Posts Tagged ‘limited ingredient diet’



Of all the different diseases veterinarians treat, “allergic inhalant dermatitis”, also known as “atopic dermatitis” or “atopy”, is no doubt the most frustrating for both owner and veterinarian alike.   Why is this you may ask?  Well in this article I will explain the many difficulties veterinarians run up against when trying to diagnose and treat a dog with “atopy”.   To begin with atopy must  first be diagnosed and distinguish from a number of other skin diseases which have as their main symptom itching and scratching.      These other conditions which must be ruled out before the diagnosis of “atopic dermatitis” can be made include mange, yeast and fungal infections, bacterial infections, food sensitivities, fleas and contact dermatitis.      To further confuse the diagnosis, pets with atopy often develop the secondary problems of yeast and bacterial infections and consequently more than one problem often exists at the same time.

To Further add  to both the veterinarian’s and owner’s frustration is the fact that atopy often causes intense itching and because the pet is so uncomfortable the pet owner is desperate to find some way to provide their pet “immediate” relief.     When these atopic dogs are scratching themselves raw it is initially necessary to break the “itch scratch cycle” with some form of cortico-steroid.    Although steroids are not the long term solution there is little else available that will give the necessary immediate relief.   Anti-histamines, fatty acid supplements,  oatmeal baths  or crème rinses, and herbal anti inflammatories may help some but rarely provide the immediate relief owners are expecting.     In spite of the fact that long term use of steroids has  unwanted side effects,  the short term use may be necessary to prevent self inflicted skin mutilation which leads to secondary bacterial infections .    Once the intense itching and scratching has subsided other supplements and medications may be used to replace steroid therapy.   Most veterinarians realize that steroid therapy is a stop gap measure that is simply treating the symptoms and not the cause of the problem, however, a short term, reducing dose course of steroids is often necessary until the other approaches have a chance to kick in.     As a holistic veterinarian I minimize many of the unwanted side effects of steroid therapy by using “natural hydrocortisone” rather than synthetic steroids like prednisone or prednisolone.

Another frustration veterinarian’s face in dealing with allergic inhalant dermatitis is the fact that many animals with atopy may, at the same time, have food sensitivities.    Allergic inhalant dermatitis usually starts out as a seasonal problem and progresses over several years to become a year round one.    Food sensitivities, on the other hand, are year round.    When animals have year round itching and scratching your veterinarian must try to discover whether the problem is atopy, food sensitivity or a combination of both.    If both airborne and food allergens are causing the dogs itching and scratching then both problems must be dealt with if the pet’s itching and scratching is to be minimized.   Because food allergies may be due to both the food and to chemicals added to the food, such as preservatives, coloring agents, flavor enhancers or texturizers, trying to discover the allergic component in the food is often quite difficult and requires the use of food trials that use limited ingredient diets.   A limited ingredient diet is defined as a diet that is made with only a single carbohydrate and a single protein source, such as duck and potato.    When attempting to reduce itching and scratching through a limited ingredient diet trial there is further frustration because the effects of the new diet can take up to 12 weeks to see if it is going to work.

Adding to the owner’s frustration is the fact that successfully treating atopic dermatitis usually requires that the pet be given several supportive drugs or nutritional supplements in addition to weekly baths that will help treat complicating yeast or bacterial infections.   It is also important to give liver and intestinal support supplements in order to reduce the number of air borne and food allergens entering the pet’s blood.   Veterinarians are well aware that giving a pet all these oral supplements along with weekly medicated bath requires a huge commitment on the part of the pet owner.    Understand that this commitment to daily therapy must go on for months.

If a pet owner makes this commitment and has conscientiously applied the therapeutic strategy for months with poor results then the next step would be to have the pet allergy tested in order to find which airborne allergens are causing the intense itching.    Once the offending airborne allergens have been identified a “hyposensitizing serum” made up of these allergens can be prepared and the owner can be taught how to give simple periodic injection just under the skin.    Unfortunately allergy testing and subsequent desensitization can be expensive and is not guaranteed to work.     To add to the frustration it can take up to 9 months of allergy serum injections to determine if the  hypo- sensitization approach will provide the answer.

By now I think it should be obvious that diagnosing and treating a dog or cat with allergic inhalant dermatitis is huge undertaking for both veterinarian and pet owner alike.   A thorough exam and careful history is just the beginning.   Periodic recheck exams at 3 to 4 week intervals will be necessary to evaluate the effectiveness of the treatment.    Changes in treatment may be necessary depending on how the pet’s skin is responding and how uncomfortable the pet is.     Following the veterinarian’s instructions to the letter is extremely important in order for him or her to judge whether therapeutic changes must be made.

