Nutritional Diets

Food Allergy and Diabetes Diets

Food Allergy - Terminology

• Food intolerance or adverse food reactions account for 1 to 6% of all dermatoses in general practice. No immunological reaction

• Food allergy constitutes 10 to 49% of allergic responses in dogs and cats

Food Allergy - MOA

• Food allergy and food hypersensitivity: 3rd after atopy and FAD–Immune mediated• Type I hypersensitivity IgE binds

with the antigen > mast cells to release chemicals• Type III hypersensitivity: GI signs

Food Allergy – Clinical Signs• Canines: – Intense Pruritus (nonseasonal): feet, axillae, inguinal– Alopecia– Lichenification, hyperpigmentation

– Blepharitis– Urticaria– Chronic otitis externa– Peri-ocular dermatitis, Pododermatitis, anal sacculitis– Few have vomiting and diarrhea

HyperpigmentationLichenification:Dff: All chronic and pruritic skin diseases

Food Allergy

Otitis externa

Food Allergy

Food Allergy – Clinical Signs

– Felines– Intense Pruritus (nonseasonal): head and neck– Alopecia– Miliary dermatitis– Ulcerative dermatitis– Many have vomiting and diarrhea

Food Allergy

Food Allergy

Food Allergy

Food Allergy - Allergen• Protein: 18-36,000

Dalton's average molecular weight • Proteins, lipoproteins,

glycoproteins, polypeptides

• Canine: Beef, dairy products, soy, chicken

• Feline: Beef, dairy products, soy, fish

Food Allergy - Diets• Protein: Novel or hydrolyzed– fish, rabbit, lamb, venison

• Carbohydrate: Single easily digestible– rice, potatoes, barley, oats

• Fats– Omega 3 and 6

• Vitamins– A and E

• Minerals– Zn

Food Allergy - Diagnosis• FOOD ELIMINATION TRIAL• The patient is fed a hypoallergenic diet for 60-

90 days. • This allows the body to become desensitized

to the offending allergens. • When the previous diet is fed back to the pet,

an acute hypersensitivity reaction may occur.• This helps to identify that a food was the

source of the allergic signs

Food allergy – Diets availableRoyal Canin •-Hypoallergenic HP – hydrolyzed protein •-Sensitivity RC – novel foods •-Sensitivity LR – novel foods •-Skin Support SS – novel food •-Potato and Duck – novel food •-Potato and Rabbit – novel food •-Potato and Whitefish – novel food •-Potato and Venison – novel food

Hills •-d/d Duck – single novel protein •-d/d Lamb – single novel protein •-d/d Potato and Duck – single novel protein •-d/d Potato and Salmon – single novel protein •-d/d Potato and Venison – single novel protein •-d/d Rice and Egg – single novel protein •-d/d Salmon – single novel protein •-d/d Venison – single novel protein •-z/d low allergen – hydrolyzed protein •-z-d Ultra allergen free – hydrolyzed protein

Food Allergy – Novel Proteins– Novel proteins

• Hills d/d

Fish and Potato

Food Allergy – Novel Proteins

Hydrolyzed chicken

• Z/D: Less than 18,000 dalton

• Ultra z/d: less than 3,000 dalton

Food Allergy – Hydrolyzed Proteins

Food allergy: Challenging

Diabetes Mellitus

Diabetes Mellitus - MOA

Diabetes Mellitus

• Definition: Disorder of carbohydrate, fat and protein metabolism caused by an absolute or relative insulin deficiency

• Type I – Insulin Dependent DM – very low or absent insulin secretory ability

• Type II – Non insulin dependent DM (insulin insensitivity) – inadequate or delayed insulin secretion relative to the needs of the patient– More common in cats

• Signalment: older patients, obese, top 3 disease in older cats

• Clinical signs: polyuria, polydipsia, polyphagia, weight loose, cataracts – dogs, Plantigrade stance (neuropathy) - cats

Diabetes Mellitus

Diabetes Mellitus

• Diagnosis– Chemistry screen: hyperglycemia– Urinalysis: glycosuria

Diabetes Mellitus

Diabetes Mellitus

• Treatment options– Insulin–Oral hypoglycemic

drugs–Dietary

management• Frequent meals

Diabetes Mellitus

• Dietary GOALS– Stabilize blood glucose levels–Minimize postprandial hyperglycemia–Prevent hypoglycemia–Prevent or delay long term effects of the

disease–Achieve and maintain an ideal body

condition

Diabetes Mellitus - Dogs• Carbohydrate–Complex– Fiber: High• Slows digestion, reduces the

post-prandial glucose spike, promotes weight loss, reduces risk of pancreatitis

–Vitamin E–Hill’s R/D or W/D

Diabetes Mellitus - Cats• Protein: high• Carbohydrate: Low–Cats use protein as their primary source of

energy – blood glucose is maintained primarily through liver metabolism of fats and proteins

• Purina DM, Hill’s M/D• Often a diet change in cats can dramatically

reduce or eliminate the need for insulin• this is particularly true for type II

References

•Miss Huff’s personal notes•http://www.veterinarypartner.com/Content.plx?P=A&A=652•http://www.ansc.purdue.edu/swineclass/PDF/Companion%20Animal%20Nutrition_1.pdf•Won-Seok Oh, DVM, PhD, Nutrition and Canine Skin Barrier, World Small Animal Veterinary Association World Congress Proceedings, 2011•Case, L. et.al. 2000. 2nd edition. Canine and Feline Nutrition•Dr. Ralf S. Mueller, Dermatology for the Small Animal Practitioner