Very Limited Ingredient Diet, help please

[Red_Akita]

http://www.nutriscan.org/
They send you a kit, you take the saliva sample and send it back to the lab.
As far as I know, the scientific community is still divided on its reliability. Also, note that it only works for intolerances, not allergies. The good news is that most likely your cat is intolerant to multiple foods; was she allergic, given the severity you have described, you should have seen her going in anaphylactic shock by now.

[loucat]

He has shown a food intolerance only after eating the Hills prescription foods..

Otherwise I believe his symptoms are those of an allergic reaction - very itchy skin, hair loss and sometimes a rash. He has been treated many times and this is the vets' diagnoses.

I am extremely relieved he has not suffered anaphylaxis - grateful for small mercies!!

But thanks for the info.. it's just a pity the saliva tests are only for discovering intolerances.. I had hoped they might provide more answers, as it is especially difficult trying to find a suitable diet when springtime environmental allergies are also clouding the picture..

[Red_Akita]

Allergies and intolerances have most symptoms in common, including skin rash, itchiness and local baldness. Allergies are incredibly rare, particularly if there are so many all together... sometimes allergy and intolerance are used interchangeably (by vets too) but there are actually differences. I wouldn't exclude your cat has just severe intolerances.

[loucat]

Perhaps you're right, I don't know.. but there's a few articles on the net that suggest intolerance causes digestive problems (vomiting, diarrhea), whilst allergies cause an immune response (itchy skin, dermatitis). For example:

http://www.petmd.com/blogs/nutritionnuggets/cat/jcoates/2012/july/food_intolerance_or_food_allergy-26384

http://www.peteducation.com/article.cfm?c=1+2141&aid=142

Hydrolysed protein diets, like Hills Z/D, should have been perfect for an elimination diet.. but something in both the Hills D/D and Z/D products makes my cat sick. (I believe both the Hills D/D and Z/D diets contain soybean oil and/or vegetable oil - but I haven't confirmed whether this ingredient is causing his intolerance).

[Red_Akita]

Those articles say the truth, but just part of it. Some intolerances are caused by the body failing to  reak down a sugar because of the absence of a specific enzime. One of the articles rightly mentions lactose intolerance as an example, where the body doesn't produce lactase enzymes needed to break down the lactose sugar.
There are though intolerances that are generated by antibodies present mainly in our intestine and in mucosae like saliva (IgA and IgG are the antibodies); the response in these cases is delayed by several minutes to few hours because the protein needs to start being digested before being attacked.
If the antibody responsible is IgE, then we talk of actual allergy: the response is immediate (think of peanut allergy).

[loucat]

So IgE = miserEEEEE?

The lab that conducted my cat's allergy tests agree that IgE scores indicate food hypersensitivity (classical allergy), and IgG scores indicate a delayed allergy.

Here are my cat's allergy test results for food allergens; (the environmental allergen results are just too many to mention!!)

BEEF - IgE: 3 / IgG: 4
PORK - IgE: 0 / IgG: 0
LAMB - IgE: 3 / IgG: 2
DUCK - IgE: 2 / IgG: 0
CHICKEN - IgE: 1 / IgG: 0
TURKEY - IgE: 1 / IgG: 0
RABBIT - IgE: 0 / IgG: 0
SALMON - IgE: 1 / IgG: 0
TUNA - IgE: 0 / IgG: 0
WHITE FISH - IgE: 0 / IgG: 0
WHEAT - IgE: 1 / IgG: 1
SOYBEAN - IgE: 3 / IgG: 2
RICE - IgE: 5 / IgG: 3
CORN (MAIZE) - IgE: 4 / IgG: 3
EGG - IgE: 0 / IgG: 0
MILK - IgE: 4 / IgG: 3

The tests were done by Avacta Animal Health (Sensitest).

He scored IgE scores for everything, except Pork, Rabbit, Tuna, Whitefish and Egg.. however I am still convinced tuna is a problem - and the lab said this is quite possible, despite the 0 score.

They also say 'any positive reaction indicates that the allergen could be problematic and should not be included when selecting foods for a dietary trial', which leaves me pretty stuck for suitable options.

I am desperate to get to the bottom of his food issues but seem to have no success with whatever I try. Another mealtime is coming up now and I just don't know what to do.

[Red_Akita]

My dog scored 3 on IgE with Duck. She's been on single protein duck food from Nov 2016 to Feb 2017 and again from the beginning of this month. No reactions whatsoever.
Even my vet said he trusted the test for environmental allergies but on food it's completely unreliable. As I said, the only real test you can make is the elimination diet, unless you want to keep your cat on hydrolised food forever.

[Meg]

Can we rewind a little......
Intolerances and sensitivities to food affect the immune system which then reacts to the 'culprit' in the food. These reactions are usually as skin reactions (for example an oversensitivity leading to generalised scratching), and less often, but may also, be accompanied by mucky ears, caused by the usual level of yeast not being correctly dealt with by the animal, leading to an overgrowth of yeast in the ears.

 There are also digestive reactions, usually looser stools ie diarrhoea, and less often accompanied by vomitting.

These over reactions shown in the saliva tests of IgA and IgM are available and you can test directly (from you to the lab) or through a vet. The link is here: http://www.nutriscan.org

NutriScan was developed by world renowned veterinarian, Dr. Jean Dodds, an American vet who has written many books, reviews and scientific papers. Her work is acknowledged and peer reviewed as well as being sourced in other research papers and I'd not dismiss looking further into this test if it may help a pet through this situation of over reactions to foods.

[Meg]

An animal's 'overly sensitive' reactivities can change at any time with environmental exposures after being stable with no reactions for some time prior.

However, food sensitivities are cumulative and happen over time, with exposure to a particular ingredient. Hence one of the reasons for a varied diet, if possible.

