Page 732 - Cote clinical veterinary advisor dogs and cats 4th

342 Flea Bite Allergy

Three mechanisms contribute to removal of that contribute to gas production, and increas- be necessary to determine the feeding strategy
that is best tolerated for the individual.
gases from the digestive tract: ing physical activity. • Minimize treats, snacks, and table foods,
VetBooks.ir • Bacterial consumption Acute General Treatment • Minimize stress associated with feeding,
• Diffusion into circulation
particularly those that contain lactose.
• When associated with GI disease, prompt
• Convection out the esophagus (eructation)
or anus (flatus)
predisposed individuals to consume meals in
The overall quantity, composition, and frequency treatment directed toward the cause is the including competitive behaviors. Allow
priority.
of gases liberated into the environment are a • Short-term use of bismuth subsalicylate or solitude and in a quiet environment.
function of the net flow of these mechanisms. zinc acetate may provide patient relief. • Modify feeding practices: smaller, more
• Nonabsorbable antibiotics (neomycin) have frequent volumes may be helpful.
DIAGNOSIS been shown to reduce flatulence in dogs, but
routine use in otherwise healthy animals is Behavior/Exercise
Diagnostic Overview not advised. • Maintain a consistent exercise regimen.
These clinical signs are typically reported by • Pharmacologic treatments such as activated • Provide outdoor walks within 30 minutes of
the owner, but attempts should be made to charcoal and simethicone have limited meals to encourage gas transit and regular
identify predisposing conditions, such as acute benefits. defecation patterns.
dietary changes.
Chronic Treatment
Differential Diagnosis • Management of primary small-intestinal PROGNOSIS & OUTCOME
• Dietary indiscretion disease may require lifelong therapy. When dietary modifications and physical
• Competitive or compulsive feeding behaviors • Dietary changes (see below) activity are implemented, prognosis is typically
• Diseases that cause maldigestion/malabsorption: • Physical activity (see below) favorable.
exocrine pancreatic insufficiency, inflammatory
bowel disease, intestinal dysbiosis, lymphangi- Nutrition/Diet PEARLS & CONSIDERATIONS
ectasia, food hypersensitivity • Highly digestible (low-fiber) diets which
reduce substrate availability for large- Comments
Initial Database intestinal bacterial fermentation may be When pursuing a diet change, a gradual
• Obtain a thorough dietary history, including useful. transition period (7-10 days) is generally
basal diet (formulation, amount, frequency, • High-fiber foods, especially soluble/ recommended to avoid GI upset and potential
duration of use), treats, snacks, human foods, fermentable (pectins, guar gum) and mixed exacerbation of the problem.
supplements, and feeding behaviors. fibers (psyllium, beet pulp), should be
• Document current medications (antibiotic minimized. Technician Tips
use may affect host microflora, resulting in ○ Aim for a diet with ≤ 5% fiber on a dry Clinical signs often require dietary modifica-
flatulence). matter basis. tions that are best identified by trial and error.
• Determine activity level, exercise regimen, • Ammonia and volatile amines may contribute Technicians caring for animals with flatulence
and environment. to excessive gas production, and excessive should encourage follow up communications
• Laboratory testing (e.g., fecal exam, serum intake of dietary protein should be avoided. with the owner to help guide future decisions.
biochemical profile, folate/cobalamin) is not Nonleguminous protein sources are preferred
necessary unless an underlying intestinal over leguminous ones. SUGGESTED READING
condition is suspected. • Abstain from offering sulfur-containing Roudebush P, et al: Flatulence. In Hand MS, et
vegetables (e.g., broccoli, cauliflower). al, editors: Small animal clinical nutrition, ed 5,
TREATMENT • Reduce access to garbage and litter boxes to Topeka, KS, 2010. Mark Morris Institute.
reduce the risk of dietary indiscretion.
Treatment Overview • If a food hypersensitivity is suspected, transi- AUTHOR: Allison Wara, DVM, DACVN
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark
Treatment is generally aimed at controlling aero- tion to a highly digestible novel protein or Thompson, DVM
phagia, decreasing consumption of substrates hydrolyzed protein diet. Trial and error may

Flea Bite Allergy Client Education
Sheet

BASIC INFORMATION Synonyms GENETICS, BREED PREDISPOSITION
Flea allergy dermatitis (FAD), flea bite Dogs and cats: no breed predisposition reported
Definition hypersensitivity
Development of hypersensitivity reaction(s) Epidemiology RISK FACTORS
and subsequent pruritic skin lesions in response • Dogs: intermittent flea exposure may increase
to exposure to flea salivary antigens is very SPECIES, AGE, SEX risk.
common in flea-endemic regions. It must • Dogs: any age but typically older than 1 • Atopic patients are at greater risk for flea
be differentiated from flea infestation alone, year of age; onset is most common in 3- to bite allergy.
where fleas are present on the animal or in the 5-year-olds
environment, but the animal does not develop • Cats: no age predisposition reported GEOGRAPHY AND SEASONALITY
clinical signs of skin disease. • Diagnosed worldwide wherever fleas are
found

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