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Hypersensitivity Dermatitis Due to Food Sensitivity Chelsea Fulton, Michelle Hervey, Amanda LaffoonTarleton State University Hypersensitivity dermatitis acquired from food allergies is a medical issue many pet owners face. This medical condition can prove to become frustrating to many owners depending on how the allergy presents itself. Veterinarians have to perform specific testing to diagnose a specific food allergy. Once the patient is diagnosed with certain food allergy, food trials can begin to help correct any adverse reactions the patient is presenting. 41910660400Fig. 1. Dog with pruritic skin. (Sousa, n.d.)Food allergy hypersensitivity dermatitis is associated with non-seasonal pruritic skin conditions. Food intolerances are an individual sensitivity to food that may occur by a variety of non-immunologic mechanisms, including metabolic, pharmacologic, and idiosyncratic (Scott, Miller, & Griffin, 2001). The food hypersensitivity reactions are actually due to the animal ingesting an antigenic ingredient within the food. Food allergy hypersensitivity dermatitis can be difficult to diagnose in animals because it can mimic other forms of hypersensitivity dermatitis reactions. Food hypersensitivity is the third most common hypersensitivity skin disease in dogs, after flea bite hypersensitivity and atopy (Scott, Miller, & Griffin, 2001). The clinical signs commonly associated with food allergy hypersensitivity reactions are non-seasonal pruritus, erythema, hair loss, possible gastrointestinal signs (diarrhea, vomiting, abdominal pain or discomfort), weight loss, and other forms of hypersensitivity dermatitis (atopy, or flea allergy dermatitis). When the skin is involved, the common affected areas are ears, rump, distal limbs, axillae, and groin. Due to the clinical signs, and mimicking other forms of hypersensitivity dermatitis; it is imperative to collect a thorough patient history including diet, preventative medications, and a thorough physical examination. Food allergy hypersensitivity reactions can manifest clinical signs as soon as a few minutes, 24 hours, or even days after the ingestion of the allergen within the food. There are many different food proteins and carbohydrates associated with food allergy dermatitis, and consequently the ones associated are the ingredients in most pet food diets. This displays why the animal’s current diet is important information for the veterinarian. It is also important to know if the animal receives any form of scraps, treats, and flavored chews from the owner as well. The foods that are known to be associated with food allergy dermatitis are beef, chicken, corn, cow’s milk, eggs, fish, food preservatives, horse meat, kidney beans, lamb and mutton, oatmeal, pasta, pork, rabbit, rice flour and rice, soy, turkey, and wheat. If the offending food is a snack or table food, the signs can be episodic depending on how often the animal eats it (Scott, Miller, & Griffin, 2001). Food allergy hypersensitivity dermatitis is not necessarily specific to a breed or the animal’s age, however there are some breeds with an increased risk for food associated hypersensitivity dermatitis. Specifically in dogs, these breeds include the American Cocker Spaniel, English Springer Spaniel, Labrador Retriever, Collie, Miniature Schnauzer, Chinese Shar-Pei, Poodle, West Highland Terrier, Wheaten Terrier, Boxer, Dachshund, Dalmatian, Lhasa Apso, German Shepherd, and Golden Retriever (Scott, Miller, & Griffin, 2001). Clinically, the patient is diagnosed at around 5-6 years of age and usually has been under diagnosed from the condition because of other forms of dermatitis throughout their life. However, food allergy hypersensitivity has been diagnosed in animals as young as one year of age or less; despite experiencing clinical signs of other forms of hypersensitivity dermatitis.Diagnosis of food hypersensitivity can be made by intradermal allergy testing or by a trail of switching to a specific diet. To properly diagnose food hypersensitivity by switching to a 381060960special food, the owner will need to make sure the pet is on an adequate flea preventative and make sure the pet is clinically healthy other than the food hypersensitivity. Next, the owner and veterinarian must choose a feed that has a different protein and carbohydrate present in it that Fig. 2. Allergy Testing (AADC, n.d.)the old feed did not have. Once the food is chosen, the owner and family members must stay compliant to all instructions given by the veterinarian. “The diet must be fed either until the clinical signs resolve or are dramatically improved or until at least 12 weeks have passed” (Joyce, 2010). Being on the specific diet for at least 12 weeks gives the pet’s immune system time to change and adapt to the new feed, and hopefully, changes will be noticed. If any changes to the pet’s diet are made in the 12-week trial, for example if the pet were to receive a treat that is not approved, then