What to feed my dog with food allergies

Food allergies or food intolerance may final a lifetime. The main goal in managing allergies or adverse reactions to food is to discover and avoid the food ingredient responsible for causing the skin and/or gastrointestinal signs. If your dog suffers from food allergies, it’s even more significant to feed the correct dog food.

Dietary elimination trials — removing the ingredient from the food your dog eats is the most practical and precise methods of diagnosing food allergies in dogs.

The food your dog eats should be balanced and contain as few ingredients and additives as possible. Be mindful to remove access to every other dog food, table food, treats, snacks and chew toys while you are isolating the allergen.

If your dog has an allergic reaction to a certain meat, you may desire to attempt a food with a new protein source that is new to your dog such as egg, duck, salmon, lamb, venison or whitefish. If none of this helps, your dog may be allergic to every of these proteins and will need a food with specially broken-down proteins. For precise diagnosis and treatment options, always consult your veterinarian and enquire them to recommend the best food for your dog’s food allergies


Is my dog sensitive to foods?

Specific diagnosis of food allergies in your dog is hard.

The most common symptoms of a food allergy/intolerance are digestive upsets or skin irritation. They are frequently characterised by itching and less commonly by gastrointestinal signs. Skin lesions on dogs are frequently located on the face, feet and ears.

Food allergies often mimic other skin diseases, and numerous dogs own other allergies such as flea-bite dermatitis and atopy. Dogs with chronic or recurring external ear infections should be evaluated for food allergies.

If your dog vomits frequently, has diarrhoea, irritated skin, a poor jacket condition or hair loss, then they may own a food allergy.

You may notice some of the following signs:

  1. Poor growth in young dogs
  2. Flatulence
  3. Vomiting or diarrhoea
  4. Red, inflamed skin
  5. Chronic ear problems
  6. Frequent scratching or hair loss
  7. Coughing, wheezing and sneezing

IMPORTANT: Some symptoms of food allergies/intolerance are similar to those of other serious conditions so consult your veterinarian if you notice any of these signs.


Food Allergy Questions to Enquire Your Veterinarian:

  • Can you provide me with written instructions or a handout on food allergies / food intolerance for my dog?
  • Ask about special nutritional concerns for your dog
  • Are there any foods I should avoid giving my dog for his allergies?

    1. Ask how human food can affect your dog’s health.
    2. Can you provide me with written instructions or a handout on food allergies / food intolerance for my dog?
    3. How quickly should I expect to see signs of improvement in my dog’s condition?
    4. Would you recommend a Hill’s Prescription Diet or Science Plan dog food for my dog’s allergies?
      1. How quickly should I expect to see signs of improvement in my dog’s condition?
      2. Discuss which treats you can feed your dog with the recommended dog food
      3. What is the best way (email/phone) to reach you or your hospital if I own questions?

        1. Ask if you need a follow-up appointment.
        2. How much and how often you should feed the recommended food to your dog
        3. Ask if a reminder email or notice will be sent.

[Updated January 30, ]

When your dog itches, you know it. That relentless licking, scratching, chewing anything he can do to relieve the itch. He seems obsessed, and he probably is. Whatever you do, dont ignore this problem (as if you could!). Incessant scratching and chewing may indicate food allergy. Hell constantly tear into any put on his body that he can reach with his teeth or claws. You may see ugly hair loss. Until you discover the cause, this problem will go from bad to worse.

Yes, persistent skin irritations can also be due to something else, including dry skin, hormonal issues, liver disease, fungal infections, drug reactions, pain, boredom, anxiety, or a combination of any of those!

For this reason, if your dog has chronic itching, its always worth a journey to the vet to law out some of these potential causes.

But the fact is, 70 percent of canine skin conditions are allergy-related and most of those are due to flea allergy and/or environmental allergens, such as pollen, mold, or dust mites. If the dog has fleas, or if his symptoms own a seasonal component, its likely that environmental allergies are his primary problem.

But an estimated 10 to 15 percent of the dogs who suffer from allergies are allergic to their food, or at least some ingredient or ingredients within their food.

Numerous owners assume that a dog with a chronically upset stomach has food allergies, but numerous dogs who own chronic upset tummies may own a food intolerance; if there is no hypersensitive immune response, its not an allergy. (That said, one can use an elimination diet to assist determine whether the dog is intolerant of certain foods, too.)

The primary symptom of food allergies, just as with inhaled or contact allergies, is itching. Dogs with food allergies might also show gastrointestinal signs (vomiting and/or diarrhea), or secondary infections, such as chronic otitis (ear infections), but they might not; non-seasonal (year-round) itching might be their only symptom.

Dog Food-Elimination Trial Proof

A food-elimination trial can be a valuable tool in determining the cause of your dogs discomfort.

But it does take commitment, vigilance, and a little additional cash. Its well worth the effort, though, if you do it correctly.

If you stick with the restricted-diet regimen, you should see a reduction in itching by 50 percent or more at the finish of the trial. If not, you havent eliminated the cause. That means you either need to attempt another combination, consisting of a new protein and new carbohydrate, or determine that dietary hypersensitivity is not the issue. Thats why its so significant to involve your veterinarian correct from the start.

If the results do prove a dietary cause, you will own been given the key to an itch-free, happy, comfortable dog.

You can then either select a commercial food that contains only those ingredients you used during the elimination trial or consult a veterinary nutritionist to construct a diet that will work for your dog. Its significant that the dogs diet for the long-term is finish and balanced.

Diet trials are hard. But the people with food-allergic dogs who successfully finish them potentially own a comfortable, itch-free pet without expensive and potentially harmful medications. Its worth it, if you can tough it out, Dr. Fatcheric says.


Cynthia Foley is an experienced dog agility competitor.

Also a lifelong horsewoman, she served as editor of Horse Journal from its inception in to

Cynthia Foley

“Allergen-free dog food“ touts one product website, while another company advertises “limited ingredient diets”. And the majority of companies that make grain-free diets propose that they may be helpful for pets with allergies. How true are these claims, though?

As it turns out, food allergies are not as common as numerous pet food companies and websites may love for you to ponder. And while food allergies are one possible cause for your dog’s itchy skin and ear infections or your cat’s diarrhea, there are numerous more likely causes which may own nothing to do with the food

What is a food allergy?

Food allergies happen when an animal’s immune system misidentifies a protein from a food as an invader rather than a food item and mounts an immune response.

The finish result of this response can be itchy skin or ear and skin infections in some pets, while it may cause vomiting or diarrhea in others. Some unlucky pets will own both skin and gastrointestinal symptoms. However, food allergies own to be distinguished from numerous other more common causes of these issues.

What are other causes of gastrointestinal signs in dogs and cats?

There are dozens of causes of gastrointestinal issues in dogs and cats – parasites, viruses, bacterial infections, pancreatitis, eating something they shouldn’t, and numerous others.

For pets that own symptoms only on certain diets, it could be due to a food allergy, but it could also be due to an intolerance – the food may own too much fat, too much or too little fiber, or own other properties or ingredients that don’t consent with that specific pet, but aren’t due to an allergy. Your vet can assist you figure it out.

What are other causes of itching, and skin and ear infections?

The most common cause of itching, skin infections, and ear infections in both dogs and cats are fleas, allergies to fleas, and environmental allergies – dust mites, pollen, grasses.

Both flea allergies and environmental allergies are MUCH more common in pets than food allergies but flea, environmental, and food allergies can every own similar symptoms.

Diagnosis of food allergies

One of the most frustrating things about food allergies is that there really isn’t an simple test. While numerous tests – using blood, saliva, and even hair that can be performed a veterinarian or purchased by a pet owner online (and even sometimes shockingly, through a Groupon!) advertise that they can diagnose food allergies or “sensitivities”, there is no proof that they work.

None of the currently available tests own been shown to be precise – that non-allergic dogs test negative and allergic dogs (and only allergic dogs) test positive. In fact, multiple studies (including this one just published) own shown that these kinds of tests are not extremely helpful in diagnosing food allergies, despite their widespread use for this purpose. Research results presented at a veterinary dermatology (skin) conference even showed that some tests “diagnosed” plain water and stuffed animal “fur” as having food allergies.

The “gold standard” or best method that we currently own, for diagnosing food allergies is the dietary elimination trial. This means feeding your pet a diet purchased through a veterinarian or carefully made at home that contains only a few ingredients (typically one protein and one carbohydrate plus necessary fats, vitamins, and minerals) that your pet has never been fed before or that are hydrolyzed (where the proteins are broken below into extremely little pieces that can hide from the immune system) or purified to remove the parts that are likely to cause allergies.

What to feed my dog with food allergies

This diet is then fed as THE ONLY FOOD OR FLAVORED THING TO GO INTO YOUR PET’S MOUTH for at least a month but potentially several, depending on your pet’s history and type of issues. If your pet’s signs dramatically improve during the trial, then to confirm a food allergy, your pet then has to go back to the ancient diet again. A quick relapse is suggestive of an allergy to an ingredient in the ancient diet. You then go back to the test diet until things get better again before trying one ingredient from the ancient diet at a time until you identify the specific foods that trigger the problem. Numerous people switch diets and their pets’ signs improve, but they never re-challenge, so we can’t know if it was coincidence or the diet that actually helped the pet!

