p9208 ebcn derm specialists

8/12/2019 P9208 EBCN Derm Specialists

1/42

Hills Evidence-Based Clinical Nutrition

for Dermatology Specialists


2/42

Discover the most complete andclinically proven line of dermatologic

nutrition from Hills

HillsPrescription Dietd/d

Formulated to help manage inammatory skin conditions such as atopy,ea allergy dermatitis and otitis externa, as well as adverse reactions tofood, including food allergy and intolerance

Increased omega-3 fatty acids, including EPA, to nourish the skin andhelp manage inammation

Added antioxidants to help support skin barrier function

Available in a wide range of novel protein options: venison, duck,salmon, lamb, egg and rabbit

HillsPrescription Dietz/d

Effective as the gold standard (home prepared foods) fordiagnosing and managing adverse reactions to food including foodallergies and intolerance

Formulated with hydrolyzed animal proteins to eliminate the potentialfor an allergic response


HillsScience DietSensitive Skin

Formulated to meet the nutrient and energy needs of adult pets withsensitive skin

Increased levels of omega-6 and omega-3 fatty acids to nourish skinand coat



3/42

Discover the most complete andclinically proven line of dermatologic

nutrition from Hills


4/42

HillsPrescription Dietd/dCanine Canned

Adverse Reactions to Food & Inflammatory Skin Conditions

Gastrointestinal Disorders

KEY BENEFITS

Protein

Number of NovelProtein Formulas

Carbohydrate

Antioxidants

Single, novel animal sourceHighly digestibleReduced

Four

Potato or rice

Added

Helps avoid common food allergens.Limits the amount of undigested protein in the gastrointestinal tract able to provoke anallergic reaction.

Duck, salmon, venison and lamb provide more choices related to a suspected allergy orpatient preference.Allergies to potato or rice are uncommon.Help maintain a healthy immune system and the skin barrier function.

Indications

Iflammatr ki cditi uch a atp, fla allrg drmatiti ad titi xtra. Advr racti t fd (fd allrg r itlrac).

Additional information

Prescription Diet d/d Caninecanned foods contain a single, novel animal protein source(duck, salmon, venison and lamb) which is not generally associated with adverse reactions tofood in dogs. A limited number of digestible novel meat protein and carbohydrate ingredientshelp avoid common food allergies.

Prescription Diet d/d Caninefoods can help aid in the management of pruritic dermatitis,

chronic gastroenteritis or colitis, inflammatory bowel disease (IBD), chronic otitis externa, fleaallergy dermatitis, and contact dermatitis.

Supplementation is unnecessary (including fatty acid supplements) and may decrease theeffectiveness of the food.

Other products to consider

For use as an elimination diet (for maximum reliability in the identification of dietarysensitivity): Prescription Dietz/dULTRA Allrg-Fr Cai.

To manage and eliminate adverse reactions to food: Prescription Dietz/dULTRAAllrg-Fr Caior Prescription Dietz/dLw Allrg Cai.

Not recommended for

Growing puppies, pregnant or nursing dogs. Patients with hyperlipidemia, pancreatitis, history of pancreatitis or at risk of pancreatitis.

These characteristics make Prescription Diet d/d Canineveterinary exclusive pet foods useful as a nutritional aid for dogs with adverse reactions to food orcertain gastrointestinal disorders:

d/d Duck Formula Canine: Cans of 13 oz (7003) in cases of 12

d/d Lamb Formula Canine: Cans of 13 oz (7002) in cases of 12

d/d Salmon Formula Canine:Cans of 13 oz (7004) in cases of 12

d/d Venison Formula Canine:Cans of 13 oz (7005) in cases of 12

Disease Category:

Animal feeding tests using AAFCO procedures substantiatethat Prescription Dietd/dCanineprovides completeand balanced nutrition for the maintenance of adult dogs.The following ranges are a starting point only and shouldbe adjusted as needed to maintain proper weight. Mixincreasing amounts of the pets new food with decreasingamounts of the old food over a 7-day period.

BodyWight (lb)

VenIson,SALMON & DUCK

FORMULASCa() (13 z)

LAMBFORMULA

Ca() (13 z)

5 - 2/3 1/3-

10 - 1 2/3-

20 1 1/3- 1 1 - 1 1/3

40 2 - 3 1 2/3- 2 1/3

60 3 - 4 2 - 3

80 3 - 5 2 - 4

100 4 - 6 3 1/3- 4 2/3

1 cup i qual t 1ca. 1 ca i qual t 1cup.

DAILY FEEDING AMOUNTS


5/42

CANNEDINGREDIENTS

1-800-548-VETS (8387) .www.HillsVet.com

1. Differs from label guarantees which are either maximums or minimums. 2. The nutrient in the product after moisture is removed. It is used to make direct

comparisons of nutrient profiles with differing moisture contents. 3. Nutrient intake for every 100 kilocalories consumed.

AVERAGE NUTRIENT CONTENTS

Salmon Formula:Water, Salmon, Potato, Potato Starch, Potato Protein,Soybean Oil, Fish Oil, Powdered Cellulose, Dicalcium Phosphate, Iodized Salt,Vitamin E Supplement, Choline Chloride, DL-Methionine, Taurine, CalciumCarbonate, Ascorbic Acid (source of vitamin C), Zinc Oxide, Ferrous Sulfate,Niacin, Thiamine Mononitrate, Vitamin A Supplement, Beta-Carotene, CalciumPantothenate, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride,Manganous Oxide, Copper Sulfate, Riboflavin, Folic Acid, Cobalt Carbonate,Calcium Iodate, Sodium Selenite.

Venison Formula:Water, Venison, Potato, Potato Starch, Potato Protein,Soybean Oil, Powdered Cellulose, Fish Oil, Calcium Carbonate, DicalciumPhosphate, Iodized Salt, Taurine, DL-Methionine, Choline Chloride, VitaminE Supplement, L-Tryptophan, Ascorbic Acid (source of vitamin C), Zinc Oxide,Ferrous Sulfate, Beta-Carotene, Thiamine Mononitrate, Niacin, Copper Sulfate,Manganous Oxide, Calcium Pantothenate, Vitamin B12 Supplement, Vitamin ASupplement, Pyridoxine Hydrochloride, Biotin, Riboflavin, Vitamin D3 Supplement,Calcium Iodate, Folic Acid, Sodium Selenite, Menadione DimethylpyrimidinolBisulfite (source of vitamin K).

SALMON VENISON

As Fed1 Dry Matter2 As Fed, Caloric Basis3 As Fed1 Dry Matter2 As Fed, Caloric Basis3

Protein 4.6 % 18.9 % 4.7 g 4.6 % 18.9 % 4.2 g

Fat 3.6 % 14.8 % 3.7 g 4.0 % 16.4 % 3.7 g

Carbohydrate (NFE) 14.4 % 59.0 % 14.7 g 14.0 % 57.4 % 12.8 g

Crude Fiber 0.5 % 2.0 % 0.5 g 0.5 % 2.0 % 0.5 g

Calcium 0.19 % 0.78 % 194 mg 0.16 % 0.66 % 147 mg

Phosphorus 0.17 % 0.70 % 174 mg 0.13 % 0.53 % 119 mg

Sodium 0.08 % 0.33 % 82 mg 0.09 % 0.37 % 82 mg

Potassium 0.19 % 0.78 % 194 mg 0.21 % 0.86 % 192 mg

Magnesium 0.015 % 0.061 % 15 mg 0.015 % 0.061 % 14 mg

Taurine 0.71 % 2.91 % 725 mg 0.20 % 0.82 % 183 mg

METABOLIZABLE ENERGY

kcal/kg 979 4,012 1,091 4,471

kcal/can 362 404

% Calories From: Protein 17 Fat 32 Carbohydrates 51 Protein 16 Fat 34 Carbohydrates 50

CANNEDINGREDIENTS


Duck Formula:Water, Duck, Potato, Duck Liver, Potato Starch, Soybean Oil,Powdered Cellulose, Dicalcium Phosphate, Fish Oil, Calcium Carbonate, IodizedSalt, DL-Methionine, Taurine, Vitamin E Supplement, Potassium Chloride, CholineChloride, L-Tryptophan, Ascorbic Acid (source of vitamin C), Zinc Oxide, FerrousSulfate, Beta-Carotene, Thiamine Mononitrate, Niacin, Manganous Oxide,Copper Sulfate, Vitamin A Supplement, Calcium Pantothenate, Vitamin B12Supplement, Biotin, Riboflavin, Vitamin D3 Supplement, Pyridoxine Hydrochloride,Cobalt Carbonate, Calcium Iodate, Folic Acid, Sodium Selenite, MenadioneDimethylpyrimidinol Bisulfite (source of vitamin K).

Lamb Formula:Water, Rice, Lamb, Lamb Liver, Rice Flour, PowderedCellulose, Soybean Oil, Fish Oil, Calcium Carbonate, Potassium Chloride,Sodium Tripolyphosphate, Iron Oxide, Dicalcium Phosphate, Choline Chloride,Vitamin E Supplement, Taurine, Ascorbic Acid (source of vitamin C), Zinc Oxide,Ferrous Sulfate, Beta-Carotene, Thiamine Mononitrate, Manganous Oxide,Niacin, Calcium Pantothenate, Vitamin B12 Supplement, PyridoxineHydrochloride, Biotin, Vitamin D3 Supplement, Riboflavin, Calcium Iodate,Folic Acid, Sodium Selenite.

