伴侣动物食物不良反应的批判性评价话题（7）：犬猫食物不良反应 ...

王帆

Critically appraised topic on adverse food reactions of companion animals (7): signalment and cutaneous manifestations of dogs and cats with adverse food reactions

伴侣动物食物不良反应的批判性评价话题(7):犬猫食物不良反应的特征和皮肤表现

 

作者：Thierry Olivry and Ralf S. Mueller

 

翻译：王帆

Abstract

Background: Outside of pruritus, there is no clear consensus on the nature and prevalence of cutaneous manifestations of adverse food reactions (AFRs) in dogs and cats.

Results: We searched two databases on August 7, 2018, for articles reporting detailed data on the signalment and clinical signs of at least one dog or cat with a cutaneous AFR (CAFR). We identified 233 and 407 citations from which were selected 32 articles reporting original information. Twenty-two articles included data on 825 dogs with CAFRs. The reported age of onset varied from less than one to 13years of age; a beginning of signs by 6 or 12 months of age was noted in 22 to 38% of dogs, respectively. The female-to-male ratio also varied considerably. Four breeds (German shepherd dogs, West Highland white terriers, Labrador and golden retrievers) accounted for about 40% of affected dogs. Most dogs diagnosed with a CAFR were pruritic, most often in a generalized pattern, with the ears, feet, and abdomen also being frequently affected; the perineum was uncommonly targeted, however. Canine CAFRs presented mainly as recurrent bacterial skin infections, otitis externa and atopic dermatitis. Twelve articles reported novel information on 210 cats with this syndrome. There was no apparent breed and gender predisposition for feline CAFRs, but cats appeared to develop signs later than dogs with the same syndrome. Most cats with a CAFR were pruritic, especially on the head/face and neck, with the abdomen and ears also commonly involved. Symmetric self-induced alopecia, a head-and-neck self-traumatic dermatitis, miliary dermatitis and variants of eosinophilic diseases were the most common manifestations of feline CAFRs.

Conclusions: CAFRs affect dogs and cats of any age, any breed, and both genders, with the proportion of juvenile dogs diagnosed about twice that of cats. There are no reliable breed predisposition data. Most patients are pruritic, with half the dogs having generalized pruritus and half the cats scratching their face/head or neck. Canine CAFRs most often manifest as bacterial skin infections, otitis externa or atopic dermatitis; cats with CAFRs will exhibit the expected clinical phenotypes associated with feline hypersensitivity dermatitides.

Keywords: Allergy, Canine, Cat, Clinical signs, Dermatology, Diet, Dog, Feline, Food allergy, Skin

摘要

背景:除了瘙痒外，关于犬猫食物不良反应(AFRs)的皮肤表现的种类和发生率还没有明确的共识。

结果:我们于2018年8月7日搜索了两个数据库，寻找关于至少有一只犬或猫患有皮肤AFR (CAFR)的临床症状和体征的详细报告。我们从32篇原始信息报道的文章中挑选出233篇和407篇参考文献。22篇文章包含了825只CAFR患犬的数据。报告的发病年龄从小于1岁到13岁不等;分别有22 - 38%的犬在6个月或12个月大时出现症状。公母比例也有很大差异。四种犬种(德国牧羊犬、西高地白㹴、拉布拉多和金毛猎犬)约占40%。大多数确诊为CAFR的犬都有瘙痒表现，通常是一种普遍的模式，耳部、足部和腹部也经常患病，但是会阴部少见。犬CAFR主要表现为复发性细菌性皮肤感染、外耳炎和异位性皮炎。12篇文章最新报道了210只患猫有这些症状。猫没有明显的品种和性别倾向，但猫似乎开始出现症状比正症状相同的犬晚。大多数CAFR患猫都瘙痒，特别是在头部/面部和颈部，腹部和耳部也经常涉及。对称性自发性脱毛、头颈部自我损伤性皮炎、粟粒性皮炎和各种嗜酸性疾病是猫科动物CAFR

最常见的表现。

结论:CAFR患犬患猫可以是任何年龄、任何品种、任何性别，幼犬确诊比例约为猫的两倍。没有可靠的品种易感性数据。大多数病例都有瘙痒症状，一半的犬有全身瘙痒症状，一半的猫抓挠他们的脸/头部或颈部。犬CAFR最常表现为细菌性皮肤感染、外耳炎或异位性皮炎;CAFR患猫预计会表现出与猫过敏性皮炎相关的临床反应模式。

关键词:过敏症、犬科、猫、临床症状、皮肤病学、日粮、犬、猫科、食物过敏、皮肤

 

Background

背景 

Adverse food reactions (AFRs) are diagnoses commonly given to dogs and cats with allergic diseases. These AFRs can manifest clinically with either noncutaneous (e.g., vomiting, diarrhea)  or cutaneous clinical signs. While pruritus is widely accepted to be the main symptom that affects pets with a cutaneous AFR (CAFR), there is a lack of consensus on the typical signalment and cutaneous manifestations of AFRs in dogs and cats.

