Page 743 - Cote clinical veterinary advisor dogs and cats 4th

Food, Adverse Reaction (Nonallergic) 349

Food, Adverse Reaction (Nonallergic) Client Education
Sheet
VetBooks.ir Diseases and Disorders

(gluttony), or eating nonfood substances
BASIC INFORMATION
evaluation of GI mucosa (p. 1098): mucosa
(pica) • Endoscopy with biopsy and histopathologic
Definition • Pharmacologic reactions such as ingestion of may be normal or show increases in lamina
Adverse reaction to an ingested food or food vasoactive amines (e.g., histamine) in food propria lymphocytes or plasma cells
additive due to nonimmunologic mechanisms such as spoiled scombroid fish
(vs. immunologically based reactions [pp. 345 Patient-induced reaction (unpredictable, TREATMENT
and 347]) individualistic response upon ingestion of a
specific food item): Treatment Overview
Synonyms • Metabolic food reaction such as lactose Treat episodes of dietary indiscretion with
Food intolerance, food poisoning or toxicity, intolerance due to lactase deficiency; difficult supportive care.
lactose intolerance, food idiosyncrasy to differentiate from true allergic reaction to
proteins in milk because clinical signs may Acute General Treatment
Epidemiology be identical and both respond to dietary • Nonspecific supportive care is based on clini-
SPECIES, AGE, SEX elimination cal signs (e.g., parenteral fluid administration
Dogs and cats: no age, sex, or breed • Idiosyncratic adverse reactions to food or for dehydration).
predisposition additives (e.g., food colorings, preserva- • Clinical signs of GI disease usually resolve
tives, emulsifying agents, thickeners): within 2 days to 2 weeks on a diet that
RISK FACTORS occur infrequently and unpredictably and does not contain the offending substance.
• Food contaminated with microorganisms or are not apparently dose related; offending
toxic metabolites agent may be suspected based on repeated Nutrition/Diet
• Specific foods or additives (e.g., onions, exposures and elimination of other • Maintain strict avoidance of offending foods
chocolate, propylene glycol in cats) triggers or ingredients.
• Preformed vasoactive amines (e.g., histamine) • Find an appropriate commercial or a
in food such as spoiled fish DIAGNOSIS complete and balanced homemade diet for
• Dairy products long-term maintenance and ensure proper
• Dietary indiscretion (gluttony, pica) Diagnostic Overview handling and storage of food.
Adverse food reaction is suspected on the • Control episodes of gluttony and pica.
CONTAGION AND ZOONOSIS basis of diet history and clinical signs, often
Food contaminant may be zoonotic (e.g., but not always occurring as a result of acute Possible Complications
Salmonella, Listeria) dietary alterations. Diagnosis is often retro- Certain types of food poisoning and tox-
spective, with resolution of clinical signs as icities can cause serious and life-threatening
ASSOCIATED DISORDERS a result of proper diet. In contrast to dietary disease.
• Lactose intolerance hypersensitivity (food allergy), the response
• Food-responsive enteropathy to the change in food is usually more rapid PROGNOSIS & OUTCOME
• Dietary hypersensitivity (often within days). If no clinical improvement
• Inflammatory bowel disease occurs within 2 weeks, the diagnosis should be Good prognosis if offending foods or ingredi-
questioned. ents are eliminated from the diet
Clinical Presentation
HISTORY, CHIEF COMPLAINT Differential Diagnosis PEARLS & CONSIDERATIONS
Clinical signs, which can occur on initial • Any primary disorder of the gastrointestinal
exposure, include vomiting, diarrhea, decreased (GI) tract (e.g., inflammatory bowel disease, Comments
appetite or anorexia, abdominal pain, abdomi- parasitism, protein-losing enteropathy, • Report suspected food-related adverse reac-
nal distention, soft feces, excessive flatulence, antibiotic-responsive enteropathy, infiltrative tions to the manufacturer and the U.S. Food
increased frequency of defecation disease) and Drug Administration (FDA) or state
• Food hypersensitivity feed control official (p. 37).
PHYSICAL EXAM FINDINGS • Non-GI disorders manifesting with GI signs • Maintain detailed medical records; instruct
Evidence of diarrhea (small or large bowel), (e.g., hypoadrenocorticism, hyperthyroidism) the owner to save food samples and package
vomiting, abdominal distention or discomfort, labels when a food-related adverse event is
dehydration, rarely urticaria or angioedema Initial Database suspected.
(secondary to vasoactive amines) • CBC, serum biochemistry profile, urinalysis:
normal, or nonspecific changes Prevention
Etiology and Pathophysiology • Fecal flotation: rule out parasitic causes of • Avoid exposure to contaminated food, food
Diet-induced reaction (occurs in most individu- GI signs toxins, dairy products, and dietary sources
als if sufficient quantity is consumed): of vasoactive amines.
• Food poisoning: consumption of raw or Advanced or Confirmatory Testing • For recurrent adverse reactions to food, a
improperly cooked/stored food contaminated Further testing may be used to identify other food diary can help monitor clinical response
with pathogenic microorganisms or their disorders with similar signs or for identifying and compliance.
toxic metabolites (e.g., aflatoxin) inciting causes (differential diagnosis). • Be alert to and notify clients of recalls on
• Food toxicosis (e.g., onions, chocolate, • Proper nutrition/elimination food trial pet foods or treats.
xylitol, propylene glycol in cats) • Abdominal radiography and ultrasonography:
• Dietary indiscretion: consumption of rule out other causes of vomiting and diar- Technician Tips
unusual or spoiled foods (e.g., scavenging rhea (e.g., intestinal obstruction, intestinal Thorough diet history is essential. Human
garbage), consumption of too much food mass) food sources, snacks, treats, and food for other

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