Food hypersensitivity

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Sections available in full article Introduction, Presenting signs, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Ian Mason BVetMed PhD CertSAD DipECVD MRCVS
Dr Philip K Nicholls BVSc BSc PhD MRCVS FRCPath
Mr David Scarff BVetMed CertSAD MRCVS

Introduction

  • An adverse reaction to ingested antigens.
  • Incidence : 1-6% of all feline dermatoses.
  • Strict definition excludes food intolerance, eg diarrhea due to sudden dietary change or excessive lactose, however the term tends to encompass any abnormal reaction to a specific food.
  • Cause : commonly proteins, but any component of diet can be implicated.
  • Signs : skin, gastrointestinal signs; rarely, respiratory and CNS signs.
  • Diagnosis : exclude differential diagnoses, elimination diets.
  • Treatment : avoid foods which trigger reaction, hypoallergenic diet.
  • Prognosis : good if offending food is identified and eliminated.

Diagnosis

Clinical signs

  • Pruritus, commonly face, head, ears and neck, but can be generalized  Skin: food allergy 03   Skin: food allergy 05   Skin: food allergy 06   Skin: food allergy 07   Skin: food allergy 08   Skin: food allergy 01   Skin: food allergy 02  .
  • Miliary dermatitis  Dermatitis: miliary   Skin: miliary dermatitis - DSH 8 years  .
  • Eosinophilic granuloma complexes  Eosinophilic granuloma complex   Skin: eosinophilic granuloma - mouth  .
  • Symmetrical alopecia.
  • Concurrent flea-bite hypersensitivity  Flea bite hypersensitivity  or atopy  Atopy   Skin: atopy and food allergy - acute  .
  • Angio-edema, urticaria and conjunctivitis  Conjunctivitis   Conjunctiva: follicular conjunctivitis 01   Conjunctiva: follicular conjunctivitis 02  .
  • Gastrointestinal signs (diarrhea  Diarrhea: dietary  , vomiting  Vomiting  , colitis  Colitis  ).
  • Sneezing, malaise, dullness.
  • Peripheral lymphadenopathy.

Diagnosis

Differential diagnosis

Other pruritic dermatoses
  • Ectoparasitism:
    • Flea allergy  Flea bite hypersensitivity  .
    • Cheyletiellosis  Cheyletiellosis  .
    • Trombiculidiasis.
  • Pediculosis  Pediculosis  .
  • Notoedric mange  Notoedric mange  .
  • Otodectic mange  Otodectes disease  .
  • Immune reactions:
    • Contact dermatitis  Skin: allergic contact dermatitis  .
    • Drug sensitivity.
    • Atopy  Atopy  .
    • Pemphigus foliaceus  Pemphigus foliaceus  .
  • Other:
    • Neurodermatitis.
    • Dermatophytoses  Dermatophytosis  .
    • Pyoderma.
    • Psychogenic alopecia.
    • Biotin or fatty acid deficiency.

Sequelae

Prognosis

  • Good - but hypersensitivity is likely to be lifelong and theoretically hypersensitivity to other components of diet or other substances can develop.

Expected response to treatment

  • Reduced pruritus on exclusion diet, but may take several months.

Reasons for treatment failure

  • Concurrent flea allergy dermatitis  Flea bite hypersensitivity  .
  • Owner non-compliance with exclusion diet.
  • Misdiagnosis.
  • Concurrent bacterial or parasitic skin disease not treated.
  • Standard reasons  Standard reasons for failure in a treatment  .

Sources

Publications

Refereed papers

  • Leistra M & Willemse T (2002)Double-blind evaluation of two commercial hypoallergenic diets in cats with adverse food reactions.J Feline Med Surg4(4), 185-188.
  • Hill P (1999)Diagnosing cutaneous food allergies in dogs and cats - practical considerations.In Pract21, 287-294.
  • Carlotti D N, Remy I & Prost C (1990)Food allergy in dogs and cats - a review and report of 43 cases.Vet Dermatol1, 55.
  • White S D & Sequoia (1989)Food hypersensitivity in cats - 14 cases (1982-1987).JAVMA194, 692.

Other sources of information

  • Rosser EJ (1996)Food hypersensitivity - new recommendations for diagnosis and management.In:Consultations in Feline Internal Medicine.3rd Edition. Ed: August. W B Saunders Co, Philadelphia. pp 209-213.

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