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Sofou EI, Aleksandrova S, Chatzis M, Samuel Badulescu E, Saridomichelakis MN. Establishment of clinical criteria for the diagnosis of adverse food reactions in dogs with atopic dermatitis. Vet Dermatol 2024; 35:418-431. [PMID: 38425024 DOI: 10.1111/vde.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/31/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Diagnosis of canine adverse food reactions (AFRs) is based on vague criteria, such as '>50% improvement' during elimination diet trial (EDT) followed by 'deterioration' during provocation test (PT). OBJECTIVE The objective of the study was to use predefined criteria to evaluate response during EDT [i.e., Owner Global Assessment of Treatment Efficacy (OGATE) = good-to-excellent] and relapse during PT [i.e., Owner Global Assessment of Challenge Deterioration (OGACD) = moderate-to-severe and/or >100% increase of lesional (Canine Atopic Dermatitis Extent and Severity Index, 4th iteration, CADESI-04) and/or of pruritus (pruritus Visual Analog Scale, PVAS) scores]. ANIMALS Twenty-nine dogs with atopic dermatitis. MATERIALS AND METHODS An extensively hydrolysed diet was fed to all dogs followed, in seven of 11 nonresponders, by a second home-made novel-protein EDT. Dogs responding to either EDT were challenged with their previous diet. RESULTS Thirteen (44.8%) dogs were diagnosed with AFRs: at the end of EDT, their OGATE was good (9 of 13; 69.2%) or excellent (four of 13; 30.8%), and both CADESI-04 (46.7%) and PVAS (71.1%) had decreased significantly; at the end of PT, OGACD was moderate or severe in 12 of 13 (92.3%) dogs, and both CADESI-04 (127.9%) and PVAS (181.8%) had increased significantly. Of the 16 dogs without AFRs, 6 (37.5%) responded to the commercial (n = 5) or home-made (n = 1) diet [OGATE = good (three of six) or excellent (three of six)], with significant concurrent reduction of CADESI-04 and nonsignificant reduction of PVAS, yet they did not relapse during PT. CONCLUSIONS AND CLINICAL RELEVANCE The proposed (predefined) criteria for the evaluation of response during EDT and deterioration during PT seem reliable and are easily applicable in clinical practice and research.
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Affiliation(s)
- Evi I Sofou
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - Svetlina Aleksandrova
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - Manolis Chatzis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - Elisa Samuel Badulescu
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
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Bradley CW, Mauldin EA, Morris DO. A review of cutaneous hypersensitivity reactions in dogs: A diagnostician's guide to allergy. Vet Pathol 2023; 60:783-795. [PMID: 37515434 DOI: 10.1177/03009858231189298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Allergic dermatoses are common in people and domestic animals. Resultant lesions are routinely biopsied and submitted for histological examination to confirm a diagnosis or rule out diseases with overlapping or atypical clinical features. Diagnostic pathologists and clinicians are often faced with the difficult task of determining whether an allergic reaction pattern is present on both the microscopic and macroscopic levels and correlating histopathologic findings with clinical and historical data to achieve a precise clinical diagnosis. The bulk of the current veterinary literature on allergic dermatoses focuses on atopic dermatitis in dogs, distantly followed by cats, horses, and other animals. The objectives of this review are to demonstrate the key histopathologic and clinical diagnostic features of the various allergy-mediated reaction patterns, and to provide diagnosticians with a practical guide for clinicopathological correlations. Current concepts in the pathophysiology of immediate hypersensitivity reactions, with a focus on atopic dermatitis, are discussed. Points of potential histopathologic overlap between the "classic" allergic reaction pattern and less common inflammatory, predominately eosinophilic, conditions that may mimic this pattern will be discussed with the goal of highlighting the critical need for collaboration between pathologists and clinicians in furthering patient care.
