogs fed a home-prepared diet to enable a diagnosis of adverse food reaction. Dogs diagnosed from this phase were entered into the second phase in which these dogs were fed the commercial limited-antigen diet. Owners of 10 of the 28 dogs quit Phase 1 before it could be completed, and one case was eliminated because extended treatment with steroids was required. Eight of the remaining 17 (47 %) dogs were diagnosed with an adverse food reaction. A reaction occurred in four of eight dogs fed the test diet in Phase 2. These results demonstrated the difficulties encountered by owners and veterinarians attempting to feed dogs home-prepared diets. In addition, the results of the study suggest that the occurrence of adverse reactions to fish could make it a less desirable ingredient as a limited antigenin canine diets.