食物不良反应(AFRs)是犬和猫常见的过敏性疾病。这些AFR临床可表现为非皮肤症状(如呕吐、腹泻)或皮肤临床症状。虽然普遍认为瘙痒是宠物皮肤AFR (CAFR)的主要症状，但对犬和猫AFR的典型特征和皮肤表现缺乏共识。

 

Clinical scenario

临床病例

You have two itchy patients: one is a three-year-old male castrated German shepherd dog with a two-year history of nonseasonal recurrent facial rubbing and pedal licking. On physical examination, you notice erythema on the groin, the palmar metacarpi, and the concave pinnae. The second is a two-year-old female spayed domestic shorthaired cat with a six-month history of severe and nearly continuous head-and-neck scratching that leads to the development of large facial excoriations. You wonder if the histories, signalment and clinical signs of your two patients would be compatible with a CAFR.

你有两个瘙痒病例:一只是三岁德国牧羊犬，已去势公犬，有两年非季节性复发性面部抓挠和舔爪部病史。体格检查时，发现腹股沟、掌部和耳廓内侧皮肤红斑。第二只是两岁已绝育家养短毛母猫，有六个月严重的、几乎持续的头部和颈部抓伤，导致面部出现大面积抓痕。你想知道这两个病例的病史、体征和临床症状是否符合CAFR。

 

Structured question

问题框架

What are the typical signalment and cutaneous manifestations of AFRs in dogs and cats?

犬、猫AFR的典型体征和皮肤表现是什么?

 

Search strategy 

搜索方法

We searched the Web of Science Core Collection and CAB Abstract databases on August 7, 2018 with the following string: ((dog or dogs or canine) or (cat or cats or feline)) and (food* or diet*) and (allerg* or reaction*) and (prurit* or cutan* or skin) not (human* or adult* or child*). This search was restricted to the January 1980 to July 2018 timeframe, and we did not set any publication language limits. The bibliography of each selected article was subsequently screened for additional relevant papers. Because of the need for detailed information, we did not search conference proceedings, as we deemed abstracts to be too succinct to allow for the extraction of quality and pertinent data. We limited our search to articles reporting the signalment and clinical signs of at least one dog or cat with a CAFR. Finally, we did not consider review papers because of our need for original information.

2018年8月7日，我们搜查了科学核心期刊和CAB文摘数据库网站，检索内容如下:((犬或犬（复数）或犬科)或(猫或猫（复数）或猫科))和(食品*或日粮*)和(过敏症*或过敏反应*)和(瘙痒*或皮*或皮肤)不包括(人*或成人*或儿童*)。这次搜索时间范围在1980年1月到2018年7月内，出版语言无限制。随后，筛选每一选定文章的参考文献，以获得其他相关论文。由于需要详细的信息，我们没有搜索大会记录，因为我们认为摘要太过简洁，无法提取高质量和相关的数据。我们将搜索范围限制在至少报道一只犬或猫CAFR特征和临床症状的文章。最后，由于需要原始信息，我们没有搜索综述性文章。

 

Identified evidence

确凿证据 

Our search identified 233 and 407 citations in the Web of Science and CAB abstracts, respectively. Among these citations, we found a majority of review papers, but we located 32 articles reporting novel, relevant and usable data. Importantly, 13 of these 32 articles were found in only one of the two databases searched, thereby highlighting the need to query multiple sources to maximize evidence identification; we added only one additional paper found in the bibliography of another. Altogether, reports included pets with CAFRs seen all over the world: cases were from Europe (16 articles), North (8) and South (2) America, Australia (2), Africa (1), Asia (1); two articles were global surveys (Additional file 1: Table S1 and Additional file 2: Table S2).

我们的搜索结果分别在《科学网》和《CAB文摘》中找到233条和407条引文。在这些引用中，我们找到了大部分的综述性文章，但是我们找到了32篇新的、相关和有用的数据报道的文章。重要的是，这32篇文章中只有13篇在两个数据库中都有，从而强调了查询多个来源以最大限度地识别证据的必要性;我们在另一篇文献的参考文献中只增加了一篇论文。总而言之，报告包括世界各地发现的患有CAFR的宠物:病例来自欧洲(16篇)、北美(8篇)和南美(2篇)、澳大利亚(2篇)、非洲(1篇)、亚洲(1篇);两篇文章是全球性调查(附加文件1:表S1和附加文件2:表S2)。

 

Evaluation of evidence

证据评估

Twenty articles reported information on dogs with CAFRs while there were ten papers describing such cats ; two included patients of both species.