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Micháľová A, Takáčová M, Karasová M, Kunay L, Grelová S, Fialkovičová M. Comparative Study of Classical and Alternative Therapy in Dogs with Allergies. Animals (Basel) 2022; 12:ani12141832. [PMID: 35883379 PMCID: PMC9312212 DOI: 10.3390/ani12141832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Acupuncture, phytotherapy, and nutrition are part of traditional Chinese medicine, which has been used for literally hundreds to a few thousand years. These traditional therapeutic methods can effectively diagnose and treat acute and chronic diseases and can be used as a primary or complementary therapy. Used properly, these alternatives are safe and without side effects. Allergy is currently a very common diagnosis affecting dogs. Conventional Western medicine can treat symptoms but often does not identify and resolve the underlying problem. This comparative study was focused on the application of alternative and conventional medicine in allergic conditions in dogs, which were divided into two groups, where the effectiveness of both types of treatment was compared. Abstract Allergy is a malfunction of the immune system that causes an inappropriate reaction to normally harmless substances known as allergens, such as food components, pollen, parasites, mites, medication, etc. It is very important to make a correct diagnosis, to identify and to eliminate the offending allergen from the body, and provide control and long-term management to achieve a comfortable life for the animal. In the case of highly intensive pruritus, drugs such as glucocorticoids, antihistamines, and Janus kinase inhibitors are generally administered. Unfortunately, common drugs are not always able to resolve the problem. This comparative clinical-outcomes study focused on the application of alternatives, where a combination of acupuncture with phytotherapy and nutrition was applied. These traditional methods do not affect the body only symptomatologically; instead, they treat the patient as a whole. In this clinical study, the therapeutic effects and partial or complete stabilization of the allergic condition of fourteen dogs divided into two groups were observed, compared, and evaluated.
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Hardy J, Gajanayake I. Diagnosis and management of adverse food reactions in dogs and cats. IN PRACTICE 2022. [DOI: 10.1002/inpr.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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A 3-Year Case Report on an Atopic Patient with a Caninised Monoclonal Antibody Treatment. FOLIA VETERINARIA 2022. [DOI: 10.2478/fv-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
A 6-year-old, male, neutered, English Mastiff dog was presented for a second opinion due to chronic pruritus. The patient had been on methylprednisolone and chlorphenamine for four years. The diagnostic investigations included: swabs for bacterial and mycology culture, hair plugs for dermatophyte culture, acetate tape strips and deep skin scrapes, skin biopsies for dermatohistopathology, biochemistry, haematology, endocrinology, serology for canine scabies using enzyme-linked immunosorbent assay (ELISA) testing and serology for allergen specific IgE antibodies. The history and the diagnostics confirmed the diagnosis of canine atopic dermatitis. This case report details the treatment with lokivetmab, which is a caninised monoclonal antibody drug. At periods of flare ups, additional treatments were prescribed, such as systemic glucocorticoids and oclacitinib in order to manage the clinical signs. The treatment showed good response to the overall treatment management during the three year period of this atopic patient.
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Possebom J, Cruz A, Gmyterco VC, de Farias MR. Combined prick and patch tests for diagnosis of food hypersensitivity in dogs with chronic pruritus. Vet Dermatol 2022; 33:124-e36. [PMID: 35014738 DOI: 10.1111/vde.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/17/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous studies have shown that patch testing with food extracts can assist formulation of elimination diets (ED) in human patients with suspected adverse food reactions (AFR). Little is known about the use of these tests in dogs. OBJECTIVES To evaluate the effectiveness of a combination of prick and patch testing in current protocols, and food challenge (FC) tests in dogs with AFR. METHODS AND MATERIALS Prick and patch tests were performed on 21 dogs with chronic, nonseasonal pruritus. Dogs then were fed an ED formulated on the basis of the results. All dogs with improved clinical signs then were challenged with a food to which there had been a positive reaction in the tests. Six dogs subsequently were challenged with a food to which they had been negative on testing. Pruritus Visual Analog Scale (pVAS) and Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) were evaluated on Day (D)0, D30 and D60 of the ED. Sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values, and the Kappa (κ)value were calculated. RESULTS Of the 21 dogs, there was a significant mean improvement in pVAS and CADESI-04 scores in 16 (76%) dogs after D30 (P < 0.01) and D60 (P < 0.01) of the ED. There were no statistical differences between D30 and D60. The combination of tests had SE, SP, PPV, NPV and κ values of 80%, 66.7%, 66.7%, 80% and -0.17, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The combination of prick and patch testing reached high values of SE and NPV. A diagnosis of AFR was made in 76% of the dogs, and test results were useful for the selection of an ED.
