Long term management of canine Atopic Dermatitis and cutaneous Adverse Food Reactions

What is the current Gold Standard treatment approach for AFR long-term management?

If the ingredients involved in CAFR have been identified, they must be removed from the diet. Otherwise, commercial diets based on hydrolyzed or selected proteins are good alternatives.

What are your tips to ensure long term client compliance?

Pet owners must understand that cAD and CAFR are lifelong syndromes. Dealing with relapses and situations where the cause is unclear can be worrisome at first, but it’s important for them to learn not to fight against cAD or CAFR but to manage them effectively. The veterinarian’s role in the first year is to teach owners how to identify early symptoms, prevent relapses, and understand the strategies for using diet and medications.

What do you look for in a diet used for this type of treatment?

Regardless of whether the diet is commercial or home-cooked, it must be formulated to avoid the offending food allergens and be complete and balanced to support skin restoration. Some commercial diets are specifically designed to avoid allergens, while others focus on supporting the skin barrier. Achieving a nutritionally balanced home-cooked diet that meets these needs is challenging, and recipes for long-term use should be created by a certified veterinary nutritionist.

Is there an ""all-in-one"" diet that can support CAFR and cAD without the need for an elimination trial?

The optimal diet to support CAFR and cAD must provide the essential nutrients while avoiding allergens that could trigger a reaction. For CAFR, the diet must be formulated precisely to exclude allergens that could provoke a reaction in the pet. For cAD, it should include nutrients that reinforce the skin barrier and help reduce inflammation.

What is recommended in terms of monitoring and follow-up for these dogs and cats?

Successful follow-up relies on a thorough understanding of the multifactorial nature of the syndrome and close collaboration with the pet owner. Initially, frequent monitoring is needed to ensure an accurate diagnosis. In the long term, success will depend on the pet owner's ability to recognize signs of disease progression, with the goal of minimizing drug use while providing an appropriate diet to maintain immune stability. Over time, pet owners will learn to identify risky situations and anticipate and control potential relapses.

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