Hypoallergenic diets - Purina HA

RE: Hypoallergenic diets - Purina HA

Stephen Courtney — Sun, 25 Apr 2021 17:21:20 GMT

I have had clients go to a specialist, be advised on diet, then go to the local pet shop and buy something recommended by some pimply oik who has a store room full of some crap to shift

Judith Joyce - why are dogs constantly hungry on home cooked diets? I home cook ( don't ask why, it's my biggest regret in life) - surely they just need more food?

It's very unlikely a dog would be allergic to vegetables - and I advise a nivelprotein and carb source, plus veg - but Honestly have no idea how honest my clients are when they update me

RE: Hypoallergenic diets - Purina HA

Beats — Fri, 16 Apr 2021 08:55:25 GMT

Home-coooked diet does sound a big ask for a lot of pet-owners. I guess unless chance that could be done lifelong if successful then limited usefulness going to that length in short-term. I'll maybe try Purina HA on next 10 diet trial cases and see if I have any more success than RCW Anallergenic, but I'm not that hopeful. Have had great success with RCW Anallergenic in diet intolerances leading to GI signs.

RE: Hypoallergenic diets - Purina HA

Freya . — Thu, 15 Apr 2021 20:33:33 GMT

I quite like purina ha, dogs seem to eat it quite well the 11kg bags are fairly good value. Tend to try to get clients to use it to see if food is a issue then in improvement give option of carrying or trying transition on to something else.

I think have moderate success with diet trials though if a client isn't engaging I go I give up quite quickly as feels like complete waste of energy. I think some form of suitable treat is useful to stop owners free styling it.

Had a wonderful compliance chat recently with a client who a colleague had recommended a specifiedy Hypoallergenic diet too but the owner said didn't seem to be helping and she had to mash jammy dodgers into the food to get her dog to eat it...

RE: Hypoallergenic diets - Purina HA

Judith Joyce — Thu, 15 Apr 2021 11:23:52 GMT

Frustrating isn't it, human nature I suppose. What do they say - an expert is someone who you travel a long way to see and charges you twice as much? Something like that. It does make referral work a lot easier than first opinion work though

RE: Hypoallergenic diets - Purina HA

Julie Innes — Thu, 15 Apr 2021 10:44:26 GMT

No need to defend, Joyce! just frustrates me that I recommend something repeatedly, client ignores, finally refer to dermatologist who recommends the same thing and client complies!

RE: Hypoallergenic diets - Purina HA

Judith Joyce — Thu, 15 Apr 2021 10:39:26 GMT

HI,

In defence of dermatologists, I would say that putting them on a hydrolysed diet is probably the second thing they do after interrogating parasite control and looking for evidence of parasitic and microbial disease. In my experience (first opinion and referral( the most common skin disease in young animals including those with ear and facial involvement is ectoparasitic reaction of some kind.

Without getting into the issue of which dermatologist is allied to which dog food company, the rationale for food trialling first is on 'do no harm' grounds -that a 'test which involves no procedures or drugs is the one that should be done first, not necessarily for the most common disease (hence the bug hunt) , and the reason for using hydrolysed diets over the home cooked is attrition caused by the huge issue of compliance, frequently with the telling of benign porkies by the client. Often, the assurance in the supermarket has hidden the fact that they have gone for another opinion elsewhere where they have been given the drugs they crave. And some just get better.

RE: Hypoallergenic diets - Purina HA

Julie Innes — Thu, 15 Apr 2021 09:46:06 GMT

I think food allergies are very common! It's my first thought in anything under a year old, or with recurrent ear/ face issues.

Client compliance is a nightmare! I try, they see the price of hydrolysed diets and decide that "he/ she won't eat that"......

I encourage them to try different protein based diets (eg swap chicken based for fish based etc) and try each for 4-6 wks. I tell them they may need to try 16 different diets until they find one that suits.

