Derm2- CAFR

  1. What is the lesion pattern in CAFR/ atopic dermatitis? (5)
    distal limbs (paws), ventrum, perianal, ears, face
  2. Since atopic dermatitis and CAFR have the same dermogram, how do we begin to clinically separate them?
    • CAFR- non-seasonal
    • Atopic dermatitis- seasonal
  3. Describe the pathophysiology of food allergies.
    IgE-mediated type I hypersensitivity reaction or non-IgE type IV HS reaction
  4. How does a food intolerance arise? (3)
    toxic (pathogens, parasites), pharmacologic (food additives), metabolic (lactose intolerance)
  5. Are there certain feed ingredients that are more allergenic than others?
  6. What can make CAFR difficult to diagnose? (3)
    no easy diagnostic test, non-specific clinical signs/history, confirmation of CAFR not usually performed
  7. Is there a connection between CAFR and a recent change in diet?
    No- they have to have exposure time to become sensitive to it (many dogs had been eating same food for >2 yr)
  8. What lesions are seen with CAFR? (5)
    no primary lesions; pruritus--> excoriations, alopecia, lichenification, hyperpigmentation, erythema etc.
  9. What are clinical signs of CAFR? (4)
    pruritus, otitis externa, secondary infections, +/- GI signs
  10. What are common etiologic agents that cause secondary infections due to CAFR? (2)
    Staph pseud, Malassezia
  11. How does CAFR present in cats? (5)
    cutaneous reaction patterns: feline symmetric alopecia, head/neck pruritus, miliary dermatitis, eosinophilic granuloma complex, +/- GI signs
  12. What other diseases have the same cutaneous reaction patterns in cats as CAFR?
    FAD and atopic dermatitis
  13. How do you diagnose CAFR? (2)
    elimination diet trials (novel ingredient diet, hydrolyzed diet), allergy testing (NOT RECOMMENDED- high false + and false -)
  14. What types of elimination diet trials are there? (2)
    novel ingredient diet, hydrolyzed diet
  15. What are the composition and properties of a novel protein diet?
    removal of previous diet and introduction of a novel protein [diets can only be hypoallergenic if the animal was never exposed to the food components before]
  16. What does it mean to hydrolyze a protein?
    break it down to peptides and AA- reduces molecule weight--> molecules become too small to cross-bind IgG on mast cells--> prevents degranulation and IgE-mediated HS
  17. What is the major disadvantage to using hydrolyzed protein diets to diagnose/treat CAFR patients?
    will not influence non-IgE-mediated forms of food allergy (type IV HS)
  18. What are the pitfalls to dietary trials? (5)
    finding a novel carbohydrate, meat/meat-by-products (inappropriate for trials), OTC "novel" diets may be contaminated with other protein sources not on label, cannot use flavored medications/treats/vitamins, need compliance of all members of household
  19. If the majority of allergic pets actually have atopic dermatitis, why is it necessary to do a dietary trial?
    CAFR is much much easier to manage, so you must rule it out
  20. How long is the duration of the food trial?
    treat secondary infections first (if necessary), initial 4 weeks then recheck, continue diet for 4 more weeks then recheck (monitor for decrease in pruritus)
  21. When do you do a rechallenge?
    if less than 50% resolution in pruritus after 8 weeks of food trial--> rechallenge
  22. Can you give steroids to reduce pruritus during a food trial?
    yes but have them stop giving steroids a few days before recheck
  23. How do you interpret a rechallenge?
    • increase in pruritus within hours up to 2 weeks--> CAFR
    • no change--> something else, atopic dermatitis
Card Set
Derm2- CAFR
vetmed derm2