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Small Animal Medicine II > Adverse Food Reactions > Flashcards

Adverse Food Reactions Flashcards

1
Q

What is the pathogenesis of food allergies? What are some likely causes?

A

absorbed food proteins of 10000-60000 daltons cause a Type I or IV reaction –> looks like atopic dermatitis!

  • genetics
  • alternation in gut permeability
  • dysbiosis
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2
Q

What are 4 non-immunologic reactions associated with adverse reactions to food?

A
  1. food intolerance
  2. idiosyncratic adverse reactions (additives)
  3. pharmacologic - vasoactive amines (histamine)
  4. food poisoning
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3
Q

What are the most common offending substrates that cause ARFs in dogs?

A
  • beef
  • diary - skim milk, whey
  • wheat
  • poultry - chicken, meal, eggs
  • lamb
  • soy
  • corn (starch)
  • pork
  • rice
  • fish
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4
Q

What are the most common offending substances that cause ARFs in cats?

A
  • beef
  • dairy
  • fish
  • poultry
  • corn
  • lamb
  • pork
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5
Q

Cross-reactivity:

A
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6
Q

What age is associated with AFRs?

A

<1-3 y/o, but seen at any age

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7
Q

What are 3 historical features associated with AFRs?

A
  1. non-seasonal
  2. same diet for an extended time (not associated with dietary changes)
  3. poorly responsive to glucocorticoid therapy
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8
Q

What are 5 PE findings in ARFs in dogs?

A
  1. non-seasonal pruritus - face rubbing, foot licking, generalized
  2. otitis externa
  3. recurrent superficial pyoderma or folliculitis
  4. interdigital pyoderma
  5. GI signs - increased frequency of defecation, borborygmus, vomiting, IBD-like signs, seborrhea, urticaria, excessive gas, soft stools
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9
Q

AFR, dog:

A

signs typically return after glucocorticoid or antibiotic treatment

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10
Q

AFR:

A

superficial pyoderma - r/o atopy vs food

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11
Q

What are 5 PE findings in cats with AFRs?

A
  1. pruritis - commonly on head, neck, ventral abdomen, pinnae
  2. facial dermatitis
  3. otitis external
  4. reaction patterns - eosinophilic dermatitis, indolent ulcers, miliary dermatitis, self-induced (symmetrical ventral) alopecia
  5. extracutaneous - GI, conjunctivitis
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12
Q

AFR, cat:

A

pinna and head commonly affected

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13
Q

AFR, cat:

A

reaction pattern - miliary dermatitis

  • flea bite hypersensitivity vs. atopy vs food
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14
Q

AFR, cat:

A

symmetrical licking down neck

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15
Q

Food vs environmental allergies:

A
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16
Q

When should allergy testing or food trials be recommended for an itchy patient?

A

ALLERGY TESTING - fulfills criteria, breed, classical signs, seasonal, response to treatment

FOOD TRIAL - signalment, non-seasonal, poor response to treatments, cat

17
Q

How does cause of pruritis compare in dogs and cats?

A

DOGS - AFR = 10-30%

CATS - AFR = 50-90%

18
Q

What are clinical features used to diagnose AFRs? What specific diagnostic is recommended? Avoided?

A

poor response to glucocorticoid therapy

hypoallergenic (elimination) diet trial - 8-12 weeks, look for >50% improvement

allergy testing

19
Q

What does diagnosis of AFR require?

A

control secondary infections/issues –> dietary trial for 8-12 weeks –> challenge with original diet –> provocative exposure to identify offending allergens

20
Q

What home-cooked diets can work as novel protein diets for trials in dogs and cats?

A

DOGS - emu and rutabaga, pinto beans and rice, pork and rice, green beans and applesauce, tofu and rice, pumpkin and pinto beans

CATS - require little to no carbohydrates

  • NOT balanced diets, only recommended for limited time
  • can be formulated to be balanced using veterinary resources
21
Q

What are 4 options for commercial novel protein diets for trials?

A
  1. Hill’s d/d - potato and salmon, egg and rice, potato and duck, potato and venison
  2. Royal Canin Select protein - kangaroo and oats, potato and venison, potato and fish
  3. Royal Canine vegetarian formula
  4. Blue Buffalo Novel Portein - alligator
22
Q

What are hydrolysate diets?

A

proteins broken down in size (<1500 daltons) to reduce allergenicity –> commonly combined with novel protein diets

  • feather protein
  • chicken liver
  • salmon soy
23
Q

What are some options for feline hydrolyzed protein diets?

A
  • Royal Canine Hypoallergenic - Brewer’s rice and hydrolyzed soy
  • Hills z/d - Brewer’s rice and chicken liver
  • Royal Canin Ultamino - corn starch and poultry aggregate
  • Hills d/d
24
Q

What kind of diet is Purina Pro Plan EL?

A

proteins are broken down to an amino acid (oligopeptide) level

25
Q

Are skin support diets acceptable for dietary trials?

A

NO - neither novel proteins nor hydrolized proteins

  • do contain fatty acids for barrier function
  • OTC diets NOT reliable, often contaminated
26
Q

When may grain free diets show improvment in animals with AFRs?

A

if they are allergic to wheat

  • clear association with DCM in dogs
27
Q

Dog hypoallergenic diets:

A
28
Q

Cat hypoallergenic diets:

A
29
Q

How long should a hypoallergenic trial extend in dogs and cats?

A

DOGS - minimum 5 weeks –> 8-12 raises sensitivity

CATS - minimum 6 weeks –> 8 weeks raises sensitivity

30
Q

AFR:

A

utricaria

31
Q

What are keys to a successful dietary trial?

A
  • know who is feeding the pet
  • eliminate all snacks and treats, including rawhides
  • NO flavored medication (heartworm)
  • administer medication with marshmallows, fruit roll-ups, or cubes of potato/rice
  • have owner keep a log or diary
  • regular phone check-ups
32
Q

What treats can be given to animals on a food trial?

A
  • hypoallergenic treats - check ingredient list!
  • ice chips
  • food part of the trial
33
Q

When is a positive response to a dietary trial expected?

A

within weeks - ranges from 2-12 weeks on the diet

  • owners may not notice a change until the pet is put back on the original diet
  • 100% improvement is only possible if a food allergy is the only problem –> concurrent atopy, perpetuating infections
34
Q

Does a positive dietary response confirm an adverse food reaction?

A

NO - other disease conditions (atopy) may respond to hypoallergenic diets rich in fatty acids

35
Q

How are AFRs confirmed? Specific causes?

A

dietary challenge - induce a relapse of clinical signs by restarting old diet and treats –> expect signs to occur within minutes to 14 days

provocative exposure - add new ingredient every 7-10 days, if no reaction, continue with hypoallergenic diet for 7 days and add a new ingredient –> goal is to find a commercial diet that is acceptable

36
Q

What long-term therapy is recommended for AFRs?

A
  • avoid allergens
  • control secondary infections - crucial if these are key manifestations, treat while starting dietary trial
37
Q

What tends to happen in dogs with environmental and food allergies? How are these dogs identified?

A

perceived failure to diet trials AND atopy therapies

  • control all secondary issues
  • allergy test to confirm atopic dermatitis
  • treat atopic disease to get a 50% reduction in itch
  • start a food trial
38
Q

What solid data is there of raw meat diets?

A

significant public health risk –> clear increase in fecal E. coli, Listeria, and Salmonella counts

Small Animal Medicine II (57 decks)

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