ALLERGY 

 

THE SAFE LONG-TERM SOLUTION

Liquid Gold

The First And Only Liquid-phase Serum Allergy Test

ALLERGY IN DOGS AND CATS IS USUALLY AN ITCH THAT RASHES .... RATHER THAN A RASH THAT ITCHES

• Non allergic skin disorders often begin as a rash or eruption and then become itchy due to secondary changes.
• Atopic dermatitis is the most common form of non-parasitic allergy in dogs and cats.  Approximately 15% of the population have a propensity to develop atopic allergy.  A significant percentage of atopic cats will present only with bronchio-respiratory (asthma) symptoms.
• Parasites and infection (bacterial and yeast) can cause prolonged itching in non-allergic animals and as a secondary phenomenon in allergic cases.

 

Atopy is a genetically programmed disease in which the patient becomes sensitized to inhaled or cutaneously absorbed environmental allergens (antigens) usually derived from pollens, dusts, molds and insects.  Clinical signs often appear seasonal at the onset and may become year-round and more intense with age.
 

• VARL Liquid Gold serum allergy testing technology provides the veterinarian a convenient method to successfully test and treat atopic patients; and allergen immunotherapy provides SAFE and EFFECTIVE long term relief with little or no adjunct medications required.

 

 ALLERGY TESTING
- of -
CANINE and FELINE PATIENTS

 

FIRST establish a clinical diagnosis with appropriate rule outs.

THEN select a test to identify offending allergens. 

• ALLERGIC DERMATITIS - ATOPY
• FOOD ALLERGY
• FLEA ALLERGY
• OTHER INSECT HYPERSENSITIVITY

 

ALLERGIC DERMATITIS

 

 -IgE antibody-mediated disease.
- May begin as a seasonal pruritic dermatitis.
- Paw licking, axillary scratching, face rubbing and eventually whole body scratching.
- Age of onset - 3 months and up.
- Often become year-round problem.
- Caused by allergens, inhaled or absorbed percutaneously.
- Usually respond favorably to corticosteroid therapy at the outset. Similar response can be expected of cyclosporin and other newer immune-modulating medications.
- Response to corticosteroid and other drugs often decline with long term use since they superficially control the itching that pet owners can observe but the underlying allergic disease continues to nurture bacterial and yeast skin infections. 
- Flea allergy is a factor in up to 80% of atopic dogs and cats (fleas can interfere with an immunotherapy program).
- Classical atopy may be overlapped by insect hypersensitivity and food allergy.
- These added factors may influence threshold for onset of symptoms.
- Atopic patients are more likely predisposed to secondary pyoderma and yeast infection.

 

 

The keys to success with immunotherapy:
 
Very important to keep in mind that allergy is not a static disease.  An immunotherapy protocol that has been effective for months may suddenly appear to be no more effective.  The problem is not the immunotherapy but rather, sudden increase in the amount of allergens from the environment.  We will guide you through these tough times with your patients.
 
 1.  Selecting the right patients by ruling out other causes of pruritus e.g.
             a.  Scabies. 
             b.  Bacterial pyoderma - allergy may be the underlying cause of recurrent bacterial pyoderma.
             c.  Yeast dermatitis.
             d.  Demodectic infection.
             e.  Primary seborrhea
 2.  Selecting appropriate allergens for testing and immunotherapy.
 3.  Give clients realistic expectations and follow each individual case
                carefully to control complications
 
 -  Safest long term therapy -  DOES NOT WORK EVERY TIME!!
 - 65 to 75% of patients will show favorable response to allergen immunotherapy, whether with oral vaccine or injections or have their requirement for cortisone and other drugs reduced significantly.
 -  Response is slow - expect to see improvement in 6 to 9 months.
 - Do not give up hope for 1 year.
 - Most patients will require treatment for life. Stopping allergen therapy on patients that have responded will result in reoccurrence of signs and symptoms of atopic disease in 90% of patients.


Each Case Must Be Managed Individually!

 

 

 

 

SKIN TESTING vs In Vitro TESTING

 

Skin Testing - Many variations determined by the tester.

  - Intradermal injection of diluted allergens selected by the clinician administering the test.

  - Immediate results scored by the clinician - subjective interpretation. Usually requires sedation and clipping of

    hair.

  - Corticosteroid and histamine cause serious interference.

  - Some patients have "reactive skin" and show clinically insignificant reactions.

  - Fresh test solutions of appropriate allergens must be prepared often - once a month recommended.

REFERRALS ARE REQUIRED TO MAKE SKIN TESTING PROFITABLE IN A VETERINARY PRACTICE.

 

 

In Vitro Testing (Blood Sample Sent To Lab)

 

   - Testing the patient’s serum for levels of IgE antibodies specific for environmental and food allergens.
   - Much more convenient than skin testing.
   - Sedation and clipping of hair not required.
   - Drugs like antihistamine and corticosteroid do not interfere with VARL Liquid Gold test.
   - New VARL Liquid Gold technology has improved reliability.

 

 

 

Two categories of serum allergy tests are available  commercially in the U.S.A.  Both categories measure serum allergen-specific IgE levels.

 

1.   VARL Liquid Gold                           

2.   ELISA/RAST

 

VARL Liquid Gold is the next generation of serum allergy testing developed after a decade of experience with ELISA and RAST indicate that a new and better technology was needed to overcome the high incidence of false positive results notorious with ELISA/RAST allergy tests.

 

Liquid Gold may not have been the first allergy test, but it is the first liquid-phase test where you can be certain that you will not be treating false positives.

