“Didy,” a clinical case of cognitive dysfunction syndrome

The term cognitive dysfunction syndrome (CDS) has been used to refer to the changes of behavior related to aging with cognitive skills deterioration, that do not stem completely from medical conditions and that are a consequence of a degenerative process of the central nervous system. It is known that the CDS in dogs is caused by the physical and chemical changes that take place in the brain due to aging. The aim of this paper is to present a clinical case of CDS which was clinically diagnosed and then confirmed by necropsy at the veterinary hospital of the National Autonomous University of Mexico.     

Phosphatidylserine (PS) as a potential nutraceutical for canine brain aging: A review

Neurodegenerative processes are one of the main age-related features of dogs. Senile neurodegeneration can be clinically asymptomatic, “borderline” (i.e., a condition that is intermediate between normal and disease state) or progress toward overt clinical abnormalities, known as age-related cognitive disorders, cognitive dysfunction syndrome (CDS), or senile dementia. The aim of the present article is to review the rationale for the use of phosphatidylserine (PS), a natural phospholipid, in the management of brain neurodegenerative processes in senior dogs. The preliminary clinical data on PS supplementation in senior dogs will also be reviewed. There is evidence that PS is absorbed rapidly, reaches high concentrations in the brain, and is well tolerated. Phosphatidylserine has emerged to exert several in vitro and in vivo neuroprotective activities. It has been shown to positively affect neurotransmitter release and neurotransmitter receptor density in several brain regions from laboratory animals with memory impairments. Phosphatidylserine also was found to revert experimentally-induced amnesia in rats and improve memory deficits both in old animals and in elderly humans with various degrees of cognitive impairment and Alzheimer's dementia. On the basis of the data reported in the scientific literature, PS stands out as an essential “brain nutrient.” In view of these features, some supplements containing PS have been licensed recently as adjuvant treatment for canine and feline brain aging. The results of the studies on its use in the preventative and combined treatment of dogs with clinical features consistent with the diagnosis of CDS are reported. Although PS-based neuroprotection in dogs and cats is still at its infancy, the preliminary collected data look promising and thus merit further investigation.     

Cognitive dysfunction in cats: a syndrome we used to dismiss as 'old age'

PRACTICAL RELEVANCE: Cognitive dysfunction syndrome (CDS) is a widely accepted diagnosis in dogs, with established treatment options. In cats, however, our understanding of cognitive dysfunction is still being shaped by ongoing research in the field, and limited treatment options are available. Recent clinical studies indicate that old age in the cat is accompanied by increased behavioural signs such as wandering, vocalization and night-time activity that are not attributable to identifiable medical problems. It is essential, therefore, that veterinarians include behavioural well-being in the routine care of senior cats. PATIENT GROUP: While the exact age of onset is not established, studies suggest that age-related behavioural changes consistent with cognitive dysfunction are prevalent in cats as early as 10 years of age and that prevalence increases significantly in older cats. CLINICAL CHALLENGES: The diagnosis of cognitive dysfunction requires the identification of geriatric behavioural changes that are not caused by other medical problems, although the two may not be mutually exclusive. Therefore, the practitioner must rely heavily on owner reports and history to ensure prompt diagnosis and treatment. The absence of any approved dietary or pharmaceutical interventions for cognitive dysfunction adds a further challenge, although several possibilities exist. EVIDENCE BASE: This article draws on recent research that has produced neuropathological, cognitive and behavioural evidence for cognitive dysfunction in aging cats. As an impetus to further our understanding of this disease and potential treatment options, the authors propose a behavioural checklist that might aid in the clinical diagnosis of feline CDS and discuss treatment options that have proven successful in the canine counterpart of this disease.     

