Nutritional management of allergic skin disease: a roundtable discussion (Sponsored by Royal Canin)


Nutritional management of allergic skin disease: a roundtable discussion (Sponsored by Royal Canin)

Dr. Felsted: When do you use hydrolyzed diets versus novel protein diets?

Dr. Strauss: I really like hydrolyzed diets. When you can't get a clear history, when you're really not sure or they have just been on so many things you can't find a novel protein diet that is going to work for this patient, I like the hydrolyzed diet.

Dr. Liska: I think not all hydrolyzed diets are created equal either. Some are not as hydrolyzed (as others) and so I am also going to choose one that has been processed to the smallest kilodalton.

Dr. Felsted: What other things do you look at when you pick your diets?

Dr. Strauss: Palatability is a big issue. Some of the earlier diets were not good.

Dr. Fadok: I have yet to see a dog turn its nose up at (Royal Canin®'s) HP. And cats, they love it.

Dr. Liska: I learned interestingly from one of the companies that the smaller they hydrolyze the protein the more bitter it tastes.

Hydrolyzed Proteins
Dr. Garfield: I use hydrolyzed diets versus novel protein diets for a couple of different reasons. One would be that if I have a patient that I truly believe is food allergic and they are not improving on a novel protein diet then I will switch them and do a hydrolyzed diet. Instead of changing flavors, I change styles.

Dr. Felsted: Do you get push back from clients on cost of food?

Dr. Strauss: Yes, especially for the bigger dogs. Some bags can cost over one hundred dollars. That is a pretty significant factor for a lot of people.

Dr. Felsted: What do you tell them to help them get over that hurdle?

Dr. Strauss: I point out that if we have to medicate the dog that is not exactly inexpensive either.

Dr. Fadok: I hear it more now than two years ago. When I'm trying to sell a food trial, I tell them it's a diagnostic tool. Once we have the answer, I tell them "You choose what you feed but you get what you pay for."

Dr. Felsted: Coming back to this multiple allergy issue, do you use diets as a component of treating atopic dermatitis where you really don't think that there is a food allergy per se? Are there diets that can help with that?

Dr. Liska: I know for example Royal Canin® has a food for the atopic patient and I have been trying that diet to see if I can further improve my patient's quality of life. If the high levels of fatty acids in the diet help my client avoid administering four capsules of fatty acid supplement then I am willing to add the diet to my medical recommendations. If I can take a patient from being a 4 out of 10 to a 2 out of 10 because I have changed the diet to something with high fatty acid level then fantastic. I have only improved the quality of that patient's life.

Dr. Felsted: What about a vegetarian diet for either dogs or cats as a hypoallergenic diet?

Dr. Fadok: There are many animals who don't do well with animal protein. Like one of our tech's dog. He flared on rabbit and potato. I switched him to (Royal Canin®) Vegetarian and he did well.