Besides the above conventional approach to treating pets with skin allergies, holistic veterinarian can add acupuncture, herbal therapy, NAET, bio identical natural hormone therapy, FSM therapy, and monolaurin therapy.

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Itching and Scratching: Holistic Allergy Care for Dogs and Cat Skin Disease


Just as with people, dogs and cats itch and scratch for many reason.    Discovering the cause of the itching and scratching can be a difficult and time consuming process.     Careful attention must be paid to history, clinical examination, and laboratory findings.    The most common diseases that can cause itching and scratching include bacterial infections, allergies, food hypersensitivities,  sarcoptic mange mites, demodectic mange mites, fleas, yeast, ringworm infections,   autoimmune diseases, and hormonal and metabolic  disorders. Sometimes it is easy for the veterinarian to diagnose the cause of itching and scratching , for example,  when a pet has fleas crawling all over his or her body    At other times,   as with allergies,  the diagnosis can be much more difficult to arrive at .  Consequently, pet owners should understand that their veterinarian may not always be  able to diagnose and prescribe  the  total treatment for the pet’s itching and scratching on the initial visit.

One of the major reasons the  diagnosis of a pet’s itching and scratching can be difficult is because more than one cause of itching and scratching can be present at the same time.      For example,  a dog or cat may have a primary allergy infection  that  allows a secondary bacterial or yeast infection to develop.    Unless both the primary and secondary causes of itching are diagnosed and treated, the scratching may lessen but it will not stop completely.

To help sort out all the possible causes of a dog or cat’s itchy skin one or more laboratory tests are often needed.   One of the most common tests performed on a pet with itchy skin is a “skin scraping”.   The skin scraping is placed under the microscope and examined for the presence of mites and fungus.    Another test called an “impression smear” is performed by pushing a glass slide firmly against the affected skin, staining it with a dye, and examining it under the microscope for bacteria, white blood cells,  yeast and mites.    A third test called a “trichogram” requires plucking hairs and examining them under the microscope for fungus and mites.    If a fungus is suspected as a cause of the scratching, a ”fungal culture” is performed on hairs harvested from affected areas.   If fungal elements are present they will grow in the culture within 3 weeks. For the very difficult cases, diagnosis may necessitate surgical removal of a small core of skin so that it can be sent to the pathologist for microscopic exam.   This surgical procedure is known as a “key punch biopsy”.     If a food allergy is suspected as cause of a pet’s scratching,  a “limited ingredient diet” should be fed for several weeks to see if it results in relief from the itching.    If airborne allergens are suspected blood or skin testing should be performed in an attempt to discover  the specific offending allergen.  Unfortunately both airborne and food borne allergies are often  present at the same time.

To further complicate diagnostic efforts, understand that yeast and bacterial infections may be either a primary or secondary cause of a pet’s scratching, whereas allergies, mites or fleas are usually the primary cause.     The reader should understand that getting rid of the most primary cause will not always stop the itching if the secondary cause is not addressed and eliminated.    Furthermore,    it is not always possible to find a flea on a dog with fleas or a mite on a dog with mites.   If this is the case then “therapeutic testing “is necessary to make the diagnostic connection.   For example, if giving a mite dip or flea medicine stops the pets itching then a diagnosis of fleas or mites is made by association.  However, if the pet with fleas or mites has a secondary bacterial infection the scratching may only be reduced but  not disappear.

When treating mites or bacterial infections the veterinarian must always consider the possibility of an underlying immune deficiency predisposing the animal to such infections. Consequently, a thyroid test should be run to see if a “hypothyroid” condition could be suppressing immunity.     Also, consider that nutritional deficiencies could be producing an immune deficiency, so evaluating the pet’s diet is very mportant.

Besides the above more common causes of scratching there are a number of less common causes that include hyperadrenalcorticism, hyperthyroidism, kidney disease, liver disease, Mast cell tumors, Cutaneous lymphoma,  Inflammatory Mammary Carcinoma,  and maldigestion.

Of course the treatment for pruritis (itching) depends on the diagnosis, however improving nutrition and reducing toxins will be beneficial regardless of the diagnosis.   Along this line, feeding food with a minimal amount of grain will reduce the likelihood of the pet developing a leaky gut syndrome.   A leaky gut will allow intestinal toxins and allergens to enter the liver circulation, overwhelm the livers detoxification capabilities and consequently enter systemic circulation.   This will overstimulate the immune system and make allergic response more likely .