We see this commonly when the seasons change – pet owners assume it was the diet that caused the improvement in their pet’s allergies when actually it is because seasonal allergens – such as certain pollens – are much reduced.

The “allergy diet” myth

There are no diets that are completely “hypoallergenic”, meaning that they will not cause allergies. The closest we own to this helpful of a diet are the hydrolyzed diets that can be purchased through veterinarians. Dogs and cats can be allergic to beautiful much any protein or carbohydrate ingredient that can be found in pet food. Feeding a diet with duck, kangaroo, lamb, or venison doesn’t prevent food allergies, it just makes it likely that if your pet develops one, it will be to that protein instead of something more common love pork or chicken. Likewise, there is no evidence that continually changing (rotating) diet ingredients prevents food allergies, but it definitely can limit diet choices to attempt to diagnose them (since every ingredient your pet has eaten before is no longer available to be used in a dietary elimination trial).

What foods are associated with the most allergies in pets?

While the overall percentage of dogs and cats that own food allergies is low, there are some ingredients that are associated with more of the confirmed cases than others.

The most commonly reported food allergies in dogs and cats are chicken, beef, dairy, and egg (and fish for cats). There is nothing particularly special about these ingredients other than they own been the most common ingredients in pet foods for the past few decades, so both cats and dogs often own been exposed to them a lot. What surprises numerous pet owners is that grains are actually unusual causes of food allergies – most pets are allergic to animal proteins! Yes, the occasional pet is allergic to a specific grain, or even another plant-sourced ingredient such as potato, or even carrot, but this is less common than an allergy to an animal protein.

Unfortunately, this information doesn’t prevent hundreds of companies from advertising their grain-free diets as being excellent for pets with allergies. Numerous companies also advertise gluten-free diets for pets. Gluten allergies seem to be extremely rare in pets, having been clearly documented only in Irish Setter dogs, possibly in Border Terrier dogs, and never in cats.

Do I own to use a diet from my vet for a diet trial?

Many companies make over-the-counter diets that they market as being excellent for dogs with allergies, but they often don’t live up to the hype. Numerous of these so-called “limited ingredient diets” contain more than 1 protein and 1 carbohydrate source.

They may contain fruits and vegetables, alfalfa, kelp, or other ingredients that could interfere with a diet trial. Even those that only own 1 protein and 1 carbohydrate as well as the necessary vitamins and minerals listed on the bag may still contaminated with other ingredients. Several studies recently own shown that large proportions of over-the-counter diets contain ingredients (admittedly sometimes in extremely little amounts) not listed on the label, likely due at least in part to the common industry practice of running one diet after another in the same manufacturing line at the factory, without a thorough cleaning in between (this is love human foods that are labeled as being made in a factory that also processes nuts even though they don’t contain nuts, they could own nut residues).

Because of the high risk of contamination for over-the-counter diets, we strongly recommend using a veterinary diet for your dietary elimination trial (either novel ingredient or hydrolyzed, depending on the individual pet) or a carefully prepared home-cooked diet designed by a board-certified veterinary nutritionist. The best diets for a food trial own ingredients plus fat sources (which are extremely low risk for allergies) and supplements. Diets for a diet trial should never include fruits and vegetables (unless a vegetable love a potato is one of the ingredients), herbs, or ingredients such as kelp because they can make it hard to interpret the results if your pet doesn’t improve on the diet.

If your veterinarian diagnoses a food allergy using a dietary elimination trial with a veterinary diet or home-cooked diet, you may be capable to manage your pet afterward with specific over-the-counter diets (once the specific allergen is identified), keeping in mind that you could see a flare-up if you unknowingly purchase a contaminated bag.

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Clinical Nutrition Team

Posts authored by the Clinical Nutrition Service team are by Dr.

Lisa M. Freeman, DVM, PhD, DACVN, Dr. Deborah E. Linder, DVM, MS, DACVN, and Dr. Cailin R. Heinze, VMD, MS, DACVN

Commercial Dog Foods for an Elimination Diet

Today, a visit to any specialty pet-supply store will reveal that any number of companies offer finish and balanced foods that contain unusual proteins such as rabbit, duck, venison, bison, and even kangaroo. Further, numerous of them are formulated to contain only one type of animal protein what the makers often call limited-ingredient formulas.

Those products seem ideal for feeding a food-allergic dog, right? Well, it depends.

A commercial food is most likely to work in an elimination diet if it contains just one novel (to your dog) protein and one novel (to your dog) carb. However, if it contains (for example) one novel ingredient (say, rabbit) and chicken which is the most common animal protein in commercial dog food today it probably wont work for use in an elimination diet. You own to glance past the headline ingredients to see whether a food might also contain ingredients your dog has consumed numerous times; it doesnt matter if a food is called Brand X Bison and Barley Dog Food if it also contains beef and rice.

There is also the matter of the potential for cross-contamination at the pet-food manufacturing facility.

A dog severely allergic to chicken, for example, may react to a food that contains no chicken, but was made on manufacturing equipment that was inadequately cleaned after running a batch of food that contained chicken.

Also, even if its a single-protein, single-carb limited ingredient commercial diet, any finish and balanced food will necessarily contain more ingredients than a home-prepared diet that contains only the protein and carb sources. While its fairly rare that the dogs allergy is to a preservative or herb or fiber source in the food, the fewer ingredients that are used in the trial diet, the more certain you can be about what is or is not causing the dogs symptoms.

How to Figure Out What Your Dog is Allergic To

Puppies arent generally born with food allergies.

What to feed my dog with food allergies

These hypersensitive immune responses tend to build up over time, generally appearing between the ages of 1 and 3 (but they can appear tardy in life, especially if the dog has been on the exact same diet for years and years). The most common food allergens for dogs are protein sources especially beef, dairy products, wheat, chicken, egg, and soy but the cause may also be a carbohydrate, a preservative, a dye, or anything else in the food.

While there are skin and blood tests that can be performed for allergies, theyre expensive and own only a 60 percent accuracy, frequently returning both untrue positives and untrue negatives. No wonder numerous veterinarians consider them useless!

Although every youre going to hurt by trying them is your wallet, a far better solution is an elimination diet.

Better described as a restricted diet, this limited-fare menu will assist you both identify the foods that cause an allergic (hypersensitive) reaction in your dog, as well as discover foods that can be fed to him without causing an allergic response.

The first step in a food-elimination trial is to ponder hard about every the types of food you own fed to your dog, and then collect the ingredient lists for every commercial foods the dog has received, or foods you own included in his home-prepared diet.

Record below (or list in a spreadsheet) every of the ingredients in the foods your dog has eaten. While it may be hard to recall (or impossible, in the case of dogs who were adopted as adults) every food a dog has eaten in his lifetime, every of the ingredients in the diets that the dog has received most recently should be included on the list.

You now own a working list of the ingredients you will avoid when selecting foods for the dogs elimination diet.

Feeding Allergy-Free Dog Food

The switch to the elimination diet should take put over the course of a few days.

Change your dogs food gradually, substituting increasing amounts of the new food for equal amounts of the ancient food until the dog is eating only the new food. If you see any signs of gastric distress (vomiting, diarrhea, constipation, which may indicate your dog is allergic to one of the ingredients you own chosen) or if your dog refuses to eat the new food, youll need to select diverse ingredients.

The length of time that you feed the initial diet (of just one protein and one carb), and how endless you should wait before introducing a new ingredient, will depend on how your dogs allergies are expressed.

Dogs whose primary allergy symptoms include diarrhea, vomiting, and gas will reply (for better or worse) relatively quickly after dietary changes are made.

However, if the dogs primary symptom is itching, it can take a lot longer for the problem to subside after the trigger food is removed from his diet. It may also take longer for him to start itching again when a problematic ingredient is added back into the diet.

For food-allergic dogs whose symptoms are gastrointestinal, you only own to do the diet trial for two weeks, Dr.

Fatcheric says, adding that it could take as much as 8 to 12 weeks for skin problems to completely clear.

If there is absolutely no change in the dogs symptoms no reduction in itching or GI problems you may desire to change both the protein source and the carb source and start a new elimination trial.

If a second trial, with all-new ingredients, produces no reduction in the dogs symptoms, its extremely likely that the dogs diet is not what hes allergic to; he most likely is allergic to something else in his environment.

In contrast, if your dogs symptoms reduce immediately and vanish quickly, you will know that there was something in his most recent diet (before the elimination diet) to which he was allergic.

Challenging the Evidence

Few owners are willing to take a further step to confirm the link between their dogs ancient diet and the dogs allergy symptoms a challenge phase but numerous veterinarians feel this step is necessary.

To definitively establish the link between the dogs previous diet (or even the single ingredient suspected of being the allergy culprit in the ancient food), some vets propose reintroducing the ancient diet (or the suspect ingredient); if the dog begins to break out in itching or GI distress, the allergen for that dog is decisively confirmed. Quickly return to the diet that your dog did well on, with no allergy symptoms.

Some owners stop there and who can blame them?

Its a pain to employ such scrupulous supervision over your dogs diet.

