ALLERGIC DERMATITIS (Atopy, Atopic Dermatitis) ALLERGIC DERMATITIS (Atopy, Atopic Dermatitis)Principal Natural Treatments
Orthomolecular therapy, topical decontamination with frequent hypoallergenic shampooing and conditioning, omega-3 fatty acids, natural diet
Other Natural Treatments
Digestive enzymes; antioxidants; MSM; proanthocyanidins; herbal therapies including the topically applied herbs aloe, witch hazel, licorice, Oregon grape, peppermint, chamomile, calendula, juniper, lavender, rose bark, uva ursi; and the oral herbs alfalfa, aloe vera, burdock root, dandelion, echinacea, feverfew, garlic, German chamomile, Ginkgo biloba, goldenseal, licorice root, nettle, red clover, Oregon grape, yarrow, and yellow dock
A llergic dermatitis is among the most common skin diseases seen in private veterinary practice. The technical term for “allergies” is atopic dermatitis, also called atopy. Atopy is a genetic disease in which the dog or cat becomes sensitized to environmental proteins called allergens. In non-allergic pets, these allergens produce no clinical signs. In allergic or atopic dogs and cats, these allergens produce the clinical signs so commonly seen.
Allergic dogs (and probably cats) develop allergen-specific IgE antibodies (and to some extent IgG antibodies as well). These IgE antibodies are involved in Type I hypersensitivity reactions in the pet’s body. While the actual immunologic response can be quite complicated, briefly this is what happens to cause allergies in your pet’s body: IgE antibody is formed upon exposure to an environmental allergen such as pollen from grasses, weeds, and trees; mold; human dander; fleas; or house dust mites. The IgE antibody attaches to a tissue cell called a mast cell. The next time the pet encounters the allergen, the allergen attaches to the IgE antibody-mast cell combination. Upon attachment to the IgE-mast cell unit, the mast cell degranulates (disintegrates, “explodes”) releasing the many chemicals contained within the cell and cell membrane. Some of these chemicals include histamine, substance P, bradykinin, and various prostaglandins. It is the presence of these chemicals that causes the clinical signs (inflammation, itching, and such) seen in allergic pets.
Atopic dermatitis is relatively common in dogs and rare in cats. As previously mentioned, atopic dermatitis is a genetic disease. For this reason dogs (and cats) with atopy should not be bred. Due to the genetic component of the disease, certain breeds of dogs have a high incidence of atopic dermatitis. Breeds with a high incidence of allergies include Cairn Terriers, Shar-peis, West Highland White Terriers, Scottish Terriers, Lhasa Apsos, Shih Tzus, Wirehaired Fox Terriers, Dalmations, Pugs, Irish Setters, Boston Terriers, Golden Retrievers, Boxers, English Setters, Labrador Retrievers, Miniature Schnauzers, and Belgian Tervurens. Despite these breed predispositions, allergic dermatitis can occur in any breed of dog. No specific cat breeds have been shown to be predisposed to atopic dermatitis. Some (but not all) studies of atopic dogs show that females are affected more than males.
According to the literature, allergies usually are seen in pets 1 to 3 years of age. However, this figure is a bit misleading. Allergies usually occur within 1 to 3 years of a pet being exposed to environmental allergens. For example, if you live in an environment where there are few environmental allergens, even if your dog had the genetic ability to develop allergies, he would not do so. If you moved to another area where there were many environmental allergens, your genetically predisposed allergic dog or cat would develop signs of allergies within 1 to 3 years of moving into the new environment. (When owners ask if allergies can be cured, the answer is usually “No,” although the rare pet will “outgrow” his allergies. If an owner were to move to another state where there were few allergens that affected the dog or cat, the allergic pet, while still technically “allergic,” would not show signs of allergies and would appear “cured.”
Despite this well-reported figure of 1 to 3 years of age (or more correctly 1 to 3 years of antigen exposure), some pets do not show signs of allergies until midlife or later. Still others show signs as early as a few months of age, barely starting their puppyhood or kittenhood.
Many allergic pets have seasonal signs, showing itching only during the season when the specific allergens to which they are allergic are most prominent. For example, pets with allergies to Bermuda grass often begin showing allergic signs in the spring when the grass begins to awaken after the winter. Eventually, over many years, most allergic pets will develop signs that last all year long.