I addition to eliminating dietary grain, food trials that begin by feeding a limited ingredient diet consisting only of a single novel protein and single novel carbohydrate will help greatly in minimizing allergic skin disease.   Feeding a limited ingredient diet will make it  less likely for food allergens to be  present.   Once the allergy symptoms are controlled by this limited diet other food ingredients should be added one by onei n an attempt to identify what foods are allergenic and which are safe.  This approach to treating allergic itching and scratching is know as a “food trial”.  Once the allergenic foods have been identified a healthier diet can be formulated  and  used in place of the limited ingredient diet.   For those not wanting to go through  the above food elimination process  predigested food are commercially available.  By predigesting the food the protein molecules are broken down into much smaller molecules which are then no longer allergenic.

In order to identify airborne and environmental allergens a sample of the pet’s blood can be sent to a laboratory that performs allergy testing.     In about 2 weeks the laboratory will send back a report on what environmental allergens the pet is sensitive too.   This same company can prepare  a hyposensitizing serum containing all of the identified allergens.    This serum will then be used to perform hyposensitizing therapy on the allergic animal.   Such serums are injected according a predesigned  schedule .     The protocol provides continually higher doses  be given.    At first the injections are given every few days but eventually they may only be given monthly.   Unfortunately hypo-sensitizing injections are not always the solution and it may take up to 9 months to see if the the therapy is effective.

Up to this point most of  the recommendations and therapies discussed have been entirely conventional.   I will now discuss more alternative therapies.   To begin with, providing digestive enzymes to a meat based low grain diet will help minimize allergens.  Then providing nutraceuticals to heal any damaged areas of the intestine and  support liver function  will help the pet repair his or he leaky gut.   Systemic enzymes should be given on an empty stomach so that they will be absorbed into the blood stream and circulate in the blood and act as a blood cleanser thereby destroying  circulating immune complexes.  Omega 3 fatty acids are important for overall skin health and to provide anti inflammatory support.  Next anti inflammatory herbs and antioxidants nutrients can be given to further reduce inflammation and minimize itching and scratching.   Natural cleansing shampoos should be given at least weekly to remove airborne allergens on the pet’s skin.   These shampoos should be followed with a cream rinse that contains a local skin anesthetic, colloidal oatmeal, and skin moisturizer.   Skin sprays containing aloe, calendula, tea tree oil, and oil of lavender are very soothing and easy to apply.    Several homotoxicological remedies are helpful with allergic skin problems.   If the pet is terribly itchy and the chewing and scratching is causing self trauma then oral natural hydrocortisone can be given for a limited period of time to reduce inflammation and calm the skin down  until the other approaches kick in.   Natural hydrocortisone is cortisone that has been harvested from the Yam plant and appears to have fewer side effects when compared to laboratory manufactured prednisone or prednisolone.   Furthermore, the herb Yucca has a strong anti inflammatory, anti itch  activity as does the plant sterol betasitosterol.


Woodside Animal Clinic is a unique, very personal, one doctor practice where, for over 35 years, Dr. Simon has been healing dogs, cats, birds, rabbits, ferrets rodents, and reptiles with both traditional and alternative medicine. Dr. Simon is certified in Acupuncture, Chiropractic and Stem cell therapy. He is the author of 4 pet care books, a past president of the Oakland County Veterinary Medical Association and past board member of the  American Holistic Veterinary Association.   Visit us at

Woodside Animal Clinic sees pets from all over Michigan but primarily from the greater Detroit area including Wayne, Oakland, Macomb, Livingston and Washtenaw counties. Cities in these counties include:  Royal Oak, Berkley, Huntington Woods, Ferndale, Pleasant Ridge, Detroit, Redford,  Allen Park, Romulus, Trenton, Livonia, Hazel Park, Madison Heights, Warren, Centerline, Clawson, Troy, Sterling Heights, Southfield, Birmingham, Lathrup Village, Bingham Farms,  Franklin, Farmington, Farmington Hills, Novi, Northville,Wixom, Brighton, Livonia, Plymouth, Commerce, Ann Arbor, Ortonville, Clarkston, Waterford, Union Lake, Rochester, Rochester Hills, Auburn Hills, Utica, White Lake, Grosse Pointe, Romeo, Swartz Creek,  Shelby township, Washington,  Flint, Hartland, Lansing, Okemos, Howell, Brighton, White Lake, Romeo, Saline, South Lyon, Battle Creek, Saginaw, Windsor Canada, Toledo Ohio