 The  antibodies to IgM measure the body's primary immune response to a recent exposure of certain foods (in secretions like saliva)  within the last 6 months.

Whereas antibodies to IgA measure the immune response to certain foods that have occured over the last 2 years.

[loucat]

Thanks for the info on the test Meg, I am open to all suggestions. Although I will have to see if I can afford it.. (the last few tests and all the vet visits have nearly finished me off). I will investigate it further. I also hope to try immuno-therapy after a few months in our new environment.

I understand food allergies can change, and that they are known to develop after constant exposure to a particular protein. However my cat's test results indicate allergic responses to proteins that were not a big part of his previous diet, so there is something more going on here. Perhaps an allergic reaction to one protein is causing reactions to others? (e.g. chicken and turkey?)

I also hope that finding and avoiding the problematic protein/s might cause the allergy to disappear eventually.. at which time, I could include it in his protein rotation.

However my immediate problem is what to feed him now. Please can you guys help me with the elimination diet?

When I realised he had food allergies (before the tests) I tried every different brand of food I could find, wet and dry - but nothing seemed to work. 4-6 hours after mealtimes, he would start scratching frantically, to different degrees depending on the food.

I kept a careful food diary and detailed spreadsheets of ingredients for months - but had no success. (I now realise that it was difficult to identify common ingredients because he has so many different food allergies).

He won't eat raw food or cooked meat.. and the hydrolysed protein diets make him sick.

So I don't know what to try next..

I suppose I could feed him a normal diet and put him on a permanent course of cortisone pills? - but then I am treating the symptoms and ignoring the problem.. Not to mention the long-term side effects of cortisone, which worry me greatly.

Anti-histamines don't seem to work.. but I have only tried Piriton so far.

If you could please can you give me some advice on what to do next, I would be very grateful. I weighed him today and he is definitely getting thinner. I would like to have him back onto a good, healthy diet as soon as possible! He is my baby and I'm really worried about him.

[loucat]

The NutriScan website looks very impressive!

[Red_Akita]

The elimination diet is very simple in principle and terribly hard in practice. Pick 1 meat, possibly one your cat never had before, and feed only that for 8 weeks. Main meals and treats, all need to be made exclusively by 1 ingredient. You can't use commercial food as they will always be combinations of different ingredients. Be merciless if he seems to be fussy; we all tend to spoil our pets but eventually hunger will prevail and no creature will chose to starve to death just because he doesn't fancy raw food.
If after 8 weeks you see improvements, well done! If he's still the same or worse, pick a different meat and start over.
I suppose that cats have the additional challenge of what they eat when they're out and about... is he free to roam the neighbourhood?

[Meg]

Yes there is a fee for animal testing to be carried out and some can be quite pricey(!)  and yet further testing may prove cost effective in the long run....? It needs considering as to the importance of if those further results could help you find food that your cat at this time might tolerate.

In the interim, to read further about hydrolysed protein foods and elimination diets (exclusion diets) there are useful threads here :


https://www.allaboutdogfood.co.uk/forum/feeding-dogs-with-health-problems/14/food-intolerance-and-exclusion-diets/762/]

https://www.allaboutdogfood.co.uk/forum/general-discussion/1/hydrolysed-dog-food-including-exclusion-diet/1272/

https://www.allaboutdogfood.co.uk/forum/general-discussion/1/peas/691/msg1055;topicseen#msg1055

[Meg]

I understand food allergies can change, and that they are known to develop after constant exposure to a particular protein. However my cat's test results indicate allergic responses to proteins that were not a big part of his previous diet, so there is something more going on here.

I wonder whether the information highlighted by another thread may offer a possible explanation to his results in this instance?  A 2015 investigation shows apparent omissions in declaring all proteins on pet food labelling for dog and cat food.
Here is the link:

https://www.allaboutdogfood.co.uk/forum/dog-foods/3/just-wondering-what-protein-is-in-my-dog-food/1426/

[loucat]

I'm sure that is possible.. maybe his old 'chicken' diet was loaded with turkey, duck and other proteins, and I didn't even know it. (I suppose 'meat derivatives' on the label could mean anything.. and I probably don't want to know what!).

Unfortunately it is pollen season so my cat's food allergy problems are being made worse by his environmental allergies. Last night was very bad - he was scratching all night, and rubbing his face - which made his eye start watering. He is also losing hair on his eyebrow area and is understandably very agitated.

I gave him more anti-histamines but they didn't work, so we ended up at the vet today for a short-acting cortisone shot. I don't like giving him cortisone, but didn't see an alternative. At least he is looking a little happier now, poor thing.

None of the foods with the 'correct' ingredients have worked.. they are either ignored or cause a reaction. And he doesn't enjoy meat at all - cooked or raw.. but I suppose you are right Akita, the elimination diet has to be cruel to be kind.

I must start him on a new diet this week.

If I consider his blood results, the best choices for elimination diet are rabbit, pork or white fish (or a novel protein - but there are really no novel options for him.. as he has eaten nearly everything!).

As my local butcher doesn't have rabbit - and pork is quite fatty - it seems fish is our best option..

So what if I put him on a white fish diet for several weeks and go from there? Is it safe to feed him fish in such large quantities?

(Another thing worries me about fish - I think it might have caused him allergic reactions in the past. So if he starts reacting on the diet, i will have to discontinue it immediately).

Otherwise I see NATURE'S MENU have a range of raw foods available which seem very convenient - they deliver frozen ready-meals direct to your door. (This would help me a great deal as a single mum!) Unfortunately all the raw food options include chicken as an ingredient, which is another one of his suspect proteins.

Do you think I should try it anyway? Does the fact that the meat is raw make any difference?