The typical allergic pet itches but has normal appearing skin (one exception mentioned in a leading dermatology text states that the English Bulldog may have red skin with minimal itching). This helps differentiate atopy from other diseases that cause itchiness but also cause skin lesions (mange, flea allergies, bacterial infections, yeast infections, skin cancer). The itchiness can be mild, moderate, or severe; but most allergic pets do not start off with severe itching (a pet with severe itching is more likely to have mange, fleas, or the rarely seen food allergies).
With time, skin lesions can develop if secondary infections occur or as a result of chronic self-trauma. Many dogs with chronic allergies develop pink or red skin, bronzing of the skin, and darkening of the skin. The pink color is from chronic inflammation (the pink color can also be seen early in the course of the disease). The bronzing color is from pigment in the dog’s saliva that discolors the skin and hair (this bronzing, which can also be seen early in the condition for dogs who excessively lick, is particularly striking in light-haired dogs). Darkening of the skin, called hyperpigmentation, can develop in any chronic skin disorder as the result of repeated trauma and inflammation.
Many dogs (and probably cats) with allergies also have flea allergies and chronic bacterial infections. Chronic skin infections are so common in allergic dogs that every dog with chronic skin infections should be screened for atopy (and also for hormonal diseases such as hypothyroidism, another overlooked underlying disorder). Because allergic skin is not “normal” skin, it is predisposed to secondary infections. Most common, staphylococcal bacteria infect the skin, causing small red bumps called papules or small pimple-like lesions called pustules. Scabs can also form when the papules or pustules rupture.
Secondary yeast infections are becoming increasingly common in atopic dogs. Most of the time the yeast Malassezia is the causative agent. Dogs with yeast infections are typically quite itchy, greasy (with greasy yellow scales), red, and quite smelly. Yeast infections are often misdiagnosed but should be considered in any dog with the aforementioned clinical signs.
Diagnosis is based upon clinical signs, ruling out other diseases by various tests (skin scrapings, fungal cultures, skin cytology, and blood testing). When needed, intradermal skin testing (allergy testing) can be done. In vitro testing (blood testing) for allergies is not as accurate as skin testing and should not be relied upon if skin testing is available. (Blood testing is inaccurate for testing for food allergies.)
The main natural treatments are designed to reduce itching and inflammation in pets with allergic dermatitis.
Orthomolecular medicine (often called “megavitamin therapy”) seeks to use increased levels of vitamins and minerals (mainly antioxidants) to help treat a variety of medical disorders. While daily amounts of vitamins and minerals have been recommended as an attempt to prevent nutritional deficiencies, orthomolecular medicine uses higher doses as part of the therapy for disease.
The pet food industry relies on recommendations by the National Research Council (NRC) to prevent diseases caused by nutrient deficiencies in the “average” pet; yet, the NRC has not attempted to determine the optimum amount of nutrients or their effects in treating medical disorders. While a minimum amount of nutrients may be satisfactory in preventing diseases caused by nutrient deficiencies, it is important to realize that there is no “average” pet, and that every pet has unique nutritional needs.
It is unlikely that our current recommendations are adequate to maintain health in every pet. Each pet has unique requirements for nutrients. Additionally, these needs will vary depending upon the pet’s health. For example, in times of stress or disease, additional nutrients above and beyond those needed for health will be required. Orthomolecular medicine evaluates the needs of the pet and uses increased nutrients to fight disease.
Note: Owners should not diagnose and treat their pets without veterinary supervision. Many medical disorders present similar symptoms. Also, megavitamin therapy can be toxic if not used properly.
The orthomolecular approach to treating atopic dermatitis uses a hypoallergenic, healthy diet as the starting point. This diet should be free of chemicals, impurities, and by-products. A blood profile is done to rule out endocrine diseases such as Cushing’s disease and hypothyroidism, as antioxidants may create changes in blood values that are normally used to screen for these common disorders. The treatment uses vitamin A (10,000 IU for small dogs and cats, up to 30,000 IU for large dogs), crystalline ascorbic acid (750 mg for small dogs and cats, up to 3,000 mg for large dogs), and vitamin E (800 IU for small dogs and cats, up to 2,400 IU for large dogs). The antioxidant mineral selenium (20 meg for small dogs and cats, up to 60 meg for large dogs) is also added to the regimen. Once asymptomatic, a maintenance protocol using lower dosages of vitamins A and E and the mineral selenium is prescribed to reduce the chance for toxicity. Promising results have been seen in many pets treated with this regimen.