I hate food allergies, as owners get really annoyed because you can't wave a magic wand and fix it, or give them "a jag"- they actually have to do something themselves, and it's tedious and costs money and their pet can't get treats. My spiel is "if this IS a food allergy, you will be back here every couple of months, no matter what treatment I give. I see these guys back and forward for months/ years, then I meet the owner in Aldi and realise I haven't seen them in ages! they tell me they changed his/ her food, and haven't needed me..." I have had some ulnikely changes produce results- one dog got miraculously cured after trying various hypoallergenic kibbles and ending up on pedigree chum! I've had a surprising few do really well on Chappie.

Always amazes me though that when we finally give in and refer them to a dermatologist the first thing they do is put them onto a hydrolysed diet, which they seem to accept without a murmur.

RE: Hypoallergenic diets - Purina HA

Lucy Fleming — Wed, 14 Apr 2021 12:06:02 GMT

Arguably food trials are "pointless" if compliance not strict enough, but I do sometimes think even a not-completely-compliant food trial may give you an idea of a) whether it may be a dietary allergy and b) whether you will ever be able to control it sufficiently with diet in "real life" to be useful.

Take trials in cats - in any indoor-outdoor cat with the chance to hunt, compliance likely to be not complete. However, are owners of a food allergic cat going to keep it in for the rest of it's life so it never eats anything other than the hypoallergenic food? Probably not. But partial response to an incomplete food trial may give you an idea if dietary restriction is likely to be useful for control of signs, or whether signs need to be controlled by other means (either non-dietary allergy or not possible to effectively control with diet)

RE: Hypoallergenic diets - Purina HA

Neil Wheadon — Wed, 14 Apr 2021 09:53:01 GMT

[quote userid="13891" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229870#229870"] I think compliance has to be the biggest issue.[/quote]

I really pick at clients home habits

The last 3 hypoallergenic food trials have always ended the same way in that they are feeding treats because the label in the shop says 'hypoallergenic'

I start with saying 'no treats' to any client, add it in the middle of the conversation and finish it with the same. However does it make any difference? The person yesterday was a classic example. I'd talked to them for 10 minutes about the diet and NO TREATS., then called them about the purina diet to find they were in Pets at Home looking at the hypoallergenic treats

Neil

RE: Hypoallergenic diets - Purina HA

Judith Joyce — Wed, 14 Apr 2021 09:26:23 GMT

Hi,

I used Purina HA when I had so many compliance failures with the 'gold standard' home cooked diet. Its advantages are novel hydrolysed protein, relative palatability and sound enough nutritionally for an adult dog for the length of an adequate food trial. It avoided the constant hunger associated with home cooked diets. I share the others experience of rarely diagnosing cutaneous adverse reaction to food. This should be a failure to diagnose bearing in mind the reported prevalence of the condition. Purists would say that the commercially produced diets aiming at reducing exposure to allergens aren't restricted enough, and many ?most contain trace quantities of other proteins. I think compliance has to be the biggest issue. Removing therapy from an itchy dog and making it constantly hungry must make the pet and its owner stressed.

I probably got to the end of a food trial more frequently with Purina HA than other diets I had tried (especially home made), but always had a niggle in the back of my mind about the level of restriction.

RE: Hypoallergenic diets - Purina HA

Lucy Fleming — Wed, 14 Apr 2021 07:54:49 GMT

[quote userid="9239" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229861#229861"]From all Virbac seems to be most palatable, smell best and it's made from salmon.[/quote]

I've used the Virbac one for cats quite a bit for this reason - seems to be much more palatable than RC. I tried it in my own cat for derm signs and ironically it gave him diarrhoea though...

I tend to agree with Beats though, I'm not sure food allergy is that common as a cause of derm signs. Or perhaps my owners just aren't being compliant enough with trials, or the dogs also have other environmental allergies...

RE: Hypoallergenic diets - Purina HA

Dinu Catilina — Tue, 13 Apr 2021 22:50:48 GMT

I used Purina HA and RC analergenic and Virbac hypoallergy. From all Virbac seems to be most palatable, smell best and it's made from salmon.