DUCK LAMB

As Fed1 Dry Matter2 As Fed, Caloric Basis3 As Fed1 Dry Matter2 As Fed, Caloric Basis3

Protein 4.3 % 17.4 % 4.5 g 4.6 % 15.8 % 3.5 g

Fat 4.1 % 16.6 % 4.3 g 7.8 % 26.8 % 5.9 g

Carbohydrate (NFE) 14.4 % 58.3 % 15.0 g 14.2 % 48.8 % 10.7 g

Crude Fiber 0.5 % 2.0 % 0.5 g 1.0 % 3.4 % 0.8 g

Calcium 0.20 % 0.81 % 208 mg 0.17 % 0.58 % 128 mg

Phosphorus 0.17 % 0.69 % 177 mg 0.09 % 0.31 % 68 mg

Sodium 0.09 % 0.36 % 94 mg 0.10 % 0.34 % 75 mg

Potassium 0.22 % 0.89 % 229 mg 0.21 % 0.72 % 158 mg

Magnesium 0.016 % 0.065 % 17 mg 0.018 % 0.062 % 14 mg

Total Omega-3 Fatty Acids 0.20 % 0.81 % 208 mg 0.33 % 1.13 % 248 mg


kcal/kg 961 3,891 1,330 4,570

kcal/can 356 492

% Calories From: Protein 15 Fat 35 Carbohydrates 50 Protein 12 Fat 50 Carbohydrates 38


6/42

Rice &Egg

Potato &Salmon

Potato &Venison

Potato &Duck

HillsPrescription Dietd/dCanine Dry



Indications

Iflammatr ki cditi uch a atp, fla allrg drmatiti ad titi xtra. Advr racti t fd (fd allrg r itlrac).


Prescription Diet d/d Caninefoods contain a single, novel animal protein source (egg,duck, salmon and venison) which is not generally associated with adverse reactions to foodin dogs. A limited number of digestible novel meat protein and carbohydrate ingredients helpavoid common food allergies.

Prescription Diet d/d Caninefoods can help aid in the management of pruritic dermatitis,

chronic gastroenteritis or colitis, inflammatory bowel disease (IBD), chronic otitis externa, fleaallergy dermatitis, and contact dermatitis.

Supplementation is unnecessary (including fatty acid supplements) and may decrease theeffectiveness of the food.


For use as an elimination diet (for maximum reliability in the identification of dietarysensitivity): Prescription Dietz/dULTRA Allrg-Fr Cai.

To manage and eliminate adverse reactions to food: Prescription Dietz/dULTRAAllrg-Fr Caior Prescription Dietz/dLw Allrg Cai.

Not recommended for

Growing puppies, pregnant or nursing dogs. Patients with hyperlipidemia, pancreatitis, history of pancreatitis or at risk of pancreatitis.

Disease Category:

Animal feeding tests using AAFCO procedures substantiatethat Prescription Dietd/dCanineprovides completeand balanced nutrition for the maintenance of adult dogs.The following ranges are a starting point only and shouldbe adjusted as needed to maintain proper weight. Mixincreasing amounts of the pets new food with decreasingamounts of the old food over a 7-day period.

BodyWight

(lb)

RICE & EGGFORMULASDry Cups

POTATO &DUCK

FORMULADry Cups

POTATO &VENISONFORMULA

ANDPOTATO &SALMONFORMULADry Cups

5 - 5/8 - 2/3 - 2/3

10 - 1 1/8 - 1 1/8 - 1 1/8

20 1 1/3- 1 1 1/3- 1 1 1/3- 1

40 2 - 3 2 - 3 2 - 3

60 3 - 4 3 - 4 3 - 4

80 3 2/3- 5 3 - 5 3 - 5

100 4 1/3- 6 4 - 6 4 - 6

1 cup i qual t 1ca. 1 ca i qual t 1cup.


d/d Ric & egg Frmula Cai:Bags of 8 lbs (5645) and 17.6 lbs (5646)

d/d Potato & Duck Formula Canine:Bags of 8 lbs (5347) and 17.6 lbs (5343)

d/d Potato & Venison Formula Canine: Bags of 8 lbs (5348) and 17.6 lbs (5342)

d/d Potato & Salmon Formula Canine:Bags of 8 lbs (5346) and 17.6 lbs (5345)

KEY BENEFITS

Protein


Carbohydrate

Antioxidants

Single, novel animal sourceHighly digestibleReduced

Four

Potato or rice

Added


Duck, salmon, venison and egg provide more choices related to a suspected allergy orpatient preference.Allergies to potato or rice are uncommon.Help maintain a healthy immune system and the skin barrier function.

These characteristics make Prescription Diet d/d Canineveterinary exclusive pet foods useful as a nutritional aid for dogs with adverse reactions to food orcertain gastrointestinal disorders:


7/42

As Fed1 Dry Matter2 As Fed, Caloric Basis3

Protein 17.0 % 18.5 % 4.4 g

Fat 15.2 % 16.5 % 3.9 g

Carbohydrate (NFE) 54.9 % 59.7 % 14.1 g

Crude Fiber 1.0 % 1.1 % 0.3 g

Calcium 0.55 % 0.60 % 142 mg

Phosphorus 0.46 % 0.50 % 118 mg

Sodium 0.26 % 0.28 % 67 mg

Potassium 0.64 % 0.70 % 165 mg

Magnesium 0.062 % 0.067 % 16 mg

Taurine 0.64 % 0.70 % 165 mg


kcal/kg 3,885 4,223kcal/cup 383

Weight oz/cup 3.5

Cups per lb 4.6

% Calories From: Protein 16 Fat 34 Carbohydrates 50

DRYINGREDIENTS





Ric ad egg Frmula:Brewers Rice, Dried Egg Product, Pork Fat (preserved with mixed tocopherols and citric acid), Natural Flavor, Soybean Oil, PowderedCellulose, Dicalcium Phosphate, Fish Oil, Potassium Chloride, Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiaminemononitrate, vitamin A supplement, calcium pantothenate, biotin, vitamin B12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3 supplement),Calcium Carbonate, Vitamin E Supplement, Choline Chloride, Iodized Salt, Taurine, preserved with Mixed Tocopherols, Citric Acid & Ethoxyquin, Minerals (ferroussulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), Beta-Carotene, Rosemary Extract.


Protein 16.6 % 18.0 % 4.5 g

Fat 15.6 % 17.0 % 4.2 g


Crude Fiber 1.5 % 1.6 % 0.4 g

Calcium 0.73 % 0.79 % 196 mg

Phosphorus 0.53 % 0.58 % 143 mg

Sodium 0.33 % 0.36 % 89 mg

Potassium 0.72 % 0.78 % 194 mg

Magnesium 0.066 % 0.072 % 18 mg

Total Omega-3 Fatty Acids 0.72 % 0.78 % 194 mg


kcal/kg 3,719 4,042

kcal/cup 366

Weight oz/cup 3.5

Cups per lb 4.6


DRYINGREDIENTS


Potato and Duck Formula:Potato, Potato Starch, Duck, Potato Protein, Pork Fat (preserved with mixed tocopherols and citric acid), Soybean Oil, Natural Flavor, DicalciumPhosphate, Potassium Chloride, Powdered Cellulose, Fish Oil, Iodized Salt, Calcium Carbonate, Duck By-Product Meal, Choline Chloride, Vitamins (l-ascorbyl-2-polyphosphate[source of vitamin C], vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, biotin, vitamin B12 supplement, pyridoxinehydrochloride, riboflavin, folic acid, vitamin D3 supplement), DL-Methionine, Vitamin E Supplement, Taurine, Glycerol Monostearate, Minerals (ferrous sulfate, zinc oxide, coppersulfate, manganous oxide, calcium iodate, sodium selenite), L-Tryptophan, preserved with Mixed Tocopherols, Citric Acid and Ethoxyquin, Beta-Carotene, Rosemary Extract.


8/42


Protein 16.6 % 18.0 % 4.5 gFat 15.2 % 16.5 % 4.1 g


Crude Fiber 1.5 % 1.6 % 0.4 g

Calcium 0.73 % 0.79 % 197 mg

Phosphorus 0.52 % 0.57 % 140 mg

Sodium 0.33 % 0.36 % 89 mg

Potassium 0.72 % 0.78 % 194 mg

Magnesium 0.064 % 0.070 % 17 mg

Taurine 0.71 % 0.77 % 191 mg


kcal/kg 3,711 4,034

kcal/cup 366

Weight oz/cup 3.5

Cups per lb 4.6


DRYINGREDIENTS




Potato and Venison Formula:Potato, Potato Starch, Venison, Potato Protein, Pork Fat (preserved with mixed tocopherols and citric acid), Soybean Oil,Natural Flavor, Dicalcium Phosphate, Potassium Chloride, Powdered Cellulose, Venison Meal, Fish Oil, Iodized Salt, Calcium Carbonate, Choline Chloride, Vitamins(l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, biotin, vitaminB12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3 supplement), DL-Methionine, Vitamin E Supplement, Taurine, Glycerol Monostearate,Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), L-Tryptophan, preserved with Mixed Tocopherols, Citric Acidand Ethoxyquin, Beta-Carotene, Rosemary Extract.


Protein 16.6 % 18.0 % 4.5 g

Fat 15.2 % 16.5 % 4.1 g


Crude Fiber 1.6 % 1.7 % 0.4 g

Calcium 0.74 % 0.80 % 199 mg

Phosphorus 0.53 % 0.58 % 143 mg

Sodium 0.34 % 0.37 % 92 mg

Potassium 0.75 % 0.82 % 202 mg

Magnesium 0.070 % 0.076 % 19 mg



kcal/kg 3,710 4,033

kcal/cup 366

Weight oz/cup 3.5

Cups per lb 4.6


DRYINGREDIENTS


Potato and Salmon Formula:Potato, Potato Starch, Salmon, Potato Protein, Pork Fat (preserved with mixed tocopherols and citric acid), Soybean Oil,Natural Flavor, Dicalcium Phosphate, Fish Meal, Potassium Chloride, Powdered Cellulose, Fish Oil, Iodized Salt, Calcium Carbonate, Choline Chloride, Vitamins(l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, biotin, vitaminB12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3 supplement), Vitamin E Supplement, DL-Methionine, Taurine, Glycerol Monostearate,Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), preserved with Mixed Tocopherols, Citric Acid and

Ethoxyquin, L-Tryptophan, Beta-Carotene, Rosemary Extract.


