Skin disease in cats and dogs represents 20% of all consultations.1 Allergic dermatitis is complex to diagnose and manage, but nutrition can play a key role in both helping us understand the underlying cause and managing it.
Atopic Dermatitis (AD) relates to environmental allergies. Canine Atopic Dermatitis (CAD) is a pruritic, inflammatory skin disease that can result from a genetic predisposition, as well as other factors such as sensitivity to allergens including pollens, molds, dust and house mites.
Adverse Food Reaction (AFR) is food-based and can be a serious condition. The pet’s body can confuse dietary proteins with harmful molecules and release inflammatory mediators to destroy them.
The clinical signs and lesions of AD and AFR can be very similar2,3,4 and some pets may be affected by both AD and AFR at the same time.2,5
Figure 1. Possible Dermatological Clinical Signs of both AFR and AD
Figure 2. Examples of Dermatological Clinical Signs in Dogs
THE VALUE OF THE ELIMINATION DIET TRIAL FOR ALLERGIC DERMATITIS
An elimination diet trial is the only reliable method to diagnose a food allergy in cats and dogs.6 This involves the dog or cat being exclusively fed an elimination diet, which means no additional treats or other sources of food can be fed for a period of 8-12 weeks. Once the clinical signs have resolved, provocation with previous diets or suspected foods one at a time can confirm the diagnosis due to relapsing clinical signs.
ROYAL CANIN® Anallergenic is designed to support elimination diet trials and long-term AFR management, with protein exclusively from hydrolyzed feather-based protein (88% of protein as pure amino acids and 99% finished product protein <6 KDa) to minimize the possibility of an allergic reaction.7,8,9
Figure 3. ROYAL CANIN® Anallergenic for Dogs and Cats
MANAGEMENT PHASE AFTER CLINICAL RESPONSE
If a food sensitivity is diagnosed, there are a few nutritional options available to pets:
- Hydrolyzed Protein Diets Formulated with proteins broken down into smaller fragments and therefore are likely to be small enough to avoid for the immune system to recognize them as foreign and trigger a response.
- Selected or Novel Protein Diets Formulated with animal protein and carbohydrate sources that are less commonly associated with food sensitivities in dogs or cats.
- Vegetarian Diets Free of animal-based proteins, they minimize the potential of an adverse food reaction through the inclusion of plant-based selected protein sources.
MANAGEMENT PHASE AFTER NO CLINICAL RESPONSE
When patients do not improve on well-conducted food elimination trials, a diagnosis of AD can be made. Several therapeutic avenues can be explored, including nutritional management targeted at reducing complications, such as pruritus, inflammation, secondary bacterial and yeast infections, and promoting skin recovery.
ROYAL CANIN® Skintopic™ is specifically designed to support the management of CAD. The Skintopic™ Small Dog formula has been adapted for small dog specificities including kibble size and urinary, digestive and dental sensitivities.
Figure 4. ROYAL CANIN® Skintopic™ for Dogs of All Sizes
PATIENCE IS A VIRTUE WHEN TREATING ALLERGIC DERMATITIS!
Managing allergic dermatitis takes time and commitment. Educating pet owners is key. By working together, owners and veterinary staff can manage the condition effectively in the long term.
- Clear communication is key! Pet owners may expect allergic dermatitis to be resolved in one visit.
- When diagnosing the underlying cause of allergic dermatitis, a thorough workup is crucial.
- Managing the causative condition is key10,11.
- When ectoparasites, infections and endocrine disease have been ruled out, the next step is to consider an elimination diet trial.
- An elimination diet trial requires full owner commitment, so choosing the correct diet is critical.
- Pet owners may need education on elimination diet trials and recommended diets.
Through proper diagnosis and the right nutritional recommendations, it is possible to improve the long-term skin health of pets.
References
- Hill PB et al. Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice. Veterinary Record 2006; 158: 533-539.
- Verlinden A, Hesta M, Millet S, Janssens G. P.J. Food allergy in dogs and cats. Critical Reviews in Food Science and Nutrition 2006; 46:3: 259-273.
- Favrot C. Feline non-flea induced hypersensitivity dermatitis – Clinical features, Diagnosis and Treatment. Journal of Feline Medicine and Surgery 2013; 15: 778–784.
- DeBoer DJ, Hillier A. The ACVD Task Force on canine atopic dermatitis (XV): Fundamental concepts in clinical diagnosis. Veterinary Immunology and Pathology 2001; 81: 271-276.
- Scott D et al. Feline dermatology at Cornell University: 1407 cases (1988–2003). Journal of Feline Medicine and Surgery 2012; 15: 307–316.
- Mueller R.S., Olivry T. Critically appraised topic on adverse food reactions of companion animals (4): Can we diagnose adverse food reactions in dogs and cats with in vivo or in vitro tests? BMC Vet Res 2017; 13: 275. https://doi.org/10.1186/s12917-017-1142-0
- Olivry T, Bizikova P. A systematic review of the evidence of reduced allergenicity and clinical benefit of food hydrolysates in dogs with cutaneous adverse food reactions. Veterinary Dermatology 2010; Feb;21(1): 32-41.
- Martin A et al. Identification of allergens responsible for canine cutaneous adverse food reactions to lamb, beef and cow’s milk. Veterinary Dermatology 2004; 15:349–56.
- Verlinden A , Hesta M, Millet S, Janssens G. P.J. Food Allergy in Dogs and Cats: A review in Critical Reviews in Food Science and Nutrition 2006; 46:3: 259-273.
a. Sera from cats with naturally occurring chicken-specific IgEs
b. Sera from dogs & cats with naturally occurring corn-specific IgEs - Halliwell R.E.W. The diagnostic approach to pruritus. Proceedings of the Continuing Education Program of the WCVD 2016; 5-13.
- Verlinden A, Hesta M, Millet S, Janssens G. P.J. Food allergy in dogs and cats. Critical Reviews in Food Science and Nutrition 2006; 46:3: 259-273