20篇文章报道CAFR患犬的信息，而有10篇论文描述了患此病的猫;其中两篇两个物种病例都有。

 

In this paper, and in an evaluation scheme similar to that of our recent review, we rated the quality of CAFR diagnosis as “strong” if the study was prospective and the diagnosis confirmed by a positive challenge that followed an elimination diet. We qualified the diagnosis strength as “moderate” if the study was retrospective in nature but included both restriction and provocation phases; otherwise, we assessed the diagnosis quality as “weak”.

在这篇论文中，在一个类似于我们最近的综述的评估方案中，如果研究是前瞻性的，并且是通过日粮排除激发试验阳性确诊的，那么我们认为CAFR诊断的质量高。如果是回顾性研究，但同时包括排除试验和激发试验，我们认为诊断强度为中等。否则，我们认为诊断质量较差。

 

Canine cutaneous adverse food reactions

犬皮肤食物不良反应

Altogether, we reviewed data on 825 dogs with CAFR (mean: 38 per paper; range: 1 to 172). In these dogs, the evidence for this diagnosis was assessed as strong in 284 (34%), moderate in 339 (41%) and weak in 203 (25%) (Additional file 1: Table S1).

我们总共审查了825只CAFR患犬的数据(平均每篇论文38只;范围:1到172)。在这些犬中，诊断的证据被评估为284(34%)强，339(41%)中，203(25%)弱(附加文件1:表S1)。

 

The reported age of onset of canine CAFR varied greatly, from less than one to 13years of age; pooled together, the mean age of onset was 2.9years (Additional file 1: Table S1; Fig. 1a). An onset of signs at six months of age or before was noted in 40/182 dogs (22%) in ten articles. Similarly, an onset of signs by one year of age was described in 217/574 dogs (38%) in 14 articles . In 13 studies reporting information on more than one dog (483 patients in total) , CAFRs affected both male and female dogs in a proportion that varied greatly between reports: while the median female-to-male ratio was 0.9, some studies reported a higher proportion of either males (a ratio of 0.4) or females (ratios of 1.5 to 2.3 – Additional file 1: Table S1; Fig.2).

报道的犬CAFR发病年龄差异很大，从小于1岁到13岁不等;合并后，平均发病年龄为2.9岁(附加文件1:表S1;图1 a)。在10篇文章中，40/182只犬(22%)在6个月或之前出现症状。类似地，在217/574只犬(38%)的14篇文章中描述了在一岁时出现症状。在13个研究大于1只犬的报告信息中(总共483例),CAFRs影响雄性和雌性犬之间的比例差异很大:而雌性比雄性的中间值为0.9,一些研究报道的比例更高，雄性(0.4的比率)或雌性(1.5到2.3的比率-附件1:表S1;图2)。

 

In the Additional file 1: Table S1, we extracted the breeds representing at least 10% of the dogs (with a minimum of three) included in each case series. Altogether, there were nine reports with 57/432 dogs (13%) being German shepherd dogs, six articles with 40/209 dogs (19%) being Labrador or golden retrievers and five papers describing 18/164 dogs (11%) as West Highland white terriers; these observations suggest the persistence of CAFR diagnosis in these breeds over time and geographical areas. A comparison with a reference canine population was only done in nine studies, however. In four of these articles, a significant association between a breed and the diagnosis of CAFR was not found, while in the five others, some breeds appeared predisposed to this syndrome when compared to the then local canine population (Additional file 1: Table S1). While we did not identify a breed consistently associated with CAFR, both Labrador retrievers and West Highland white terriers were predisposed breeds in three reports each.

在附件1:表S1中，我们提取了每个案例系列中至少包含10%的犬种(至少包含3只)。总共有9篇报告，57/432只犬(13%)是德国牧羊犬，6篇文章，40/209只犬(19%)是拉布拉多或金毛猎犬，5篇论文，18/164只犬(11%)是西高地白㹴 ;这些观察表明，随着时间和地理区域的推移，CAFR诊断在这些品种中持续存在。然而，只在9项研究中对参考犬种进行了比较。在这四篇文章中，没有发现一个犬种与CAFR诊断之间的显著相关性，而在其他五篇文章中，与当时的本地犬种群相比，一些犬种似乎更容易出现这种综合征(附加文件1:表S1)。虽然我们没有确定一个与CAFR一致的品种，但拉布拉多猎犬和西高地白㹴在各自的三份报告中都是易感品种。

 

Pruritus was the dominant symptom reported in 16/17 articles (94%). Overall, and excluding a single dog affected with a nonpruritic acute eosinophilic dermatitis with edema (i.e., Wells’ syndrome), 13/16 articles (81%) reported more than 90% of the included dogs as being pruritic. The pruritus was characterized as glucocorticoid-responsive in two studies (Additional file 1: Table S1).

