No results found.
Shannon Palermo, VMD, University of Pennsylvania
Sign in to Print/View PDF
This is a filled error message
To access full articles on www.cliniciansbrief.com, please sign in below.
Create an account for free
Want free access to the #1 publication for diagnostic and treatment information? Create a free account to read full articles and access web-exclusive content on cliniciansbrief.com.
Passwords do not match
Where are you from?
AG|Antigua and Barbuda
BA|Bosnia and Herzegovina
IO|British Indian Ocean Territory
CF|Central African Republic
CC|Cocos (Keeling) Islands
CD|Congo, the Democratic Republic of the
FK|Falkland Islands (Malvinas)
TF|French Southern Territories
HM|Heard Island and McDonald Islands
VA|Holy See (Vatican City State)
KR|Korea, Republic of
LY|Libyan Arab Jamahiriya
MK|Macedonia, the former Yugoslav Republic
FM|Micronesia, Federated States of
MD|Moldova, Republic of
MP|Northern Mariana Islands
PG|Papua New Guinea
KN|Saint Kitts and Nevis
VC|Saint Vincent and the Grenadines
ST|Sao Tome and Principe
GS|South Georgia and the South Sandwich Islands
PM|Saint Pierre and Miquelon
SJ|Svalbard and Jan Mayen
SY|Syrian Arab Republic
TW|Taiwan, Province of China
TZ|Tanzania, United Republic of
TT|Trinidad and Tobago
TC|Turks and Caicos Islands
AE|United Arab Emirates
UM|United States Minor Outlying Islands
VG|Virgin Islands, British
VI|Virgin Islands, U.S.
WF|Wallis and Futuna
DC|District of Columbia
Micronesia (Federated States Of)
US Minor Outlying Islands
Armed Forces Africa
Armed Forces Americas Aa (except Canada)
Armed Forces Canada
Armed Forces Europe Ae
Armed Forces Middle East Ae
Armed Forces Pacific Ap
PE|Prince Edward Island
Tell us about yourself
Choose the category that describes your business/professional activity
What best describes your position? (question 1 of 2)
Veterinarian Role: (question 2 of 2)
Non-Veterinarian Role: (question 2 of 2)
Yes, I would like to receive updates about products & services, promotions, special offers, news & events from Brief Media.
Already have an account? Sign in here.
Acceptance to the GDPR regulations is required.
Sponsored by Spectrum
Itchy pets are one of the most common reasons for examination room visits; however, clinical signs of allergies may be mild at the onset. By incorporating allergy testing into standard examination visits, appropriate treatment can be initiated sooner to provide faster relief to pets (and owners). Allergy testing can also help eliminate other possible causes of skin disease such as endocrinopathies, immune-mediated disease, and neoplasia. There is no cure for allergic disease, but proper diagnosis is the first step toward successful long-term management.
The prevalence of allergy-related GI conditions is not known, but estimates range from 10% to 23%.1 Exposure to allergens results in an IgE-mediated antibody response, and the culmination of these responses results in the clinical manifestation of allergy signs. Serum IgE tests such as Spectrum’s SPOT test will detect levels of allergen-specific IgE for each food type. Approximately 90% of patients tested for environmental and food allergies and subsequently hyposensitized show significant improvement in clinical signs, according to a survey of veterinarians.2
Many dogs with food allergies or atopy have skin lesions associated with the ears, which can lead to recurrent otitis externa. Allergies account for approximately 5%-10% of all skin disorders and 31% of non-seasonal canine dermatitis cases.3 Without removing the inciting cause or predisposing factor, ear infections are likely to continue to recur and can lead to fibrosis and narrowing of the ear canal. Surgical correction is ultimately necessary in many cases.
Excessive itching and scratching not only places pets at risk for secondary infections but also can (literally) keep owners up at night. Itchy pets are at risk for developing secondary infections, which can delay time to clinical improvement and can create a cycle of inflammation and perpetuation of skin disease. Specific allergy testing for these patients can lead to diagnosis and allow the initiation of specific treatment to break the itch cycle.