I read that hydrolised diets can actually be contaminated with non hydrolised protein:

https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-018-1571-4

https://onlinelibrary.wiley.com/doi/full/10.1111/jpn.12045

So where possible I will recommend sweet potato and a protein not used before like rabbit or kangaroo. But the meat must be chunks and not minced to reduce the risk of contamination.

RE: Hypoallergenic diets - Purina HA

Beats — Tue, 13 Apr 2021 20:58:55 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229858#229858"]I used to say they were really uncommon, but recent CPD has suggested between 15 - 25% of allergy cases are food driven[/quote]

Which makes it all the more remarkable that I don't seem to be able to diagnose them.

It remains "uncommon" that I diagnose them anyway. I have diagnosed more cases of leishmania causing dermatitis this year than food allergy, and I would call leishmania in a non-endemic country "really uncommon".

Either:

1) I am very bad at diagnosing food-induced atopic dermatitis

2) I am very unlucky

3) 15%-25% of allergy cases are not food driven.

I'm keeping an open mind, and it could of course be a combination of the three.

RE: Hypoallergenic diets - Purina HA

Neil Wheadon — Tue, 13 Apr 2021 20:17:09 GMT

[quote userid="12930" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229857#229857"]But then I'm not sure I've ever successfully diagnosed a food allergy causing skin problems in a dog[/quote]

I used to say they were really uncommon, but recent CPD has suggested between 15 - 25% of allergy cases are food driven

Another interesting observation from CPD recently is that contact allergy doesn't really exist

Neil

RE: Hypoallergenic diets - Purina HA

Beats — Tue, 13 Apr 2021 20:12:56 GMT

Here's my generic sheet, Neil, if of help. But then I'm not sure I've ever successfully diagnosed a food allergy causing skin problems in a dog, so perhaps best ignored! I used to get them back after 4 weeks and check any pyoderma cleared etc (lest I may miss a food allergy dog just because it was still scratching due to pyoderma), and then again at 8 weeks before challenge, but bit short of time for such luxuries these days.

I always recommend a specific food and where to get it and how much to feed when recommending a diet trial. Sometimes novel protein/carbohydrate (eg dog less than one year with known dietary history), but often just go for a hydrolysed - I've used anallergenic the most, but I have a list of all available that sometimes refer back to if needed. Purina HA is pretty popular I gather.

"Another possibility for *****’s skin problems is a food allergy. This is generally an uncommon problem, but could result in ******’s current issues. Given the nature of the current problems, I would advise starting an elimination-challenge diet trial for *****. The ideal time to perform such a diet trial is in the winter when other allergies from pollens are less likely to cause confusion, but a diet trial can be done at any time of the year.

I recommend a hydrolysed diet to perform such a trial ideally, and in ******’s case, I have made the specific recommendation to feed Royal Canin Anallergenic kibble exclusively for 8 weeks.
We stock small (trial) bags of the food at the clinic, and can order larger bags for you, however it can be obtained cheaper through the internet at the following web-address:
*URL linking to the specific bag at a internet shop that doesn't charge delivery in my locality*

The amount to be fed is ***g per day (split into 2 or more meals), meaning the 3kg bag would last ** days. I would recommend ordering the 3kg bag first and taking a few days mixing the food ******’s regular diet first to transition him across and ensure he is happy to eat the prescribed diet. Please remember to order a further 8kg bag in time so there is not a break in the diet trial after the initial first 2-3 weeks, otherwise the whole process needs to start over again. If he does not like the food and it has been ordered from us we can refund the returned bag as long as at least three-quarters of it remains.

Towards the end of the 8 week diet trial, please get in contact with me at the clinic to discuss what to do, but generally will recommend reducing / stopping any ongoing anti-itch medicines to see how much itching remains, and then “challenge” by feeding the normal food again for a week and see if itching gets worse. I will often phone owners myself (time-permitting) at intervals during a diet trial as I have found this helps to trouble-shoot any early problems and give further advice as the trial gets under way, but please feel free to phone me for advice at any time during the trial.

