Flavored medications have become an increasingly common challenge to overcome when enforcing a food trial. Many flavored medications
contain beef and pork protein. I have observed patients flare from their once-monthly flavored heartworm preventive. Glucosamine
chondroitin is another potential allergen commonly administered.
When it's not just food
It is not uncommon for an atopic dog or cat to have multiple triggers for their disease, with both food and environmental
allergens playing a role. A clinician trying to sort out these multiple triggers will also sometimes have to make compromises
when developing a comprehensive treatment plan for the pruritic patient. Feeding a large dog such as a Labrador retriever
a novel therapeutic diet long-term may leave nothing else in the budget for control of the environmental triggers.
In such cases, I will frequently recommend some of the over-the-counter fish-based diets in an attempt to find an over-the-counter
food that will not trigger the food allergy and possibly provide some supportive care for the atopic dermatitis because of
the omega-three fatty acids. This, of course, assumes the patient is not allergic to fish and that there are not other protein
contaminants in the food but not listed on the label.
In our practice, even though we use handouts to help educate clients on the principles of the food trial, we do not rely on
the handouts alone. It requires time to properly educate a client on how to perform the food trial. We schedule a follow-up
appointment with one of our office staff a few days after initiating the trial, and we schedule another follow-up four to
six weeks after starting the trial so that progress, or lack thereof, can be assessed.
Dr. Lewis sees dermatology patients in California, Arizona, Nebraska, New Mexico and Washington. In 1991 he established Dermatology
for Animals, PC.
1. 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) 2011;95(1):90-97.