FOOD ALLERGIES and ELIMINATION DIETS (long)

I came across this in my files today and thought it was worth posting. I may have posted it before but I can't remember (that happens to me a lot these days) . Anyway, I hope you find it helpful, or at least interesting. H
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I decided to write this article as I have received so many requests (should I say “pleas”) for help from people whose dogs are experiencing severe allergy symptoms. [footnote 1] Please note that I am not a medical professional and provide this information from experience with my own and foster dogs, from my own research and from information from my own vets. You should test my advice by doing research of your own and checking with your own canine medical professionals. Just be forewarned that many vets, including some dermatologists, deny the connection between allergies/ “atopy” and food intolerance and have a vested interest in promoting diets they stock in their clinics. It is helpful to understand that nutrition is an extremely small component of vet training and is often sponsored by certain kibble manufacturers. If the vet has not taken post-graduate studies in nutrition, their knowledge may not be as reliable as you would expect. In fact, some of them “don’t know what they don’t know”. So it is up to you to ensure that you are getting proper nutrition counsel.

To provide a simplified explanation, a food allergy is the manifestation of the dog’s immune system creating antibodies acting against the offending food, just like a vaccination creates antibodies to fight a disease. When the dog eats the offending food from then on, the antibodies bind to the protein in the food and cause histamines to be released from the mast cells and basophils. This process sets up an inflammatory response that shows up as itchy spots, ear infections, etc. The immune system is over-reacting, literally treating the food as an invader and fighting it.

You need to identify which ingredients are the culprits for your particular dog. Unfortunately lab tests (e.g. patch tests) are not nearly reliable enough at identifying food allergens. There is too great an incidence of false-positive and false-negative results and a very real risk of cross-contamination of foods in the manufacturing process. However, patch tests are fine for identifying environmental allergens. Often a dog will have allergies to both food and environmental allergens and it is useful to know this since allergies are cumulative. For instance, a dog may have an allergy to, say, beef, but does not manifest symptoms most of the year. But if that dog is also allergic to leaf mold, it will begin scratching like mad in early spring and late fall. At those times, when they are exposed to leaf mold, they have surpassed their “itch threshold” [footnote 2] and you might think they have only seasonal allergies. But the true culprit may be the food.

In my experience, grains (especially wheat and corn) are the most common food allergens for dogs. So my first piece of advice is to remove all grains from the dog’s meals and treats. While this usually rectifies the problem, sometimes the symptoms persist and we have to look at other foods as the potential culprits. Dogs, like humans, can be allergic to all kinds of food from some meat/poultry to certain vegetables to additives [footnote 3]. “Food allergies cause a lot of harmful reactions, including swelling of thyroid glands. When eaten raw, cruciferous foods such as broccoli, cauliflower, spinach and asparagus are major allergy factors in thyroid inflammation, as they contain a natural chemical known as goitrogens, which is a goiter producer”. [footnote 4] This is when trying a food elimination diet becomes useful. Studies have shown that beef and dairy products (including cheese) are high potential allergens. To a lesser extent, chicken, eggs, soy and additives (dyes, preservatives) should also be checked. Oftentimes, allergic dogs are switched to fish-based kibbles, or specialty foods such as “venison and potato” because they are “novel proteins”, i.e. foods the dog has not been previously exposed to and therefore has not developed an allergy to.

Often a vet will advise the inclusion of an oil to the atopic dog’s diet. But we must be careful what oils we use – whether they are high in omega-3 [footnote 5] or omega-6 [footnote 6] essential fatty acids (EFAs). When the dog consumes EFAs, its body produces certain prostaglandin hormones. From consumption of omega-6 EFAs, the body produces the prostaglandin which increases the immune system’s response. Since the immune system is already over-reacting to the “invader”, this will aggravate the allergy systems. On the other hand, consuming omega-3 EFAs dampens the immune system’s response. A balance is required.

I personally prefer coconut oil to any other oil. Fish and vegetable oils contain long-chain polyunsaturated fatty acids that are prone to oxidization in the body and use up vitamin E to prevent that. Coconut oil, on the other hand, is a saturated fat consisting of short and medium-chain fatty acids which actually enhance the absorption of vitamin E. Containing a high level of lauric acid, it has many benefits which you can read about here: http://www.coconut-info.com/coconut_oil_why_it_is_good_for_you.htm and here: http://www.whole-dog-journal.com/issues/8_10/features/15754-1.html (you’ll need to order the article). I particularly like its antimicrobial and thyroid-stimulating properties.

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FOOD ELIMINATION TRIAL

The basic premise behind a food elimination trial is to isolate each food in order to determine which one or more the dog is allergic to. Because of cross-contamination in the manufacturing process, kibble elimination trials, as I know from first hand experience, are not sufficiently effective for most dogs and we must go back to the original, unprocessed raw food to get a true result.

Please note that the food elimination process is not a balanced diet and so is not recommended for puppies who need a nutritionally complete diet for growth and development. Adults suffering from allergies can usually afford some temporary nutritional deficiency (e.g. imbalanced calcium:phosphorus ration to get to the root of their problems). It should be used with extreme caution when dealing with dogs with other health issues, including hypo- or hyperthyroidism, urine infections, etc.

Note also that the natural foods used in the trial will not necessarily be the same as their counterpart ingredients used in commercial diets. For instance, the “chicken meal” in kibble has been processed so even if the dog can tolerate raw chicken, it might not be able to tolerate the chicken-based kibble. You need to remember this if you are considering reverting to a kibble diet (even a so-called hypoallergenic diet) after the trial.

Note:
• Do not use treats other than bits of the food already tested
• Do not add supplements or vitamins until you have a stable base of safe foods
• Portions stated are for a pug weighing about 15 to 22 lbs.; most pugs over this weight could probably stand to lose a little weight.

Here’s how it works.

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Go to the supermarket and buy some pork chops or a pork roast. Don't be scared off by the fact it is pork; supermarket grade pork in Canada does not carry the parasites that we have historically associated with it. (I’m suggesting pork to start off with because most dogs haven’t been exposed to it – it’s a “novel protein” – but you could substitute another meat/poultry choice instead – e .g. turkey.) Cut the raw pork up into kibble size pieces (remove the fat as much as possible) and freeze for at least 2 days in portions of about 3-4 oz. (about the size of your closed fist). Defrost a portion for every meal - one for breakfast and one for dinner. Obviously you cannot free-feed so if you are in the habit of just putting the food down and leaving it, you'll have to switch. Do this for every meal - only pork cubes for about 10 days. Nothing else. No additives, supplements, etc. Any treats should be little bits of the pork. Introduction of ANYTHING else will defeat the purpose of the trial. Evaluate if there is any improvement or not. You should notice the coat becoming softer, less scratching, no hives, etc. You may not notice an improvement in ear or eye discharge and you may even notice an increase as the body begins to detoxify.

If the symptoms persist or worsen, note pork as an allergen and stop feeding it. Switch to another protein source and repeat the process.

If, however, you determine that pork is a “safe” food for your dog, add another protein source such as turkey (or chicken or beef …). Turkey is more expensive and I buy whole utility turkeys when they are on sale for 99 cents a pound, but then I have 6 pugs. You probably want to buy turkey legs and cut the meat off the bone, initially. When you add the second protein source, you alternate meals - so, pork in the morning and turkey in the evening or vice versa. Do that for another 10 days and evaluate the symptoms. If they worsen, note turkey as an allergen and replace it with something else. If the symptoms continue to improve, it’s time to rotate in a third protein source.

After consuming only two proteins over about 3 weeks, the dog has had very little calcium so we should add some. I buy chicken thighs, take the skin off and use poultry shears to chop the thigh (bones and all!) into kibble size pieces. This is obviously more time-consuming than pouring a bowl of kibble but well worth it. If you’d rather, you can just serve the thigh whole and the dog will eat the whole thing, bones included, but most people starting out on raw meat tend to be afraid to do this in case of choking. Hold one end of the thigh until the dog gets used to the process and, as normal, never leave your dog eating unattended! Don’t be afraid that eating chicken bones will harm your dog. They won’t unless they are cooked. There is one long bone in the thigh that is harder than the others and tends to split into pieces with sharp ends. You may want to remove these sharp pieces when you’re chopping the thigh up.

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Alternate the pork, turkey and chicken and assess the symptoms for 10 days or so. Then keep adding new protein sources. I would suggest some fresh or frozen sardines next. I buy bags of frozen sardines at the supermarket; some supermarkets don’t stock these, but you can usually get them at ethnic supermarkets if all else fails. I cut off the tails as they are too sharp and then feed the fish whole (about 6 inches long per pug) or chop up in pieces.

Your dog should have some organ meat in their diet (liver, heart, etc.) and you can start adding this as about 10% of their total diet, as long as the organs are not from an animal the dog is allergic to.