Topical decontamination with frequent hypoallergenic shampooing and conditioning is important in removing foreign proteins from the skin and coat of allergic animals. Additionally, frequent bathing and conditioning can temporarily relieve itching in many pets with atopic dermatitis. Products vary. Those with aloe vera and colloidal oatmeal are usually tried first and work on most pets if frequency of bathing is maintained. (Most allergic pets should be bathed every 24 to 48 hours until itching decreases, then 1 to 3 times weekly as needed to control itching.) If aloe vera and oatmeal products do not help decrease itching, medicated products containing antihistamines or corticosteroids can be tried. Finally, residual “leave-on” conditioners can be used to increase contact time between the allergic pet’s skin and the hypoallergenic product.
Omega-3 fatty acids—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are derived from fish oils of coldwater fish (salmon, trout, or most commonly menhaden fish) and flaxseed. Omega-6 fatty acids—linolenic acid (LA) and gamma-linolenic acid (GLA)—are derived from the oils of seeds such as evening primrose, black currant, and borage. Often, fatty acids are added to the diet with other supplements to attain an additive effect.
Just how do the fatty acids work to help in controlling inflammation in pets? Cell membranes contain phospholipids. When membrane injury occurs, an enzyme acts on the phospholipids in the cell membranes to produce fatty acids, including arachidonic acid (an omega-6 fatty acid) and eicos-apentaenoic acid (an omega-3 fatty acid). Further metabolism of the arachidonic acid and eicosapen-taenoic acid by additional enzymes (the lipooxygenase and cyclooxygenase pathways) yields the production of chemicals called eicosanoids. The eicosanoids produced by metabolism of arachidonic acid are pro-inflammatory and cause inflammation, suppress the immune system, and cause platelets to aggregate and clot; the eicosanoids produced by metabolism of eicosapentaenoic acid are noninflammatory, not immunosuppressive, and help inhibit platelets from clotting. (There is some overlap and the actual biochemical pathway is a bit more complicated than I have suggested here. For example, one of the by-products of omega-6 fatty acid metabolism is Prostaglandin E1, which is antiinflammatory. This is one reason why some research has shown that using certain omega-6 fatty acids can also act to limit inflammation.)
Supplementation of the diet with omega-3 fatty acids works in this biochemical reaction. By providing extra amounts of these non-inflammatory compounds, we try to overwhelm the body with the production of non-inflammatory eicosanoids. Therefore, since the same enzymes metabolize both omega-3 and omega-6 fatty acids, and since metabolism of the omega-6 fatty acids tends to cause inflammation (with the exception of Prostaglandin E1 by metabolism of omega-6 as mentioned), by supplying a large amount of omega-3 fatty acids, we favor the production of non-inflammatory chemicals.
Many disorders are due to overproduction of the eicosanoids responsible for producing inflammation, including arthritis and atopic dermatitis. Fatty acid supplementation can be beneficial in inflammatory disorders by regulating the eicosanoid production.
In general, the products of omega-3 (specifically EPA) and one omega-6 fatty acid (DGLA) are less inflammatory than the products of arachidonic acid (another omega-6 fatty acid). By changing dietary fatty acid consumption, we can change eicosanoid production right at the cellular level and try to modify (decrease) inflammation within the body. By providing the proper fatty acids, we can use fatty acids as an anti-inflammatory substance. However, since the products of omega-6 fatty acid metabolism (specifically arachidonic acid) are not the sole cause of the inflammation, fatty acid therapy is rarely effective as the sole therapy but is used as an adjunct therapy to achieve an additive effect.
Note: Flaxseed oil is a popular source of alpha-linoleic acid (ALA), an omega-3 fatty acid that is ultimately converted to EPA and DHA. However, many species of pets (probably including dogs) and some people cannot convert ALA to these other more active non-inflammatory omega-3 fatty acids. In one study in people, flaxseed oil was ineffective in reducing symptoms or raising levels of EPA and DHA. While flaxseed oil has been suggested as a less smelly substitute for fish oil, there is no evidence that it is effective when used for the same therapeutic purposes as fish oil. Therefore, supplementation with EPA and DHA is important, and this is the reason flaxseed oil is not recommended as the sole fatty acid supplement for pets. Flaxseed oil can be used to provide ALA and as a coat conditioner.