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Affiliation(s)
- Juliane Possebom
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Ariane Cruz
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Vanessa Cunningham Gmyterco
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Marconi Rodrigues de Farias
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
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Weemhoff JL, MacLeay JM, Brejda J, Schiefelbein H, Wernimont SM, Gross KL. Successful nutritional control of scratching and clinical signs associated with adverse food reaction: A randomized controlled COSCAD'18 adherent clinical trial in dogs in the United States. J Vet Intern Med 2021; 35:1884-1892. [PMID: 34114677 PMCID: PMC8295670 DOI: 10.1111/jvim.16193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background Adverse reactions to food are a common dermatological condition in dogs, requiring nutritional intervention using a novel or hydrolysate protein‐based food. Objective To evaluate a therapeutic food containing egg and phytonutrients in dogs with food allergies using an activity monitor and core outcome set for canine atopic dermatitis (COSCAD'18) guidelines and in a controlled double‐masked, multicenter, prospective clinical trial. Animals Adult dogs with a history of adverse food reaction as diagnosed by a food elimination trial were recruited from general practices. Methods After a 21‐day baseline period, dogs were randomized to test or positive control (hydrolyzed protein) food for 21 days. Owner (pruritus visual analog score [PVAS], coat quality, food acceptance, and satisfaction) and veterinarian (canine atopic dermatitis lesion index [CADLI], physical examination) assessments were completed on days 0, 21, and 42. Dogs wore a collar‐mounted activity monitor to record scratching and shaking behavior throughout the study. Statistical analysis included within‐group comparison to baseline and between‐group comparison at study end using a significance threshold of alpha = 0.05. Results At the end of the treatment period, all results were similar between groups for CADLI, PVAS, owner satisfaction, activity, and questionnaire data. Scores for hair dullness, brittleness, amount of dandruff, feces quality, and food acceptance were positive and not statistically different between groups. Conclusions and Clinical Importance The therapeutic test food was well‐accepted and efficacious in managing signs of adverse reactions to food compared to baseline as well as compared to the positive control food.
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Affiliation(s)
- James L Weemhoff
- Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
| | - Jennifer M MacLeay
- Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
| | | | - Heidi Schiefelbein
- Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
| | - Susan M Wernimont
- Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
| | - Kathy L Gross
- Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
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Weemhoff JL, MacLeay JM, Brejda J, Schiefelbein H, Wernimont SM, Gross KL. Successful nutritional control of scratching and clinical signs associated with adverse food reaction: A randomized controlled COSCAD'18 adherent clinical trial in dogs in the United Kingdom. J Vet Intern Med 2021; 35:1893-1901. [PMID: 34114684 PMCID: PMC8295676 DOI: 10.1111/jvim.16192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
Background Adverse reactions to food are a common dermatological condition in dogs, requiring nutritional intervention using novel or hydrolysate protein‐based foods. Objective To evaluate a therapeutic food containing egg and phytonutrients in dogs with food allergies using an activity monitor and core outcome set for canine atopic dermatitis (COSCAD'18) in a controlled double‐masked, multicenter, prospective clinical trial. Animals Adult dogs with a history of adverse food reaction as diagnosed by a food elimination trial were recruited from general practices. Methods After a 21‐day baseline period, dogs were randomized to test or positive control (hydrolyzed protein) food for 21 days. Owner (pruritus visual analog score [PVAS], coat quality, food acceptance, and satisfaction) and veterinarian (canine atopic dermatitis lesion index [CADLI], physical examination) assessments were completed on days 0, 21, and 42. Dogs wore a collar‐mounted activity monitor to record sleep, scratching, and shaking behavior throughout the study. Statistical analysis included within‐group comparison to baseline and between‐group comparison at study end using a significance threshold of alpha = 0.05. Results At the end of the treatment period, all results were similar between groups for CADLI, PVAS, owner satisfaction, activity, and questionnaire data. Scores for hair dullness, brittleness, amount of dandruff, feces quality, and food acceptance were positive and were not statistically different between groups. Conclusions and Clinical Importance The therapeutic test food was well‐accepted and efficacious in managing signs of adverse reactions to food compared to baseline as well as compared to the positive control food.
