This document discusses adverse reactions to food, including food allergies and intolerances. It provides information on identifying allergens, avoiding allergens through food elimination tests and novel or hydrolyzed protein diets. The document also discusses recovery feeding for pets and the importance of early feeding. Finally, it covers canine osteoarthritis, including risk factors, joint structure and function, and managing the condition through diet and supplements.
2. Food Allergies
Less common than atopy
Non – seasonal
Blood and skin allergy tests are not accurate
Diet trial is the best
Dogs- beef, dairy, wheat, chicken and egg
Cats- beef, dairy and fish
3. Diet trials
4-10 weeks , gi gets better faster than skin
Can rechallenge with original diet is the animal does
well
Avoid offending ingredients
4. Adverse Reactions to Food
Defined as a clinically abnormal response attributed to an
ingested food substance, and may be further categorized as
immunologic or non-immunologic in nature
Food allergy is an immunologically mediated, reaction to
ingested food.
Food intolerance, which is a non-immunologically mediated
adverse reaction including toxic reactions, pharmacological reactions,
metabolic reactions, and idiosyncratic reactions
5. Food Intolerance
Examples of food intolerance include lactose
intolerance, gluten intolerance, reaction to vasoactive
amines in diet, reactions to histamine-containing
foods or foods that stimulate histamine release,
reactions to foods that contain opiates, food additives,
and toxic reaction to food substances.
6. Adverse Reactions to Food
How adverse reactions to food manifest (what happens to
the patient):
Food Allergy causes dermatitis
1. Pyoderma
2. Otitis ( chronic ear infections can be related to food)
3. Dermatitis
Food Intolerance causes gastroenteritis
1. Vomiting
2. Diarrhea
7. What foods can cause
these reactions?
Chicken,
Chicken egg
Soy, Lamb
25%
Other
7%
Beef, Dairy,
Wheat
68%
Beef, Dairy,
Fish 89%
Other
11%
DOGS
CATS
12. Adverse Reaction Goals
1. Identify the allergen
2. Avoid the allergen
FOOD ELIMINATION
TEST IS MOST
ACCURATE FOR
FOOD ALLERGY TESTING
13. Avoid Adverse Reactions
Provide a:
Novel protein ( one they have not eaten )like salmon,
rabbit, venison or
Hydrolyzed protein ( protein that has been broken
down small enough to not elicit histamine release)
Utilize Diets that provide:
Highly digestible protein
Limited number of protein sources
14. What Novel Proteins Are Available?
Lamb
Kangaroo
Chicken
Alligator
Duck
Whitefish
Opossum
Venison
Rabbit
15. LA Limited Antigen®
HA Hypoallergenic® Gentle Snackers®
Skin and Coat Response FP Skin and
Coat Response Response LB
Skin and Coat Response Response KO
Prescription Diet® d/d
Prescription Diet® z/d Low Allergen
Prescription Diet® z/d ULTRA
Hypoallergenic HP 19
Novel sources: potato, rabbit, venison,
whitefish, vegetarian
16. Not all diets will work for all
patients
You may need to try different diets before you find the
one that works for your patient
These diets are expensive and owners need to
understand that a food trial lasts 6-8 weeks before we
can say if the diet is working or not
Owners must not give table food or treats
19. ANSWER
They will feel better when they eat
Fluid therapy does not replace eating
Cats that are licking the gravy off the canned
food are not eating enough to sustain
themselves
Owners must understand how important eating is
for the recovery of their pet
20. Recovery Care
Anorexia – lack or loss of appetite
Hypermetabolism – increased need
for energy and nutrients caused by
disease or recovery process
21. Recovery Care
Enteral feeding – use of the alimentary
tract (mouth, esophagus, stomach, small intestine)
Parenteral feeding – routes other than
alimentary tract; ex: I/V, I/P
TPN – all nutrients parenteral ( not gi tract)
22. Recovery Care
Indications for assisted feeding
Mechanical dysfunction ( they can’t eat)
Anorexia
Increased energy requirement
Increased nutrient requirement
Assisted feeding should begin within first 24 hours
23. Recovery Care
Benefits of assisted feeding
Prevent dehydration
Enhances wound healing
Decrease recovery time
Prevents muscle and weight loss
Counteracts immunosuppressive effects
24. Recovery Care
Assess:
1. History
2. Weight/BCS
3. Calculate needs
4. Monitor intake and output
5. Monitor weight ( daily in hospitalized
patients)
25. What Is the Best Food to
Encourage a Pet to Eat?