9/421-800-548-VETS (8387) .www.HillsVet.com


10/42

HillsPrescription Dietz/dULTRA Allrg-Fr Cai



KEY BENEFITS

Protein

Carbohydrate

omga-3 Fatt Acidomga-6 Fatt Acid

Antioxidants

Hydrolyzed

Refined

Increased

Added

Highly digestible animal protein source with an average molecular weight


11/42


Protein 4.8 % 19.6 % 4.9 g

Fat 3.4 % 13.9 % 3.5 gCarbohydrate (NFE) 13.9 % 56.7 % 14.3 g

Crude Fiber 1.1 % 4.5 % 1.1 g

Calcium 0.18 % 0.73 % 185 mg

Phosphorus 0.14 % 0.57 % 144 mg

Sodium 0.05 % 0.20 % 51 mg

Potassium 0.16 % 0.65 % 164 mg

Magnesium 0.014 % 0.057 % 14 mg


Total Omega-6 Fatty Acids 0.99 % 4.04 % 1,017 mg


kcal/kg 973 3,971

kcal/can small (5.5 oz): 152; large (13 oz): 360


CANNEDINGREDIENTS


Water, Hydrolyzed Chicken Liver, Corn Starch, Powdered Cellulose, Soybean Oil, Dicalcium Phosphate,Calcium Carbonate, Potassium Citrate, DL-Methionine, Choline Chloride,Iodized Salt, Vitamin E Supplement, Taurine, Ascorbic Acid (source of vitamin C), L-Threonine, Zinc Oxide, Ferrous Sulfate, L-Tryptophan, Beta-Carotene, Thiamine Mononitrate,Copper Sulfate, Manganous Oxide, Niacin, Calcium Pantothenate, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Biotin, Calcium Iodate, Vitamin D3 Supplement,Riboflavin, Sodium Selenite, Folic Acid.

DRYINGREDIENTS


Starch, Hydrolyzed Chicken Liver, Soybean Oil (preserved with BHA, propyl gallate and citric acid), Hydrolyzed Chicken, Powdered Cellulose, Dicalcium Phosphate, CalciumCarbonate, Glyceryl Monostearate, Potassium Chloride, Iodized Salt, Choline Chloride, Vitamins (vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement,l-ascorbyl-2-polyphosphate [source of vitamin C], calcium pantothenate, biotin, vitamin B12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3 supplement),DL-Methionine, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), Taurine, Ethoxyquin (a preservative), Beta-Carotene.


Protein 17.5 % 19.0 % 4.7 g

Fat 12.8 % 13.9 % 3.4 g


Crude Fiber 2.5 % 2.7 % 0.7 g

Calcium 0.61 % 0.66 % 164 mg

Phosphorus 0.47 % 0.51 % 126 mg

Sodium 0.27 % 0.29 % 73 mg

Potassium 0.61 % 0.66 % 164 mg

Magnesium 0.050 % 0.054 % 13 mg




kcal/kg 3,724 4,048

kcal/cup 254

Weight oz/cup 2.4

Cups per lb 6.6






12/42

HillsPrescription Dietz/dLw Allrg Cai



KEY BENEFITS

Protein

Carbohydrate


Antioxidants

Hydrolyzed

Single source

Increased

Added



13/42


Protein 18.9 % 20.5 % 5.1 g

Fat 12.0 % 13.0 % 3.3 g


Crude Fiber 3.2 % 3.5 % 0.9 g

Calcium 0.57 % 0.62 % 155 mg

Phosphorus 0.49 % 0.53 % 133 mg

Sodium 0.36 % 0.39 % 98 mg

Potassium 1.20 % 1.30 % 326 mg

Magnesium 0.089 % 0.097 % 24 mg




kcal/kg 3,679 3,999

kcal/cup 363

Weight oz/cup 3.5

Cups per lb 4.6


DRYINGREDIENTS





Dried Potato Product, Hydrolyzed Chicken Liver, Potato Starch, Soybean Oil (preserved with BHA, propyl gallate and citric acid), Hydrolyzed Chicken, Powdered Cellulose,Calcium Sulfate, Dicalcium Phosphate, Glyceryl Monostearate, Iodized Salt, Choline Chloride, Vitamins (vitamin E supplement, l-ascorbyl-2-polyphosphate [source of vitaminC], niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, biotin, vitamin B12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3supplement), Calcium Carbonate, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), DL-Methionine, Taurine, Ethoxyquin(a preservative), Beta-Carotene.


14/42

Venison &Green Pea

Duck & GreenPea

Rabbit & GreenPea

HillsPrescription Dietd/dFeline



KEY BENEFITS

Protein


Carbohydrate

Antioxidants

Single, novel animal sourceHighly digestible

Three

Green pea

Added


Duck, rabbit or venison provide more choices related to a suspected allergy orpatient preference.Allergies to green pea are uncommon.Help maintain a healthy immune system and the skin barrier function.

Indications

Iflammatr ki cditi uch a atp, fla allrg drmatiti ad fliiphilic graulma cmplx

Advr racti t fd (fd allrg r itlrac).


Prescription Diet d/d Felinefoods contain a single, novel animal protein source (duck, rabbit, orvenison) which is not generally associated with adverse reactions to food in cats.

Prescription Diet d/d Felinefoods may help aid in the management of the following:Pruritic dermatitis: Adverse food reactions in cats typically occur as pruritic dermatitis, with orwithout concurrent gastrointestinal signs.

Chric gatrtriti, chric cliti:Adverse food reactions can result in chronic vomitingand/or diarrhea associated with gastrointestinal inflammation; mildly affected cats may only show anincrease in the number of bowel movements or may have occasional vomiting.Iflammatr bwl dia (IBD):Adverse reactions to food may potentiate IBD.Atpic drmatiti, fd allrgand fla allrgcan occur in the same patient concurrently.Allrgic drmatitipatients may have clinical signs of eosinophilic granuloma complex.Ctact drmatiti.

Supplementation beyond the analogous canned or dry formula (including fatty acid supplements) isunnecessary and may decrease the effectiveness of the food.


For use as an elimination food, for patients with IBD, or to manage and eliminateadverse reactions to food: Prescription Dietz/dULTRAAllrg-Fr Fli andPrescription Dietz/d Lw Allrg Fli.

Not recommended for

Growing kittens, pregnant or nursing cats. Patients with concurrent use of urinary acidifiers.

These characteristics make Prescription Diet d/d Felineveterinary exclusive pet foods useful as a nutritional aid for dogs with adverse reactions to food:

d/d Duck Formula Feline:Cans of 5.5 oz (5364) in cases of 24d/d Venison Formula Feline: Cans of 5.5 oz (5365) in cases of 24d/d Duck & Green Pea Formula Feline:Bags of 3.5 lbs (5351) and 8.5 lbs (5355)d/d Rabbit & Green Pea Formula Feline:Bags of 3.5 lbs (5352) and 8.5 lbs (5357)d/d Venison & Green Pea Formula Feline:Bags of 3.5 lbs (5350) and 8.5 lbs (5356)

Disease Category:

Animal feeding tests using AAFCO procedures substantiatethat Prescription Dietd/dFelineprovides completeand balanced nutrition for the maintenance of adult cats.The following ranges are a starting point only and shouldbe adjusted as needed to maintain proper weight. Mixincreasing amounts of the pets new food with decreasingamounts of the old food over a 7-day period.

BodyWight (lb)

ALL CANNEDFORMULAS

Ca() (5.5 z)

ALL DRYFORMULASDry Cups

5 2/3- 1 - 3/8

10 1 - 1 2/3 - 5/8

15 1 - 2 5/8- 7/8


1 cup i qual t 2 5/8ca.1 ca i qual t 3/8cup.1 cup i qual t 2 ca (vi frmula l).


15/42


Protein 10.1 % 38.1 % 8.4 g

Fat 7.7 % 29.1 % 6.4 g


Crude Fiber 1.2 % 4.5 % 1.0 g

Calcium 0.21 % 0.79 % 174 mg

Phosphorus 0.20 % 0.75 % 165 mg

Sodium 0.08 % 0.30 % 66 mg

Potassium 0.25 % 0.94 % 207 mg

Magnesium 0.022 % 0.083 % 18 mg

Taurine .015 % 0.57 % 124 mg


METABOLIZABLE ENERGYkcal/kg 1,209 4,562

kcal/can 189


CANNEDINGREDIENTS


Duck Formula:Water, Duck, Duck Liver, Ground Green Pea, Powdered Cellulose, Soybean Oil, Pea Protein Concentrate, Brewers Dried Yeast,Fish Oil, Glucose, Calcium Carbonate, DL-Methionine, Dicalcium Phosphate, Taurine, L-Cysteine, Choline Chloride, Iron Oxide, Glycine, PotassiumChloride, Iodized Salt, Vitamin E Supplement, Potassium Citrate, Thiamine Mononitrate, Ascorbic Acid (source of vitamin C), Zinc Oxide, FerrousSulfate, Thiamine Hydrochloride, Niacin, Pyridoxine Hydrochloride, Beta-Carotene, Manganous Oxide, Calcium Pantothenate, Vitamin B12Supplement, Riboflavin, Biotin, Vitamin D3 Supplement, Calcium Iodate, Folic Acid, Sodium Selenite.





Protein 9.7 % 37.3 % 7.7 g

Fat 7.9 % 30.4 % 6.3 g


Crude Fiber 1.2 % 4.6 % 1.0 g

Calcium 0.21 % 0.81 % 166 mg

Phosphorus 0.19 % 0.73 % 150 mg

Sodium 0.09 % 0.35 % 71 mg

Potassium 0.24 % 0.92 % 190 mg

Magnesium 0.023 % 0.088 % 18 mg

Taurine 0.10 % 0.38 % 79 mg



kcal/kg 1,263 4,858

kcal/can 197


CANNEDINGREDIENTS


Venison Formula:Venison, Water, Venison Liver, Ground Green Pea, Pea Protein Concentrate, Soybean Oil, Powdered Cellulose, Fish Oil,DL-Methionine, Choline Chloride, Calcium Carbonate, Iron Oxide, Calcium Sulfate, Iodized Salt, Potassium Chloride, Taurine, Dicalcium Phosphate,Vitamin E Supplement, Thiamine Mononitrate, Ascorbic Acid (source of vitamin C), Zinc Oxide, Ferrous Sulfate, Beta-Carotene, Niacin, ManganousOxide, Copper Sulfate, Pyridoxine Hydrochloride, Calcium Pantothenate, Vitamin B12 Supplement, Riboflavin, Biotin, Vitamin D3 Supplement,Calcium Iodate, Folic Acid, Sodium Selenite.


