#1 5SE PT 20 15
Adverse Food Reactions How long should an elimination trial last?
Median percentage of clinical remission in the 5 dog studies (n=209)
Available articles:
Looringh van Beeck F, Watson A, Bos M, Biourge V, Wilemse T. The effect of long-term feeding of skin barrier-fortified diets on the owner-assessed incidence of atopic dermatitis symptoms in Labrador retrievers. Journal of Nutritional Science (2015), vol. 4, e5
80% 70%
Olivry T, Ralf Mueller R, Pascal Prélaud P. Critically appraised topic on adverse food reactions of companion animals (1): duration of elimination diets. BMC Veterinary Research 2015, 11:225 http://www.biomedcentral.com/1746-6148/11/225
60% 50% 40%
20% 10% 0% 1
2
3
4
5
6
7
8
9 10 11 12 13
Elimination trial duration (weeks)
Median percentage of clinical remission in the 3 cat studies (n=40) % of clinical remission
Long term effects of the “skin barrier cocktail” on the incidence of clinical signs of atopic dermatitis (see News from Research n°10)
90%
30%
Increased dietary fibre: a tool to limit hairball formation (see News from Research n°12) Weber M, Sams L, Feugier A, Michel S, Biourge V. Influence of dietary fibre levels on faecal hair excretion after 14 days in short and long-haired domestic cats. Vet Med Sci, 2015;1:30-37
100%
The authors conclude that to diagnose cAFR in at least 80% of dogs and cats, an elimination trial should last a minimum of 5 weeks in dogs, and 6 weeks in cats. The sensitivity of the diagnosis will increase to more than 90% of cases in both species when the duration of the elimination trial is increased to 8 weeks. The final confirmation of cAFR will be obtained after performing a provocation test with suspected food or ingredients.
100% 90% 80% 70%
Intro Critically appraised topics: benefit from the help of talented dermatology specialists to improve your daily practice As with any field of veterinary medicine, some of what is taught in dermatology is handed down from one practitioner to the other without critical appraisal of its scientific value. Bad tips and habits are thus picked up and are never corrected. To help answer practical questions about the management of adverse food reactions, ROYAL CANIN® has initiated and supported a group of recognised veterinary dermatologists (Drs. Thierry Olivry, Ralf Mueller and Pascal Prélaud) to publish a series of “Critically appraised topics”, with the objective of reviewing existing knowledge and dogmas on this disorder. Their conclusions will result in practical tips available to both practitioners and researchers, published in the BioMed Central open access peer-reviewed journal BMC Veterinary Research. The first one (see last page) has already been downloaded more than 1100 times in two weeks. Marie-Anne Hours & Hélène Charles (R&D-Scientific Support)
Urinary Struvite stone dissolution in the urine of dogs fed ROYAL CANIN® S/O-Kcal Control This study assessed the in vitro dissolution of uroliths in sterile canine urine with struvite RSS below 1. Relative Super Saturation (RSS) is considered as the gold standard methodology to measure the risk of crystal formation or dissolution in humans, and has been validated in dog and cat urine. This method is based on the saturation level of poorly soluble salts such as calcium oxalate or struvite. In cats, a struvite RSS below 1 is predictive of both in vivo and in vitro urolith dissolution. The aim of this study was to assess whether sterile canine urine with a struvite RSS below 1 leads to in vitro struvite dissolution.
Six healthy adult Miniature Schnauzers were fed ROYAL CANIN® S/O-Kcal Control Canine dry diet for 10 days: 7 days of adaptation, followed by 3 days of collection. After pooling the urine samples collected from each dog over the 3 days, the urinary pH and the concentrations of 10 solutes (Ca2+, Mg2+, Na+, K+, NH4+, phosphate, citrate, sulfate, oxalate and uric acid) were measured to calculate RSS using the SupersatTM software. The pool of urine was then split between 25 bottles containing 30 ml each and was kept at -20°C until the dissolution test. A canine urolith analysed as 100% struvite was immersed at day 0 in a bottle of urine which was maintained at 38°C and stirred. 24 hours later, the urine was filtered to
collect the stone, which was then dried and weighed. Every day until all the urine had been used (25 days), the stone was placed in a new bottle and the procedure was repeated to monitor the dissolution of the stone. For each dog and for the pool of urine, the struvite RSS was below 1. After 25 days, 60% of the struvite urolith had dissolved. Sterile canine urine with struvite RSS below 1, obtained from dogs fed ROYAL CANIN® S/O-kcal control, effectively dissolves struvite stone. Sagols E, Moniot D, Defiez A, Faur E, Nuns C, Billy H, Queau Y. A struvite RSS below 1 is predictive of in vitro struvite dissolution in dog urine. Proceedings of the 40th WSAVA congress, Bangkok (Thailand), May 15-18, 2015
60% 50%
Kinetics of canine struvite stone dissolution in urine with struvite RSS < 1
40% 30% 20% 10% 0% 1
2
3
4
5
6
7
8
9 10 11 12 13
Elimination trial duration (weeks)
WEIGHT (mg)
Hot off the press!
In these articles, the diagnosis of cAFR was made after the exclusion of other relevant causes of pruritus and a complete or marked improvement of clinical signs after feeding an elimination diet (including novel or hydrolysed ingredients). Patients were then confirmed as having cAFR after the recurrence of signs when the previous food items were reintroduced.
With the information gathered from these studies involving 209 dogs and 40 cats with cAFR, the group of specialists estimated that: - From 5 weeks onwards, clinical signs had disappeared in more than 85% of dogs, increasing to over 95% if the trial was extended to 8 weeks. - It took approximatively 4, 6 and 8 weeks of an elimination diet for 50, 80 and 90% of cats to achieve a clinical remission, respectively.
- by La Sentinelle • ©ROYAL CANIN® SAS 2015. All Rights Reserved.
Performing a dietary restrictionprovocation test (“elimination trial”) is considered to be the standard procedure to diagnose cutaneous Adverse Food Reactions (cAFR) in dogs and cats. However, there is no consensus available on the optimal duration of such trials, and recommendations have varied from 3 to 12 weeks.
The authors (Drs.Thierry Olivry, Ralf Mueller and Pascal Prélaud) searched out and analysed the scientific literature available. They selected eight papers providing specific data on the time needed for clinical signs of cutaneous AFR to improve in patients fed an elimination diet (5 in dogs, 3 in cats).
% of clinical remission
The first “critically appraised topic” on adverse food reactions in companion animals aimed at reviewing existing knowledge on the duration of elimination trials. A group of recognised dermatology specialists determined that they should last at least 8 weeks to allow diagnosis in more than 90% patients.
250 230 210 190 170 130 110 90 70 50 D1
D3
D5
D7
D9
D11
D13
TIME (days)
D15
D17
D19
D21
D23
D25