Skin inflammation and allergic skin disease can predispose pets to developing anal gland problems. This can manifest as recurrent scooting, licking, or biting at the region. Food intolerance is also a common cause of anal sac disease. Problems result secondary to glandular hypersecretion and perianal inflammation. If left untreated, impaction, anal sacculitis, and abscesses may occur.
Seasonal allergies can result in both ocular and nasal signs. These signs may be subtle, but they can last the entirety of the allergy season and cause discomfort and irritation to pets that suffer from seasonal allergies.
Patients that suffer from coughing and nasal congestion, especially seasonally, are great candidates for allergy testing. Although these clinical signs are also found with primary respiratory diseases, missing a diagnosis of allergies can result in overmedicating and masking clinical signs without appropriately providing treatment and relief to pets suffering from seasonal allergies.5
Early diagnosis is key to treating allergic conditions. Medicating clinical signs without definitive diagnosis may only mask the underlying problem at hand and lead to long-term treatment failure and further complications. Once on treatment, these patients should continue immunotherapy year-round to ensure proper management and maximum comfort.
The first step in treating an allergic patient is obtaining a thorough history. The most common allergies in pets are flea allergy, food allergy, and atopy. Inquiring about environmental triggers, seasonality, current diet, and recent dietary changes can provide a great deal of insight regarding the cause of a pet’s clinical signs and can ultimately help with diagnosis. For example, a pet with clinical signs that are seasonal is unlikely to have a food allergy. Clients should be instructed to keep a log or diary of clinical signs, which can help identify allergy triggers or patterns of seasonality. A good history alone can narrow the differentials and help guide the most appropriate next diagnostic step.
Food allergies account for approximately 9% to 36% of allergies seen in dogs and approximately 40% of allergies seen in cats.3,4 They represent the third most common allergy (after flea-bite allergy and atopy) in the pet population.6
The most common culprits are protein sources in the diet. A diet trial consists of feeding a novel diet—ideally for 12 weeks, but for a minimum of 8 weeks. There are 2 types of commercial diets available: novel protein diets and hydrolyzed protein diets. Novel protein diets contain unusual protein sources such as kangaroo, catfish, and venison. Hydrolyzed diets include common protein sources that have been broken down to short peptide chains; this theoretically makes them unrecognizable to the immune system. Home-cooked diets may also be used, but supplementation is required with long-term use.
During a dietary trial, it is crucial to avoid all other diets, treats, and flavored medications. Many owners find this challenging, but compliance is crucial. If a marked reduction in clinical signs occurs after 8 weeks, the pet is then challenged with the original diet. If clinical signs return following this challenge, food allergy is diagnosed.
The most reliable way to definitively diagnose allergies in both dogs and cats is with specific allergy testing. Allergy testing can provide a diagnosis for an itchy pet and is the first step toward long-term management via allergen-specific therapy.
There are 2 types of allergy testing available that involve serum or skin testing. Blood tests evaluate for allergen-induced antibodies in the serum and include both radioallergosorbant (RAST) and ELISA tests. Neither test is affected by recent steroid administration or by cyclosporine or antihistamine use.7 The second category of allergy testing is intradermal skin testing, which does require weaning off of any suppression therapies prior to testing. Intradermal testing involves injecting test allergens under the patient’s skin and monitoring the injection sites for evidence of an allergic reaction. Both blood and intradermal tests evaluate specific allergens, which vary based on geographic location. Once a diagnosis is confirmed, specific treatment can be initiated to provide allergy relief.
References and Author Information
Material from Clinician’s Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*
*2007-2017 PERQ and Essential Media Studies
It's Free & Simple
Delivered to Your Inbox
Join the Conversation
Follow us @CliniciansBrief
© 2018 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved.