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Critically appraised topic on adverse food reactions of companion animals (2): Common food allergen sources in dogs and cats

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To diagnose cutaneous adverse food reactions (CAFRs) in dogs and cats, dietary restriction-provocation trials are performed. Knowing the most common offending food allergens for these species would help determining the order of food challenges to optimize the time to diagnosis. The search for, and review and analysis of the best evidence available as of January 16, 2015 suggests that the most likely food allergens contributing to canine CAFRs are beef, dairy products, chicken, and wheat. The most common food allergens in cats are beef, fish and chicken. In dogs and cats, after a period of dietary restriction leading to the complete remission of clinical signs, food challenges to diagnose CAFR should begin with beef and dairy products, the most commonly recognized food allergens in these two species.
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R E S E A R C H A R T I C L E Open Access
Critically appraised topic on adverse
food reactions of companion animals
(2): common food allergen sources in
dogs and cats
Ralf S. Mueller
1
, Thierry Olivry
2*
and Pascal Prélaud
3
Abstract
Background: To diagnose cutaneous adverse food reactions (CAFRs) in dogs and cats, dietary restriction-provocation
trials are performed. Knowing the most common offending food allergens for these species would help determining
the order of food challenges to optimize the time to diagnosis.
Results: The search for, and review and analysis of the best evidence available as of January 16, 2015 suggests that the
most likely food allergens contributing to canine CAFRs are beef, dairy products, chicken, and wheat. The most common
food allergens in cats are beef, fish and chicken.
Conclusions: In dogs and cats, after a period of dietary restriction leading to the complete remission of clinical signs,
food challenges to diagnose CAFR should begin with beef and dairy products, the most commonly recognized food
allergens in these two species.
Keywords: Allergen, Allergy, Atopic dermatitis, Canine, Cat, Dietary, Dog, Feline, Food allergy
Background
The diagnosis of cutaneous adverse food reactions
(CAFRs) in dogs and cats relies on the performance of
dietary restriction-provocation trials. Knowing the most
common offending allergens in these species would help
determine which food challenges should be performed
first to faster confirm the diagnosis of CAFR.
Clinical scenarios
You have two patients: The first is a 1-year-old male
Labrador retriever with a 3-month history of pruritus
and recurrent mucous diarrhea. This dog has been
eating a commercial diet for the last 6 months. On phys-
ical examination, you do not detect anomalies besides
soft stools on rectal palpation. Your second patient is a
2-year-old female spayed Persian cat that has been
scratching her face for the last year. This self-trauma
only responds partially to high dose of prednisolone.
Physical examination reveals the cat to be thinner than
expected and to have excoriations on the head and neck.
You suspect that both patients could be reactive to their
commercial diets, but you wonder which one of the
ingredients listed on the labels would be the most likely
sources of allergens.
Structured question
In dogs and cats suspected of CAFR, which food sources
are most often reported to induce clinical signs after
challenge?
Search strategy
The CAB Abstracts and Web of Science (Science Citation
Index Expanded) databases were searched on January 16,
2015, using the following string: ((dog or dogs or canine)
or (cat or cats or feline)) and (food or diet*) and (allerg* or
atop* or hypersens* or intolerance). The search was
limited to the period 1985 to 2015. Bibliographies of
* Correspondence: tolivry@ncsu.edu
2
Department of Clinical Sciences, College of Veterinary Medicine, North
Carolina State University, Raleigh, NC, USA
Full list of author information is available at the end of the article
© 2016 Mueller et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Mueller et al. BMC Veterinary Research (2016) 12:9
DOI 10.1186/s12917-016-0633-8
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identified articles were then further searched for
additional relevant reports.