16/42


Protein 30.1 % 32.0 % 7.9 g

Fat 20.9 % 22.2 % 5.5 g


Crude Fiber 4.7 % 5.0 % 1.2 g

Calcium 0.69 % 0.73 % 182 mg

Phosphorus 0.69 % 0.73 % 182 mg

Sodium 0.32 % 0.34 % 84 mg

Potassium 0.89 % 0.95 % 235 mg

Magnesium 0.111 % 0.118 % 29 mg

Taurine 0.34 % 0.36 % 90 mg



kcal/kg 3,794 4,036

kcal/can 460

Weight oz/cup 4.3

Cups per lb 3.7


DRYINGREDIENTS


Rabbit & Green Pea Formula:Pea Protein Concentrate, Rabbit, Pea Bran Meal, Ground Green Peas, Pork Fat (preserved with mixedtocopherols and citric acid), Rabbit Meal, Soybean Oil, Calcium Sulfate, Natural Flavor, Fish Oil, DL-Methionine, Dicalcium Phosphate, Choline

Chloride, L-Cystene, Iodized Salt, Taurine, Calcium Carbonate, Vitamin E Supplement, Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C],vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, riboflavin, biotin, vitamin B12 supplement,pyridoxine hydrochloride, folic acid, vitamin D3 supplement), Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calciumiodate, sodium selenite), preserved with Mixed Tocopherols, Citric Acid and Ethoxyquin, Beta-Carotene, Rosemary Extract.

DRYINGREDIENTS

Duck & Green Pea Formula:Pea Protein Concentrate, Duck, Pea Bran Meal, Ground Green Peas, Pork Fat (preserved with mixed tocopherolsand citric acid), Duck Meal, Soybean Oil, Calcium Sulfate, Natural Flavor, Fish Oil, Choline Chloride, DL-Methionine, Iodized Salt, L-Cysteine,Taurine, Dicalcium Phosphate, Vitamin E Supplement, Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin,thiamine mononitrate, vitamin A supplement, calcium pantothenate, riboflavin, biotin, vitamin B12 supplement, pyridoxine hydrochloride, folicacid, vitamin D3 supplement), Potassium Sulfate, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodiumselenite), preserved with Mixed Tocopherols, Citric Acid and Ethoxyquin, Beta-Carotene, Rosemary Extract.


Protein 30.1 % 32.0 % 7.8 g

Fat 22.5 % 23.9 % 5.9 g


Crude Fiber 4.7 % 5.0 % 1.2 g

Calcium 0.68 % 0.72 % 177 mg

Phosphorus 0.68 % 0.72 % 177 mg

Sodium 0.38 % 0.40 % 99 mg

Potassium 0.94 % 1.00 % 245 mg

Magnesium 0.104 % 0.111 % 27 mg

Taurine 0.35 % 0.37 % 91 mg

Total Omega-3 Fatty Acids 0.70 % 0.74 % 182 mgMETABOLIZABLE ENERGY

kcal/kg 3,842 4,087

kcal/can 466

Weight oz/cup 4.3

Cups per lb 3.7




17/42

DRYINGREDIENTS

Venison & Green Pea Formula:Pea Protein Concentrate, Venison, Pea Bran Meal, Ground Green Peas, Pork Fat (preserved with mixedtocopherols and citric acid), Venison Meal, Soybean Oil, Calcium Sulfate, Natural Flavor, Fish Oil, Choline Chloride, DL-Methionine, L-Cysteine,Iodized Salt, Taurine, Vitamin E Supplement, Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiaminemononitrate, vitamin A supplement, calcium pantothenate, riboflavin, biotin, vitamin B12 supplement, pyridoxine hydrochloride, folic acid, vitaminD3 supplement), Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), preserved with MixedTocopherols, Citric Acid and Ethoxyquin, Beta-Carotene, Rosemary Extract.


Protein 30.1 % 32.0 % 7.8 g

Fat 21.4 % 22.8 % 5.5 g


Crude Fiber 4.6 % 4.9 % 1.2 g

Calcium 0.79 % 0.84 % 204 mg

Phosphorus 0.70 % 0.74 % 181 mg

Sodium 0.28 % 0.30 % 72 mg

Potassium 0.90 % 0.96 % 232 mg

Magnesium 0.109 % 0.116 % 28 mg

Taurine 0.35 % 0.37 % 90 mg

Total Omega-3 Fatty Acids 0.68 % 0.72 % 176 mgMETABOLIZABLE ENERGY

kcal/kg 3,872 4,119

kcal/can 470

Weight oz/cup 4.3

Cups per lb 3.7







18/42

HillsPrescription Dietz/dULTRA Allrg-Fr Fli



KEY BENEFITS

Protein

Carbohydrate


Antioxidants

Hydrolyzed

Refined source

HighIncreased

Added



19/42


Protein 8.9 % 33.7 % 8.2 g

Fat 4.8 % 18.2 % 4.4 gCarbohydrate (NFE) 10.7 % 40.5 % 9.9 g

Crude Fiber 0.4 % 1.5 % 0.4 g

Calcium 0.19 % 0.72 % 176 mg

Phosphorus 0.17 % 0.64 % 157 mg

Sodium 0.08 % 0.30 % 74 mg

Potassium 0.21 % 0.80 % 194 mg

Magnesium 0.017 % 0.064 % 16 mg

Taurine 0.10 % 0.38 % 93 mg




kcal/kg 1,081 4,095

kcal/can 169


CANNEDINGREDIENTS


Hydrolyzed Chicken Liver, Water, Corn Starch, Soybean Oil, Powdered Cellulose, Calcium Carbonate, DL-Methionine, Potassium Chloride,Dicalcium Phosphate, Choline Chloride, Iodized Salt, Vitamin E Supplement, Taurine, Calcium Sulfate, Thiamine Mononitrate, Zinc Oxide,Ascorbic Acid (source of vitamin C), Ferrous Sulfate, Niacin, Beta-Carotene, Manganous Oxide, Copper Sulfate, Pyridoxine Hydrochloride, CalciumPantothenate, Vitamin B12 Supplement, Riboflavin, Biotin, Vitamin D3 Supplement, Calcium Iodate, Folic Acid, Sodium Selenite.





20/42

HillsPrescription Dietz/dLw Allrg Fli



KEY BENEFITS

Protein

Carbohydrate


Antioxidants

Hydrolyzed

Single source

HighIncreased

Added



21/42


Protein 37.0 % 40.0 % 9.7 g

Fat 15.9 % 17.2 % 4.2 g


Crude Fiber 1.7 % 1.8 % 0.4 g

Calcium 0.65 % 0.71 % 172 mg

Phosphorus 0.56 % 0.61 % 147 mg

Sodium 0.33 % 0.36 % 88 mg

Potassium 0.68 % 0.74 % 180 mg

Magnesium 0.067 % 0.072 % 18 mg

Taurine 0.21 % 0.23 % 55 mg




kcal/kg 3,797 4,105

kcal/cup 396

Weight oz/cup 3.7

Cups per lb 4.4


DRYINGREDIENTS


Rice Protein Concentrate, Brewers Rice, Hydrolyzed Chicken Liver, Soybean Oil (preserved with BHA, propyl gallate and citric acid), PowderedCellulose, Hydrolyzed Chicken, Calcium Carbonate, Potassium Chloride, Glyceryl Monostearate, Choline Chloride, Dicalcium Phosphate,Vitamins (vitamin E supplement, l-ascorbyl-2-polyphosphate [source of vitamin C], niacin, thiamine mononitrate, vitamin A supplement, calciumpantothenate, riboflavin, biotin, vitamin B12 supplement, pyridoxine hydrochloride, folic acid, vitamin D3 supplement), Iodized Salt, CalciumSulfate, Taurine, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), Ethoxyquin (apreservative), Beta-Carotene.





22/42

HillsScience DietSensitive Skin Adult Canine

Adult dg with itiv ki

KEY BENEFITS FOR PET OWNERS

Uiqu PrtiCombination for Skin Health

High Fatt Acid Lvl

Superior Antioxidant Formula

Naturally Preserved

High-quality protein, including egg protein and other essential amino acids provide key building blocks forhealthy skin and a shiny coat.

High levels of omega-6 and omega-3 fatty acids to nourish skin and help replenish its natural oils.

A higher level of vitamins E + C versus major competitive brands.A powerful combination of antioxidants helps keep the immune system healthy. Antioxidants are known to helpslow cell damage. Vitamins E and C are known to support healthy skin and coat.

Mixed tocopherols (a form of vitamin E) preserve freshness and great taste.

Recommended for

Adult dg 1 6 ar f ag with dr, flak, itch ad itiv ki.


Formulated with high levels of skin-essential nutrients: vitamins E and C, omega-6 andomega-3 fatty acids.

Supports skin and coat health to help avoid dry, flaky, itchy, sensitive skin, and dullunhealthy coat.

100% Guarantee pets will love the taste or consumers can return the unused portionfor a full refund.


For dogs with skin problems due to adverse reactions to food or inflammatory skin conditions:Prescription Dietz/dCanine orPrescription Dietd/dCanine.

Not recommended for

Puppies, pregnant or nursing dogs.

Sensitive Skin Adult Canine:

Bags of 4.5 lbs (8533), 17.5 lbs (8534) and 35 lbs (8535)

Disease Category:

Animal feeding tests using AAFCO procedures substantiatethat Science DietSensitive Skin Adult Caninedryfood provides complete and balanced nutrition for themaintenance of adult dogs. These ranges are a startingpoint only and should be adjusted to maintain properweight. Mix increasing amounts of the pets new foodwith decreasing amounts of the old food over a 7-dayperiod. For maximum benefit, this product must be fedas the only food. Use of supplements or mixing with anyother food is not recommended.