Association between neurologic and cognitive dysfunction signs in a sample of aging dogs

In human neurology, patients with Alzheimer's disease show seizures and signs of motor deficits, such as movement disorders (i.e., restlessness, slowness, impaired gait, and, rarely, resting tremors). Because canine Cognitive Dysfunction Syndrome (CDS) is considered an Alzheimer-like disease in dogs, it might be possible to document concurrent behavioral and neurologic signs in aging canine patients as well. Twenty-one dogs (14 dogs with CDS-related signs, 7 normal dogs) greater than 7 years of age were studied. Owners completed a behavioral questionnaire and the dogs underwent a neurologic evaluation. Dogs with CDS were twice as likely to show neurologic deficits as dogs without CDS. However, based on this pilot study, a sample of 187 dogs affected with CDS are required to show statistically significant differences between the proportions of dogs with CDS and with neurologic signs and the proportions of control dogs without any of these disorders.     

Concentrations of platelet α2-adrenoceptors,lymphocyte muscarinic receptors,and blood monoamines in dogs (Canis familiaris) affected by canine cognitive dysfunction syndrome

Canine cognitive dysfunction syndrome (CDS) is a neurodegenerative disorder of aged dogs characterized by a progressive decline in cognitive function. In humans and laboratory animals, a variety of neurotransmitter abnormalities have been described in patients affected by age-related dementia. Specifically, the regulatory role of the catecholaminergic, serotonergic, and cholinergic systems has been outlined. The aim of the present study was to measure blood monoamine levels, platelet α₂-adrenergic receptors, and lymphocyte muscarinic receptors in healthy adult and aged dogs and in dogs affected by canine cognitive dysfunction. Based on clinical and behavioral examination, 40 dogs were divided into 3 groups: healthy adults (n = 14), aged dogs (n = 17), and aged dogs affected by canine cognitive dysfunction (n = 9). A significant reduction in plasma levels of norepinephrine and dopamine was observed both in aged dogs (0.16 ± 0.02 ng/mL, P < 0.01; 0.11 ± 02 ng/mL, P < 0.01, respectively) and in CDS dogs (0.14 ± 0.03 ng/mL, P < 0.05; 0.10 ± 00.005 ng/mL, P < 0.01, respectively) compared with adults (0.29 ± 0.04 ng/mL and 0.15 ± 0.02 ng/mL, respectively). No significant differences were observed among groups for α₂-adrenergic receptor concentrations. Canine lymphocytes express 2 distinct classes of muscarinic receptors, characterized by high (HA) and low affinity (LA) for [³H]-N-methyl-scopolamine. A significant age-dependent decrease in HA muscarinic receptors was observed. However, no differences were found between aged dogs (87.65 ± 11.08 sites/cell × 10²) and in CDS dogs (90.17 ± 6.75 sites/cell × 10² ) for HA muscarinic receptor concentrations. As far as LA muscarinic receptors are concerned, CDS dogs showed a significant increase (393.48 ± 63 sites/cell × 10²; P < 0.05) with respect to healthy adult dogs (188.84 ± 16.50 sites/cell × 10²). Our results suggest that the reduction in HA muscarinic receptor-binding sites could be representative of the physiological aging process, whereas the increase in lymphocyte LA muscarinic receptor levels could be related to the cognitive decline.     

Enhancing brain functions in senior dogs: a new nutritional approach

Aging induces many morphological and metabolic changes in the brain, which may eventually lead to cognitive impairment and dementia called cognitive dysfunction syndrome in senior dogs. Cognitive impairment and dementia can adversely affect the quality of life in both dogs and their owners. Progress has been made over the past years to understand how aging affects brain and its functions in humans and animals including dogs. Existing data indicate that aging-induced changes in the brain are gradual and irreversible. Therefore, it is too late to effectively manage dogs with cognitive impairment and cognitive dysfunction syndrome. The best option to manage brain aging successfully is to reduce or prevent aging-induced changes in the brain by correcting early metabolic changes and eliminating risk factors associated with brain aging and dementia. This article reviews behavioral, morphological, and metabolic changes in the brain induced by aging and discusses a novel nutritional solution for the aging-induced metabolic changes in the brain.     

