DERMATOLOGY
DERMATOLOGY
generic and widely accepted criteria is not necessary.
What I am aiming to achieve in asking owners to
score the skin is ensuring that the owners look and
think daily about what is happening and score that
response in a numerical way (albeit very subjective).
It is important that the same person should do the
scoring daily. Scores must be written down so that
at the follow up consultation when the response to
the diet trial will be assessed, the score sheet can be
examined and discussed by veterinarian and owner.
For this reason long term use of a medicated
shampoo is always indicated. In some instances
topical ear canal rinsing (or even steroid application) 2
to 3 times a week is necessary. Should an animal that
was previously well controlled suddenly deteriorate,
the first place to look ( as long as there wasn’t dietary
indiscretion) is a flare up of secondary infection
(bacteria or Malassezia).
References of interest
1.
What to do if the diet trial results in a significant
improvement in the skin score?
To be sure that food really is playing an important role
in the signs seen, provocative exposure to the old diet
is required. That said, many owners are unwilling to
do this. In these cases they may choose to stay on the
hydrolysed diet or try to change to a sensitive skin diet
formulation and monitor response.
Always remind owners that allergy is never cured and
as such this pet is going to require lifelong assistance
to keep the skin disease controlled (as control, not
cure, is our objective). In addition to diet it is important
to remember that these pets are more prone to
relapsing secondary skin and ear infections.
Mueller RS & Olivry T (2017) Critically appraised topic on adverse food reac-
tions of companion animals (4): can we diagnose adverse food reactions in
dogs and cats with in vivo or in vitro tests? BMC Vet Res 13(1):275.
2.
Mueller RS & Olivry T (2018) Critically appraised topic on adverse food reac-
tions of companion animals (6): prevalence of noncutaneous manifestations of
adverse food reactions in dogs and cats. BMC Vet Res 14(1):341.
3.
Mueller RS, Olivry T, & Prelaud P (2016) Critically appraised topic on adverse
food reactions of companion animals (2): common food allergen sources in
dogs and cats. BMC Vet Res 12:9.
4.
Olivry T & Mueller RS (2017) Critically appraised topic on adverse food
reactions of companion animals (3): prevalence of cutaneous adverse food
reactions in dogs and cats. BMC Vet Res 13(1):51.
5.
Olivry T & Mueller RS (2018) Critically appraised topic on adverse food
reactions of companion animals (5): discrepancies between ingredients and
labeling in commercial pet foods. BMC Vet Res 14(1):24.
6.
Olivry T, Mueller RS, & Prelaud P (2015) Critically appraised topic on adverse
food reactions of companion animals (1): duration of elimination diets. BMC
Vet Res 11:225.
Table 1. Favorot’s criteria. Dogs that fulfil these criteria are most likely to have either atopy or a cutaneous adverse reaction to food.
Set 1
Criteria
1 Age of onset<3 years
2 Mostly indoor
3 Corticosteroid-response pruritus
4 Chronic or recurrent yeast infections
5 Affected front feet
6 Affected ear pinnae
7 Non-affected ear margins
8 Non-affected dorso-lumbar area
Use Reliability
Used for clinical studies If 5 criteria are met:
Sens = 85.4%
Spec = 79.1%
If higher specifity required eg. drug
trials, then 6 criteria should be met.
If higher sensitivity is required, then 5
criteria should be met If 6 criteria are met:
Sens = 58.2%
Spec = 88.5%
Use Reliability
Set 2
Criteria
1 Age of onset<3 years 2 Mostly indoor 3 Alesional pruritus at onset 4 Affected front feet 5 Criteria should be fulfilled.
5 Affected ear pinnae 6 Non-affected ear margins Do no use alone for diagnosis of AD,
rule out similar diseases
7 Non-affected dorso-lumbar area
Used to evaluate the probability of a
diagnosis of Atopic Dermatitis (AD)
If 5 criteria are met:
Sens = 77.2%
Spec = 83%
Shaping the future of animal health
Issue 02 | MAY 2019 | 27