Bd Wight (lb) Dry Cups

5 - 5/8

10 3/4- 1 1/8

20 11

/3- 13

/4

40 2 - 3

60 3 - 4

80 3 2/3- 5

100 4 1/3- 6



23/42


Protein 25.3 % 27.5 % 6.7 g

Fat 16.0 % 17.4 % 4.2 g


Crude Fiber 1.3 % 1.4 % 0.3 g

Calcium 0.74 % 0.80 % 195 mg

Phosphorus 0.56 % 0.61 % 148 mg

Sodium 0.32 % 0.35 % 84 mg

Potassium 0.64 % 0.70 % 169 mg

Magnesium 0.078 % 0.085 % 21 mg



Vitamin C 305 mg/kg (ppm) 332 mg/kg (ppm) 8.05 mg

Vitamin E 559 mg/kg (ppm) 608 mg/kg (ppm) 14.75 IU/100 kcal


kcal/kg 3,791 4,121

kcal/cup 374

Weight oz/cup 3.5

Cups per lb 4.6


DRYINGREDIENTS


Brewers Rice, Ground Whole Grain Corn, Corn Gluten Meal, Pork Meal, Dried Egg Product, Soybean Oil, Flaxseed, Animal Fat (preserved withmixed tocopherols and citric acid), Chicken Liver Flavor, Potassium Chloride, L-Lysine, Iodized Salt, DL-Methionine, Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calcium pantothenate, biotin,vitamin B12 supplement, pyridoxine hydrochloride, riboflavin, folic acid, vitamin D3 supplement), Calcium Carbonate, Choline Chloride, VitaminE Supplement, L-Tryptophan, preserved with Mixed Tocopherols and Citric Acid, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganousoxide, calcium iodate, sodium selenite), Taurine, Beta-Carotene, Rosemary Extract.





24/42


25/42


Protein 32.3 % 35.1 % 8.3 g

Fat 20.4 % 22.2 % 5.2 g


Crude Fiber 0.7 % 0.8 % 0.2 g

Calcium 0.71 % 0.77 % 182 mg

Phosphorus 0.68 % 0.74 % 174 mg

Sodium 0.38 % 0.41 % 97 mg

Potassium 0.62 % 0.67 % 159 mg

Magnesium 0.056 % 0.061 % 14 mg

Taurine 0.19 % 0.21 % 49 mg



Vitamin C 240 mg/kg (ppm) 261 mg/kg (ppm) 6.15 mg

Vitamin E 829 IU/kg 901 IU/kg 21.23 IU/100 kcal


kcal/kg 3,904 4,243

kcal/cup 400

Weight oz/cup 3.6

Cups per lb 4.4


DRYINGREDIENTS


Brewers Rice, Corn Gluten Meal, Chicken By-Product Meal, Ground Whole Grain Corn, Animal Fat (preserved with mixed tocopherols and citricacid), Dried Egg Product, Soybean Oil, Chicken Liver Flavor, Potassium Chloride, Calcium Carbonate, Choline Chloride, DL-Methionine, L-Lysine,Vitamins (l-ascorbyl-2-polyphosphate [source of vitamin C], vitamin E supplement, niacin, thiamine mononitrate, vitamin A supplement, calciumpantothenate, riboflavin, biotin, vitamin B12 supplement, pyridoxine hydrochloride, folic acid, vitamin D3 supplement), Vitamin E Supplement,Iodized Salt, Taurine, Fish Oil, Minerals (ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), preservedwith Mixed Tocopherols and Citric Acid, Beta-Carotene, L-Tryptophan, Rosemary Extract.





26/42


27/42

EPA and DHA in cutaneous cellular membranes may decrease

inflammation through competition with AA for metabolic

enzymes or because of the anti-inflammatory nature of the

eicosanoids produced. The rationale for specifically administering

products high in GLA is that GLA can be incorporated into

the skin, where it is rapidly elongated to DGLA. Because skin

lacks desaturase enzymes, DGLA is not further metabolized

to arachidonic acid. As a result, DGLA competes with AA formetabolic enzymes. Thus there is a decrease in AA-derived

eicosanoids and an increase in the anti-inflammatory eicosanoids.

ALA is an omega-3 PUFA that is metabolized to EPA and

DHA and incorporated into the skin of normal dogs. Findings

suggest that atopic dermatitis in human beings is associated

with a deficiency of -6-desaturase activity, which prevents the

rapid conversion of ALA to EPA and DHA in atopic individuals.

Comparable studies using atopic dogs and cats have not been

published. However, one study suggested that subsets of atopic

dogs exist with different fatty acid metabolic capabilities.

The use of fatty acids for treating atopic dermatitis and chronic

pruritus has been extensively studied in dogs. Unfortunately, most

of these studies have been uncontrolled, nonblinded clinical trials

using low doses of fatty acids for short periods. Well-controlled

clinical studies using placebos and high doses of fatty acids for

six weeks or more showed decreased pruritus in 0 to more than

50% of the patients. Dogs who did not have decreased pruritus

still showed improvement in other clinical signs, including

less erythroderma and skin edema. The benefit of fatty acid

supplementation is maximized in dogs if other contributing

diseases such as adverse reactions to food, flea hypersensitivity,

bacterial pyoderma, and Malasseziadermatitis are controlled.

Overall, it is probably safe to inform clients that 50 to 65% of

dogs with allergic dermatitis and otitis externa will improve

with modification in fatty acid intake, if secondary bacterial and

yeast infections are controlled. Synergistic effects have been

documented between fatty acid supplementation and use of

other antipruritic agents such as antihistamines

and glucocorticoids.

The use of fatty acids for management of allergic skin disease and

papulocrustous (miliary) dermatitis in cats has been reported. More

than 50% of allergic cats may improve, based on the results of

uncontrolled, nonblinded clinical trials.

Recommendation for use of fatty acids for inflammatory skin disease in

dogs and cats: deliver 50 to 250 mg total omega-3 fatty acids/kg body

weight/day, or 0.8 to 3.0% total omega-3 fatty acids in the food (dry

matter basis) with omega-6 to omega-3 ratio of 2:1 to 5:1.

Use of fatty acid supplementation for patients

with arthritis

Canine models have been widely used to study the biological and

molecular mechanisms involved in cartilage matrix degradation

as the pathogenesis of degenerative joint disease progresses.

Mechanisms of cartilage metabolism in canine osteoarthritis (OA)

and the potential role of omega-3 fatty acids to ameliorate the

early events in the disease process have been investigated with

thesein vitromodels. These studies use cartilage tissue explants

exposed to a variety of different cytokines, growth factors

and chemical mediators that activate degradative enzymes

and metabolic factors that induce and propagate cartilage

matrix degradation. Studies were conducted to investigate the

potential for omega-3 fatty acids to modulate these degenerative

processes in canine cartilage metabolism. Importantly, EPA was

the only omega-3 fatty acid able to significantly decrease loss of

aggrecan and potentially ameliorate cartilage degradation in the

clinical setting.

Based on the results of these in vitrostudies, clinical studies were

conducted with a therapeutic food designed to be useful as a

nutrition aid for dogs with OA. Four clinical studies (randomized,

double-masked, controlled studies) were completed in dogs

with spontaneous OA fed either a control or a test food. The test

food contained a 39-fold increase in the total omega-3 fatty

acid concentration and a 39-fold increase in EPA concentration

compared to the control food. Owners could feed either a dry

food or a combination of a dry plus canned foods of the control

or test formulas. Studies were conducted as six-month (one study)

or three-month prospective studies (two studies) in veterinary

hospitals in the United States. A fourth study was conducted as a

three-month prospective study in two academic specialty practices

in the United States.

Investigators reported that the animals being fed the EPA-

supplemented test formula improved in several parameters

which were evaluated during scheduled physical examinations

throughout the studies. Veterinarians reported a significant

improvement in range of motion and ability to bear weight, along

with a decrease in pain (upon palpation of the affected joint) and

lameness as compared with the condition of these dogs prior

to participating in the studies. In addition, pet owners observed

improvements in multiple clinical signs associated with OA: rising

from rest, running, walking, and playing.

In the academic specialty practice study, variables were

assessed at the beginning of the study and at 45 and 90 days

after onset of feeding the control or test food. Additionally,

gait analyses using a computerized biomechanical force plate

were also conducted at the same time intervals. On clinical

orthopedic examination, a significantly greater percentage of

dogs consuming the test food were evaluated as improved vs.

those consuming the control food. In addition, more dogs in the


28/42

test group had a reduction in pain at the end of the 90-day trial

when the affected joint was palpated. Vertical peak force was the

key parameter measured to determine weight bearing of affected

limbs. There was no significant change in mean peak force over

the duration of the 90-day feeding trial for the control group. The

mean vertical peak force increased significantly for the test group

over the same time interval. The percent mean change in vertical

peak force was also significantly different between groups,indicating that the test group increased weight bearing on the

affected limb over the course of the study. Additionally, only 31% of

dogs in the control group had improved weight bearing after the 90-

day feeding trial, whereas 82% of dogs in the test group increased

weight bearing; this difference was also statistically significant.

The objective of one clinical study was to determine if the test

food altered the dose of a nonsteroidal anti-inflammatory drug

(NSAID) required to manage clinical signs in dogs with OA. In this

particular study, all dogs were administered the NSAID carprofen

to help manage clinical signs. At each evaluation period (three,

six, nine and 12 weeks), the veterinarian considered the results ofthe orthopedic examination and the pet owners assessment to

determine if lowering the dose of carprofen was feasible. For the

group consuming the test food, the mean carprofen dose reduction

was 25%. Significantly greater reductions in carprofen dose (mg/lb

body weight) were possible in the dogs consuming the test food

compared with the control food.

These clinical studies indicate that nutrition management

using a therapeutic food with high levels of total omega-3

fatty acids and EPA helps improve the clinical signs of OA in

dogs as measured by pet owner evaluation, clinical orthopedic

examination, and gait analysis of ground reaction forces.

Furthermore, doses of NSAID can often be reduced in dogs with

osteoarthritis consuming these types of foods.

Recommendation for use of fatty acids for canine osteoarthritis:

deliver 70 to 150 mg EPA/kg body weight/day, or 3.5 to 4.5%

total omega-3 fatty acids and 0.45 to 1.1% EPA in the food (dry

matter basis) with omega-6 to omega-3 ratio of around 0.7:1.