Cognitive dysfunction in cats: clinical assessment and management

Increasing numbers of cats are living to become elderly and they commonly develop behavioral changes. The objectives of this article are to consider the possible causes and prevalence of behavioral problems in pet cats, to describe how cognitive dysfunction syndrome (CDS) typically presents, and how its diagnosis and management are often complicated by the concurrent presence of multiple interacting disease processes. The most frequently reported behavioral problems in old cats are loss of litter box training and crying out loudly at night. The most common causes of these problems are CDS, osteoarthritis, systemic hypertension (commonly secondary to chronic kidney disease or hyperthyroidism), hyperthyroidism (even without hypertension), deafness, and brain tumors. These conditions all occur frequently in older cats, many of which suffer from a number of concurrent interacting conditions. Owners and veterinary surgeons often mistake these for "normal aging changes," so many treatable conditions are neglected and go untreated. Almost one third of cats 11 to 14 years of age develop at least one geriatric-onset behavior problem that appears to relate to CDS, and this increases to over 50% for cats 15 years of age or older. For optimum management of elderly cats with behavioral problems, all interacting conditions need to be diagnosed and addressed concurrently with management for CDS.     

Clinical feasibility of cognitive testing in dogs (Canis lupus familiaris)

Several cognitive tests have been developed to evaluate specific aspects of human and animal learning and memory. These tests have been used for early detection of cognitive deficits and to monitor the treatment of dogs with cognitive impairment. Thus, this article evaluated the feasibility of cognitive tests for use in canine neurology clinical routines and the suitability of the different tests to accomplish this aim. Fifteen healthy adult dogs were used for the cognitive tests of reward approach learning, object approach learning, object discrimination learning, reversal learning, delayed non-matched to position, and delayed non-matched to sample to assess different aspects of memory. No difference was observed between tests of delayed non-matched to position (3.13 ± 2.23 days) and delayed non-matched to sample (3.20 ± 2.40 days) (P = 0.944). However, dogs had greater difficulty in reversal learning (8.47 ± 2.61 days) than in object discrimination learning (4.60 ± 1.64 days) (P ≤ 0.001). Based on the tests performed, the delayed non-matched to position test may be performed in clinical routine if the owner and the veterinarian have time available, because this test is sensitive to evaluate dogs with cognitive impairments, but requires approximately 10 days of training. Thus, elderly dogs are excellent experimental models to study pathological aging based on their similarities with some human brain diseases, such as Alzheimer disease.     

RADIOGRAPHIC FINDINGS DURING RECOVERY FROM DISCOSPONDYLITIS

The diagnosis of discospondylitis is based on radiographic changes in the vertebrae. The limitations of this method are the time gap between the onset of clinical signs and the first appearance of the radiographic findings, as well as the disassociation between the clinical and radiographic signs during recovery. It is known that the radiographic changes appear only two to four weeks after the onset of clinical signs, but the characteristics of radiographic changes during recovery has yet to be documented, thus making follow-up radiographs difficult to interpret. A prospective and retrospective study was designed to document typical radiographic changes during recovery from discospondylitis. We reviewed 12 dogs that had complete and uneventful recovery with antibiotic therapy alone. Periodic follow-up radiographs and clinical examinations were conducted up to five months after the onset of clinical signs to correlate between the clinical status and radiographic changes during recovery. Although the clinical signs improved within the first 10 days of antibiotic therapy, the radiographic deterioration continued before regression and signs of radiographic recovery were noticed. This radiographic deterioration, despite successful antibiotic therapy, appeared shorter in young dogs (less than one year old) and lasted three to nine weeks in older dogs.     

Prevalence of behavioral changes associated with age-related cognitive impairment in dogs

OBJECTIVE: To determine the prevalence of age-related behavioral changes, namely impairment, in a randomly chosen population of dogs. DESIGN: Age-stratified cohort study. ANIMALS: 97 spayed female and 83 castrated male dogs that were 11 to 16 years old. PROCEDURE: Data on possible impairment in 4 behavioral categories (ie, orientation in the home and yard, social interaction, house training, and sleep-wake cycle) linked to cognitive dysfunction were obtained from dog owners, using a structured telephone interview. Hospital records of dogs had been screened to exclude dogs with dysfunction in organ systems that may cause behavioral changes. Dogs with behavioral impairment were those with > or = 2 signs of dysfunction within a category. Dogs with impairment in 1 category were considered mildly impaired and those with impairment in > or =2 categories were considered severely impaired. RESULTS: Age by sex interactions for dogs with impairment in any category were not significant, and, therefore, data on castrated males and spayed females were pooled for analyses across ages. The prevalence of age-related progressive impairment was significant in all categories. The percentage of 11- to 12-year-old dogs with impairment in > or = 1 category was 28% (22/80), of which 10% (8/80) had impairment in > or = 2 behavioral categories. Of 15- to 16-year-old dogs, 68% (23/34) had impairment in > or =1 category, of which 35% (12/34) had impairments in > or = 2 categories. There were no significant effects of body weight on the prevalence of signs of dysfunction in the behavioral categories. CONCLUSIONS AND CLINICAL RELEVANCE: Data collected provide estimates of the prevalence of various degrees of age-related behavioral changes associated with cognitive dysfunction in dogs. Age-related behavioral changes may be useful indicators for medical intervention for dogs with signs of cognitive impairment.     