Performing an effective diet trial on a dog can be quite a challenge. Here are some top tips:
· NOTHING can go in the mouth other than the prescribed food and water.
· That means NO:
o Treats
o Dentastix
o Scraps of food
o Food left for other animals
o Other people offering food, such as relatives and neighbours
o Cheese/chicken etc given to help administer tablets
o Meat-flavoured medicines
o Flavoured toothpaste
o Etc.
· Washing out a treat jar and filling it with the prescribed food can be helpful so treats (the Royal Canin Anallergenic kibble only) are available to give at times when treats are normally given.
· If you are adventurous, and a competent chef, then these kibbles can be mashed down with water and baked in oven on clean tinfoil to create larger biscuits for treat purposes if that is required.
· If any digestive signs such as soft motions, excessive numbers of motions, flatulence, rumbling-tummy, mucous-coating motions etc. are present, then these are expected to resolve within 2 weeks of starting the diet trial. If these signs are present and not noted to improve within 2 weeks of starting the diet trial, please contact me at the clinic, while continuing the trial meantime.
· The trial should run for a full 8 weeks to be sure of identifying up to 90% of dogs with food as a component of their allergies.

Should you have any queries on the advice supplied, please feel free to contact me at the clinic on xxxxxxxxxx."

RE: Hypoallergenic diets - Purina HA

Lucy Fleming — Tue, 13 Apr 2021 19:59:06 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229848#229848"]

By the way, has anyone seen this site https://www.allaboutdogfood.co.uk/

[/quote]

Yes, I see it recommended quite a lot on online groups etc (pet owner recommendations, not vet!) It seems well meaning, but if you look at the "about" page, the person running it doesn't seem to hav e any specific nutrition qualifications. It also appears to have the usual biases against Hills/ RCW/ Purina and towards grain free type diets. Not a source I recommend

RE: Hypoallergenic diets - Purina HA

Sarah Keir — Tue, 13 Apr 2021 19:21:27 GMT

I don't believe you can get a true hypoallergenic food in Pets At Home; certainly not when I last walked through a store over a year ago. 'Hypoallergenic' is not a legally protected title so it can be stuck on any bag of food. I print of a list of suitable and foods and how to do a diet trial and get the client to get the food online.

RE: Hypoallergenic diets - Purina HA

Neil Wheadon — Tue, 13 Apr 2021 19:01:09 GMT

[quote userid="10320" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/29773/hypoallergenic-diets---purina-ha/229841#229841"]

Are you wanting opinions of Purina HA or alternatives?

I quite like it. It's soy based, seems pretty palatable.

We are a royal cabin practice but I usually suggest HA over anallergenic

[/quote]

I have no familiarity with it and asking a client to do a 6-10 week food trial is quite an undertaking, so looking for recommendadtions/advise.

By the way, has anyone seen this site https://www.allaboutdogfood.co.uk/

Neil

PS I called the client about the food, and she was in pets at home contemplating the treats, so asked if any were OK, even though I had told him/her 4 times that nothing else. To me non complience is a huge issue

RE: Hypoallergenic diets - Purina HA

Thomas Johnson — Tue, 13 Apr 2021 15:30:28 GMT

I've been using Purina HA as my hypoallergenic diet of choice for a number of years, mainly because I've found it more palatable (not personally!) than the Hills or Royal Canin equivalents, also being soya based if recombination of proteins is something you're worried about it's still a novel protein source.

RE: Hypoallergenic diets - Purina HA

Lucy Fleming — Tue, 13 Apr 2021 13:35:26 GMT

Are you wanting opinions of Purina HA or alternatives?

I quite like it. It's soy based, seems pretty palatable.

We are a royal cabin practice but I usually suggest HA over anallergenic