Use of fatty acid supplementation for patients with

chronic kidney disease

Recent studies in several species have suggested a potentialbenefit from dietary polyunsaturated fatty acid supplementation in

patients with chronic kidney disease (CKD), especially those with

systemic hypertension and inflammatory glomerular lesions. Dietary

supplementation with omega-3 fatty acids has been shown to be

beneficial in dogs with induced chronic kidney disease. Compared

with dogs fed foods high in saturated fats or omega-6 fatty acids,

dogs consuming a food supplemented with omega-3 fatty acids

had lower mortality, better renal function, fewer renal lesions, less

proteinuria and lower cholesterol levels. In dogs fed the food with

higher omega-3 fatty acid levels, renal function actually increased

and remained above baseline over 20 months of study. Lesions

of glomerulosclerosis, tubulointerstitial fibrosis, and interstitial

inflammatory cell infiltrates were also diminished in dogs fed the

food with higher levels of omega-3 fatty acids.

Many therapeutic renal foods already contain sources of

omega-3 fatty acids and additional supplementation may not be

appropriate for animals already consuming these foods. There

is strong evidence from randomized, controlled clinical trials to

support a recommendation to feed therapeutic renal foods to

dogs and cats with stages 2, 3 and 4 CKD. The benefits shown

to accrue from this recommendation, including increased survival,

reduced risk of uremia, and improved quality of life, are of great

clinical consequence to owners and pets.

Recommendation for use of fatty acids for pets with chronic

kidney disease: deliver 200 to 250 mg total omega-3 fatty acids/

kg body weight/day or 1 to 2% total omega-3 fatty acids in the

food (dry matter basis) with omega-6 to omega-3 ratio of 2:1 as

part of a therapeutic renal food.


with cancer

The use of high levels of omega-3 fatty acids (EPA and DHA)

has been evaluated in both experimental rodent models of

cancer and in naturally occurring cancer cases in dogs and

people. Results of well-controlled clinical trials in dogs suggest

that such dietary manipulation reverses metabolic abnormalities

(hyperinsulinism, hyperlactatemia) recognized in canine patients

with cancer, improves survival in dogs undergoing chemotherapy,

and improves quality of life. In other clinical trials, high levels ofdietary omega-3 fatty acids also appear to be protective against

the negative effects of radiation therapy.

Recommendation for use of fatty acids for dogs with cancer:

deliver 800 mg total omega-3 fatty acids/kg body weight/day

or 7.5% total omega-3 fatty acids in the food (dry matter basis)

with omega-6 to omega-3 ratio of 0.3:1.


with heart disease

One study characterized the nutritional and cytokine alterations

in dogs with heart failure and tested the ability of fish oilto reduce cytokines and improve clinical outcome. Body

composition, insulin-like growth factor-1, fatty acids, and

cytokines were measured in 28 dogs with heart failure and

in five healthy controls. Dogs with heart failure then were

randomized to receive either fish oil or placebo for eight weeks.

All parameters were measured again at the end of the study

period. Baseline plasma AA, EPA and DHA concentrations

were lower in dogs with heart failure than in controls. Fish

oil supplementation decreased interleukin-1 beta (IL-1)

concentrations and improved cachexia compared with the


29/42

placebo group. The mean caloric intake of the heart failure dogs

as a group was below the maintenance energy requirement, but

no difference was found in food intake between the fish oil and

placebo groups. Insulin-like growth factor-1 concentrations and

reductions in circulating IL-1 concentrations over the study period

correlated with survival. These data demonstrate that canine

heart failure is associated with cachexia, alterations in fatty acids,

and reduced caloric intake. Fish oil supplementation decreasedIL-1 concentrations and improved cachexia.

Intravenous administration of omega-3 fatty acids has been

shown to prevent fatal ventricular arrhythmias in a canine

model of sudden cardiac death. Omega-3 fatty acids appear to

electrically stabilize myocardial cells by modulating ion channels.

Additional studies have shown that fish oil supplementation

reduces cardiac arrhythmias (ventricular premature contractions)

in dogs with cardiomyopathy.

Recommendation for use of fatty acids for dogs with heart

disease and/or cardiac dysrhythmias: deliver at least 65 to 100mg total omega-3 fatty acids/kg body weight/day or 0.5 to 1%

total omega-3 fatty acids in the food (dry matter basis) as part of

a therapeutic cardiac food.

HOW TO USE FATTY ACID SUPPLEMENTATION

In answer to the question posed in the title of this article, it is

clear that dietary fatty acid levels well above those needed to

avoid fatty acid deficiency benefit some animals with seborrhea,

arthritis, allergic skin disease, chronic kidney disease, heart

disease and cancer. Dietary omega-3 fatty acid concentrations can

be increased by using a supplement (usually cold water marineoils) or changing to food(s) that contains flaxseed, fish meal and/

or sh oil as major ingredients. Dietary GLA concentrations can be

increased by using a supplement with evening primrose, borage

or black currant oil. Most commercial pet foods already exceed

the omega-6 essential fatty acid requirement for linoleic acid by

using vegetable oil and/or vegetable ingredients in their formulas.

Many commercial pet foods also contain levels of omega-3 fatty

acids higher than those found in popular fatty acid supplements

(Tabl 1 & 2).

What i l clar ar awr t th fllwig quti:

1)which fatty acid or combination of fatty acids is most effective,

2) what ratio of omega-6 to omega-3 fatty acids is optimal,

3) what absolute amount of omega-6 and omega-3 fatty acids is

appropriate in normal animals and what amount is effective in

animals with clinical disease,

4)what levels of other nutrients (vitamins, trace minerals) are

needed to allow fatty acid therapy to be effective and

5)what level of total dietary fat is needed to optimize fatty acid

metabolism and clinical efficacy.

Although definitive answers to these questions are lacking in

many situations, laboratory and clinical studies in a number of

species have established a daily dosage for total omega-3 fatty

acids that seems to be a reasonable starting point in patients

with inflammatory and other diseases. An initial dose of 50 to

250 mg of total omega-3 fatty acids (ALA, EPA and/or DHA) per

kg body weight per day seemed to be effective in a large number

of studies. This total dose can be supplied through a combination

of appropriate foods and supplements. It is important to note

that many therapeutic foods contain much higher levels of fatty

acids than those found in typical fatty acid supplements. Use of

fatty acids in management of a wide variety of conditions will be

easier and more cost effective if an appropriate food is used vs.

adding a fatty acid supplement to the regular diet. Very high levels

of omega-3 fatty acids appear beneficial in canine patients with

cancer and can only be provided effectively in a therapeutic food.

The risks and side effects of high levels of dietary fatty acids arefew. Soft feces, overt diarrhea, flatulence, vomiting and halitosis

(fishy breath) are most commonly noted at typical levels of

fatty acid supplementation. More serious potential side effects

include hemorrhage due to reduced platelet function, decreased

plasma vitamin E concentrations, and increased susceptibility to

oxidative injury. Hemorrhagic problems have not been recognized

in dogs consuming levels of omega-3 fatty acids found in pet

foods and typical supplements; cats, however, appear to be more

susceptible to hemorrhagic problems associated with fatty acid

supplementation, and caution should be used with high omega-3

fatty acid intake in cats.


30/42

Foods Fd cumd (g)

Totalmga-6

consumed(mg)

Totalmga-3

consumed(mg)

HillsPrescription Dietd/dLamb Formula Canine Canned 451 3,972 1,488

HillsPrescription Dietd/dPotato & Duck Formula Canine Dry 161 4,854 1,164

HillsPrescription Dietd/dDuck Formula Canine Canned 624 4,932 1,248

Hills

Prescription Diet

d/d

Potato & Salmon Formula Canine Dry 162 4,206 2,100HillsPrescription Dietd/dSalmon Formula Canine Canned 613 5,148 4,350

HillsPrescription Dietd/dPotato & Venison Formula Canine Dry 161 4,932 1,146

HillsPrescription Dietd/dVenison Formula Canine Canned 550 4,950 1,098

HillsPrescription Dietd/dRice & Egg Formula Canine Dry 154 4,692 990

HillsPrescription Dietn/dCanine Canned 380 2,772 8,088

HillsPrescription Dietz/dULTRA Allergen-Free Canine Canned 617 6,102 738

HillsPrescription Dietz/dCanine Low Allergen Dry 163 4,812 618

HillsPrescription Dietz/dULTRA Allergen-Free Canine Dry 161 6,222 804

HillsPrescription Dieta/dCanine/Feline Canned 521 6,882 3,126

HillsPrescription Dietb/dCanine Dry 165 4,884 1,548

HillsPrescription Dietj/dCanine Canned 446 4,104 6,066

HillsPrescription Dietj/dCanine Dry 176 4,032 5,688

HillsScience DietAdult Original Canine Dry 162 5,310 726

HillsScience DietActive Adult Canine Dry 130 5,976 678

HillsScience DietLamb Meal & Rice Recipe Adult Canine Dry 162 4,815 1,002

HillsScience DietAdvanced Protection Adult Canine Dry 158 4,554 1,410

HillsScience DietSenior 7+ Original Canine Dry 163 4,590 1,710

HillsScience DietAdvanced Protection Senior 7+ Canine Dry 163 5,640 1,974

HillsScience DietLight Adult Canine Dry 200 5,988 618

HillsScience DietSensitive Skin Canine Dry 158 7,392 2,166

EukanubaAdult Maintenance Formula, dry 139 4,800 600

EukanubaReduced Fat Adult Formula, dry 155 3,600 600

EukanubaSenior Maintenance Formula, dry 142 3,600 600

Eukanuba Veterinary DietsSenior Plus, dry 142 4,200 600

Eukanuba Veterinary DietsResponseFP, dry 147 1,600 400

Eukanuba Veterinary DietsResponseFP, moist 475 9,600 1,200

Royal CaninIVDLimited Ingredient DietsPotato & Duck Canine Formula, dry 175 2,940 1,020

Royal CaninIVDLimited Ingredient DietsPotato & Rabbit Canine Formula, dry 177 3,120 1,380

Royal CaninIVDLimited Ingredient DietsWhitefish Canine Formula, moist 522 6,600 3,300

Royal CaninIVDLimited Ingredient DietsDuck Canine Formula, moist 536 5,340 720

Royal Canin Veterinary DietSkin Support SS21,dry 153 4,884 1,758

Royal Canin Veterinary DietHypoallergenic HP19,dry 143 7,158 1,158

Royal Canin Veterinary DietSensitivity RC21,dry 168 3,354 1,512

NutroUltraAdult, dry 166 7,998 1,290

NutroUltraSenior, dry 168 7,392 1,380

Purina Veterinary DietsLA Limited AntigenCanine Formula, dry 151 1,680 1,680

Supplements3V Capsfor Large & Giant Breeds 1 capsule 0 417

3V Capsfor Medium & Large Breeds 1 capsule 0 300

3V Capsfor Small & Medium Breeds 1 capsule 0 171

3V CapsLiquid 0.75 ml 0 187

3V CapsLiquid HR 1 ml 0 450

DermCaps100 lb 1 capsule 402 252

DermCapsES 1 capsule 368 123

DermCapsES Liquid 1 ml 375 130

DermCapsLiquid 1 ml 621 65

(Table 1 continues on next page)

Tabl 1


31/42

Tabl 1. The total essential fatty acid intake for a 10-kg dog eating 600 kcal per day of selected commercial foods or being given one of the selected supplements.