 

Some labs test routinely for less than 25 allergens; others test for more. Testing for individual allergens is preferred over testing for allergen groups. VARL Liquid Gold routinely tests for 40 individual allergens that are selected based on zip codes for each geographical region.  Comprehensive panel of individual food allergy tests are also offered for a more complete work-up.

 

FOOD ALLERGY

 

- Onset at any age
- Not apt to be seasonal
- Small percentage of cases respond favorably to corticosteroid
- Otitis is common early finding (up to 80% )
- Intense pruritus about head and neck in cats (many reports)
- Signs involving other body systems are occasionally reported (GI signs, seizures, behavioral changes, etc.)
- May be present in conjunction with other allergies and will contribute to the pruritic threshold i.e. level of allergen load above where clinical signs result.
- “New Food” is seldom the cause of food allergy.  In proven food allergic cases, the offending foods have been fed for 3 to 12 months.
- No such thing as “Hypoallergenic Diet”.  Many special or “limited allergen” diets are available. 
- Consider the importance of good nutrition to skin health.

 

Food Allergy Testing       

Much more complex compared to environmental allergens. One reason is that foods undergo changes during processing and digestion.

 

- Elimination diets lasting 6 to 12 weeks is considered to be the method of choice.  Feed a single protein source and a single carbohydrate source that the patient has not eaten before.  Very frustrating for both clients and practitioners!  Skin testing for food allergy not reliable.

 

- VARL Liquid Gold food allergy testing uses epitopes of cooked/denatured proteins and has proven to be helpful in selecting appropriate elimination diets. VARL Liquid Gold offers a comprehensive panel of individual food allergy tests for a more complete work-up of allergic dogs and cats.

  

 

Our Position on Food Allergy Testing

 

The controversy over food allergy testing is not whether it is IgE antibody mediated or not.  Food allergy is an IgE antibody-mediated disease.  There may be other components that lead to such manifestations as food intolerance or bowel irritations.  If we are limiting the problem to strictly allergic reactions, IgE antibodies must be the mediators of the reaction. In our testing, if we find IgE antibody specific for a particular food item we are certain that the IgE to that food is really present.  We are also able to detect the specific IgE antibodies with Western blots.  How much it is contributing to the overall clinical symptoms is hard to determine.  We would suggest diets that do not contain the ingredients to be tried for the patient.  Why food allergy testing will remain controversial is because it is far more complex than environmental allergens.  For example, Timothy Grass pollen will always remain Timothy Grass pollen with no alteration to its allergenic potential.  On the other hand, foods are prepared before ingestion and the mode of preparation may alter their allergenicity.  We know from human studies that there are individuals who have severe allergic reaction to roasted peanuts.  However, some of these individuals can eat boiled peanut without any reaction.  Roasted peanuts bind IgE at higher levels than raw peanuts.  It has also been shown that frying or boiling of peanuts reduce their allergenicity as compared to peanuts that are dry roasted.  Depending on what form of peanut is used for testing would therefore determine the result obtained. 

 

Foods also undergo digestion and changes in the gastrointestinal tract may further modify the initial proteins ingested.  Our analyses with Western blots indicate that some patients are reacting to epitopes in partially digested materials that are not revealed in the intact proteins in some foods.  Two individuals with severe allergy to shrimp unknowingly ingested meal containing ground shrimp used as flavoring.  Within one hour one of these individuals suffered an anaphylactic reaction and was saved by paramedics.  The other individual showed no sign of reaction until eight hours later when he erupted with severe rashes all over his body.  Here we see two different individuals reacting to the same allergen, but at different stages of digestion.

 

We suggest that food allergy testing should be used not as a diagnostic tool, as it is generally used for environmental allergens, but rather as a guide for which food to avoid and as a starting point for food trial.  When clients have paid for food allergy testing we have found that their compliance to stick to the diet suggested based on test results is quite high.  Ultimately, each practitioner must decide if testing for food allergy will be to the benefit of their patient.  We believe that they will find that it is.

 

 

 References

Beyer, Kirsten et al. Effects of cooking methods on peanut allergenicity.

J. Allergy Clin Immunol 2001;107:1077-1081.

Moneret-Vautrin, D. et al. Cross-allergenicity of peanut and lupine: The risk of lupine allergyin patients allergic to peanuts. J Allergy Clin Immunol 1999;104:883-888

Maleki, Soheila J. et al. The effects of  roasting on the allergenic properties of peanut proteins.

J. Allergy Clin Immunol 2000;106:763-768

Mittag, D. et al. Ara h 8, aBet v1-homologous allergen from peanut, is a major allergen in

patients with combined birch pollen and peanut allergy.

J. Allergy Clin Immunol 2004;114:14101417

Sicherer, Scott H. Clinical implications of cross-reactive food allergens. J. Allergy Clin Immunol 2001;108:881-890

 

FLEA ALLERGY

- One of the most common hypersensitivity disorder in dogs and cats
- Onset at any age with multiple mechanisms for mediation - not always totally IgE-mediated.  When it is IgE mediated, the hypersensitivity is measurable by in vitro tests.  Flea hypersensitivity is sometimes cell-mediated with delayed reaction - up to 10 days post exposure.  Negative in vitro test probably indicate cell-mediated basis and other mechanisms not quite understood.  There is no substitute for complete flea control!

 

- Hyposensitization for flea allergy is of questionable value.  Attempts at hyposensitization with flea allergen might make some cases worse!

- Complete flea control is attainable with products now on the market.

- Many cases of flea allergy will require at least some steroid.

- If atopy is controlled by hyposensitization, the flea allergy component will be more easily controlled.

 

 

With  VARL  Liquid Gold
You Will Not Be Treating False Positives ...
GUARANTEED !