Because of their anti-inflammatory effects, large doses (2 to 4 times the label dose, as the label dose on most products is suspected to be too low to provide anti-inflammatory effects) of omega-3 fatty acids have been shown beneficial in treating allergic dogs and cats. Inhibition of pro-inflammatory prostaglandins, as well as decreased levels of leukotriene B4 production from white blood cells (leukotriene B4 is an important mediator in inflammatory skin disorders) is the explanation for the effectiveness of omega-3 fatty acids in allergic pets. As with the other supplements, they often allow doctors to lower the dosages of drugs such as corticosteroids or nonsteroidal medications.
In allergic dogs, fatty acid supplements were effective in 11 to 27% of dogs treated (over 50% of allergic cats responded to fatty acid supplements). How well fatty acids work in an allergic pet depends upon a number of factors, including product used, dosage used, and the presence of other diseases that may contribute to itching. Many atopic pets also have flea allergies, bacterial skin infections, yeast skin infections with Malassezia organisms, and food hypersensitivity. Until these other concurrent problems are identified and treated properly, simply administering fatty acid supplements to a pet suspected of just having atopic dermatitis is unlikely to be effective. In general, the literature reports that about 20% of allergic (atopic) dogs and 50% of cats may respond partially or totally to fatty acid supplementation.
While many doctors use fatty acids for a variety of medical problems, there is considerable debate about the use of fatty acids. The debate concerns several areas:
What is the “best” dose to use in the treatment of pets? (Most doctors use anywhere from 2 to 10 times the label dose.) Research in the treatment of allergies indicates that the label dose is ineffective. In people, the dosage that showed effectiveness in many studies were 1.4 to 2.8 grams of GLA per day, or 1.7 grams of EPA and 0.9 grams of DHA per day, which is hard for people to obtain from the supplements currently available. If this were shown to be the correct dosage for pets, a 50-pound dog would need to take 10 or more fatty acids capsules per day to obtain a similar dosage, depending upon which supplement (and there are many choices on the market) was used. Therefore, while the studies with omega-3 fatty acids show many potential health benefits, it is almost impossible to administer the large number of capsules needed to approximate the same dosage used in these studies. The best that owners can hope for at this time is to work with their veterinarians and try to increase, as best as possible, the amount of omega-3 fatty acids in the diet to try to get to what seems to be the “preferred” ratio of 5:1, omega-6:omega-3 fatty acids.
What is the “correct” fatty acid to use? Should we use just omega-3 (EPA and DHA) fatty acids, or combine them with omega-6 (GLA) fatty acids? Is there an “ideal” ratio of omega-6 to omega-3 fatty acids? Through research on pets with atopic dermatitis, the ideal dietary ratio seems to be 5:1 of omega-6:omega-3 fatty acids, although this is also debated.
Is supplementation with fatty acid capsules or liquids the best approach, or is dietary manipulation (adding the “ideal” ratio of omega-6 and omega-3 fatty acids) preferred for the treatment of inflammatory conditions? There are, in fact, diets constructed with this “ideal” ratio. For owners who do not like giving their pets medication, or for those pets who don’t take the fatty acid supplements easily, it might be wise to try some of these medically formulated diets (available from your pet’s doctor) that contain the fatty acids. (However, because these medicated diets may not be as natural as possible due to the inclusion of by-products and chemical preservatives, holistic pet owners may need to try other options.)
Fish Oils Since processed foods have increased omega-6 fatty acids and decreased omega-3 fatty acids, supplementing the diets of all pets with omega-3 fatty acids seems warranted and will not harm your pet. As discussed above, omega-3 can be derived from fish oils.
Fish oil supplements are usually in the form of a capsule. Since fish oils can easily oxidize and become rancid, some manufacturers add vitamin E to fish oil capsules and liquid products to keep the oil from spoiling (others remove oxygen from the capsule).
The bottom line is that there are many questions regarding the use of fatty acid therapy. More research is needed to determine the effectiveness of the fatty acids in the treatment of various medical problems, as well as the proper doses needed to achieve clinical results. Until definitive answers are obtained, you will need to work with your doctor (knowing the limitations of our current research) to determine the use of these supplements for your pet.
Flaxseed Oil Flaxseed oil is derived from the seeds of the flax plant and has been proposed as a less smelly alternative to fish oil. Flaxseed oil contains alpha-linolenic acid (ALA), an omega-3 fatty acid that is ultimately converted to EPA and DHA. In fact, flaxseed oil contains higher levels of omega-3 fatty acids (ALA) than fish oil. It also contains omega-6 fatty acids.