Identified evidence
Our literature search identified 140 and 1534 citations in
CAB Abstracts and Web of Science, of which three [13]
and 15 [1, 317] respectively contained relevant informa-
tion. Citations that were not selected were those of articles
not specifically identifying offending allergens in dogs and
cats exhibiting clinical signs of CAFR. Six more relevant
citations were identified in the bibliography of articles
found with the electronic search [1822], and three
sources were abstracts of recent conference proceedings
[2325]. Offending allergens were reported in case reports
[12, 14, 18, 22, 26] or case series of dogs and cats with
clinical evidence of adverse food reaction [15, 7, 10, 13,
16, 19, 25, 27], in studies evaluating diagnostic techniques
for adverse food reactions [5, 8, 9, 11, 17, 23, 24] or
(rarely) in studies evaluating reaction patterns such as
vasculitis or symmetrical lupoid onychitis with multiple
Table 1 Details of studies about allergens suspected of causing CAFRs in cats
Reference Number
of dogs
Number of individual
rechallenges per dog
Details of rechallenges Offending allergens and comments
Walton [2] 82 unclear unclear cow's milk (22), tinned food (16), beef
(13), wheat (11), mutton (6), egg, pork
(3 each), herring (2), cod, maize, rabbit,
dog biscuits, kidney bean (1 each)
Chesney [4] 19 unclear, but only 9 owners
rechallenged their dogs
unclear beef (4), milk (3), chicken, dog biscuit
(2 each), cheese, turkey, pork (1 each)
Guilford et al. [5] 8 3 to 6 rechallenge with corn, soy, cow's milk
(8/8 each), wheat (2/8), lamb (7/8),
beef (3/8) (14-16 g of each, once daily
for 14 days)
corn (2), wheat, milk (1 each)
Harvey [7] 25 at least 6 1 week of beef, milk, cheese, egg, mixer
biscuit, bread in all dogs, additionally
chicken, lamb and chocolate one each
in 3 of the dogs
bread and mixer biscuit (same 7 dogs),
cheese and milk (same 7 dogs), beef (2),
egg, lamb, chocolate (1 each)
Ishida et al. [8] 8 9 beef, chicken, chicken egg, wheat, corn,
rice, tuna, cod, milk (increasing to 120 g
daily for 7 days)
beef (5), rice (3), egg, wheat, cod (1
each)
Jeffers et al. [9] 13 6 beef, cow's milk, chicken, chicken egg,
soybean, wheat for 1 week each
beef (12), milk (5), wheat (4), chicken,
soybean (3 each), egg (2)
Jeffers et al. [10] 25 5 beef, chicken, chicken eggs, cow's milk,
soy for 1 week each
beef (15), soy (8), chicken, milk (7 each),
wheat (6), 5 (egg)
Mueller and Tsohalis [11] 8 unclear unclear beef (7), dairy (1), chicken (1)
Ohmori et al. [12] 1 unclear unclear beef
Paterson [13] 20 at least 5 Beef, dairy products, wheat, lamb and
chicken for one week each as one
additional test meal while on elimination
diet followed by other allergens based
on diet history
beef (13), lamb (5), gluten, egg (4 each),
chicken, milk, pork (2 each), soy, corn
(1 each)
Salzo [16] 20 unclear 7 days of rechallenge beef (11), chicken (7), rice (5), milk, wheat
(1 each)
Vaden et al. [17] 6 7 1 meal containing a different allergen
every other day
chicken, corn (5 each), tofu (3), cottage
cheese, wheat, lamb (2)
Coyner [18] 1 1 unclear beef
Mueller et al. [20] 1 5 rechallenge with beef, cow's milk,
chicken, mutton, wheat, details unclear
beef
Nicholls et al. [21] 2 unclear unclear beef (2)
Johansen et al. [23] 4 unclear unclear beef (2), pork, salmon (1 each)
Johansen et al. [24] 5 unclear unclear chicken (5), corn (3), but preselected out
of a population with such allergies
Tarpataki and Nagy [25] 39 unclear unclear chicken (16), beef (12)
Fujimura et al. [26] 1 1 10 g of fresh tomato led to
clinical signs within 30 minutes
tomato
Mueller et al. BMC Veterinary Research (2016) 12:9 Page 2 of 4
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causes [20, 21]. A positive rechallenge was considered the
only solid evidence for identifying an offending allergen.
From these selected publications, we added the number of
cases in which positive challenges had occurred with the
various food items, and the frequency of reaction among
total number of dogs was calculated.
Evaluation of evidence
Altogether, at least one offending food allergen source was
reported in each of the 297 dogs included in the selected
studies [2, 4, 5, 713, 1618, 20, 21, 2326] (Table 1). The
most frequently reported food allergens involved in
CAFRs in dogs were beef (102 dogs, 34 %), dairy products
(51 dogs, 17 %), chicken (45 dogs, 15 %), wheat (38 dogs,
13 %) and lamb (14, 5 %). Other less commonly reported
offending food sources were soy (18 dogs, 6 %), corn
(13 dogs, 4 %), egg (11 dogs, 4 %), pork (7 dogs, 2 %), fish
and rice (5 dogs each, 2 %). Barley, rabbit, chocolate, kid-
ney bean and tomato were also reported as food allergens
for single dogs.