Nutraceuticals, aging, and cognitive dysfunction.

Decline in cognitive function that accompanies aging in dogs might have a biological basis, and many of the disorders associated with aging in canines might be preventable through dietary modifications that incorporate specific nutraceuticals. Based on previous research and the results of laboratory and clinical studies, antioxidants might be one class of nutraceutical that benefits aged dogs. Brains of aged dogs accumulate oxidative damage to proteins and lipids, which can lead to dysfunction of neuronal cells. The production of free radicals and lack of increase in compensatory antioxidant enzymes might lead to detrimental modifications to important macromolecules within neurons. Reducing oxidative damage through food ingredients rich in a broad spectrum of antioxidants significantly improves, or slows the decline of, learning and memory in aged dogs; however, determining which compounds, combinations, dosage ranges, when to initiate intervention, and long-term effects constitute critical gaps in knowledge about this subject.     

Conditions associated with canine hypothyroidism.

Careful review of the literature regarding clinical signs caused by hypothyroidism in dogs has shown that some assumptions regarding the relation of hypothyroidism to other conditions are based on anecdotal evidence. Cutaneous manifestations are present in most hypothyroid dogs, but the specific abnormalities and breed variations remain to be clearly defined. Decreased metabolic rate manifested by obesity and lethargy is also common. Neurologic manifestations, although uncommon, clearly occur in hypothyroid dogs. Cardiac abnormalities seem to be common, but their clinical significance is questionable. The only consistent hematologic abnormality that occurs in hypothyroid dogs is anemia; evidence for acquired von Willebrand's disease or other bleeding disorders is negligible. Reproductive dysfunction secondary to hypothyroidism is unlikely to occur in male dogs, and there is no evidence to support abnormalities in female dogs. The relation of megaesophagus, laryngeal paralysis, ocular abnormalities, and gastrointestinal disorders with hypothyroidism remains to be established. Future research into canine hypothyroidism may serve to convert dogma into a more clear understanding of the manifestations and pathophysiologic findings of this common endocrinopathy.     

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (dish) resulting in adjacent segment disease

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) are usually incidental findings and in most dogs are either asymptomatic or associated with mild clinical signs. Severe spondylosis deformans and DISH can result in complete bony fusion of consecutive vertebral segments. One of the recognised complications following vertebral fusion in human patients is the development of adjacent segment disease, which is defined as degenerative changes, most commonly degenerative intervertebral disc disease, in the mobile vertebral segment neighboring a region of complete vertebral fusion. A similar syndrome following cervical fusion in dogs has been termed the domino effect. The purpose of this retrospective study was to investigate the hypothesis that vertebral fusion occurring secondary to spondylosis deformans or DISH in dogs would protect fused intervertebral disc spaces from undergoing degeneration, but result in adjacent segment disease at neighbouring unfused intervertebral disc spaces. Eight dogs with clinical signs of thoracolumbar myelopathy, magnetic resonance imaging of the thoracolumbar vertebral column, and spondylosis deformans or DISH producing fusion of > or = 2 consecutive intervertebral disc spaces were evaluated. Vertebral fusion of > or = 2 consecutive intervertebral disc spaces was correlated (P = 0.0017) with adjacent segment disease at the neighbouring unfused intervertebral disc space. Vertebral fusion appeared to protect fused intervertebral disc spaces from undergoing degeneration (P < 0.0001). Adjacent segment disease should be considered in dogs with severe spondylosis deformans or DISH occurring in conjunction with a thoracolumbar myelopathy.     