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Affiliation(s)
| | | | | | | | | | - Kathy L Gross
- Hill's Pet Nutrition, Inc, Topeka, Kansas 66616, USA
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Favrot C, Bizikova P, Fischer N, Rostaher A, Olivry T. The usefulness of short-course prednisolone during the initial phase of an elimination diet trial in dogs with food-induced atopic dermatitis. Vet Dermatol 2019; 30:498-e149. [PMID: 31617265 DOI: 10.1111/vde.12793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Food allergy is a possible cause of atopic dermatitis (AD) in dogs; it is typically diagnosed following an eight-week elimination diet trial (EDT) and a provocation with the original diet. This lengthy procedure is difficult for owners and its interpretation may be unclear. HYPOTHESIS/OBJECTIVES To test the effect of prednisolone used in the first weeks of an EDT in order to reduce the total time period for diagnosis. The goal was to perform food challenges earlier than after the traditionally recommended eight weeks. ANIMALS Fifty-three dogs with AD were included in the study. METHODS AND MATERIALS All dogs were fed a commercially available extensively hydrolyzed protein-based commercial pet food and treated with prednisolone for at least two weeks to control pruritus and inflammation. Dogs were challenged two weeks after prednisolone finished, provided that no flare had occurred. Dogs with relapsing signs were fed the hydrolyzate for at least eight weeks with or without further prednisolone treatment. RESULTS Ten of 53 dogs (19%) had no relapse after two weeks off prednisolone: they were subsequently challenged with their regular food, had a relapse of signs and were diagnosed with a food-induced AD within four to six weeks of starting the EDT. In the other dogs, signs remained uncontrolled without prednisolone or relapsed rapidly after its discontinuation: they were considered nonfood-allergic after an eight week EDT. CONCLUSION AND CLINICAL IMPORTANCE This study demonstrates that a shorter EDT is possible if the allergic pruritus and inflammation are initially controlled with a short course of glucocorticoids. This shortened trial is likely to improve owner adherence and facilitate the diagnosis of food allergy.
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Affiliation(s)
- Claude Favrot
- Dermatology Unit, Clinical for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dive, Raleigh, NC, 27607, USA
| | - Petra Bizikova
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dive, Raleigh, NC, 27607, USA
| | - Nina Fischer
- Dermatology Unit, Clinical for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Ana Rostaher
- Dermatology Unit, Clinical for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dive, Raleigh, NC, 27607, USA
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Mueller RS, Olivry T. Critically appraised topic on adverse food reactions of companion animals (6): prevalence of noncutaneous manifestations of adverse food reactions in dogs and cats. BMC Vet Res 2018; 14:341. [PMID: 30419909 PMCID: PMC6233561 DOI: 10.1186/s12917-018-1656-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many reports describe the cutaneous signs of adverse food reactions (AFR) in the dog and cat. However, various non-cutaneous clinical signs are less well described. Our objective was to systematically evaluate these non-cutaneous signs of AFR in small animals. RESULTS We searched two databases (MEDLINE and Web of Science) for pertinent references on non-cutaneous signs of adverse food reactions. Among 117 and 764 articles found in the MEDLINE and Web of Science databases, respectively, we selected 47 articles that reported data related to non-cutaneous clinical signs of AFR. Gastrointestinal signs, symmetrical lupoid onychitis, conjunctivitis, sneezing, and anaphylaxis were reported to be associated with AFR in dogs and gastrointestinal and respiratory signs, conjunctivitis, and hyperactive behaviour in cats. In Border terriers with paroxysmal gluten-sensitive dyskinesia, an underlying AFR should be considered. Of these clinical signs diarrhoea and frequent defecation were most frequently reported to be diet-responsive in dogs; in the cat, these were vomiting and diarrhoea. CONCLUSIONS An elimination diet should be considered early in the work-up of dogs and cats with chronic vomiting and diarrhoea. Other non-cutaneous signs occur less commonly because of AFRs.