Tabl 2. The total essential fatty acid intake for a 4.5-kg cat eating 260 kcal per day of selected commercial foods or being given one of the selected supplements.

Foods Fd cumd (g)

Totalmga-6

consumed(mg)

Totalmga-3

consumed(mg)

HillsPrescription Dietd/dDuck & Green Pea Formula Feline Dry 68 2,254 473

HillsPrescription Dietd/dDuck Formula Feline Canned 215 3,354 666

HillsPrescription Dietd/dRabbit & Green Pea Formula Feline Dry 69 2,304 460

HillsPrescription Dietd/dRabbit Formula Feline Canned 233 3,403 699

HillsPrescription Dietd/dVenison & Green Pea Formula Feline Dry 67 2,142 458

HillsPrescription Dietd/dVenison Formula Feline Canned 206 4,178 988

HillsPrescription Dietz/dULTRA Allergen-Free Feline Canned 241 2,574 289

HillsPrescription Dietz/dLow Allergen Feline Dry 69 3,630 419

HillsPrescription Dieta/dCanine/Feline Canned 226 3,344 1,422

HillsScience DietAdult Original Feline Dry 64 2,301 140

HillsScience DietAdvanced ProtectionAdult Feline Dry 66 2,025 354

HillsScience DietMature Adult 7+ Original Feline Dry 66 2,114 146

HillsScience DietAdvanced ProtectionSenior 7+ Feline Dry 68 1,932 361HillsScience DietSavory Salmon Entre Adult Feline Canned 250 2,072 1,147

HillsScience DietSensitive Skin Adult Feline Dry 67 3,123 294

EukanubaChicken & Rice Formula Cat Food, dry 55 2,158 302

EukanubaMature Care Formula for Cats, dry 61 2,049 411

Eukanuba Veterinary DietsResponse LB/Feline, moist 199 2,600 520

Royal CaninIVDLimited Ingredient DietsGreen Pea & Venison Feline Formula, dry 73 1,794 624

Royal Canin Veterinary DietFeline Hypoallergenic HP 23, dry 63 3,003 486

Royal Canin Veterinary DietFeline Sensitivity RD 30, dry 67 2,140 213

Royal Canin Skin Care 30Cat Food, dry 63 2,951 499

Royal Canin Adult Fit 32Cat Food, dry 68 2,462 322

Royal Canin Indoor 27Cat Food, dry 70 2,395 408

Royal Canin Persian 30

Cat Food, dry 60 2,889 481Supplements

3V Capsfor Small & Medium Breeds 1 capsule 0 171

3V CapsLiquid HR 1 ml 0 450

DermCapsES Liquid 1 ml 375 130

DermCapsLiquid 1 ml 621 65

DermCapsRegular 1 capsule 402 108

NutrivedO.F.A. Granules 1 scoop 539 129

EicosaDerm 1/2 pump 0 300

Welactin 1 pump 0 330-364

Nordic NaturalsOmega-3 1 capsule 0 350

Tabl 1 (continued)

Table 2

Supplements Fd cumd (g)

Totalmga-6

consumed(mg)

Totalmga-3

consumed(mg)

DermCapsRegular 1 capsule 402 108

NutrivedO.F.A. Granules 1 scoop 539 129

EicosaDerm 1 pump 0 600

Welactin 1 pump 0 330-364Nordic NaturalsOmega-3 1 capsule 0 350

Nordic NaturalsArctic Cod Liver Oil 1 capsule 0 280

Nordic NaturalsUltimate Omega 1 capsule 0 700


32/42

What nw i Fatt Acid: Rlvi, Prtcti ad omga-3-Drivd Mdiatr

Philip Roudebush, DVM, DACVIM (SAIM)

Hills Scientific Affairs

Beneficial actions of polyunsaturated fatty acids were noted manyyears ago, but the underlying mechanisms for these effects are

poorly understood. It is clear that arachidonic acid is transformedinto many potent bioactive compounds such as prostaglandins,leukotrienes and lipoxins. The departure of fatty acids from simplyplaying structural roles in cell membranes and/or as energy storescame largely from the recognition of the rapid transformationof arachidonic acid to these potent eicosanoids by both cyclo-oxygenase and lipoxygenase mechanisms. Many of the classicprostaglandins and leukotriene mediators are pro-inflammatoryand play a decisive role in inflammation and/or in systems whereprostaglandins are key physiologic regulators. Inflammation is a vitalreaction, but it also plays a central role in many prevalent chronicdiseases such as osteoarthritis, periodontal disease, inflammatorybowel disease, cancer, brain aging/dementia, allergic dermatitis and

lower urinary tract disease.

In sharp contrast, it has become clear in recent years that counter-regulatory substances such as lipoxins are generated during theresolution of acute inflammation, and that these serve as agonistsfor endogenous anti-inflammatory mechanisms. This constitutesthe first evidence that the resolution of inflammation, which wasonce thought to be apassive process, is actually an active processthat involves up-regulating specific pro-resolution circuits. Thus,resolution of inflammation is an active endogenous process aimedat protecting the host from exacerbated inflammation.

THe oMeGA-3 FATTy ACID ConneCTIon

The molecular mechanisms underlying the beneficial actions ofpolyunsaturated fatty acids remain an area of active research(Figure 1). Investigators have recently identified novel oxygenatedproducts generated by enzymatic processes from the precursoromega-3 fatty acids EPA (eicosapentaenoic acid) and DHA(docosahexaenoic acid). These new compounds possess potentactions in the resolution of inflammation and may also haveneuroprotective properties. The term resolvin(resolution phaseinteraction products) has been proposed for some of thesecompounds since they display both potent anti-inflammatory andimmunoregulatory properties, reducing neutrophil traffic and themagnitude of the inflammatory response. The termprotectin(or

neuroprotectin) has been proposed, given the protective actions ofsome of these compounds in neural and retinal tissues.

Resolvins are derived from both EPA (E series) and DHA (D series).Both the D and E classes of resolvins appear as biosyntheticproducts involving cell-to-cell interaction with vascular endothelialcells and are potent regulators of leukocyte infiltration.Specifically, resolvin E1 (RvE1) has been shown to dramaticallyreduce dermal inflammation, peritonitis, colitis, periodontitis,dendritic cell migration and interleukin (IL)-12 production inanimal models. Resolvins of the D series block tumor necrosis factor(TNF)-activity and act as potent regulators to limit leukocyteinfiltration into inflamed brain, skin and peritoneum.

Among the essential fatty acids, DHA is concentrated in thecentral nervous system, neurons and retina, where it is thought toregulate membrane fluidity and ion fluxes. The term docosanoidshas been proposed to describe products generated from DHA.DHA-derived docosatrienes have neuroprotective action in retinal

cells and can improve the sequelae associated with stroke anddementia. The termsprotectinor neuroprotectindescribe thesecompounds, which are rapidly generated from DHA and releasedlocally into tissues. There is emerging evidence that resolvins anddocosanoid compounds may also have immunoregulatory actionsby influencing antigen-presenting cells and T-cell traffic.

CONCLUSION AND CLINICAL IMPLICATIONS

Fatty acid supplementation has been used for many years tohelp manage patients with a variety of inflammatory diseases.The underlying mechanisms for the beneficial effects of fatty acidsupplementation have been poorly understood. Recent research

has identified novel oxygenated compounds termed resolvinsandprotectins, which are generated from the omega-3 fatty acids EPA andDHA. These endogenous lipid/chemical mediators are switched-onin the resolution phase of an inflammatory response, thus acting asbraking-signals in inflammation and reducing leukocyte-mediatedinjury in several different tissues (Figure 1). The discovery of resolvinsand protectins offers molecular mechanisms that could underliesome of the beneficial actions of dietary fatty acid supplementationobserved in many patients.

References

Arita M, Clish CB, Serhan CN. The contributions of aspirin and

microbial oxygenase to the biosynthesis of anti-inflammatoryresolvins: novel oxygenase products from omega-3polyunsaturated fatty acids. Biochem Biophys Res Commun2005;338:149-157.

Bannenberg GL, Chiang N, Ariel A, et al. Molecular circuits ofresolution: formation and actions of resolvins and protectins.

J Immunol2005;174:4345-4355. Schwab JM, Serhan CN. Lipoxins and new lipid mediators in the

resolution of inflammation. Curr Opin Pharm2006;6:414-420. Serhan CN. Novel eicosanoid and docosanoid mediators:

resolvins, docosatrienes and neuroprotectins. Curr Opin Clin NutrMetab Care2005;8:115-121.


33/42

Figur 1(from Schwab JM, Serhan CN. Curr Opin Pharm2006).