As mentioned, many species of pets (probably including dogs and cats) and some people cannot convert ALA to these other more active non-inflammatory omega-3 fatty acids. In one study in people, flaxseed oil was ineffective in reducing symptoms or raising levels of EPA and DHA. While flaxseed oil has been suggested as a substitute for fish oil, there is no evidence that it is effective when used for the same therapeutic purposes as fish oil. Unlike the case for fish oil, there is little evidence that flaxseed oil is effective for any specific therapeutic purpose.
Therefore, supplementation with EPA and DHA is important, and this is the reason flaxseed oil is not recommended as the sole fatty acid supplement for pets. Flaxseed oil can be used to provide ALA and as a coat conditioner.
Flaxseed oil does contain lignans, which are currently being studied for use in preventing cancer in people.
The essential fatty acids in flax can be damaged by exposure to heat, light, and oxygen (essentially, they become rancid). For this reason, you shouldn’t cook with flaxseed oil. A good product should be sold in an opaque container, and the manufacturing process should keep the temperature under 100° F (some products are prepared by cold extraction methods). Some producers combine the product with vitamin E because it helps prevent rancidity.
The best use of flaxseed oil is as a general nutritional supplement to provide essential fatty acids.
Flaxseed oil appears to be a safe nutritional supplement when used as recommended.
Fish oil appears to be safe. The most common side effect seen in people and pets is a fish odor to the breath or the skin.
Because fish oil has a mild “blood-thinning” effect, it should not be combined with powerful blood-thinning medications, such as Coumadin (warfarin) or heparin, except on a veterinarian’s advice. Fish oil does not seem to cause bleeding problems when it is taken by itself at commonly recommended dosages. Also, fish oil does not appear to raise blood sugar levels in people or pets with diabetes.
True food allergies are quite rare in pets. Food intolerances, in which the pet develops an allergic response to a non-nutrient in the food (such as an additive) occur in pets, but the true incidence is hard to gauge. While dietary therapy is not a mainstay in the treatment of itchy pets, feeding the best, most natural and holistic diet possible is recommended for at least three reasons:
All pets, regardless of the presence of disease, benefit from eating the best diet.
Supplements work best when fed with a good diet. Supplements form the foundation of the treatment of many pets with allergic dermatitis, so feeding the best diet to these pets is indicated.
Some pets experience modest to dramatic improvement in their skin disorders (less itching, less flakiness, less redness, less body odor, and so on) when fed a wholesome diet even when the diagnosis of “food allergy” is not technically the correct diagnosis. This may be the result of contamination of the commercially purchased diet with additives, chemical preservatives, pesticides, or hormones. It may also occur as the result of processing the food, which removes nutrients from the diet and alters the nutrients. (For example, heating of the foods to temperatures over 400°F causes an increased level of trans-fatty acids.) Many foods contain increased levels of omega-6 fatty acids relative to omega-3 fatty acids; increased omega-6 fatty acids predispose to inflammation. Because feeding a wholesome diet designed to be hypoallergenic is easily done by most owners, dietary therapy is often recommended for pets with skin disorders.
Diets designed for pets with gastrointestinal disease can be useful for pets with skin disorders with some modification. These modified diets are used to assess and treat food allergies as well as assess any improvement in the pet with any skin disorder, including atopic dermatitis. Keep in mind that even itchy pets without a true food allergy may still show improvement when fed the diet used to test and treat food allergies.
There are several medicated diets containing the “correct” amount of fatty acids that supposedly help the pet with allergic dermatitis. Other medicated diets contain novel or chemically modified protein sources that supposedly reduce the allergic reaction and may help the itchy pet. While these diets can and do help some allergic pets, the holistic pet owner should keep two important considerations in mind before feeding these diets. First, it appears that the “correct” ratio of omega-6 to omega-3 fatty acids is 5:1, although more research is necessary before this becomes accepted as fact. While it is difficult to achieve this ratio simply by adding omega-3 fatty acids to the diet, a large amount of research shows positive benefit in some allergic pets when omega-3 fatty acid supplements are added to the diet, even if the 5:1 ratio is not achieved. Therefore these special supplemented diets are not always needed in pets with allergic dermatitis.