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Affiliation(s)
- Ralf S. Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA
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Mueller R, Unterer S. Adverse food reactions: Pathogenesis, clinical signs, diagnosis and alternatives to elimination diets. Vet J 2018; 236:89-95. [DOI: 10.1016/j.tvjl.2018.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023]
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Maina E, Matricoti I, Noli C. An assessment of a Western blot method for the investigation of canine cutaneous adverse food reactions. Vet Dermatol 2018; 29:217-e78. [DOI: 10.1111/vde.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Maina
- Laboratory of Immunology; Ghent University of Veterinary Medicine; Salisburylaan 133 Merelbeke 9820 Belgium
| | - Irina Matricoti
- Servizi Dermatologici Veterinari; Via Santo Stefano 168 Bologna 40125 Italy
| | - Chiara Noli
- Servizi Dermatologici Veterinari; Strada Bedale della Ressia 2 Peveragno 12016 Italy
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Mueller RS, 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. [PMID: 28854915 PMCID: PMC5577833 DOI: 10.1186/s12917-017-1142-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 07/14/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The gold standard to diagnose adverse food reactions (AFRs) in the dog and cat is currently an elimination diet with subsequent provocation trials. However, those trials are inconvenient and client compliance can be low. Our objective was to systematically review the literature to evaluate in vivo and in vitro tests used to diagnose AFR in small animals. RESULTS We searched three databases (CAB Abstracts, MEDLINE and Web of Science) for pertinent references on September 16, 2016. Among 71, 544 and 41 articles found in the CAB Abstract, MEDLINE and Web of Science databases, respectively, we selected 22 articles and abstracts from conference proceedings that reported data usable for evaluation of tests for AFR. Serum tests for food-specific IgE and IgG, intradermal testing with food antigens, lymphocyte proliferation tests, fecal food-specific IgE, patch, gastroscopic, and colonoscopic testing were evaluated. CONCLUSIONS Testing for serum food-specific IgE and IgG showed low repeatability and, in dogs, a highly variable accuracy. In cats, the accuracy of testing for food-specific IgE was low. Lymphocyte proliferation tests were more frequently positive and more accurate in animals with AFR, but, as they are more difficult to perform, they remain currently a research tool. All other reported tests were only evaluated by individual studies with small numbers of animals. Negative patch test reactions have a very high negative predictability in dogs and could enable a choice of ingredients for the elimination diet in selected patients. Gastroscopic and colonoscopic testing as well as food-specific fecal IgE or food-specific serum IgG measurements appear less useful. Currently, the best diagnostic procedure to identify AFRs in small animals remains an elimination diet with subsequent provocation trials.
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Affiliation(s)
- Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539, Munich, Germany.
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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Hensel P, Santoro D, Favrot C, Hill P, Griffin C. Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification. BMC Vet Res 2015; 11:196. [PMID: 26260508 PMCID: PMC4531508 DOI: 10.1186/s12917-015-0515-5] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Canine atopic dermatitis (AD) is a common, genetically predisposed, inflammatory and pruritic skin disease. The variation in clinical presentations, due to genetic factors, extent of the lesions, stage of the disease, secondary infections, as well as resemblance to other non-atopic related skin diseases, can complicate a diagnosis of canine AD. A sub-group of the International Committee for Allergic Diseases in Animals (ICADA) was tasked with the development of a set of practical guidelines that can be used to assist practitioners and researchers in the diagnosis of canine AD. Online citation databases and abstracts from international meetings were searched for publications related to the topic, and combined with expert opinion where necessary. The final set of guidelines was approved by the entire ICADA committee. RESULTS A total of 81 publications relevant for this review were identified. The guidelines generated focus on three aspects of the diagnostic approach: 1. Ruling out of other skin conditions with clinical signs resembling, or overlapping with canine AD. 2. Detailed interpretation of the historical and clinical features of patients affected by canine AD. 3. Allergy testing by intradermal versus allergen-specific IgE serum testing. CONCLUSIONS The diagnosis of canine AD is based on meeting clinical criteria and ruling out other possible causes with similar clinical signs. Flea combing, skin scraping and cytology should be performed, where necessary, as part of a thorough work-up. Elimination diet trials are required for patients with perennial pruritus and/or concurrent gastrointestinal signs. Once a clinical diagnosis of canine AD is made, allergy testing can be performed to identify potential causative allergens for allergen-specific immunotherapy.
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Affiliation(s)
- Patrick Hensel
- Tierdermatologie Basel, Emil Frey-Strasse 127, Münchenstein, Switzerland.
| | - Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Claude Favrot
- Vetsuisse Faculty University of Zurich, Clinic of Small Animal Internal Medicine, Zurich, Switzerland.
| | - Peter Hill
- Companion Animal Health Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, SA, 5371, Australia.
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