Pro-inflammatory to pro-resolving: switch of lipid mediators over time during inflammation (ontogeny). (a) Hypothetical sequence of lipid-derived mediatorsmoderating the ontogeny of self-limited, acute inflammation: from onset (initiation, acute phase of inflammation) toward resolution (termination, return tohomeostasis). (b) Lipid mediators controlling influx into the inflammation site: switching from pro-inflammatory (PGE2, PGI2, LTB4) to anti-inflammatory andpro-resolution (LXA4). As exemplified by LTB4, AA-derived mediators foster extravasation and homing of inflammatory cells at the inflammatory site. In contrast,cell-cell interactions, exemplified by platelet-leukocytes within the vasculature and/or PMN-mucosal interactions, enhance generation of LXs. With time, aclass-shift occurs toward pro-resolving lipid-derived mediators (LXA4, Rvs, PDs) that block ongoing leukocyte extravasation into the inflammation site ascharacteristic hallmarks of inflammatory resolution. The -3/ -6-derived lipid mediators LXA4, ATL, Rv E/D series and PDs share anti-inflammatory propertiesbut have distinct impacts within resolution, suggesting a characteristic role in the orchestrated resolution program1,2.

1 Levy BD, Clish CB, Schmidt B, et al. Lipid mediator class switching during acute inflammation: signals in resolution. Nat Immunol. 2001;2:612619.2 Bannenberg N, Chiang A, Ariel M, et al. Molecular circuits of resolution: formation and actions of resolvins and protectins.J Immunol. 2005;174:43454355.

T

(a) Lipid mediator class switching orchestrates the sequence of resolution

Onset Resolution

-6 -3

-3 PUFA-derived:resolvins

protectins

Cell-cellinteraction:

lipoxins

Prostaglandinsleukotrienes

Initiation

PMN phagocytosis(b)

Lipid mediator class switching

Block recruitment/limiting leukocyte influx

Current Opinion in Pharmacology

VenuleVenule

VasodilationPGE2-LTB4

PGD2

PGE2

Vessel lumenVessel lumen PMN activation Blood flow

Resolution phase: RVE1 and PD1 stopextravasation and recruitment to the inflammation site

Acute inflammatory phase: AA-derived lipid mediator LTB4drives extravasation and recruitment to the inflammation site

Resolvins (E-series: D-series)NeuroprotectinsLXA4

Time

Terminationreturn to homeostasis


34/42

0

30

40

20

10

60

70

50

80

90

100

NumberofCases

Allergic Reaction

Total

Beef - 95

Dairy - 55

Wheat - 42

Chicken - 24

Egg - 18

Lamb - 13

Soy - 13

Corn - 7

Pork - 7

Fish - 6

Rice - 5

Rviw f litratur cai fd allrg (1967-prt)

278 CAnIne CAses (prblm igrdit wa clarl idtifid)

REFERENCESCarlotti DN, Remy I, Prost C. Food allergy in dogs and cats. A review and report of 43 cases. Vet Dermatol1990;1:55-62.Chesney CJ. Food sensitivity in the dog: a quantitative study. J Sm Anim Pract2002;43:203-207.Elwood CM, Rutgers HC, Batt RM. Gastroscopic food sensitivity testing in 17 dogs.J Sm Anim Pract1994;35:199-203.Harvey RG. Food allergy and dietary intolerance in dogs: a report of 25 cases.J Sm Anim Pract1993;34:175-179.Ishida R, Masuda K, Sakaguchi M, et al. Antigen-specific histamine release in dogs with food hypersensitivity.J Vet Med Sci2003;65:435-438.Ishida R, Masuda K, Kurata K, et al. Lymphocyte blastogenic responses to inciting food allergens in dogs with food hypersensitivity. J Vet Intern Med2004;18:25-30.Jeffers JG, Shanley KJ, Meyer EK. Diagnostic testing of dogs for food hypersensitivity.J Am Vet Med Assoc1991;189:245-250.Jeffers JG, Meyer EK, Sosis EJ. Responses of dogs with food allergies to single-ingredient dietary provocation.J Am Vet Med Assoc1996;209:608-611.Kunkle G, Horner S. Validity of skin testing for diagnosis of food allergy in dogs.J Am Vet Med Assoc1992;200:677-680.Mueller RS, Tsohalis J. Evaluation of serum allergen-specific IgE for the diagnosis of food adverse reactions in the dog. Vet Dermatol1998;9:167-171.Mueller RS, Friend S, Shipstone MA, et al. Diagnosis of canine claw disease a prospective study of 24 dogs. Vet Dermatol2000;11:133-141.

Nichols PR, Morris DO, Beale KM. A retrospective study of canine and feline cutaneous vasculitis. Vet Dermatol2001;12:255-264.Paterson S. Food hypersensitivity in 20 dogs with skin and gastrointestinal signs.J Sm Anim Pract1995;36:529-534.Tapp T, Griffin C, Rosenkrantz W, et al. Comparison of a commercial limited-antigen diet versus home-prepared diets in the diagnosis of canine adverse foodreactions. Vet Therapeutics2002;3:244-251.Walton GS. Skin responses in the dog and cat to ingested allergens. Vet Rec1967;81:709-713


35/42

Rviw f litratur fli fd allrg (1967-prt)

56 FeLIne CAses (prblm igrdit wa clarl idtifid)

0

5

10

15

20

GI onlySkin & GISkin onlyTotal

Beef - 16

Dairy - 16

Wheat - 3

Chicken - 4

Egg - 2

Lamb - 4

Corn gluten/Corn - 4

Fish - 13

NumberofCases

Allergic Reaction

REFERENCESCarlotti DN, Remy I, Prost C. Food allergy in dogs and cats. A review and report of 43 cases. Vet Dermatol1990;1:55-62.Guaguere E. Food intolerance in cats with cutaneous manifestations: a review of 17 cases. Eur J Companion Anim Pract1995;5:27-35.Guilford WG, Jones BR, Harte JG, et al. Prevalence of food sensitivity in cats with chronic vomiting, diarrhea or pruritus (abstract).J Vet Intern Med1996;10:156.Guilford WG, Jones BR, Markwell PJ, et al. Food sensitivity in cats with chronic idiopathic gastrointestinal problems.J Vet Intern Med2001;15:7-13.Ishida R, Masuda K, Kurata K, et al. Lymphocyte blastogenic responses to food antigens in cats with food hypersensitivity. Unpublished data. University ofTokyo, 2002.Reedy RM. Food hypersensitivity to lamb in a cat.J Am Vet Med Assoc1994;204:1039-1040.Stogdale L, Bomzon L, Bland van den Berg P. Food allergy in cats. J Am Anim Hosp Assoc 1982;18:188-194.Walton GS. Skin responses in the dog and cat to ingested allergens. Vet Rec1967;81:709-713.Walton GS, Parish WE, Coombs RRA. Spontaneous allergic dermatitis and enteritis in a cat. Vet Rec1968;83:35-41.

White SD, Sequoia D. Food hypersensitivity in cats: 14 cases (1982-1987).J Am Vet Med Assoc1989;194:692-695.


36/42


37/42


38/42

46 dogs (65%) completing the feeding trial had improvements in

pruritus and clinical scores. Of these 30 dogs, 22 had improvement

in pruritus that recurred after challenge with their original food,

indicating that an adverse food reaction was involved in their

clinical condition. Adverse food reaction alone was diagnosed in

nine dogs (20%), atopic dermatitis was diagnosed in 17 dogs

(37%), and atopic dermatitis with concurrent adverse food reaction

was diagnosed in nine dogs (20%).

Concurrent signs of gastrointestinal disease were reported in six

dogs with adverse food reactions. These gastrointestinal signs

resolved in all cases and recurred in five dogs when challenged

with the original food. Average defecation frequency was higher

in dogs with adverse food reactions (3.1 times per day) than in

dogs without adverse food reactions (2.1 times per day). Overall,

19 of 21 dogs with concurrent signs of gastrointestinal disease had

complete resolution of their clinical signs during the dietary trial.

Prescription Diet z/d ULTRA Canine Dry is useful in the diagnosis of

adverse food reactions in dogs with non-seasonal pruritus when fed

exclusively at least six weeks.

Loeffler A, Soares-Magalhaes R, Bond R, et al. A retrospective

analysis of case series using home-prepared and chicken

hydrolysate diets in the diagnosis of adverse food reactions in

181 pruritic dogs. Vet Dermatol2006;17:273-279.

The purpose of this retrospective study was to compare home-

prepared and chicken hydrolysate foods in the diagnosis of

canine adverse reactions to food (ARF). Seventy-two dogs were

fed home-prepared foods and 109 were fed a hydrolysate-based

food (Prescription Diet z/d ULTRA Canine Dry). Owners chose the

type of food at presentation, and ingredients of home-prepared

diets were selected depending on each dogs dietary history.Ectoparasitic infestations and microbial infections were treated

during the trials. Cutaneous and gastrointestinal signs and

pruritus scores were recorded before starting the diet, six weeks

into the trials, and after provocation with the original foods. ARF

was diagnosed if pruritus resolved during the trial and recurred

on dietary provocation. The dropout rate was lower for home-

prepared foods, although not statistically significant (18.1%

home prepared; 24.7% hydrolysate, P = 0.377). ARF alone was

diagnosed in 10 dogs (17%) using home-prepared diets and in

15 (18.3%) fed the hydrolysate. Gastrointestinal problems were

more frequent in dogs with ARF than in dogs without ARF

(P = 0.001). Another 11 dogs (18.6%) in the home-prepared food

group and 20 (24.4%) in the hydrolysate diet group had ARF

concurrent with other pruritic diseases, mainly atopy. The similar

frequencies of ARF diagnosis in the two groups (P = 0.837 ARF;

P = 0.416 concurrent ARF) indicate that Prescription Diet z/d

ULTRA Canine may be a valuable alternative to home-prepared

foods in the diagnosis of canine ARF.

Madsen LM. A mysterious effusion. Vet Forum2003;20:24-28.

A 3-year-old male Norwich terrier was evaluated for respiratory

distress and found to have pleural effusion associated with

hypoproteinemia and hypoalbuminemia. Diagnostic evaluation

showed evidence of protein-losing enteropathy due to

inflammatory bowel disease. The

p9208 ebcn derm specialists

Documents