What to feed my dog with food allergies

If you feel confident that the trial and challenge own identified the ingredient that is problematic for your dog, you can start looking for (or formulating) a new, finish and balanced diet that is free of that ingredient.

However, it can be incredibly useful to continue for a few more weeks, to challenge your dog with a few more ingredients (one at a time), in hopes of finding more ingredients that are safe for him to consume.

Feed him the trial diet until his allergy symptoms are gone again, and then add one ingredient that you would love to use in his diet in the future. If you are capable to add it and he doesnt react with signs of allergy within two to three weeks, you can put that ingredient on his safe list for now. Once you own challenged his system with a few proteins and carbs without an allergic response, you should own enough ingredients on his safe list to enable you to purchase or build a finish and balanced diet containing those ingredients (and none of the ones that hes proven to be allergic to).

If youre fortunate, you may be capable to discover a commercial diet that contains only the ingredients on your dogs safe list and none of the ones that trigger an allergic reaction in your dog.

But if you cant discover such a diet, or desire to continue to prepare your dogs diet at home, Dr. Fatcheric recommends that you work with a veterinary nutritionist to make certain your diet is balanced and finish. Another option is to consult with a company love JustFoodForDogs, which will formulate a diet based on your dogs special needs. (See Better Choices for Home-Prepared and Special Needs Recipes, December )

Dog Food Ingredients for Allergic Dogs

The goal for the first stage of the trial is to discover ingredients that the dog has never received, in order to discover some to which he is not allergic.

You will then start him on a diet of these novel ingredients, in hopes that his itching reduces and then stops, indicating he is no longer eating something to which he is allergic, and that he is not allergic to any of the novel ingredients.

If his itching and other dog food allergy symptoms stop, you can start adding other ingredients back into his diet, one at a time. If the itching recurs, the most recently added ingredient is then put onto your dogs list of forbidden foods.

Ideally, an elimination diet initially consists of just one protein source and one carbohydrate source, neither of which appears on the list of foods your dog has previously eaten.

I recommend a limited-antigen diet: one protein, one carbohydrate, says Eileen Fatcheric, DVM, co-owner of the Fairmount Animal Hospital in Fairmount, New York. The foods should be novel, meaning the dog has not eaten them before.

In order to ensure the food is new (novel) for your dog, your veterinarian may recommend some seemingly crazy cuisine. Ingredients often recommended for elimination diets include:

Proteins
Rabbit
Venison
Duck
Buffalo/Bison
Kangaroo

Carbohydrates
Pumpkin
Oats
Barley
Quinoa
Chickpeas (also a excellent protein source)

Keep in mind that this initial, one novel protein and one novel carb diet is being used in hopes that you own eliminated whatever your dog has been reacting to in his diet, so that he stops itching, his skin clears, and any other allergic symptoms he has cease.

Once he is totally asymptomatic and this may takes weeks you can add one ingredient to his diet for a few weeks. If he starts itching, that ingredient gets added to the forbidden list, and you retreat to feeding the diet that didnt make him itch, wait until every is calm again, and then attempt adding yet another ingredient.

The ingredients you select to use for this initial trial should be new to your dog, but readily available to you and affordable. Some of the more unique proteins may be more available in frozen, dehydrated, or canned form than unused.

Decades ago, beef was the most common animal protein used in commercial dog foods, and so when a dog appeared to own a food allergy, most veterinarians would recommend a lamb and rice food. These ingredients were rarely seen in commercial foods at the time and, therefore, were novel to most dogs. The combination was even dubbed hypoallergenic a misnomer for any dog who is allergic to lamb or rice! Of course, when food-allergic dogs improved on these foods, they became popular; soon, even owners whose dogs didnt own allergies tried them, and more companies began offering foods that contained lamb and rice.

The upshot is that within a relatively short time, both lamb and rice lost that all-important novel characteristic for numerous dogs.

The same phenomenon is making it even more hard for dog owners to discover foods that contain ingredients that are novel for their dogs. The popularity of grain-free foods, and their inclusion of potatoes, sweet potatoes, peas, and chickpeas (as replacement carbohydrate sources for grains) means that numerous dogs own been fed these formerly rare (in dog foods) carbs, eliminating those ingredients from the pool of potential base ingredients for the allergic dogs preliminary restricted diet.

Other owners may own fed novel proteins to their dogs in foods that appealed to them for reasons other than food allergies just to provide the dog with variety, for example.

We propose that owners avoid feeding foods that contain unusual proteins to their dogs, so they are available for use in the dogs diet if he should develop food allergies later.

Homemade Dog Food for Canine Allergies

Another option is to make your own dog food for dogs with allergies a course of action that has its own benefits and pitfalls. While it provides you with the ultimate method of ensuring that your dogs diet contains only those ingredients that prove to be safe for your dog, it may take some trial and error to figure out appropriate portion sizes and the best ratio of meat to carbohydrate for your dog.

Also, you may be limited as to how endless you can hold your dog on the diet, as it isnt likely to be nutritionally balanced.

It can also be expensive. When dog-food manufacturers use something love kangaroo or rabbit in their diets, they own the benefit of buying those novel proteins in bulk, for much lower prices than you are likely to pay. Thats why it can be a grand boon if youve never fed your dog a diet that contains a common animal protein, that is, when your dogs novel protein is something thats simple to discover and affordable, love fish or beef.

Tips to Ensure Clear Results

Make certain your dog consumes only the trial food even for treats. For training treats, use dried bits of the animal protein you are using in the trial. (See How to Make High Quality Dehydrated Dog Treats in the May issue of WDJ.)

Be certain to check any medications your dog may be on, such as a monthly heartworm preventative, to make certain they own no flavorings.

If they do or youre not certain, enquire your veterinarian for an unflavored alternative. It is critical that you are vigilant about your dogs diet during this time.

If you own several pets, youll need to oversee dinner time to ensure your dog doesnt eat someone elses meal. Or put every the dogs in the household on the same diet for the trial period. With an elimination diet, your dog cant even lick the cats bowl clean or gobble below something he finds exterior. Youll need to watch everything he does. This is another time when its valuable for your dog to be happy and habituated in a crate for the periods when you cant supervise him directly.

What to feed my dog with food allergies

I myself would own a hard time being completely compliant for two to three months. No treats (of foods that arent part of the diet). No nothing. Be careful in homes with toddlers who drop food on the floor. And watch for well-meaning neighbors or in-laws slipping a treat, Dr. Fatcheric says.

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A German shepherd with recurring pyoderma. A Siamese cat with pruritus and alopecia. A golden retriever with otitis and diarrhea. These are animals potentially suffering from food allergies-and they may also be your patients.

Dogs and cats can become allergic to any food they are exposed to.

A common misconception about food allergy is that it is likely to develop after a recent diet change. In fact, food allergies can develop at any time. Numerous studies propose food allergy develops in young dogs (less than 1 year of age) more frequently than atopic dermatitis.1 The most common allergens in dogs (beef, chicken, chicken egg, cow milk, wheat, soy, corn) and cats (chicken, fish, dairy) are also common ingredients in numerous commercial dog and cat foods.1,2

Clinical signs in dogs

No age predisposition exists for food allergic dogs, but numerous exhibit clinical signs before they are 1 year ancient.

Clinical signs include nonseasonal pruritus, otitis, dermatitis, eosinophilic vasculitis, recurring pyoderma, seborrhea or urticaria. Almost half of my food allergy patients own gastrointestinal signs. These signs may include vomiting, diarrhea, flatulence or more than two bowel movements a day.

Rarely reported clinical signs of adverse food reactions include seizures and respiratory signs, including bronchitis, rhinitis and chronic obstructive pulmonary disease.1

It is also possible for the effects of a food allergy to be low or under the “itch threshold” and only observe flares of pruritus with the addition of environmental allergens during high pollen seasons.

Clinical signs in cats

The classic clinical sign for food allergy in cats is pruritus, especially of the head and ears.

Other signs will manifest as self-induced alopecia or any manifestation of the eosinophilic granuloma complex.

Diagnosing a food allergy

Several clues may lift the index of suspicion that a patient is suffering from a food allergy. One is the pattern of skin disease. Food allergies are known to commonly affect the ears and rears of dogs. Also, the clinical signs of food allergy are generally nonseasonal, but they could be episodic if due to sporadic treat istration.

Another potentially useful clue is the response to corticosteroids, or even occlacitinib (Apoquel-Zoetis). Atopic dermatitis is generally responsive to these drugs at anti-inflammatory doses.

When pruritus is not corticosteroid-responsive, a food allergy should be considered (of course, just because pruritus responds to corticosteroids does not law out the possibility that the patient has a food allergy).

Definitively diagnosing a food allergy in a dog or cat is a challenge. Intradermal allergy testing, serology testing and skin patch testing every produce unreliable results. An elimination diet trial is the only precise method to identify a food allergy.

Performing an elimination diet trial

Step 1: Select the trial diet

There is no foolproof, works-every-time test diet.

Choosing the best diet to feed a suspected food-allergic patient requires choosing a diet:

1) that consists of proteins the patient has not been exposed to

2) that has minimal chance of cross reactions with previously fed proteins (for example, some patients allergic to beef will cross-react or show clinical signs when exposed to other ruminants, chicken may cross react with duck or turkey)

3) that is palatable to the patient

4) that the owner is capable and willing to feed.