the 12-week trial will need to start all over. It is critical that owners have a full understanding of how food trails are performed and how important they are to diagnosing food hypersensitivity in dogs and cats.Food hypersensitivity in dogs can be difficult for owners to get ahead of regarding treatments and what to do with the situation. Constantly changing feed is not tolerated well with the intestinal tract in a dog and can also cause flare-ups in food sensitivity. Every veterinarian has their way of treating food sensitivity, but the main treatment used is changing the diet to something that does not contain the same ingredients currently in the dog's diet. Diets that help veterinarians with treating food sensitivity are: “novelty protein and hydrolyzed protein diets, therapeutic diets that are formulated with higher and balanced levels of omega 3 and 6 fatty acids, and hypoallergenic diets that are produced by major manufacturers as their way of a therapeutic diet” (Lewis, 2012). Financially supporting a novel diet can be very 3810457200expensive over an extended period. For this reason, owner compliance is the biggest problem facing veterinarians in the fight with food allergies. Another issue is all the grain-free and novel protein diets that are on the market today. Many pet owners are switching to these diets because they are supposed to be healthier and Fig. 3. Novel diet. (Hills Pet Nutrition, n.d.)better for pets. “If a food elimination trial cannot be done properly, don’t do it at all” (Joyce, 2010). It is important that if owners want to switch their pet’s feed; they will need to follow through with the entire process. Owners will need to stay with the diet specifically, or their pet’s food hypersensitivity will not be properly diagnosed. Although it is difficult for clients to adhere to strict forms of treatment; the animal must avoid being fed the offending foods. Once the animal is on the hypoallergenic diet that has been effectively challenged, diagnosis, and is confirmed the prognosis is typically good. Most owners will want to switch the animal to a commercial novel protein diet automatically, but it is preferred to add single foodstuffs to the hypoallergenic diet. By adding single food items to the hypoallergenic diet, the owner and veterinarian are singling out the ingredients responsible for the food allergy hypersensitivity. These trials for adding the possible offending food ingredients will need to be tested for at least 10 to 14 days per ingredient, and the animal will need to be able to tolerate the varied diet for at least 4 to 6 months. Once the offending food ingredients are identified the veterinarian will be able to prescribe a wider variety of food for the animal to eat. Though 20% of animals will not be able to consume any commercial diet and must be maintained on a home-prepared diet (Scott, Miller, & Griffin, 2001). Fig. 4. Otitis Externa. (Vetbook, 2013.)left754380Many animals will still require frequent visits to the veterinarian for re-evaluations, and if the diet alone is not managing the food allergy hypersensitivity dermatitis, systemic glucocorticoids and antihistamine may be added. Typically, animals with food hypersensitivity also have additional skin related hypersensitivities such as flea allergy dermatitis, atopy, and bilateral otitis externa (secondary bacterial or Malassezia infections). Secondary seborrheic skin disease, or bacterial pyoderma or both can also be a factor. Animals experiencing other forms of hypersensitivity dermatitis will need to be treated appropriately for each skin condition to keep all complications under control.Many patients are seen in a clinical setting presenting with hypersensitivity dermatitis. The food allergy is due to a patient’s diet resulting in non-seasonal pruritus of the skin, along with ear canal disease, hair loss, gastrointestinal disease, and weight loss. Understanding food allergies starts with a detailed history of the patient's diet along with testing to determine the specific allergy. When the patient is diagnosed with a specific food allergy a proper diet can be prescribed to help control the disease; along with glucocorticoids, and antihistamines in severe cases. ReferencesAADC. (n.d.). Allergy skin testing [Photograph]. Retrieved from Pet Nutrition. (n.d.). z/d? Canine [Photograph]. Retrieved from HYPERLINK "" Joyce, J. (2010). Notes on small animal dermatology. Ames, Iowa: Wiley-Blackwell.Lewis, T. (2012, April 1). Food hypersensitivities: Performing an elimination diet trial. DVM360 Magazine. Retrieved from performing-elimination-diet-trial Scott, D. W., Miller, W. H., and Griffin, C. E. (2001). Muller & Kirk’s small animal dermatology (Sixth Edition). W. B. Saunders Company. Philadelphia, Pennsylvania.Sousa, C. (n.d.). Canine skin allergy reaction to dog food [Photograph]. Retrieved from . (2013, January 29). Otitis externa [Photograph]. Retrieved from ................
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