Effect of gonadectomy on subsequent development of age-related cognitive impairment in dogs.

OBJECTIVE: To determine whether gonadectomy predisposes dogs to development of age-related behavioral changes linked to cognitive impairment. DESIGN: Cohort study. ANIMALS: 29 sexually intact male dogs, 63 spayed female dogs, and 47 castrated male dogs 11 to 14 years old. PROCEDURE: Information on possible impairments in 4 behavioral categories linked to cognitive impairment (orientation in the home and yard, social interactions, house training, and sleep-wake cycle) was obtained from owners of the dogs by use of a structured telephone interview format. A second interview was performed 12 to 18 months after the initial interview, and differences in responses were evaluated. RESULTS: Sexually intact male dogs were significantly less likely than neutered dogs to progress from mild impairment (i.e., impairment in 1 category) to severe impairment (i.e., impairment in > or = 2 categories) during the time between the first and second interviews. This difference was not attributable to differences in ages of the dogs, duration of follow-up, or the owners' perceptions of the dogs' overall health. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the presence of circulating testosterone in aging sexually intact male dogs may slow the progression of cognitive impairment, at least among dogs that already have signs of mild impairment. Estrogens would be expected to have a similar protective role in sexually intact female dogs; unfortunately, too few sexually intact female dogs were available for inclusion in the study to test this hypothesis. There may be a need to evaluate possible methods for counteracting the effects of loss of sex hormones in gonadectomized dogs.     

ULTRASONOGRAPHIC FEATURES OF CANINE HEPATIC NODULAR HYPERPLASIA

Hepatic nodular hyperplasia is a benign, usually clinically inapparent, proliferative lesion commonly found at necropsy in older dogs. Three examples of hepatic nodular hyperplasia are described in dogs with clinical signs compatible with hepatic disease in which ultrasonography revealed a variety of echotextural changes in the liver similar to those reported in primary or secondary hepatic neoplasia. In subsequent in vitro ultrasonographic studies of hepatic nodular hyperplasia lesions detected at necropsy in dogs without clinical signs of hepatic disease, only subtle echotextural changes were seen. Hence, hepatic nodular hyperplasia may be inapparent in vivo in many dogs. Hepatic nodular hyperplasia is a potentially confusing sporadic finding which must be considered by ultrasonographers examining dogs with clinical signs of hepatic disease. The diagnosis of hepatic neoplasia should not be made on the basis of ultrasonographic findings alone.     

Pulmonary Abnormalities in Dogs with Leptospirosis

Background: Leptospirosis in dogs is a multiorgan disease affecting mostly kidneys and liver. Objectives: The objective was to characterize prevalence, clinical, and radiological features and outcome of dogs with leptospirosis and pulmonary abnormalities. Animals: Fifty dogs with leptospirosis. Methods: Medical records of dogs diagnosed with leptospirosis at the Small Animal Clinic, Berlin, were reviewed. Diagnosis was based on microscopic agglutination test, blood or urine polymerase chain reaction, and histopathology. Based on clinical and/or radiological signs, patients were grouped into dogs with lung abnormalities (group 1) or without (group 2). Severity of respiratory distress was scored as mild to moderate (grade 1) or severe (grade 2). Thoracic radiographs were scored based on pulmonary changes and location as grade 1 (caudal interstitial pattern), 2 (generalized mild to moderate reticulonodular interstitial pattern), or 3 (generalized severe reticulonodular interstitial pattern with patchy alveolar consolidations). Results of CBC and biochemistry were compared between groups. Results: Thirty‐five dogs had radiological pulmonary changes (grade 1: 5; grade 2: 14; grade 3: 16); 31 of them had pulmonary distress (grade 1: 13, grade 2: 18). Sixty‐seven percent of the dogs with dyspnea grade 2 were mainly euthanized because of respiratory distress. Fifteen percent of the dogs with dyspnea grade 1 and 21% without clinical respiratory signs were euthanized because of acute renal failure or sepsis. Conclusions and Clinical Importance: In 70% of dogs with leptospirosis pulmonary changes were detected. Lung involvement represented a severe complication causing increased case fatality depending on the severity of respiratory distress.     