Food from home (have owners bring in food and
encourage pets to eat)
Table food, boiled chicken and hamburger
AD, highly palatable, can be fed through a syringe if
needed
Make sure animal is clean, comfortable
27. Recovery Care - Goals
•Formula conducive to enteral feeding
•Water
•Increased B vitamins, electrolytes
•High energy density
•Relatively high protein
•Omega 3 Fatty acids
•Arginine, glutamine,
carnitine
Provide Nutrients
Energy Dense Formula
Support Organ Function
Support Immune Function
28. KNF Comparison: Recovery Care
Products
Purina CV
Feline
Iam’s
Stress/Weigh
t Gain Max
Cal
Prescription
Diet a/d
Energy
Density
223 kcals/can 333 kcals/can 180 kcals/can
Protein 42.53% Min. 14% 44.3%
Glutamine n/a n/a 7.23%
29. Recovery Products ( examples)
CV CardioVascular® Feline
Stress/Weight Gain Maximum Calorie
Canine and Feline Canned Formula
Prescription Diet® a/d
Recovery RS
31. Osteoarthritis
Common syndrome resulting in pain and disability.
Approximately 1 in 4 dogs will be affected.
22% of dogs < 1 year of age will develop osteoarthritis
with 20% of these possibly having a nutrition-related
cause.
Nutrition plays a role in prevention of and
management of dogs and cats with OA.
32. NUTRITION Can Help with PREVENTION of
These MUSCULOSKELETAL DISEASES
Developmental Orthopedic Disease ( hip dysplasia and OCD
(osteochondritis dessecans) in large breed dogs Bones that grow too
quickly are less dense making the skeleton, including joints, weak.
Exponential growth accompanied by increased body mass puts
additional strain on bones and joints. So puppies should not get too fat!
Obesity can become a life long disease- it is the number one
nutritional disease of pets in the United States
33. Developmental Orthopedic Disease (DOD).
Group of skeletal abnormalities that affect primarily rapidly growing,
large- and giant-breed dogs.
Nutrient excess (calcium and energy) and rapid growth (overfeeding
and excess energy) increase the development of this disease in breeds
genetically prone to it.
Dietary calcium greater than 3% on a dry matter basis is associated
with increased risk.
Restrict food intake to slows growth rate to help prevent this disease.
34. Obesity
Body fat exceeding ideal body weight by 15-20% or
more.
Excess weight on joints and articular cartilage, may
lead to inactivity and further development of obesity.
Adipose tissue is metabolically active and pro-
inflammatory; therefore, obesity may contribute to
inflammation.
35. “Lance” 6 yrs old,
Golden Retriever, M(i)
100# BCS 5/5 “Lucy” 1 yr old,
Great Dane, F(n)
103# BCS 3/5
What Arthritis Risk Factors Do These Dogs Have?
Thanks
Sara!
36. Arthritis Risk Factors
Breed
Size
Genetic predisposition
Trauma
Obesity
Johnston SA. Vet Clin N Amer 1997
38. Joint Structure and Function
Core
Protein
Hyaluronan
Link
protein
Others Keratan Chondroitin
sulfates sulfates
Glycosaminoglycans (GAGs)
Aggrecan
39. Joint Structure and Function
Aggrecanases
Proteinases responsible for degradation of
aggrecan, resulting in GAG release
40. Joint Structure & Function
Link
protein
Aggrecanases cause
GAGs to break off
Core
Protein
Others Keratan Chondroitin
sulfates sulfates
Glycosaminoglycans (GAGs)
42. Managing Canine Osteoarthritis
Structural &
Functional Failure
Physical Stress
• DOD
• Weight
• Trauma
Inflammation
Degradation
Matrix
Damage
Chondrocyte
Damage
Medications
Omega-3 FA
X
X
Omega-3 FA
Chondroprotectives
X
43. Canine Osteoarthritis Goals
Manage predisposing factors
Reduce pain, inflammation
Improve joint function and mobility
44. Canine Osteoarthritis KNF
High levels of Eicosapentaenoic Acid (EPA)
Omega-3 fatty acid that is biologically active in dog
cartilage; selectively stored
Stops degradation, decreases inflammation
Added Glucosamine & Chondroitin Sulfate
High levels of Carnitine
45. DIETS FOR OSTEOARTHRITIS IN DOGS AND CATS
Higher levels of omega-3 fatty acids and may contain
chondromodulators and antioxidants.
Contain antioxidants that may be beneficial in decreasing free radical
induced injury with OA.
Chondromodulating agents are also often included in “joint” diets (
glucosamine, chondroitin sulfate)
OA occurs commonly in cats; diet high in n-3 fatty acids and
supplemented with green-lipped mussel extract and
glucosamine/chondroitin has been beneficial
47. Cats also suffer from arthritis
Owners may not notice is as early as they do in the dog
because cats are usually more sedentary
Make sure you assess your cat patients for arthritis and
get a good history of the cats activity level at home.