Dietary Sensitivity

Question 1

Define dietary sensitivity

Answer 1

Any adverse reaction to food, food poisoning, food intolerance, food allergy

Question 2

How do You manage dietary sensitivity

Answer 2

Excluding the foods from the diet that cause the aversion

Question 3

What is food poisoning

Answer 3

The direct action of toxins released within food by organisms that are contaminating it. Infection of the patient by the organism that has contaminated food!

Question 4

Define Food intolerance and describe the two types

Answer 4

A reproducible adverse reaction to food
Predictable- ingestion unsafe foods, gorging, in-adequately prepared foods
Unpredictable- non-immunological reactions in susceptible individuals.
Reasons may include-intestinal flora, enzyme activity, permeability, post absorption metabolism, mast cell stability.

Question 5

Define food allergy

Answer 5

A reproducible adverse reaction to a specific food or food additive proven immunological basis

Question 6

What does food allergy present with?

Answer 6

Pruitic skin disease, vomiting, abdominal pain, weight loss, altered appetite, haematemesis, diarrhoea

Question 7

Intolerance versus a food allergy

Answer 7

No clinical relevance, dose dependant, only on first exposure, avoidance of antigenic related food unneccessary

Question 8

What are the Mechanisms of food allergy?

Answer 8

Genetic- inadequate mucosal barrier, abnormal antigen presentation, Dysregulation of the mucosal immune system
Environmental triggers

Question 9

List the common food allergies seen in dogs and cats

Answer 9

Dogs- gluten, beef, dairy

Cats- beef dairy products and fish

Question 10

Signs of a food allergy

Answer 10

Urticaria, dermatological, GI, anaphylaxis, behaviour, seizures, lameness and asthma
Vomiting ± blood
 Abdominal ‘pain’
 Diarrhoea ± blood (colitis?)
 Altered appetite
 Weight loss or failure to thrive

Question 11

How is a food allergy diagnosed?

Answer 11

Indirect- Intradermal skin tests (not reliable). Serology (unreliable)
Direct-exclusion trial diets

Question 12

What are the 4 components of an exclusion diet

Answer 12

Exclusion-trying pet with a diet that they have never been exposed to previously
Challenge and rescue-once remission is achieved challenge with original diet
Provocation and rescue- after relapse during the challenge series of provocation tests single foods are reintroduced
Maintain on a safe regular diet that excludes all the antigenic foods discovered

Question 13

List and describe the three main trial diets

Answer 13

Traditional (restricted antigen)- single protein and carb source

Hydrolysed- proteins are split up into smaller molecules that theoretically will not stimulate and immune response igE (won’t completely abolish immune response) very expensive.

Elemental diets- anallergenic hydrolysed feather proteins less than 1kD

Question 14

How long should an exclusion diet be challenged for?

Answer 14

Up to 14 days relapse on at least two days

Question 15

List the histological changes within the gut that indicate food allergy

Answer 15

Villus atrophy
Eosinophillic inflitrate
Intraepithelial lymphocyte infiltration
Lymphoplasmacytic infiltrate

Question 16

Why should you not give dairy products to animals with D+?

Answer 16

Lactase deficiency
secondary reduction in activity may also occur
following mucosal damage
adult cats have low lactase activity compared
with kittens

Question 17

What diseases respond to diet changes?

Answer 17

SIBO
 IBD
 Lymphangiectasia
 Chronic gastritis
 GE reflux
 Gastric emptying
disorders
 EPI
 Pancreatitis
 PSS
 Obesity