Because of these factors, rabbit, kangaroo and occasionally fish own historically been the first diet of choice for most suspected food-allergic patients.

However, most of these ingredients are now found in over-the-counter (OTC) foods. In addition, because of difficulty in supplying a dependable quantity of novel proteins, some manufacturers own been forced to add hydrolyzed proteins, particularly hydrolyzed soy, to the novel protein diets.

Novel vs. hydrolyzed protein

Hydrolyzed protein diets are another option for the elimination diet trial, and clearly the wave of the future. There are conflicting studies on the effectiveness of hydrolyzed diets for allergic patients, with anywhere from 10% to 40% of patients allergic to the basic protein continuing to show clinical signs on a hydrolyzed version of the same protein.³

Currently commercial options include hydrolyzed soy, chicken, feathers and salmon.

None of these proteins are necessarily novel. The degree of hydrolysis can vary, and, presumably, the greater the hydrolysis and the smaller the resulting protein or amino acid, the better the chance a food allergic patient will improve. At this time, since hydrolyzed diets are often the only option, it is still best to attempt and select a hydrolyzed diet to which the patient has had little or limited exposure to the parent protein.

A recent study in 10 dogs known to be allergic to chicken protein resulted in four of 10 dogs flaring when fed a hydrolyzed chicken-liver based diet, but none of the dogs flared when fed a extremely finely hydrolyzed diet consisting of poultry feathers.4 Recently a hydrolyzed salmon diet has been made commercially available and provides another feeding option.

Additional clinical trials and field experience are needed, but samples I've submitted to an independent laboratory performing ELISA testing found no trace of poultry, beef, pork, soy or dairy products.

In-house therapeutic vs. OTC diets

Although there is a plethora of OTC novel protein diets available, when analyzed, numerous of these diet own been shown to include additional ingredients not listed on the label.5 In this day of instant online access to information and products, most patients reach at our office having already been fed one or numerous OTC diets with supposedly limited and novel protein diets.

Yet when we read the label together (available online), we may discover ingredients such as “animal digest,” or other proteins that are hardly novel! I advise clients that therapeutic diets are more expensive for a reason-they are “more pure.”

Patients do not own to eat the therapeutic diet indefinitely. Once the food-allergic patient is stable, the client can potentially “work backward” and challenge the patient with an OTC novel protein diet and monitor for a flare (whereas improvement on a diet may require weeks, most patients flare within days or even hours of being fed the offending food).

Step 2: Start the trial diet and treat infections

Start the patient on the elimination diet trial.

This diet should be the only food the patient receives. Remind owners that means no treats, chewable medications or protein-based supplements. I typically recommend owners switch the food completely and abruptly rather than transition slowly (giving half a bowl of new food and half a bowl of ancient food). If food is truly the problem, it has never made sense to me to give “half the problem” during the transition.

During the food trial, it is significant to treat secondary infections (such as pyoderma and Malassezia species infections). It is not unusual for patients to get antimicrobial therapy for potentially the first half of the food trial.

This may offer a challenge as owners will be limited to what the medications can be hidden in since products such as meats, cheese or pill pockets cannot be used. It may be possible to treat infections with injectable long-lasting antibiotics, or even more preferably, with topical antimicrobial products such as shampoos, wipes, sprays or foam.

Apply flea control in flea-endemic areas to minimize other causes of pruritus, preferably using topical or pour-on products and avoiding chewable products.

Client communication tips for those follow-ups

It's always hard to determine the best way to recommend and then charge for rechecks and not own clients balk.

We asked Karen Felsted, CPA, MS, DVM, CVPM, her thoughts specifically on food allergy trial rechecks, which she thinks should be charged no differently than anything else.

“Rechecks are tricky because we don't do a excellent enough occupation educating why the recheck is necessary,” says Dr. Felsted. “The term ‘recheck' means nothing to pet owners. What you need to tell is, ‘We need to own Fluffy back in two weeks to see her ears and skin and make certain the food trial is making a difference.'”

And Dr. Felsted says not to sofa the recheck in vague clinical terminology either.

“The term ‘medical progress exam'-even saying that correct now, it sounds love a pet owner will ponder it's a grand way to get him or her back in for another $ It's better to be specific about the need for a recheck, not focus on the expression itself. Tell, ‘Here's what we desire to glance at. We desire to peer below at the eardrum, glance for swelling and redness'-whatever it is you're looking for."

Step 3: Follow up one week later

Have a team member call the pet owner after one week to make certain that the elimination diet trial has been started.

Answer any questions that own come up in the final week.

Step 4: Check the patient's progress after six weeks

After six weeks, check on the patient's progress. If the patient is improving, discuss continuing the trial for another six weeks for maximum improvement or introducing a long-term maintenance diet, such as an OTC novel protein diet (only if the owner desires a switch).

If the patient has not improved, remind owners that this is just the first step.

Now is the time to problem solve any obstacles encountered during the first elimination diet trial and discover any sneaky saboteurs that the owners might own overlooked. The ones I commonly encounter include:

Owners fed the patient an appropriate test diet but continued to feed treats.

Small children at home dropped food that the patient ate.

Unsupportive family members in the home gave the patient non-elimination diet food because they didn't ponder it would make a difference.

The patient snuck a few bites from another dog's food bowl.

The patient received medication or supplements with beef- or pork-based additives or flavoring.

If the elimination diet trial appears to own been performed correctly but the patient did not improve, then the patient is likely suffering from atopic dermatitis and reacting to environmental allergens.

Since this life-long condition cannot be cured, or avoided, long-term control is necessary. Numerous new drugs are available for the treatment of atopic dermatitis, as well as non-drug options such as allergen specific immunotherapy. If an owner is interested in allergen specific immunotherapy, it is probably time to refer the patient to a veterinary dermatologist unless the practitioner has a solid working knowledge of aeroallergens and immunotherapy and the skills to correlate allergy specific immunotherapy with the patient's history and clinical signs.

References

1. Carlotti DN.

Cutaneous manifestations of food hypersensitivity. In: Veterinary allergy. Chichester, UK: Wiley Blackwell, ;

2. Jeffers JG, Meyer EK, Sosis EJ. Responses of dogs with food allergies to single-ingredient dietary provocation. J Am Vet Med Assoc ;

3. Olivry T, Bizikova. A systematic review of the evidence of reduced allergenicity and clinical benefit of food hydrolysates in dogs with cutaneous adverse food reactions. Vet Dermatol ;

4. Bizikova P, Olivry T. A randomized, double-blinded crossover trial testing the benefit of two hydrolyzed poultry-based commercial diets for dogs with spontaneous pruritic chicken allergy.

Vet Dermatol ;

5. Raditic DM, Remillard RL, Tater KC. ELISA testing for common food antigens in four dry dog foods used in dietary elimination trials. J Anim Physiol Anim Nutr (Berl) ;

Dr. Lewis practices at Dermatology for Animals in Gilbert, Arizona, Campbell, California, and Spokane, Washington.

Features June Issue

[Updated January 30, ]

When your dog itches, you know it. That relentless licking, scratching, chewing anything he can do to relieve the itch. He seems obsessed, and he probably is. Whatever you do, dont ignore this problem (as if you could!). Incessant scratching and chewing may indicate food allergy.

Hell constantly tear into any put on his body that he can reach with his teeth or claws. You may see ugly hair loss. Until you discover the cause, this problem will go from bad to worse.

Yes, persistent skin irritations can also be due to something else, including dry skin, hormonal issues, liver disease, fungal infections, drug reactions, pain, boredom, anxiety, or a combination of any of those! For this reason, if your dog has chronic itching, its always worth a journey to the vet to law out some of these potential causes.

But the fact is, 70 percent of canine skin conditions are allergy-related and most of those are due to flea allergy and/or environmental allergens, such as pollen, mold, or dust mites.

If the dog has fleas, or if his symptoms own a seasonal component, its likely that environmental allergies are his primary problem.

But an estimated 10 to 15 percent of the dogs who suffer from allergies are allergic to their food, or at least some ingredient or ingredients within their food. Numerous owners assume that a dog with a chronically upset stomach has food allergies, but numerous dogs who own chronic upset tummies may own a food intolerance; if there is no hypersensitive immune response, its not an allergy. (That said, one can use an elimination diet to assist determine whether the dog is intolerant of certain foods, too.)

The primary symptom of food allergies, just as with inhaled or contact allergies, is itching.

Dogs with food allergies might also show gastrointestinal signs (vomiting and/or diarrhea), or secondary infections, such as chronic otitis (ear infections), but they might not; non-seasonal (year-round) itching might be their only symptom.

Dog Food-Elimination Trial Proof

A food-elimination trial can be a valuable tool in determining the cause of your dogs discomfort. But it does take commitment, vigilance, and a little additional cash. Its well worth the effort, though, if you do it correctly.

If you stick with the restricted-diet regimen, you should see a reduction in itching by 50 percent or more at the finish of the trial. If not, you havent eliminated the cause.