By now, unless you have uncovered some allergens, you should begin to notice significant improvement in your dog’s health and the diet is becoming more balanced. Some things you might want to add are duck necks (great for calcium) and green tripe (a fabulous source of nutrients with the ideal calcium:phosphorus ratio). Note that tripe can come from beef, goat, lamb or any other ruminant so if you have identified that, let’s say, beef is an allergen, avoid beef tripe and go for a different kind. Also make sure you wash off any hay etc. that still clings to the tripe. If you don’t want to do this, you can buy canned tripe. It’s not ideal but still good. You can, but I don’t, feed whole meals of tripe. It is quite rich so I usually add several bite-size pieces to something else for their dinner meal a couple of times a week.

At this point you want to check for additional potential allergens. Add a scrambled egg to their dinner meal for 3 consecutive days and note any change. If this doesn’t cause a problem, serve an egg once a week as a regular addition.

Wait a few days and add a tbsp of plain no-fat yoghurt to their breakfast meal for 3 consecutive days (to check for dairy allergy). Try small pieces of cheese as a treat.

Wait a few days and add a tbsp of pure canned pumpkin (not the pie filling kind) to their breakfast for 3 consecutive days. This is great for regulating bowel movements – it helps with both diarrhea and constipation.

You can continue testing various fruits and vegetables in isolation. Treating is a good way to do this. Raw baby carrots or little pieces of apple, cucumber or zucchini make great healthy treats as long as the dog isn’t allergic to them. Don’t feed raisins or grapes as they are toxic to dogs. Forget about most store-bought treats as they are full of preservatives and usually grains (including wheat and rye). If you're going to buy store-bought treats, stick with dehydrated liver with no additives, or you can dehydrate your own, avoiding liver from any meat you have identified as an allergen.

Finally, I would suggest you switch at this point to a pre-made mixture of raw food (either home-prepared or store-bought) for the breakfast meal and, for dinner, continue to rotate the various chopped pork, turkey, chicken, beef, lamb, duck, fish in rotation. Variety is very good for them. I have a recipe for Breakfast Slop that I have been feeding successfully for several years and would be happy to share with you.

As you can imagine with 6 dogs, money is an issue and I have to keep my eye out for bargains. While you're testing tolerance to various foods, you won't have the luxury of buying stuff on sale or in bulk, but once you know what foods are not triggers, you can plan better, buy on sale and freeze, and it will become cheaper. And, huge benefit, the vet and drug bills should almost stop.

One final word – about vaccinating allergic dogs. Vets are becoming better at heeding the vaccine manufacturer labels to not vaccinate an unhealthy dog. If your dog is exhibiting allergy symptoms, its immune system is working very hard at fighting the allergen. It should not be further compromised by a vaccination and you should request (and get) a medical waiver for any vaccine that is required – usually only rabies is required by law. Furthermore, there is some thought that there may be a correlation between vaccinating and the worsening of allergies in dogs; the February 2009 issue of Dogs in Canada contains an article which states, “There’s much controversy about the link between atopic dermatitis and vaccinations. In dogs that are allergic to corn, there was a significant rise in the concentration of corn-specific antibodies in the blood after vaccination. Normal (AD-free) dogs did not have the same rise in antibodies. This suggests (but has not been conclusively proven) that vaccination could make symptoms in AD worse, at least temporarily.” And be aware that a significantly compromised immune system may not be strong enough to generate the antibodies that the vaccine is designed to create.

Thank you, thank you for posting this!!

I have my foster girl Daisy...she is having terrible allergies right now, and I have no idea what to do! We are on the prescription z/d, per the vet....but, I just don't feel good about it. I think it is the wrong way to go. The vet says it is yeast. She had them when she came into rescue, but honestly, they have just gotten worse since I got her.

Here are some pictures of her spots:



Don't mind Ichiro catching a sniff....(perv!)







Here is a question: I have heard that immune compromised dogs should not have raw...since obviously Daisy has immune problems, should I lightly cook the meat before giving it to her? Or is this a myth?

There was no-one more immune compromised than my Kimmy and she had pure raw for 5 years. And yes, that black skin looks like yeast. My Farnsworth came into foster like that. I switched him immediately to raw and the vet gave him ketoconazole for the yeast and an antibiotic for the bacterial skin infection he also had. Did your vet do a skin scraping to determine exactly what you are dealing with?

Renee:
It really depends alot on what the immune compromising is caused by. I didn't put Tank on raw initially as we needed to wean him off of the pred first and he was severely immune compromised. I just felt it was better to get him off of the pred (or significantly reduced) first.

His immune system still isn't 100% but it never will be. The pred has done too much damage, but he is wholly raw fed now and has been for almost two years.