Skin: food hypersensitivity

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Sections available in full article Introduction, Presenting signs, Acute presentation, Geographic incidence, Age predisposition, Cost considerations, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Standard treatment, Monitoring, Subsequent management, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr David Scarff BVetMed CertSAD MRCVS
Dr Rosanna Marsella DVM DipACVD
Synonyms Dietary intolerance, Food hypersensitivity

Introduction

  • Cause : sensitivity to components of the diet resulting in skin disease.
  • Signs : there may be concurrent gastrointestinal signs and this may be the reason for advice being sought.
  • Can mimic any dermatosis, but often clinically indistinguishable from atopy.
  • Diagnosis : history, clinical signs, histopathology, response to treatment.
  • Treatment : hypoallergenic diet.
  • Prognosis : excellent if allergens identified and eliminated.

Diagnosis

Clinical signs

  • Pruritus either generalized or regional.
  • Primary maculopapular lesions with no site predilection.
  • Secondary staphylococcal pyoderma which often recurs very soon after antibiotic withdrawal.
  • Self-trauma leading to excoriation, alopecia, scale and crust.
  • Otitis externa Skin: otitis externa.
  • Urticarial reactions.
  • Malassezia dermatitis Malassezia dermatitis: cytology.

Diagnosis

Differential diagnosis


Pruritus
  • Atopy Skin: atopy.
  • Flea allergic dermatitis Skin: flea bite hypersensitivity.
  • Sarcoptic mange Skin: sarcoptic mange.
  • Superficial folliculitis Skin: bacterial skin disease - overview.
  • Lice Skin: parasitic disease - overview.
  • Seborrhea Skin: primary seborrhea.
  • Cheyletiellosis Skin: cheyletiellosis.
  • Malasseziadermatitis Skin: malassezia disease.
  • Intestinal parasitic hypersensitivity.
  • Drug hypersensitivity Skin: erythema multiforme.

Sequelae

Prognosis

  • Excellent if offending allergens identified and eliminated.

Expected response to treatment

  • A few dogs will develop further intolerances over time.

Reasons for treatment failure

  • Client not willing to carry out diet trial.
  • Preparing home-cooked food for a large dog in the long-term is onerous.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Ellwood C M & Garden O A (1999) Gastrointestinal immunity in health and disease. Vet Clin North Am Small Anim Pract 29 (2), 471-500.
  • Hill P (1999) Diagnosing cutaneous food allergies in dogs and cats - practical considerations. In Practice. 21 , 287-294.
  • White S D (1998) Food allergy in dogs. Comp Cont Ed Prac Vet 20 , 261-269.
  • Paterson S (1995) Food hypersensitivity in 20 dogs with skin and gastrointestinal signs. JSAP 36 , 529-534.
  • Simpson J W (1995) Management of colonic disease in the dog. Waltham Focus 5 , 17-22.
  • Fadok V A (1994) Diagnosing and managing the food-allergic dog. Comp Cont Ed Prac Vet 16 , 1541-1544.
  • Halliwell R E W (1993) The serological diagnosis of IgE-mediated allergic disease in domestic animals. J Clin Immunoassay 16 (2), 103-108.
  • Rosser E J (1993) Diagnosis of food allergy in dogs. JAVMA 203 , 259-262.
  • Kunkle G & Horner S (1992) Validity of skin testing for diagnosis of food allergy in dogs. JAVMA 200 (5), 677-680.
  • Halliwell R E W (1992) Management of dietary hypersensitivity in the dog. JSAP 33 , 156-160.
  • Jeffers J G, Shanley K J & Meyer E K (1991) Diagnostic testing of dogs for food hypersensitivity. JAVMA 198 , 245-250.
  • Scott D W (1978) Immunologic skin disorders of the dog and cat. Vet Clin North Am 8 , 641-664.

Other sources of information

  • Brostoff J & Hall A (1996) In: Immunology. 4th edn. Roti I, Brostoff J & Male D (eds). D Mosby, London. pp 15.
  • Wills J M & Halliwell R E W (1994) Dietary Sensitivity. In: The Waltham Book of Clinical Nutrition of the Dog and Cat. pp 167-188.
  • Reedy L M & Miller W H (1989) Allergic skin diseases of Dogs and Cats. W B Saunders, Philadelphia. pp 147-159.

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