Intestinal diseases and food intolerance   

 

The intestinal tract is one of the most important organs of the body. It is lined with a secretory and absorptive membrane responsible for the resorption of fluids and nutrition.This membrane has to be highly permeable and is therefore very susceptible for any kind of impairment.
Food, parasites, viruses, toxins and enzymes can cause an antigenic strain. Bacterial growth, there are 1014 bacteria in the gut, need a good balance to prevent overgrowth and endotoxin damage.

- Food intolerance and food allergy are terms often used to describe the same condition, 
  but they are literally two different things
- Food intolerance is a reaction that is caused by some metabolic disorder, for example
- actose intolerance
- carbohydrate intolerance
- aldolase deficiency
- histamine intolerance   (e.g. high concentrations in fish)

An allergy is an altered reactivity following a second or subsequent exposure to different antigens. A true food allergy (or hypersensitivity) is the reaction mediated through different immune mechanisms. Allergens get inhaled or digested and cause a response of the immune system. Genetic predisposition plays as well an important role as age and environmental factors. Clinical signs vary, but are typically gastrointestinal, with frequent diarrhoea containing mucus or blood. Further signs are an increased defecation rate, flatulence and vomitus and of course inflammatory bowel diseases such as eosinophilic colitis and lymphocytic-plasmacytic colitis

Diagnosis

Diagnosis of an adverse reaction to food is usually confirmed through the response to an exclusion or hypoallergenic diet. Although a wide range of commercial hypoallergenic diets are available, it is generally agreed that the most effective method of diagnosing an adverse reaction to food is through the response to a home prepared elimination or hypoallergenic diet
followed by test meal challenge. Usually it is necessary to feed the diet for at least 12 weeks. Owner compliance can be poor if the benefits are not rapidly apparent.Therefore serological allergy tests can be of an advantage to confirm the suspicion of a food hypersensitivity.

Food-allergy-test

This kind of test is successfully used in the United Kingdom for some years. In cats and dogs the diagnosis of a food hypersensitivity is therefore easily available.
Food allergen-specific IgE and IgG antibodies can be detected in one test. IgE is responsible for allergic reactions of the immediate type (type I), whereas IgG is commonly applied to reactions involving delayed (type IV) hypersensitivity.
Allergy test have normally a high negative predictable value. This means that a negative test result has a high likelihood that this foodstuff is not causing the clinical signs.
An other advantage is the chance to decrease the time to find the right diet.

Result

In 50% of the samples we tested at LABOKLIN a positive result of a food hypersensitivity could have been confirmed. In dogs with gastrointestinal problems the change of diet showed in nearly 80% of the cases a remarkable improvement of the clinical sings.Food-allergy-test (simultaneous detection of IgE and IgG) 

  
Protein sourceCarbohydrate source
Beef Wheat
Pork Soybean
Lamb Barley
DuckRice
Chicken Potato
Turkey Corn (Maize)
Egg Oats
White fish Cow's milk

This test is species-specific and covers 90% of the relevant foodstuff in a cats or dogs diet.

 

Diagnostic procedures in diarrhoea of dogs and cats


1. Diagnostic of small intestine diarrhoea
   

 
Parameter Material Test forComment
parasitology


faeces


Worm eggs, protozoa oocysts (enrichment method) ELISA for Giardia, Cryptosporidiacollect faeces samples
of 3 days

Pancreatic
function

serum
(starving),
faeces
TLI
dog: pancreatic
elastase E1
cat: total faecal fat
combined with vitamin B12 and folic acid to detect „bacterial overgrowth“ or malabsorption following villous atrophy.
„Bacterial
overgrowth“
serum
folic acid
detection in combination
with vitamin B12.
 faeces
 

total bile acid
 

As a result of bacterial deconjugation the amount of bile acids in faeces is increased.
 urine
sphenol, a-Nitro-sonaphthol, Indikandetection of bacterial metabolites 
Blood profile


EDTA-blood


- microcytic, anaemia,
- eosinophilia
- lymphopenia
malena parasitosis, hypersensitivity,
eosinophilic enterocolitis
lymphangiectasis
Liver-Kidney profile serum 
 
organ insufficiency
 
 
Total protein

serum

panhypoproteinaemia

malabsorption syndrome, protein loosing enteropathy lymphangiectasis, neoplasia
Protein loosing enteropathyfaeces 
 
a-1 Antitrypsin,nitrogen detection  
Urinalysis
Protein
urine 
 
sediment, protein-
electrophoresis
differentiate between renal
and enteral protein loss
Electrolytes
(Na, K, Cl, Ca, PO4, Mg)
serum 
 
 
electrolyte imbalance
hyperkalemia
natrium /potassium ratio
indication for infection with trichuris
decreased ratio is indicating hypoadrenocorticism.
Feline hyperthyroidismserum 
 
total thyroxin
mainly in elderly cats > 6 years cachexia and diarrhoea
FeLV, FIV, Feline Coronavirus serum 
 
 antigene or antibodies 
Parvo-, Corona, Rota Virusfaeces
 
antigen (ELISA, PCR)
 
important in puppies and young adults
Canine distemper Virus
 
conjunctival swab EDTA-blood antigen (ELISA, PCR)
 
 
 

Diagnostic of food allergy

Parameter Material Test for: Comment
IgE, IgGserumallergenspecific IgE and IgG test of hypersensitivity
for 12 different food allergens 

Diagnostic of large intestine diarrhoea

Parameter Material Test for: Comment
ParasitologyfaecesWorm eggs, protozoa oocysts (enrichment method) ELISA for Giardia, Cryptosporidiacollect faeces samples of 3 days
Bacteriologyfaecesdysbacteria, obligate pathogenic germs like salmonella, Campylobacter, YersiniaFor obligate pathogenic species it is necessary to use the enrichment method. For culture special medium has to be used
Clostridium-
enterotoxin-test
faecesCl. perfringens-
enterotoxin,
Cl. Difficile-toxin A
and B
Cl. perfringensis part of the physiological intestinal flora. Enterotoxins can cause colitis.
 





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