Signalment and History
Whether the disease is called cutaneous adverse food reaction or a food allergy in dogs and cats, many things are known about this disease. The following discussion addresses the facts that are known concerning cutaneous adverse food reactions.
In dogs, there is no age, sex, or breed predilection.4 The age of onset in dogs varies from as young as 4 months to as old as 12.5 years.9 However, neonatal puppies exhibiting otitis externa due to a cutaneous adverse food reaction may be “cured” before seeing a specialist for their skin disease. The index of suspicion for cutaneous adverse food reactions exceeds environmental allergen-induced atopic dermatitis (atopy) when the onset of clinical signs occurs in geriatric dogs.
In cats, the Siamese may be predisposed, but any breed can be affected.4,5 The age of onset ranges from 3 months to 11 years (mean 4 to 5 years).
Historical information that would be consistent with cutaneous adverse food reaction would include nonseasonal pruritus, recurrent or unresolved otitis externa, bacterial pyoderma, and Malassezia dermatitis. Responsiveness of pruritus to antiinflammatory doses (1∕4 mg/pound q 12 hours orally) of prednisone or prednisolone varies from complete to poor. Therefore if a pruritic dog is poorly responsive to glucocorticoids, diseases such as uncomplicated environmental allergen-induced atopic dermatitis (atopy) are very unlikely, while cutaneous adverse food reaction would still be likely. If a pruritic dog responds well to glucocorticoids, both environmental allergen-induced atopic dermatitis (atopy) and cutaneous adverse food reaction would be ruled out. The only consistent sign of cutaneous adverse food reaction is pruritus. The distribution of the pruritus is not much different than that of dogs with environmental allergen-induced atopic dermatitis (atopy) (face, feet, flexor surfaces of the limbs and folds) or with flea allergy dermatitis (rump and tail head).
However some dogs have a propensity for otic and perineal pruritus. As with environmental allergen-induced atopic dermatitis (atopy), dogs with cutaneous adverse food reaction may only have otic disease. In one study, 20% of dogs with cutaneous adverse food reaction had only otitis externa as the presenting clinical sign.12 Of these dogs, there were a number who had only unilateral disease.13 Otitis externa as the only presenting sign is more common in dogs with cutaneous adverse food reaction than in environmental allergen-induced atopic dermatitis (atopy).14 Dogs and cats with otitis externa may show very little, if any, clinical signs, in which case the diagnosis is established only by otoscopic examination. This occurs most commonly, in the author’s experience, in dogs or cats having previous episodes of otitis externa. It appears that some animals become somewhat tolerant of otitis externa if they have experienced it previously. More commonly, dogs and cats show (any or all of) the following clinical signs:• Odor or discharge from the ear(s)
• Scratching the ear(s)
• Shaking the head
• Otic pain or tenderness (this may be most apparent when the owner pets or manipulates the animal’s head and ears).
In contrast to IgE-mediated food allergy in humans, systemic anaphylaxis from cutaneous food reaction has not been reported in cats or dogs.
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