Vet360 Vol 3 Issue 04 August 2016 - Page 24

GASTROENTEROLOGY to moderate disease down to insignificant disease in dogs; and a FIBDAI score reduction from 5 to 9 down to 0 in cats. By definition a 75% reduction in FIBDAI score is considered positive. A well conducted food diet trial will solve both dietary hypersensitivities and food intolerances; both of which can cause IBD symptoms. Most clinical trials see a high percentage of patients responding to diet. Canine patients with lower CIBDAI or CCECAI scores (<5) and clinical signs associated with diffuse lower intestine disease are more likely to respond to dietary therapy than those with very high (>5) CIBDAI or CCECAI scores. No such predictions can be made using the FIBDAI score in cats. Dietary hypersensitivities are immunological reactions to dietary antigens and dietary intolerances are nonimmunological reactions to perturbations within the diet itself. For this reason some animals will respond to highly digestible, fat restricted and variable fibre diets that do not have any antigenic modifications. Usually single protein diets, containing a highly digestible novel protein source or hydrolysed diets are used. Size and structure of dietary proteins appears to affect their potential for immunoreactivity. The role of the immune system and host microbiota in dietary hypersensitivities are being investigated. Perinuclear anti-neutrophilic cytoplasmic antibodies (pANCA) were significantly higher in diet responders than idiopathic IBD patients in one study but the clinical usefulness has not been established. Skin reactions are usually only seen with dietary hypersensitivity. In the case of hydrolysed diets, potential problems include palatability issues and molecule sizes that still evoke an immune response. A complete dietary history is necessary to select the protein and carbohydrate sources in an elimination diet to suit that patient. Dietary history forms are available on the WSAVA website. Immediate, Type I and II, as well as delayed, Type IV hypersensitivities are possible with dietary antigens. Establishing cause and effect in these cases requires strict owner compliance. Response to diet may occur within 10 to 15 days or as long as 8 to 12 weeks. Canine diet responders have an excellent prognosis but complete \ۙ\[[\HKX[[BY\ [۝X]\H[و\H]Y[[XZ[\[\X]XۈH\\HوZ\ܚY[[\Hو HX\ۈ܈\\[ۛۈ]X^BH[]YY]\H[\[\܈Y]\H[XY[\[H\Y[ZXܛؚ[YHوH]Y[]\[Y]\H\\[]]]Y\ˈ[ܝ[][BYHY\[\[H܈\ۜHY][][\\]X[H[]X[\ۙ\›X^H[\H[ۈ\]Z\H[[][\\]H\\K܈HY]X[ܚH]Y[]\HX][\]]H[][[X^HH[[[YB[ܙ^X\\˂Y]\H\\[]]]Y\\H[[][X[XX[ۜY]\H[Y[[Y]\B[\[\\HۋZ[[][X[XX[ۜœ\\][ۜ][HY]][ˈۙX[[\\X[[X[XX[[ۜ\ۙ\^YH[X[X\ۜ]B[\]\ TJB\[\[[\ؚ[\\H]\H\ܚX[[X[H\\[\[H[\[[ZXܛؚ[H\X[H\HوX[[\[[X\X[ݙ\ܛ PK\H\\[H^HوY\]X][B[۝[[HXYۛ[X\X[\ؚ[\[B[X[]X][ۈܝوH\\]]XX[܈\œX\ۈHۙ][ۈ\Xۚ\Y\[[X[X\ۜ]H[\]H TJK[X[X[\\X[H\Y[YH[[X[[Y]ۚY^K]]XX[\[\[^[H[[[HXHو[X[X\[ۈH[XX[&\˜X\ˈY]ۚY^H\ٝ[Y]Y][X[\[[XYHYXوۙ]\HYZ[\][ۂ\HHۘ\[[\[\]Yۙ\H[X^H[X][ܞ\ܚY][H[X[ۈ[YH\\]\[ۙHوH][X[X\Y\[ܛ]Z[ۙ\]YH]\]\H\Y]Y[H][ۘ[\[]\K[[\X]]HYZ[ܘ[K\]]H[ܘ[K[Y]]HKܘ[K\]]B[^X\XN]\YX]HYZ[\\XXHH[[[ۙ[H ]\\YܙH\Y\\]Y\\HYZ[XYXX\X[[\]\]]\[Y[H[BH[\[[ZXܛؚ[HXHH[[Bܛو[YXX[[Y[[X\XH[H\\[[]\[\X\XK\[H\ MHYšQZ^Y]H܈][XH[][B\[K]Y[]\ۙ[X[X\H]Yܚ\Y\][TKH\Hو[ܛ]Z[ۙ\\]Z[YXYX[H܈\HRQP\H\XY H\][ۂوH[X[X\H\\X[H KLYZYܙB]Y[\H[ۚ]ܙY܈H[\Hو[X[Yۜ˂\]Y[H[]\]Hو[\\]\Z[HBYY܈۝[[\[\Z][Y[\܈XX]BۛHX]Y[ HHو[XؘX\[X[ۈ[P\[Y[Y [ۙHX[YH[ܙ\[H[]HXY\][ۈX\]Y\\H\YXYۛHHܙ[\H[Y[[\[H\][][K[H\[Bو\]\ˈH[YHX\]YH\\Yœ\][ۈY\8'\H\\x'H[Y]\H\\B\[]]Y \H\\H\ۛHX[Y[Y[H]Y[][X[Yۜ[\]X[]Y[Hو\]\[H\[Hو[XؘX\ܙ[\\˂] ͌\YH UQT M U ͌UQT Mܚ[˚[  M ̍H LN B