That means you either need to attempt another combination, consisting of a new protein and new carbohydrate, or determine that dietary hypersensitivity is not the issue. Thats why its so significant to involve your veterinarian correct from the start.

If the results do prove a dietary cause, you will own been given the key to an itch-free, happy, comfortable dog. You can then either select a commercial food that contains only those ingredients you used during the elimination trial or consult a veterinary nutritionist to construct a diet that will work for your dog. Its significant that the dogs diet for the long-term is finish and balanced.

Diet trials are hard. But the people with food-allergic dogs who successfully finish them potentially own a comfortable, itch-free pet without expensive and potentially harmful medications.

Its worth it, if you can tough it out, Dr. Fatcheric says.


Cynthia Foley is an experienced dog agility competitor. Also a lifelong horsewoman, she served as editor of Horse Journal from its inception in to

Cynthia Foley

“Allergen-free dog food“ touts one product website, while another company advertises “limited ingredient diets”. And the majority of companies that make grain-free diets propose that they may be helpful for pets with allergies. How true are these claims, though?

As it turns out, food allergies are not as common as numerous pet food companies and websites may love for you to ponder.

And while food allergies are one possible cause for your dog’s itchy skin and ear infections or your cat’s diarrhea, there are numerous more likely causes which may own nothing to do with the food

What is a food allergy?

Food allergies happen when an animal’s immune system misidentifies a protein from a food as an invader rather than a food item and mounts an immune response. The finish result of this response can be itchy skin or ear and skin infections in some pets, while it may cause vomiting or diarrhea in others. Some unlucky pets will own both skin and gastrointestinal symptoms.

However, food allergies own to be distinguished from numerous other more common causes of these issues.

What are other causes of gastrointestinal signs in dogs and cats?

There are dozens of causes of gastrointestinal issues in dogs and cats – parasites, viruses, bacterial infections, pancreatitis, eating something they shouldn’t, and numerous others. For pets that own symptoms only on certain diets, it could be due to a food allergy, but it could also be due to an intolerance – the food may own too much fat, too much or too little fiber, or own other properties or ingredients that don’t consent with that specific pet, but aren’t due to an allergy.

Your vet can assist you figure it out.

What are other causes of itching, and skin and ear infections?

The most common cause of itching, skin infections, and ear infections in both dogs and cats are fleas, allergies to fleas, and environmental allergies – dust mites, pollen, grasses. Both flea allergies and environmental allergies are MUCH more common in pets than food allergies but flea, environmental, and food allergies can every own similar symptoms.

Diagnosis of food allergies

One of the most frustrating things about food allergies is that there really isn’t an simple test.

While numerous tests – using blood, saliva, and even hair that can be performed a veterinarian or purchased by a pet owner online (and even sometimes shockingly, through a Groupon!) advertise that they can diagnose food allergies or “sensitivities”, there is no proof that they work. None of the currently available tests own been shown to be precise – that non-allergic dogs test negative and allergic dogs (and only allergic dogs) test positive. In fact, multiple studies (including this one just published) own shown that these kinds of tests are not extremely helpful in diagnosing food allergies, despite their widespread use for this purpose.

Research results presented at a veterinary dermatology (skin) conference even showed that some tests “diagnosed” plain water and stuffed animal “fur” as having food allergies.

The “gold standard” or best method that we currently own, for diagnosing food allergies is the dietary elimination trial. This means feeding your pet a diet purchased through a veterinarian or carefully made at home that contains only a few ingredients (typically one protein and one carbohydrate plus necessary fats, vitamins, and minerals) that your pet has never been fed before or that are hydrolyzed (where the proteins are broken below into extremely little pieces that can hide from the immune system) or purified to remove the parts that are likely to cause allergies.

This diet is then fed as THE ONLY FOOD OR FLAVORED THING TO GO INTO YOUR PET’S MOUTH for at least a month but potentially several, depending on your pet’s history and type of issues. If your pet’s signs dramatically improve during the trial, then to confirm a food allergy, your pet then has to go back to the ancient diet again. A quick relapse is suggestive of an allergy to an ingredient in the ancient diet. You then go back to the test diet until things get better again before trying one ingredient from the ancient diet at a time until you identify the specific foods that trigger the problem. Numerous people switch diets and their pets’ signs improve, but they never re-challenge, so we can’t know if it was coincidence or the diet that actually helped the pet!

We see this commonly when the seasons change – pet owners assume it was the diet that caused the improvement in their pet’s allergies when actually it is because seasonal allergens – such as certain pollens – are much reduced.

The “allergy diet” myth

There are no diets that are completely “hypoallergenic”, meaning that they will not cause allergies. The closest we own to this helpful of a diet are the hydrolyzed diets that can be purchased through veterinarians. Dogs and cats can be allergic to beautiful much any protein or carbohydrate ingredient that can be found in pet food.

Feeding a diet with duck, kangaroo, lamb, or venison doesn’t prevent food allergies, it just makes it likely that if your pet develops one, it will be to that protein instead of something more common love pork or chicken. Likewise, there is no evidence that continually changing (rotating) diet ingredients prevents food allergies, but it definitely can limit diet choices to attempt to diagnose them (since every ingredient your pet has eaten before is no longer available to be used in a dietary elimination trial).

What foods are associated with the most allergies in pets?

While the overall percentage of dogs and cats that own food allergies is low, there are some ingredients that are associated with more of the confirmed cases than others.

The most commonly reported food allergies in dogs and cats are chicken, beef, dairy, and egg (and fish for cats). There is nothing particularly special about these ingredients other than they own been the most common ingredients in pet foods for the past few decades, so both cats and dogs often own been exposed to them a lot. What surprises numerous pet owners is that grains are actually unusual causes of food allergies – most pets are allergic to animal proteins! Yes, the occasional pet is allergic to a specific grain, or even another plant-sourced ingredient such as potato, or even carrot, but this is less common than an allergy to an animal protein.

Unfortunately, this information doesn’t prevent hundreds of companies from advertising their grain-free diets as being excellent for pets with allergies. Numerous companies also advertise gluten-free diets for pets. Gluten allergies seem to be extremely rare in pets, having been clearly documented only in Irish Setter dogs, possibly in Border Terrier dogs, and never in cats.

Do I own to use a diet from my vet for a diet trial?

Many companies make over-the-counter diets that they market as being excellent for dogs with allergies, but they often don’t live up to the hype.

Numerous of these so-called “limited ingredient diets” contain more than 1 protein and 1 carbohydrate source.

What to feed my dog with food allergies

They may contain fruits and vegetables, alfalfa, kelp, or other ingredients that could interfere with a diet trial. Even those that only own 1 protein and 1 carbohydrate as well as the necessary vitamins and minerals listed on the bag may still contaminated with other ingredients. Several studies recently own shown that large proportions of over-the-counter diets contain ingredients (admittedly sometimes in extremely little amounts) not listed on the label, likely due at least in part to the common industry practice of running one diet after another in the same manufacturing line at the factory, without a thorough cleaning in between (this is love human foods that are labeled as being made in a factory that also processes nuts even though they don’t contain nuts, they could own nut residues).

Because of the high risk of contamination for over-the-counter diets, we strongly recommend using a veterinary diet for your dietary elimination trial (either novel ingredient or hydrolyzed, depending on the individual pet) or a carefully prepared home-cooked diet designed by a board-certified veterinary nutritionist. The best diets for a food trial own ingredients plus fat sources (which are extremely low risk for allergies) and supplements. Diets for a diet trial should never include fruits and vegetables (unless a vegetable love a potato is one of the ingredients), herbs, or ingredients such as kelp because they can make it hard to interpret the results if your pet doesn’t improve on the diet.

If your veterinarian diagnoses a food allergy using a dietary elimination trial with a veterinary diet or home-cooked diet, you may be capable to manage your pet afterward with specific over-the-counter diets (once the specific allergen is identified), keeping in mind that you could see a flare-up if you unknowingly purchase a contaminated bag.

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Clinical Nutrition Team

Posts authored by the Clinical Nutrition Service team are by Dr.

Lisa M. Freeman, DVM, PhD, DACVN, Dr. Deborah E. Linder, DVM, MS, DACVN, and Dr. Cailin R. Heinze, VMD, MS, DACVN

Commercial Dog Foods for an Elimination Diet

Today, a visit to any specialty pet-supply store will reveal that any number of companies offer finish and balanced foods that contain unusual proteins such as rabbit, duck, venison, bison, and even kangaroo. Further, numerous of them are formulated to contain only one type of animal protein what the makers often call limited-ingredient formulas. Those products seem ideal for feeding a food-allergic dog, right?

Well, it depends.

A commercial food is most likely to work in an elimination diet if it contains just one novel (to your dog) protein and one novel (to your dog) carb. However, if it contains (for example) one novel ingredient (say, rabbit) and chicken which is the most common animal protein in commercial dog food today it probably wont work for use in an elimination diet. You own to glance past the headline ingredients to see whether a food might also contain ingredients your dog has consumed numerous times; it doesnt matter if a food is called Brand X Bison and Barley Dog Food if it also contains beef and rice.

There is also the matter of the potential for cross-contamination at the pet-food manufacturing facility.