At least one food allergen was identified in each one
of the 78 cats reported in selected articles [13, 6, 14,
19, 22, 27] (Table 2) . The food sources most frequently
causing CAFR in cats were beef (14 cats, 18 %), fish (13
cats, 17 %), chicken (4 cats, 5 %), wheat, corn and dairy
products (3 cats each, 4 %) and lamb (2 cats, 3 %). Egg,
barley and rabbit were also reported as offending aller-
gens in individual cats.
There were several limitations in interpreting the data
presented. In most studies details of the provocation
with individual allergens were not provided. Further-
more, most reports only listed allergens associated with
a deterioration of signs upon rechallenge, but not those
associated with negative provocations; this could
possibly bias the estimation of the prevalence of offend-
ing allergens. Only five studies had used a standardized
rechallenge sequence in dogs [710, 13]. In these stud-
ies, beef, chicken, wheat, soy and dairy products were
the most common involved allergens, reflecting the data
gathered from the literature. In cats, only one study
attempted those uniform provocations [27], and beef,
fish and chicken were the allergens most commonly
involved in that study. In addition the previous diet
history was generally not provided, thereby preventing a
clinically relevant interpretation of the data. Thus, the
information gathered herein does not allow a true esti-
mate of the prevalence of offending allergens nor any
statement about the likelihood of positive provocations
in relation to previously fed foods. Finally, the offending
allergens found herein could merely reflect pet feeding
habits in the preceding decades, and these allergens
could change once new pet foods become fashionable
and used more frequently.
Conclusion and implication for practitioners
In a dog living in Australia, Europe or North Amer-
ica, the allergens most likely contributing to CAFRs
are beef, dairy products, chicken, wheat and lamb. As
a result, these foods should be the first used for aller-
gen provocation for CAFR diagnosis. In cats, the
most common allergens causing CAFRs are beef, fish
and chicken.
Importantly, the identified evidence does not allow an
estimation of the real prevalence of offending allergens
in the population of dogs and cats with CAFR, as
animals were usually only challenged with a small
number ofbut not allallergens. As a result, the true
Table 2 Details of studies about allergens suspected of causing CAFRs in cats
Reference Number
of cats
Number of individual
rechallenges per cat
Details of rechallenges Offending allergens and comments
Stogdale [1] 2 6 in 1 cat, unclear in
the other
Chicken, fish, beef, horse, mutton, milk in
one cat, various fresh meats and commercial
foods in the other cat, details unclear
chicken, fish, beef in the first cat,and not
chicken and fish in the other cat
(all other meats led to deterioration)
Walton [2] 18 unclear unclear cow's milk (7), beef (5), rabbit, chicken,
whale meat (1 each)
White and Sequoia [3] 14 unclear various commercial diets, dairy products,
fish were administered to 11 of 14 cats
further details were not provided
fish (6), dairy products (2)
Guilford et al. [6] 16 unclear, depending
on the diet history
15-50 g of allergen daily for 7 days beef, corn, wheat (3 each), gluten, barley,
chicken, lamb, sardines, lactose, viscera,
food additives (1 each)
Reedy [14] 1 2 3 days of tuna and lamb tuna, lamb (1)
Guaguère [19] 10 unclear 2 weeks with each allergen beef (4), milk (3), fish (2), egg (1)
Walton et al. [22] 1 unclear 7 days with each allergen milk
Vogelnest and Cheng [27] 17 beef, chicken, lamb, fish, diary, wheat for
7 days each (attempted only in 8 cats and
completed in 6 of them)
fish (2), chicken (1), beef (1)
Mueller et al. BMC Veterinary Research (2016) 12:9 Page 3 of 4
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prevalence of each offending allergens in dogs and cats
is likely to be higher than that reported above.
Importantly, all these estimates of prevalence will need
to be reevaluated with prospective studies performing
controlled rechallenges in a larger number of animals with
a detailed history of their previous dietary exposure.
