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Terms in this set (48)
An environmental or exogenous antigen that creates a hypersensitivity reaction
Pruritus secondary to food. Includes hypersensitivity immune responses and non-immunologic mechanisms. "Cutaneous" - to distinguish from gastrointestinal adverse food reactions
Cutaneous adverse food reaction (CAFR)
Elimination diet trial
What is the gold standard diagnostic test for diagnosis of CAFR?
Pruritic inflammatory skin disease involving
abnormalities in skin barrier and hypersensitivity reactions to environmental and food allergens
Atopic Dermatitis (AD)
Tendency to develop hypersensitivity (allergic) responses to otherwise harmless antigens (allergens)
Protein involved in formation of effective skin barrier
Variety of allergic diseases in cats including allergic dermatitis, asthma/respiratory diseases, and gastrointestinal diseases that may be associated with a hypersensitivity to environmental allergens and foods
Feline Atopic Syndrome (FAS)
Variable cutaneous signs in cats associated with hypersensitivity to environmental allergens (the feline version of atopic dermatitis)
Feline Atopic Skin Syndrome (FASS)
A feline reaction pattern characterized by pruritic and sometimes crusted papules; can often result in excoriations, erosions and varying degrees of hair loss
Any of several clinical presentations in cats in which eosinophils infiltrate the skin creating ulcerated plaques
Eosinophilic granuloma complex (EGC)
Ulcerated plaque created by eosinophilic infiltration of the feline upper lip at the mucocutaneous junction; usually not pruritic unless secondary bacterial infection is present(a type of EGC)
Indolent ulcer ('rodent ulcer')
2; sensitization and effector phase
How many phases does a hypersensitivity reaction have?
Initial exposure, antigen presentation, T-cell activation
What happens in the sensitization phase during a hypersensitivity reaction?
Harmful inflammatory response to the antigen (now allergen)
What happens in the effector phase during a hypersensitivity reaction?
False; atopic dermatitis has a genetic predisposition caused by filaggrin mutations
T/F Atopic dermatitis has a genetic predisposition caused by failure of passive transfer
Dog with AD has a decreased biodiversity and increased amount of staphylococci
How do dogs skin microbiome with atopic dermatitis differ from a healthy dog?
Eliminate all foods currently eating, do not give medication, supplements, treats, etc. Feed only a hydrolyzed diet for 8-12 weeks.
After 8 weeks is done, if pruritus has resolved, re-challenge original diet and monitor for recurring pruritus over 14 days.
Then return to hydrolyzed diet and see if pruritus improves or resolves
How do you perform an elimination diet trial?
None; we get diagnosis by excluding all other potential causes of pruritus
What diagnostic test do you perform to diagnose AD?
Only if the client is willing to try and desensitize the patient to offending allergens (ASIT); should never be used as a diagnosis
When should allergy testing be done?
False; it is included with or without GI signs
T/F adverse food reactions are only included in a differential diagnosis list of there are GI signs
What percentage of dogs with chronic enteropathies respond to dietary change?
Pruritus, erythema, excoriations
What are common clinical signs associated with CAFR?
Vomiting, abdominal discomfort, flatulence, frequent defecation, borborygmi
In dogs with CAFR, food-responsive diarrhea is common, what are some other GI signs?
T/F dogs with atopic dermatitis usually have a combination of environmental and food allergens
1. Serum testing for food-specific IgE
2. Intradermal testing with food antigens
3. Patch testing with food antigens
4. Lymphocyte proliferation test
5. Salivary immunoglobins A and M
6. DNA testing of hair
7. Gastroscopy or colonoscopy
None of these are recommended for diagnosis; all studies have been inconclusive
What are other tests used to "diagnose" adverse food reactions?
Are any of them a useful tool for diagnosis of AFR?
Bacterial/yeast infections (skin or ear)
What does canine atopic dermatitis (CAD) often co-exist with?
T/F CAD is a common hereditary skin disease
Defective skin barrier allowing microbial adherence, penetration of allergic proteins and initiation of abnormal inflammatory and allergic responses
What is the pathogenesis for CAD?
Initial: TH2 cells
Chronic: a combination of TH cells
What cells initially dominate CAD responses? Chronic?
West highland white terrier
What breeds are suggested to be predisposed to CAD?
6 months to 3 years old
What is the typical age for onset of CAD?
What has to be present in the history to consider CAD as a differential diagnosis?
Lack of pathognomonic signs and varying clinical signs. Pruritus will be present, but sometimes it is so mild the owner may not notice. We have to rely on indirect evidence of pruritus (excoriations and broken or saliva-colored hairs)
Why can CAD be difficult to diagnose?
You have to rule out everything else first (infection, parasites and allergies)
How do you diagnose CAD?
Not curable; treatment plan should maximize quality of life for pet
Once diagnosed with CAD, how do you treat it?
Relies on history and clinical signs and exclusion of other diseases with similar clinical features
How do you diagnose feline atopic skin syndrome (FASS)?
These are variable and less predictable in distribution, but most cats present with 1 or more 'cutaneous reaction patterns'
What is the clinical appearance of FASS?
Head and neck pruritus
Eosinophilic granuloma complex
What are the different 'cutaneous reaction patterns'?
Cat removes hairs by repetitively licking, biting or pulling at fur; often results in hairballs and may cause vomiting (owners may mistake for normal grooming habits)
*Cat may perform this alone causing the owner to believe hair loss is spontaneous
Describe self-inflicted alopecia/hypotrichosis
Characterized by intense pruritus of the face, head and neck
Patient may claw or scratch frantically at the areas resulting in varying degrees of excoriation, erosion and ulceration
Describe head and neck pruritus
Indolent ulcer, eosinophilic granuloma, and eosinophilic plaque
What clinical syndromes are included in the eosinophilic granuloma complex?
Lesions appear in variety of locations each different in appearance:
Lesions on rear legs - linear areas of dermal thickening on the caudal aspect of the thigh and may extend distally past the stifle fold
Proliferative lesions in the mouth - located on tongue or hard palate, can also look like poorly defined chin swelling
Describe eosinophilic granuloma ('linear granuloma')
Lesions on ventral abdomen and medial thighs, can appear in other locations
Characterized by raised, eroded or ulcerated areas
Often pruritic with excoriations
Often complicated by secondary bacterial infection
Describe eosinophilic plaque
T/F FASS occurs more frequently in females
What breed was overrepresented in two studies regarding FASS?
FASS and feline food allergies
What two diseases are under feline atopic syndrome?
Infection (staph and malassezia overgrowth), parasites (ectoparasites), allergies (flea allergy dermatitis and food allergies)
What diseases do you need to rule out before looking to FASS?
You have to rule other diagnoses out first; but once a diagnosis is reached...
Allergen testing can be used to support diagnosis of FASS and should only be used if allergen-specific immunotherapy is treatment.
Allergen-specific IgE serology testing is used widely, but accuracy of test is unknown.
What diagnostic tests can be used for FASS?
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