A dog severely allergic to chicken, for example, may react to a food that contains no chicken, but was made on manufacturing equipment that was inadequately cleaned after running a batch of food that contained chicken.

Also, even if its a single-protein, single-carb limited ingredient commercial diet, any finish and balanced food will necessarily contain more ingredients than a home-prepared diet that contains only the protein and carb sources.

While its fairly rare that the dogs allergy is to a preservative or herb or fiber source in the food, the fewer ingredients that are used in the trial diet, the more certain you can be about what is or is not causing the dogs symptoms.

How to Figure Out What Your Dog is Allergic To

Puppies arent generally born with food allergies. These hypersensitive immune responses tend to build up over time, generally appearing between the ages of 1 and 3 (but they can appear tardy in life, especially if the dog has been on the exact same diet for years and years).

The most common food allergens for dogs are protein sources especially beef, dairy products, wheat, chicken, egg, and soy but the cause may also be a carbohydrate, a preservative, a dye, or anything else in the food.

While there are skin and blood tests that can be performed for allergies, theyre expensive and own only a 60 percent accuracy, frequently returning both untrue positives and untrue negatives. No wonder numerous veterinarians consider them useless! Although every youre going to hurt by trying them is your wallet, a far better solution is an elimination diet.

Better described as a restricted diet, this limited-fare menu will assist you both identify the foods that cause an allergic (hypersensitive) reaction in your dog, as well as discover foods that can be fed to him without causing an allergic response.

The first step in a food-elimination trial is to ponder hard about every the types of food you own fed to your dog, and then collect the ingredient lists for every commercial foods the dog has received, or foods you own included in his home-prepared diet. Record below (or list in a spreadsheet) every of the ingredients in the foods your dog has eaten. While it may be hard to recall (or impossible, in the case of dogs who were adopted as adults) every food a dog has eaten in his lifetime, every of the ingredients in the diets that the dog has received most recently should be included on the list.

You now own a working list of the ingredients you will avoid when selecting foods for the dogs elimination diet.

Feeding Allergy-Free Dog Food

The switch to the elimination diet should take put over the course of a few days.

Change your dogs food gradually, substituting increasing amounts of the new food for equal amounts of the ancient food until the dog is eating only the new food. If you see any signs of gastric distress (vomiting, diarrhea, constipation, which may indicate your dog is allergic to one of the ingredients you own chosen) or if your dog refuses to eat the new food, youll need to select diverse ingredients.

The length of time that you feed the initial diet (of just one protein and one carb), and how endless you should wait before introducing a new ingredient, will depend on how your dogs allergies are expressed.

Dogs whose primary allergy symptoms include diarrhea, vomiting, and gas will reply (for better or worse) relatively quickly after dietary changes are made.

However, if the dogs primary symptom is itching, it can take a lot longer for the problem to subside after the trigger food is removed from his diet. It may also take longer for him to start itching again when a problematic ingredient is added back into the diet.

For food-allergic dogs whose symptoms are gastrointestinal, you only own to do the diet trial for two weeks, Dr.

Fatcheric says, adding that it could take as much as 8 to 12 weeks for skin problems to completely clear.

If there is absolutely no change in the dogs symptoms no reduction in itching or GI problems you may desire to change both the protein source and the carb source and start a new elimination trial.

If a second trial, with all-new ingredients, produces no reduction in the dogs symptoms, its extremely likely that the dogs diet is not what hes allergic to; he most likely is allergic to something else in his environment.

In contrast, if your dogs symptoms reduce immediately and vanish quickly, you will know that there was something in his most recent diet (before the elimination diet) to which he was allergic.

Challenging the Evidence

Few owners are willing to take a further step to confirm the link between their dogs ancient diet and the dogs allergy symptoms a challenge phase but numerous veterinarians feel this step is necessary. To definitively establish the link between the dogs previous diet (or even the single ingredient suspected of being the allergy culprit in the ancient food), some vets propose reintroducing the ancient diet (or the suspect ingredient); if the dog begins to break out in itching or GI distress, the allergen for that dog is decisively confirmed.

Quickly return to the diet that your dog did well on, with no allergy symptoms.

Some owners stop there and who can blame them? Its a pain to employ such scrupulous supervision over your dogs diet. If you feel confident that the trial and challenge own identified the ingredient that is problematic for your dog, you can start looking for (or formulating) a new, finish and balanced diet that is free of that ingredient.

However, it can be incredibly useful to continue for a few more weeks, to challenge your dog with a few more ingredients (one at a time), in hopes of finding more ingredients that are safe for him to consume.

Feed him the trial diet until his allergy symptoms are gone again, and then add one ingredient that you would love to use in his diet in the future. If you are capable to add it and he doesnt react with signs of allergy within two to three weeks, you can put that ingredient on his safe list for now. Once you own challenged his system with a few proteins and carbs without an allergic response, you should own enough ingredients on his safe list to enable you to purchase or build a finish and balanced diet containing those ingredients (and none of the ones that hes proven to be allergic to).

If youre fortunate, you may be capable to discover a commercial diet that contains only the ingredients on your dogs safe list and none of the ones that trigger an allergic reaction in your dog.

But if you cant discover such a diet, or desire to continue to prepare your dogs diet at home, Dr. Fatcheric recommends that you work with a veterinary nutritionist to make certain your diet is balanced and finish. Another option is to consult with a company love JustFoodForDogs, which will formulate a diet based on your dogs special needs. (See Better Choices for Home-Prepared and Special Needs Recipes, December )

Dog Food Ingredients for Allergic Dogs

The goal for the first stage of the trial is to discover ingredients that the dog has never received, in order to discover some to which he is not allergic.

You will then start him on a diet of these novel ingredients, in hopes that his itching reduces and then stops, indicating he is no longer eating something to which he is allergic, and that he is not allergic to any of the novel ingredients.

If his itching and other dog food allergy symptoms stop, you can start adding other ingredients back into his diet, one at a time. If the itching recurs, the most recently added ingredient is then put onto your dogs list of forbidden foods.

Ideally, an elimination diet initially consists of just one protein source and one carbohydrate source, neither of which appears on the list of foods your dog has previously eaten.

I recommend a limited-antigen diet: one protein, one carbohydrate, says Eileen Fatcheric, DVM, co-owner of the Fairmount Animal Hospital in Fairmount, New York. The foods should be novel, meaning the dog has not eaten them before.

In order to ensure the food is new (novel) for your dog, your veterinarian may recommend some seemingly crazy cuisine. Ingredients often recommended for elimination diets include:

Proteins
Rabbit
Venison
Duck
Buffalo/Bison
Kangaroo

Carbohydrates
Pumpkin
Oats
Barley
Quinoa
Chickpeas (also a excellent protein source)

Keep in mind that this initial, one novel protein and one novel carb diet is being used in hopes that you own eliminated whatever your dog has been reacting to in his diet, so that he stops itching, his skin clears, and any other allergic symptoms he has cease.

Once he is totally asymptomatic and this may takes weeks you can add one ingredient to his diet for a few weeks. If he starts itching, that ingredient gets added to the forbidden list, and you retreat to feeding the diet that didnt make him itch, wait until every is calm again, and then attempt adding yet another ingredient.

The ingredients you select to use for this initial trial should be new to your dog, but readily available to you and affordable. Some of the more unique proteins may be more available in frozen, dehydrated, or canned form than unused.

Decades ago, beef was the most common animal protein used in commercial dog foods, and so when a dog appeared to own a food allergy, most veterinarians would recommend a lamb and rice food. These ingredients were rarely seen in commercial foods at the time and, therefore, were novel to most dogs. The combination was even dubbed hypoallergenic a misnomer for any dog who is allergic to lamb or rice! Of course, when food-allergic dogs improved on these foods, they became popular; soon, even owners whose dogs didnt own allergies tried them, and more companies began offering foods that contained lamb and rice.

The upshot is that within a relatively short time, both lamb and rice lost that all-important novel characteristic for numerous dogs.

The same phenomenon is making it even more hard for dog owners to discover foods that contain ingredients that are novel for their dogs. The popularity of grain-free foods, and their inclusion of potatoes, sweet potatoes, peas, and chickpeas (as replacement carbohydrate sources for grains) means that numerous dogs own been fed these formerly rare (in dog foods) carbs, eliminating those ingredients from the pool of potential base ingredients for the allergic dogs preliminary restricted diet.

Other owners may own fed novel proteins to their dogs in foods that appealed to them for reasons other than food allergies just to provide the dog with variety, for example.

We propose that owners avoid feeding foods that contain unusual proteins to their dogs, so they are available for use in the dogs diet if he should develop food allergies later.

Homemade Dog Food for Canine Allergies

Another option is to make your own dog food for dogs with allergies a course of action that has its own benefits and pitfalls. While it provides you with the ultimate method of ensuring that your dogs diet contains only those ingredients that prove to be safe for your dog, it may take some trial and error to figure out appropriate portion sizes and the best ratio of meat to carbohydrate for your dog. Also, you may be limited as to how endless you can hold your dog on the diet, as it isnt likely to be nutritionally balanced.