Second, most of these special diets may still use animal by-products and chemical preservatives (it is difficult to say that a commercial diet is free of pesticides and preservatives). This practice defeats the purpose of trying to feed pets a natural, wholesome diet. The best diet is a home-prepared one, ideally made with organically grown vegetables and organically raised animal tissues. If your pet will not eat the homemade diet and does require one of these special diets, be sure to work with your veterinarian to pick the one that is most wholesome.
For pets with allergies, hypoallergenic diets can be tried to see if the level of itching and redness decreases. Hypoallergenic diets are those that contain nutrients to which the pet is unlikely to react with an allergic response. The most common allergic foods are protein sources that the pet has eaten for months or years, rather than a new diet to which the pet has just been introduced. As a result, protein sources that the pet has not eaten before are used (most often rabbit, lamb, or venison). Gluten-free carbohydrate sources are used to prevent gluten allergies.
When indicated by the results of the physical examination and history you provide your veterinarian, a food trial might be indicated. To evaluate the response of a pet with a suspected reaction to food, it is necessary to feed the hypoallergenic diet (and nothing else) for at least 8 weeks. Monthly flavored heartworm preventive should be discontinued and replaced with a non-flavored product. Fresh or distilled water can be used. No treats or table scraps can be given to the pet, or the 8-week dietary trial must begin again. The most common reason for failing to improve is one of two causes: the pet’s itching is not related to a food allergy/hypersensitivity, or the owner rushes the dietary trial and does not give the pet at least 8 weeks to see whether the hypoallergenic diet will work.
Vitamins and minerals, which most often contain flavoring, are added after the trial, and the pet is assessed for any reaction to these supplements. Because food allergy trials are difficult, they should be done under veterinary supervision.
Glutamine, recommended for pets with inflammatory bowel disease, has also been suggested as a treatment for food allergies, based on the “leaky gut syndrome.” This theory holds that in some pets, whole proteins leak through the wall of the digestive tract and enter the blood, causing allergic reactions. Very preliminary evidence suggests that glutamine supplements might reduce leakage through the intestinal walls. It can be tried for pets with allergic skin disease.
Note: Before you start to feed your dog or cat a home-prepared diet, it is strongly recommended that you discuss your decision with your veterinarian or a holistic veterinarian in your area. It is essential that you follow any diet’s recommendations closely, including all ingredients and supplements. Failure to do so may result in serious health consequences for your pet.
Diets for dogs with allergies must contain protein sources the dog has not previously eaten. Using the basic dog diet we would substitute ½ cup of a meat such as rabbit or venison. Brown rice (2-3 cups) or baked or boiled potato with skin (2-3 cups) serves as the carbohydrate source. Canola oil is added as per the basic diet.
The diet provides approximately 650 kcal with 29 grams of protein and 18 grams of fat.
Fresh, raw or slightly steamed vegetables (carrots, broccoli, etc.) can be used as a top dressing for the diet for extra nutrition and variety (approximately ½-1 cup per recipe.) Most vegetables provide approximately 25 kcal per ½ cup.
Since this diet is not totally balanced, vitamins and minerals are added later (in 4-8 weeks), as the dog improves, to balance the diet. Add four bonemeal tablets (10 grain or equivalent) or 1 teaspoon of bonemeal powder to supply calcium and phosphorus with a multi-vitamin mineral supplement using the label instructions.
Alternatively, a natural product from Standard Process (Calcifood Wafers or Calcium Lactate) can be used (use 1 Calcifood Wafer or 2 Calcium Lactate tablets for each 2 bonemeal tablets.)
When possible, natural vitamins made from raw whole foods, rather than synthetic vitamins (although both can be used in combination) are preferred, as the natural vitamins also supply plant phytochemicals, enzymes, and other nutrients not found in chemically- synthesized vitamins. Catalyn from Standard Process can be used as the natural vitamin in this recipe, at a dose of 1 Catalyn per 25 pounds; Canine Plus (VetriScience) could also be used following label dosages.
Add one new ingredient at a time. If itching does not worsen within 3 to 5 days, add another ingredient if desired.
The nutrient composition of the diet will vary depending upon which ingredients are used. In general, the above recipe supplies the daily nutritional and calorie needs for a 20 pound dog. The actual amount to feed will vary based upon the pet’s weight (feed less if weight gain, more if weight loss.)
