Straight Talk with Clients is a Critical Piece of the Adverse Food Reaction “Puzzle”

Sticking to an elimination diet trial can be challenging for pet owners

By June Hacker-Traiger, VMD, CCRP; Oradell Animal Hospital, Paramus, NJ • Purina


Managing dogs with adverse food reactions can be a puzzle for veterinarians and a wait-and-see game for clients. The more information we share with clients, the more likely we are to solve the puzzle. When talking with clients, I first explain what an adverse food reaction is and describe the clinical signs. I then walk them through the steps to diagnosing and managing their dog’s condition.

Client education: There are no shortcuts.

Sticking to an elimination diet trial can be challenging for pet owners. I believe it is important to be candid and tell them that it will be hard—but ultimately worth it. Here are some strategies that have worked for me.

  • Provide a realistic timetable. When clients learn that seeing a response for dermatologic signs of food allergy is typically achieved through conducting an eight- to 12-week elimination diet trial, they may feel overwhelmed. I stress that two or three months is not that long, and that if the dog has gastrointestinal (GI) signs of food allergy, these could improve in about four weeks.
  • Set clear, specific expectations. Be precise about what it means to have the dog only eat the elimination diet. It’s natural for clients to think, “Oh, it’s just the main food that I put in the bowl,” versus anything that goes in the dog’s mouth. I take the time to explain that it’s also dog treats, flavored medications and flavored toys—not to mention the “people” food their child drops on the floor. I also stress that everyone in the family needs to be on board if the diet trial is to be successful.
  • Reinforce the message(s). Two steps that have made a difference with adherence are: (1) putting it in writing with a handout from our hospital; and (2) asking clients to call me with a weekly progress report. Not only do these calls inform me if clinical signs are resolving; they also help me catch missteps early. For instance, the client may say, “Yes, I’m feeding the food you prescribed—with chicken!” While I need to backtrack and clarify they can’t feed foods other than the diet, at least we can catch these problems early.
  • Share a success story. I often tell clients about my own dog, Ona, who has been through serious health challenges and a diet trial—and is now doing very well. (See “Ona’s Story.”) I believe that hearing about her can inspire them to believe their dog can be successful, too.


My Labrador retriever Ona developed acute hemorrhagic diarrhea syndrome at age 1. She was hospitalized and recovered but began having intermittent episodes of vomiting and diarrhea a year later. After performing a fecal flotation to rule out parasitism and running a complete blood count and chemistry panel, I switched Ona to a highly digestible diet. A month later, her signs had not resolved. A maldigestion panel and ACTH stimulation test were normal; however, other blood work indicated elevated eosinophils and an abdominal ultrasound showed diffuse enteropathy.

Knowing that many enteropathies are food responsive, I placed Ona on a hydrolyzed diet. She improved, but soft stools and elevated eosinophils continued. Several months later, I switched to Purina® Pro Plan® Veterinary Diets EL Elemental—an amino acid-based diet formulated with purified amino acids. Now, Ona’s stools are perfectly formed and low-volume, and she continues to enjoy eating the diet. I rechecked blood work after six months on EL Elemental and eosinophils were normal, with much of the inflammation in her gastrointestinal (GI) tract resolved.

EL Elemental is formulated to provide complete and balanced nutrition for canine growth and maintenance, so it can be used with younger dogs. And, because it is highly digestible with limited fat, EL Elemental may also be an option for dogs with compromised GI tracts as a result of chronic enteropathies. It worked for Ona, and I believe other patients who haven’t responded well to a hydrolyzed diet could also benefit.

This Education Center article was underwritten by Purina.

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