It can also be expensive. When dog-food manufacturers use something love kangaroo or rabbit in their diets, they own the benefit of buying those novel proteins in bulk, for much lower prices than you are likely to pay. Thats why it can be a grand boon if youve never fed your dog a diet that contains a common animal protein, that is, when your dogs novel protein is something thats simple to discover and affordable, love fish or beef.

Tips to Ensure Clear Results

Make certain your dog consumes only the trial food even for treats.

For training treats, use dried bits of the animal protein you are using in the trial. (See How to Make High Quality Dehydrated Dog Treats in the May issue of WDJ.)

Be certain to check any medications your dog may be on, such as a monthly heartworm preventative, to make certain they own no flavorings. If they do or youre not certain, enquire your veterinarian for an unflavored alternative. It is critical that you are vigilant about your dogs diet during this time.

If you own several pets, youll need to oversee dinner time to ensure your dog doesnt eat someone elses meal. Or put every the dogs in the household on the same diet for the trial period.

With an elimination diet, your dog cant even lick the cats bowl clean or gobble below something he finds exterior. Youll need to watch everything he does. This is another time when its valuable for your dog to be happy and habituated in a crate for the periods when you cant supervise him directly.

I myself would own a hard time being completely compliant for two to three months. No treats (of foods that arent part of the diet).

No nothing. Be careful in homes with toddlers who drop food on the floor. And watch for well-meaning neighbors or in-laws slipping a treat, Dr. Fatcheric says.

Want to read more information on feeding your pet?

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A German shepherd with recurring pyoderma. A Siamese cat with pruritus and alopecia. A golden retriever with otitis and diarrhea. These are animals potentially suffering from food allergies-and they may also be your patients.

Dogs and cats can become allergic to any food they are exposed to. A common misconception about food allergy is that it is likely to develop after a recent diet change.

In fact, food allergies can develop at any time. Numerous studies propose food allergy develops in young dogs (less than 1 year of age) more frequently than atopic dermatitis.1 The most common allergens in dogs (beef, chicken, chicken egg, cow milk, wheat, soy, corn) and cats (chicken, fish, dairy) are also common ingredients in numerous commercial dog and cat foods.1,2

Clinical signs in dogs

No age predisposition exists for food allergic dogs, but numerous exhibit clinical signs before they are 1 year ancient.

Clinical signs include nonseasonal pruritus, otitis, dermatitis, eosinophilic vasculitis, recurring pyoderma, seborrhea or urticaria. Almost half of my food allergy patients own gastrointestinal signs. These signs may include vomiting, diarrhea, flatulence or more than two bowel movements a day.

Rarely reported clinical signs of adverse food reactions include seizures and respiratory signs, including bronchitis, rhinitis and chronic obstructive pulmonary disease.1

It is also possible for the effects of a food allergy to be low or under the “itch threshold” and only observe flares of pruritus with the addition of environmental allergens during high pollen seasons.

Clinical signs in cats

The classic clinical sign for food allergy in cats is pruritus, especially of the head and ears.

Other signs will manifest as self-induced alopecia or any manifestation of the eosinophilic granuloma complex.

Diagnosing a food allergy

Several clues may lift the index of suspicion that a patient is suffering from a food allergy. One is the pattern of skin disease. Food allergies are known to commonly affect the ears and rears of dogs. Also, the clinical signs of food allergy are generally nonseasonal, but they could be episodic if due to sporadic treat istration.

Another potentially useful clue is the response to corticosteroids, or even occlacitinib (Apoquel-Zoetis). Atopic dermatitis is generally responsive to these drugs at anti-inflammatory doses. When pruritus is not corticosteroid-responsive, a food allergy should be considered (of course, just because pruritus responds to corticosteroids does not law out the possibility that the patient has a food allergy).

Definitively diagnosing a food allergy in a dog or cat is a challenge.

Intradermal allergy testing, serology testing and skin patch testing every produce unreliable results. An elimination diet trial is the only precise method to identify a food allergy.

Performing an elimination diet trial

Step 1: Select the trial diet

There is no foolproof, works-every-time test diet. Choosing the best diet to feed a suspected food-allergic patient requires choosing a diet:

1) that consists of proteins the patient has not been exposed to

2) that has minimal chance of cross reactions with previously fed proteins (for example, some patients allergic to beef will cross-react or show clinical signs when exposed to other ruminants, chicken may cross react with duck or turkey)

3) that is palatable to the patient

4) that the owner is capable and willing to feed.

Because of these factors, rabbit, kangaroo and occasionally fish own historically been the first diet of choice for most suspected food-allergic patients.

However, most of these ingredients are now found in over-the-counter (OTC) foods. In addition, because of difficulty in supplying a dependable quantity of novel proteins, some manufacturers own been forced to add hydrolyzed proteins, particularly hydrolyzed soy, to the novel protein diets.

Novel vs. hydrolyzed protein

Hydrolyzed protein diets are another option for the elimination diet trial, and clearly the wave of the future.

There are conflicting studies on the effectiveness of hydrolyzed diets for allergic patients, with anywhere from 10% to 40% of patients allergic to the basic protein continuing to show clinical signs on a hydrolyzed version of the same protein.³

Currently commercial options include hydrolyzed soy, chicken, feathers and salmon. None of these proteins are necessarily novel. The degree of hydrolysis can vary, and, presumably, the greater the hydrolysis and the smaller the resulting protein or amino acid, the better the chance a food allergic patient will improve.

At this time, since hydrolyzed diets are often the only option, it is still best to attempt and select a hydrolyzed diet to which the patient has had little or limited exposure to the parent protein.

A recent study in 10 dogs known to be allergic to chicken protein resulted in four of 10 dogs flaring when fed a hydrolyzed chicken-liver based diet, but none of the dogs flared when fed a extremely finely hydrolyzed diet consisting of poultry feathers.4 Recently a hydrolyzed salmon diet has been made commercially available and provides another feeding option.

Additional clinical trials and field experience are needed, but samples I've submitted to an independent laboratory performing ELISA testing found no trace of poultry, beef, pork, soy or dairy products.

In-house therapeutic vs. OTC diets

Although there is a plethora of OTC novel protein diets available, when analyzed, numerous of these diet own been shown to include additional ingredients not listed on the label.5 In this day of instant online access to information and products, most patients reach at our office having already been fed one or numerous OTC diets with supposedly limited and novel protein diets.

Yet when we read the label together (available online), we may discover ingredients such as “animal digest,” or other proteins that are hardly novel! I advise clients that therapeutic diets are more expensive for a reason-they are “more pure.”

Patients do not own to eat the therapeutic diet indefinitely. Once the food-allergic patient is stable, the client can potentially “work backward” and challenge the patient with an OTC novel protein diet and monitor for a flare (whereas improvement on a diet may require weeks, most patients flare within days or even hours of being fed the offending food).

Step 2: Start the trial diet and treat infections

Start the patient on the elimination diet trial.

This diet should be the only food the patient receives. Remind owners that means no treats, chewable medications or protein-based supplements. I typically recommend owners switch the food completely and abruptly rather than transition slowly (giving half a bowl of new food and half a bowl of ancient food). If food is truly the problem, it has never made sense to me to give “half the problem” during the transition.

During the food trial, it is significant to treat secondary infections (such as pyoderma and Malassezia species infections). It is not unusual for patients to get antimicrobial therapy for potentially the first half of the food trial.

This may offer a challenge as owners will be limited to what the medications can be hidden in since products such as meats, cheese or pill pockets cannot be used. It may be possible to treat infections with injectable long-lasting antibiotics, or even more preferably, with topical antimicrobial products such as shampoos, wipes, sprays or foam.

Apply flea control in flea-endemic areas to minimize other causes of pruritus, preferably using topical or pour-on products and avoiding chewable products.

Client communication tips for those follow-ups

It's always hard to determine the best way to recommend and then charge for rechecks and not own clients balk.

We asked Karen Felsted, CPA, MS, DVM, CVPM, her thoughts specifically on food allergy trial rechecks, which she thinks should be charged no differently than anything else.

“Rechecks are tricky because we don't do a excellent enough occupation educating why the recheck is necessary,” says Dr. Felsted. “The term ‘recheck' means nothing to pet owners. What you need to tell is, ‘We need to own Fluffy back in two weeks to see her ears and skin and make certain the food trial is making a difference.'”

And Dr.

Felsted says not to sofa the recheck in vague clinical terminology either. “The term ‘medical progress exam'-even saying that correct now, it sounds love a pet owner will ponder it's a grand way to get him or her back in for another $ It's better to be specific about the need for a recheck, not focus on the expression itself. Tell, ‘Here's what we desire to glance at. We desire to peer below at the eardrum, glance for swelling and redness'-whatever it is you're looking for."

Step 3: Follow up one week later

Have a team member call the pet owner after one week to make certain that the elimination diet trial has been started.

Answer any questions that own come up in the final week.

Step 4: Check the patient's progress after six weeks

After six weeks, check on the patient's progress. If the patient is improving, discuss continuing the trial for another six weeks for maximum improvement or introducing a long-term maintenance diet, such as an OTC novel protein diet (only if the owner desires a switch).

If the patient has not improved, remind owners that this is just the first step. Now is the time to problem solve any obstacles encountered during the first elimination diet trial and discover any sneaky saboteurs that the owners might own overlooked.