Ageing changes in cat brains demonstrated by beta-amyloid and AT8-immunoreactive phosphorylated tau deposits

The life expectancy of domestic pet cats is increasing, along with the occurrence of geriatric-onset behavioural problems, such as cognitive dysfunction syndrome (CDS). While the cause of CDS is unclear, it has been suggested that it may result from age-related neurodegeneration. In aged and in particular senile human beings, histopathological changes may include the extracellular accumulation of plaque-like deposits of beta-amyloid (Abeta) protein and the intracellular accumulation of an abnormally hyperphosphorylated form of the microtubule-associated protein, tau. In severe cases, the latter may form into neurofibrillary tangles. Brain material was assessed from 19 cats, aged from 16 weeks to 14 years; 17 of which had clinical signs of neurological dysfunction. Immunohistochemical methods were used to detect Abeta and its intracellular precursor protein (amyloid precursor protein (APP)) and hyperphosphorylated-tau. APP was constitutively expressed, with diffuse staining of neurons and blood vessels being detected in all cats. More intense staining and diffuse extracellular Abeta staining deposits were found within the deep cortical areas of the anterior- and occasionally mid-cerebrum of seven cats, all of which were over 10 years of age. Neurons staining intensely positive for AT8-immunoreactivity were seen in two cats, aged 11 and 13 years. However, no mature neurofibrillary tangles were detected. This study demonstrated that extracellular Abeta accumulation and AT8-immunoreactivity within neurons are age-related phenomena in cats, and that they can occur concurrently. There are similarities between these changes and those observed in the brains of aged people and other old mammals.     

USE OF FORCE PLATE ANALYSIS TO EVALUATE THE EFFICACY OF EXTERNAL BEAM RADIATION TO ALLEVIATE OSTEOSARCOMA PAIN

A standard of therapy for osteosarcoma includes amputation with or without adjuvant chemotherapy. There is a subset of dogs with osteosarcoma that are unsuitable for amputation. We evaluated kinetic variables in dogs with appendicular osteosarcoma treated with a single 8 Gy dose of radiation. Eighteen pet dogs with appendicular osteosarcoma received one 8 Gy fraction of palliative radiation on day 0. Force plate measurements and clinical assessments were made on days 0, 7, 14, and 21. Peak vertical forces ( F _z) were recorded for each limb and a symmetric index (SI) was calculated. There were no significant changes in kinetic parameters after one 8 Gy dose of radiation therapy. Nine of these 18 dogs exhibited increased limb function at day 21 based on force plate analysis. Significant factors affecting F _z included gender and tumor location. There was a significant correlation between F _z and response to therapy based on SI at day 21. SI seems to be useful to objectively assess response in this mixed population of dogs. One 8 Gy fraction of radiation therapy alone did not reduce lameness associated with appendicular osteosarcoma, but a subset of dogs did have improved limb function after a single dose.     

MAGNETIC RESONANCE IMAGING FINDINGS IN SPINAL CORD INFARCTION IN THREE SMALL BREED DOGS

Fibrocartilaginous embolization (FCE) of the spinal cord is a common disease in large breed dogs. There are only a few reports about this entity in small breed dogs and it has never been reported in chondrodystrophic breed. For definitive diagnosis histopathologic examination is necessary. Magnetic resonance imaging (MRI) as a potential diagnostic tool for intravitam diagnosis of FCE has been mentioned before, but results have not been reported so far. This report describes the neurological findings and MRI results in three small breed dogs, including a Pekingese dog, with FCE of the spinal cord. The disease was suspected in two animals based upon clinical and MRI-appearance and confirmed in the third by histopathological examination. In all three cases, similar focal intramedullary lesions, consisting of hyperintensive signals on T2-weighted images, were detected. Based on these findings, high-field MRI may be used as an antemortem tool for the diagnosis of FCE. It is also shown that FCE can occur in chondrodystrophic dogs.     

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.