Abbreviations
CAFR: cutaneous adverse food reaction; CAT: critically-appraised topic.
Competing interests
In the past three years, the three authors have lectured for, and received
research funding and/or consulting honoraria from Royal Canin (Aimargues,
France), which paid publication charges for this article.
Authorscontributions
The three authors selected the topic of this CAT. RSM performed the literature
search, extracted and summarized the evidence. TO and PP verified the
evidence and TO wrote the first draft of the article. The three authors edited
and then approved the final manuscript.
Acknowledgements
The authors thank Drs. Philippe Marniquet, Isabelle Mougeot and Sara Soler
from Royal Canin for the initiation and support of this series of critically
appraised topics on adverse food reactions and for paying publication
charges for this article.
Author details
1
Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, Ludwig
Maximilian University, Munich, Germany.
2
Department of Clinical Sciences,
College of Veterinary Medicine, North Carolina State University, Raleigh, NC,
USA.
3
Clinique Advetia, Paris, France.
Received: 10 July 2015 Accepted: 3 November 2015
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Background These days the number of potential food allergens is very large, but chicken is one of the most common allergens in dogs. Elimination diet is one of the clinical tools for the diagnosis of allergies and allergy tests are not very reliable. The restriction diet is most commonly carried out by feeding pet foods, relying on the ingredients on the label to select an elimination diet not containing previously eaten foods. Unfortunately, mislabeling of pet food is quite common. The purpose of this study was to determine the absence or presence of chicken DNA using both qualitative and quantitative polymerase chain reaction (PCR) analysis methods in dry and wet maintenance complete pet foods for adult dogs. Results were used to verify the declared composition on the labels. Results Eleven out of fifteen (73%) dog foods were produced as declared by the manufacturer, two of which showed the presence of chicken protein as stated on the label. The remaining nine foods contained amounts of chicken DNA below 1%, consistent with declarations that no chicken was added in the composition. Four of tested dog foods (27%) were not produced consistently with the declaration on the packaging. Two dog foods (one dry and one wet) did not contain the claimed chicken protein. In two foods the addition of chicken DNA was detected at the level of over 2% and almost 6%, respectively. Conclusions In this study, we focused on one of the most commonly undeclared animal species on the label—chicken protein—and performed DNA analyzes to investigate possible contamination and mislabeling. The results showed some inaccuracies. However, most of them are trace amounts below 1%, which proves compliance with the label. Our results showed that undeclared animal species can be as common as missing an animal protein declared on the label. The conducted research indicates that both dry and wet analyzed foods should not be recommended as a diagnostic tool in elimination tests, because it may result in false negative results. Over-the-counter maintenance foods for dogs should not be recommended for the diagnosis and treatment of food hypersensitivity.
... However, the presence of even traces of undeclared ingredients can result in a risk of allergy. Beef, fish and chicken meat, in particular, are among the most commonly known feed allergens (Mueller et al., 2016). The possibility of rejection of certain animal-based feed by pet owners for religious reasons should also be considered. ...
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A system of four multiplexes has been developed and optimized to detect up to 18 animal species simultaneously. The system consists of one quadruplex making it possible to detect the most common species – cattle, pigs, and chicken – and to reveal potential inhibitors. An additional 15 meat species can be proven using another three pentaplexes. The uniqueness of the system lies not only in the multiplexing of many different samples, but also in its high sensitivity making it possible to detect 10 pg/μl of DNA or even less. Targeting specific sequences in genomic DNA instead of mitochondrial DNA represents another exclusivity of the system and further increases its specificity. The application of the system on real samples of pet foods obtained from retail showed non-declared species in up to 60% of samples. This demonstrates the great need for a precise and sensitive system for the control of food/feed adulteration and fraud.
... Cutaneous adverse food reaction (CAFR) is caused by food allergens and is a common allergic dermatosis that makes CAD difficult to control by triggering the flare of CAD [2,3]. It is generally characterized by non-seasonal pruritus, secondary infection associated with ingestion of various kinds of food allergens such as beef, dairy products, chicken, and wheat in dogs, and exhibit a partial-to-poor response to glucocorticoids [4,5]. As allergic skin reactions to food allergens present CAD-like clinical signs, it is challenging to clearly distinguishing CAFR from CAD based on lesion distribution alone [6,7]. ...
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