The ones I commonly encounter include:

Owners fed the patient an appropriate test diet but continued to feed treats.

Small children at home dropped food that the patient ate.

Unsupportive family members in the home gave the patient non-elimination diet food because they didn't ponder it would make a difference.

The patient snuck a few bites from another dog's food bowl.

The patient received medication or supplements with beef- or pork-based additives or flavoring.

If the elimination diet trial appears to own been performed correctly but the patient did not improve, then the patient is likely suffering from atopic dermatitis and reacting to environmental allergens.

Since this life-long condition cannot be cured, or avoided, long-term control is necessary. Numerous new drugs are available for the treatment of atopic dermatitis, as well as non-drug options such as allergen specific immunotherapy. If an owner is interested in allergen specific immunotherapy, it is probably time to refer the patient to a veterinary dermatologist unless the practitioner has a solid working knowledge of aeroallergens and immunotherapy and the skills to correlate allergy specific immunotherapy with the patient's history and clinical signs.

References

1. Carlotti DN. Cutaneous manifestations of food hypersensitivity. In: Veterinary allergy. Chichester, UK: Wiley Blackwell, ;

2.

Jeffers JG, Meyer EK, Sosis EJ. Responses of dogs with food allergies to single-ingredient dietary provocation. J Am Vet Med Assoc ;

3. Olivry T, Bizikova. A systematic review of the evidence of reduced allergenicity and clinical benefit of food hydrolysates in dogs with cutaneous adverse food reactions. Vet Dermatol ;

4. Bizikova P, Olivry T. A randomized, double-blinded crossover trial testing the benefit of two hydrolyzed poultry-based commercial diets for dogs with spontaneous pruritic chicken allergy.

Vet Dermatol ;

5. Raditic DM, Remillard RL, Tater KC. ELISA testing for common food antigens in four dry dog foods used in dietary elimination trials. J Anim Physiol Anim Nutr (Berl) ;

Dr. Lewis practices at Dermatology for Animals in Gilbert, Arizona, Campbell, California, and Spokane, Washington.

Features June Issue


Getting at the genuine reason your dog is having every those symptoms.

Your dogs skin is itching, perhaps to the point that he may even be licking his paws or chewing on his feet.

Or he keeps vomiting or having diarrhea. It must be a food allergy, you ponder to yourself, so you put him on a special diet. But it doesnt work. Frustrated, you attempt other food combinations, finally bringing him to the veterinarian for assist in figuring out which ingredient is causing the allergic reaction.

Suspected food allergy is a common reason people come to the nutrition clinic at Tufts, says Cailin Heinze, VMD, a board-certified veterinary nutritionist at the Cummings School.

By the time they get here, theyve often tried five, six, seven diverse diets. But if they every own diverse ingredients and the dog is not any better, its probably not a food allergy. Of those dogs whose owners ponder they may own a food allergy, perhaps only 10 percent or less actually do.

Why do so numerous people believe their dogs are suffering from food allergies, besides the fact that the Internet is rife with articles and postings erroneously suggesting that food allergies in pets are fairly common?

People desire to assist their dog, and if the problem is food, thats simple to repair, Dr.

Heinze says. You just remove the food from the diet. So to some extent its wishful thinking. Add to that the fact that they hold reading online that food allergies are common, and it really snowballs.

But the fact is that most of the incessant itching and scratching seen in some dogs is the result of atopy allergies not to food but to airborne substances hanging around the environment, including pollen, mold, and dust mites. When allergic people breathe in those substances, they finish up with runny noses, watery eyes, sneezing, and congestion.

When allergic dogs breathe them in or stroll through them (and perhaps lick them off), they itch; the problem plays out largely on their skin. They often get ear infections as well. And since you cant simply remove the offending environmental substances from the dogs world, treating allergic reactions to them may involve istering medicines to the dog and other treatments for the relax of his life a more involved plan than simply changing the diet.

Gastrointestinal symptoms love vomiting that numerous people also assume are food allergies tend to own another cause, too. Food allergies can cause GI upset, but most likely, food-related nausea or other discomfort is the result of a food intolerance rather than a true allergic reaction, which is an attack by the immune system on a foreign substance.

In fact, Dr. Heinze says, often, when an owner switches a dogs food and the GI symptoms clear up, the person believes he has correctly diagnosed a food allergy. But more commonly, she says, its something about the quantity of fat in the food, or the way the food was cooked, or the fiber level. A dog might simply do better with twice the fiber or half the fat.

What to feed my dog with food allergies

An allergy has nothing to do with that. Of course, sometimes, a dog has a disease of the gastrointestinal tract that needs to be identified and treated.

How do you diagnose a true food allergy?

The only way to definitely diagnose a true food allergy is to do a diet trial, Dr. Heinze says. Even then, if food is the culprit of a dogs symptoms and the dog is having GI upset rather than itching, its hard to distinguish sometimes whether its a food allergy or a food intolerance. But at least youre getting at the source of the problem.

Before the diet trial begins, its critical to get a finish diet history a list of every single ingredient in the foods a dog ever eats, particularly when he is doing poorly, either with itching, GI problems, or both.

Once a veterinary nutritionist reviews the diet history, she will select for the dog a diet to which the pet has never been exposed.

Maybe a dog has been on a chicken, rice, and fish diet, Dr. Heinze says, so well put him on a therapeutic diet made with kangaroo and oats things the dog has never had. Or well put him on what is known as a hydrolyzed protein diet. Its generally the proteins in foods to which dogs (and people) are allergic, but if you take a protein-rich food love soy or chicken and use enzymes to break up the proteins into smaller pieces, the dogs immune system may not recognize the proteins for what they are and therefore not go into overdrive and cause an allergic reaction.

Dr.

Heinze says you then feed that diet from four to 12 weeks but no flavored medications, no treats, nothing the kids drop on the floor, no flavored toothpaste, because ingredients in any of those things can cause the symptoms to continue.

Restricting a dogs diet to that degree tends to be extremely hard for owners to do, Dr. Heinze says. But if the symptoms resolve or largely resolve, it suggests it was something in the diet that was causing them. If the symptoms were in the GI tract rather than on the skin, you cant tell if its an allergy or an intolerance. But at least you know that it looks love you might extremely well be on to a dietary solution.

Then you put the dog back on the ancient diet, Dr.

Heinze explains. If the symptoms start up again immediately, you know it was the food.

You can then select to feed the dog the new diet indefinitely or take ingredients from the ancient diet and reintroduce them one at a time. For instance, attempt the chicken again for a week or two. If the chickens okay, then attempt the rice. If the dogs starts to itch or throw up again, youve found the culprit and can then select an over-the-counter food that doesnt contain it. But its a endless process diagnosing a specific food allergy is not as simple as numerous people ponder and a lot of owners are not willing to go that far. They stick with the therapeutic food prescribed by�the veterinarian.

Thats okay.

It just might be somewhat more expensive and will require more frequent trips to the veterinarians office rather than to the supermarket.

Of course, if a completely diverse diet doesnt resolve the symptoms, its time to see a veterinary dermatologist who can test for atopy, or, if the problem is not itching but in the GI tract, to explore the possibility of a disease somewhere between the throat and the colon.

Often, the owner is referred elsewhere for further testing when a veterinary nutritionist is suspicious that the symptoms are unlikely to be the result of a food allergy, Dr.

Heinze says. That said, she comments that we do see a few cases where were really confident that a food allergy is the problem. We had one dog come in whose owner thought she had a food allergy and had put her on a sweet-potato-and-pork diet. It was home cooked and completely unbalanced. The dog was losing weight and having other issues. But her itching was percent resolved. We then tried her ancient diet again and within a few hours of her first meal, she was itching again, rolling on the floor and licking her feet.

Her owner then tried adding back in one ingredient at a time and found, finally, that it was white potato to which she was allergic.

So we identified an over-the-counter diet with no white potato just fish, oats, barley, and rice and she does grand on it. But it was a multiple-month process with a extremely dedicated owner. And since the dogs symptoms were more love atopy than GI upset, there was no confusion over whether it might be a food intolerance. Because of the itching, it was clear that it was an allergy.

As far as testing for whether a reaction to a food ingredient is an allergy versus an intolerance, blood tests are available, but theyre notoriously unreliable, Dr.

Heinze says. In my experience, there own been a lot of untrue positives on blood allergy panels for food allergies in dogs, she reports. That is, you can assume with a blood test that youve diagnosed a food allergy but own not. It leads people to start changing a dogs diet unnecessarily.�

Read More on These Topics


What causes food allergies / intolerance?

It may take months or years before your dog develops an allergic response to a specific food.

However, once allergic, there will almost always be a negative reaction to that food. Allergic reactions are most commonly associated with protein sources — generally the meat in your dog’s food.

Food: The most common causes of food allergies/intolerance in dogs are beef, milk products and wheat.

Damage: Inflammation, infection, surgery and some medications can damage the digestive system and may lead to food allergies/intolerance.

Age: Food allergies/intolerance can happen at any age.

Breed: Some dog breeds appear more likely to develop food allergies/intolerance, including West Highland White Terriers, Cocker Spaniels and Irish Setters.


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