Added supplements which can be beneficial include omega-3 fatty acids, plant enzymes, and a super green food or health blend formula The health blend formula may contain nutrients that could exacerbate the pet’s allergies and should only be added after clinical signs resolve.
Diets for cats with allergies must contain protein sources the cat has not previously eaten.
Using the basic cat diet we would substitute ¾ cup of a meat such as rabbit or venison. Canola oil is added as per the basic diet. Taurine (100 mg) is also added.
Since this diet is not totally balanced, vitamins and minerals are added later (in 4–8 weeks), as the cat improves, to balance the diet. Add two to three bonemeal tablets (10 grain or equivalent) or ¾ teaspoon of bonemeal powder to supply calcium and phosphorus with a multi-vitamin mineral supplement using the label instructions.
Alternatively, a natural product from Standard Process (Calcifood Wafers or Calcium Lactate) can be used (use 1 Calcifood Wafer or 2 Calcium Lactate tablets for each 2 bonemeal tablets.)
When possible, natural vitamins made from raw whole foods, rather than synthetic vitamins (although both can be used in combination) are preferred, as the natural vitamins also supply plant phytochemicals, enzymes, and other nutrients not found in chemically-synthesized vitamins. Catalyn from Standard Process can be used as the natural vitamin in this recipe, at a dose of 1 Catalyn per 10 pounds; NuCat (VetriScience) could also be used following label dosages.
Brown rice (½ cup) or baked or boiled potato with skin (¾ cup) can be added to serve as the carbohydrate source, although cats do not have a true carbohydrate requirement.
This diet will provide about 350 kcal with 31 grams of protein and 25 grams of fat, which would provide the daily amount of nutrients needed for a 10 pound cat.
Fresh, raw or slightly steamed vegetables (carrots, broccoli, etc.) can be used as a top dressing for the diet for extra nutrition and variety (approximately ½-1 cup per recipe), although most cats do not like eating vegetables.
Most vegetables provide approximately 25 kcal per ½ cup. Add one new ingredient at a time. If itching does not worsen within 3 to 5 days, add another ingredient if desired.
The nutrient composition of the diet will vary depending upon which ingredients are used. In general, the above recipe supplies the daily nutritional and calorie needs for a 10 pound cat. The actual amount to feed will vary based upon the pet’s weight (feed less if weight gain, more if weight loss.)
Added supplements which can be beneficial include omega-3 fatty acids, plant enzymes, and a super green food or health blend formula. The health blend formula may contain nutrients that could exacerbate the pet’s allergies and should only be added after clinical signs resolve.
Conventional therapy for atopic dermatitis relies on corticosteroids and antihistamines. Corticosteroids can be given by injection, by mouth, or by both routes of administration. The most commonly used corticosteroids are prednisone, prednisolone, dexamethasone, and triamcinolone. Corticosteroid injections can be short-acting or longer-acting (depot) injections.
While very effective when used to control itching and inflammation, corticosteroids have both short-term and long-term side effects. Short-term side effects include increased water intake, increased urination, increased appetite, destruction of joint cartilage, and very rarely, either depression or excitability. Long-term side effects that can occur are numerous; they include suppression of the immune system, infections, diabetes, liver disease, osteoporosis, Cushing’s disease, and obesity. Side effects, both short- and long-term, are common in dogs but relatively rare in cats.
When needed, short-term use of fast-acting corticosteroids are preferred. Depot injections, while commonly used in cats, should rarely, if ever, be used in dogs. In cats, an occasional depot injection (1 to 3 times per year) is usually not associated with side effects, but when possible, short-acting injections and oral corticosteroids are preferred.
Antihistamines may be effective in selected pets with atopic dermatitis. They can be used as the sole conventional therapy or combined with corticosteroids. Any of several antihistamines can be tried to relieve itching and inflammation in allergic pets. Usually, one antihistamine is given for a period of 7 to 10 days; if no response is seen, another antihistamine can be given. Because histamine is not the only chemical that causes signs in allergic pets, histamines are not effective in every atopic pet. Side effects are rare; mainly, sedation (which may resolve in several days) is seen. The main drawback is that most antihistamines must be given 2 to 3 times daily. When effective, antihistamines cause fewer side effects and offer a safer alternative than corticosteroids.
For a greater discussion about the causes and treatments of allergic dermatitis, see The Allergy Solution for Dogs (Prima Publishing, 2000).