瘙痒是16/17篇文献报道的主要症状(94%)。总的来说，不包括一只患有非瘙痒性急性嗜酸性皮炎和水肿的犬(即威尔斯综合征，13/16篇文章(81%)报道了超过90%的被纳入研究的犬有瘙痒症状。在两项研究中，瘙痒被描述为对糖皮质激素有效(附加文件1:表S1)。

 

The main body locations in which pruritus was present varied between reports (Additional file 1: Table S1): studies in which more than half of the dogs exhibited a specific pattern of pruritus described it as generalized or affecting the ears , feet or ventrum. In contrary to commonly-held beliefs, perineal pruritus, when reported, affected only a minority (4 to 25%) of dogs with CAFRs .

瘙痒的主要部位在不同的报告中有所不同(补充文件1:表S1):在研究中，超过一半的犬表现出一种特定的瘙痒模式，并将其描述为全身瘙痒或影响耳部、爪部或腹部。与人们普遍认为的相反，据报道，会阴部瘙痒只有少数(4 - 25%)CAFR的患犬。

 

There was much heterogeneity in the reporting of cutaneous manifestations of AFRs in the dog, with some studies describing individual skin lesions (e.g., erythema, alopecia …) and others mentioning specific diagnoses (e.g., atopic dermatitis, urticaria …) or syndromes without further details (e.g., otitis externa, recurrent pyoderma...) (Additional file 1: Table S1).

报告有很多异质性的皮肤表现的误判率的犬,和一些研究描述单一皮肤病变(如红斑,脱发毛)和其他人提及具体诊断(如过敏性皮炎、荨麻疹)或症状没有进一步的细节(如外耳炎、复发性脓皮病…)(附加文件1:表S1)。

 

Excluding studies with single lesion descriptions, the most common manifestations of canine CAFRs (reported in more than one paper) were various presentations of often-recurrent or chronic (presumed staphylococcal) pyoderma (i.e., bacterial skin infections; ten reports with between 11 and 70% of dogs affected ), otitis externa (nine studies: 3 to 69% of dogs ), atopic dermatitis (AD, nine reports; 13 to 100% of dogs ) and pyotraumatic dermatitis (four studies; 1 to 9% of dogs )(Additional file 1: Table S1). It is needless to add that multiple manifestations of CAFRs often coexisted in the same patient (Additional file 1: Table S1).

除了单一病变描述的研究外，犬CAFRs最常见的表现(在多篇论文中有报道)是各种经常复发或慢性(假定为葡萄球菌性)脓皮病(即葡萄球菌性脓皮病)。皮肤细菌感染;10份报告，11 - 70%的患犬)，外耳炎(9份研究:3 - 69%的患犬)，异位性皮炎(AD, 9份报告;13到100%的犬)和化脓性创伤性皮炎(4项研究;1 ~ 9%的犬)(附加文件1:表S1)。无需补充的是，CAFRs的多种表现常常同时存在于同一病例上(附加文件1:表S1)。

 

Malassezia dermatitis, urticaria and perianal fistulae/ furunculosis were reported as manifestations of CAFRs in a surprisingly small number of dogs and reports (93 dogs/two articles  nine dogs/four articles and four dogs/two articles respectively; Additional file 1: Table S1).

马拉色菌性皮炎、荨麻疹和肛周瘘管/疖病被报告为CAFRs的表现，数量少得惊人(93只犬/ 2篇文章9只犬/ 4篇文章和4只犬/ 2篇文章;附加文件1:表S1)。

 

Feline cutaneous adverse food reactions

猫皮肤食物不良反应

In total, we extracted relevant information from 210 CAFR-affected cats (median: 14 cats in each article; range: 1 to 61). In these cats, the evidence for a diagnosis of CAFR was rated as strong, moderate or weak in 22 (10% of cats), 175 (83%) and 13 (6%), respectively (Additional file 2: Table S2).

我们总共从210只CAFR患猫中提取了相关信息(中位数:每篇文章中有14只猫;范围:1到61)。在这些猫中，分别有22只(10%)、175只(83%)和13只(6%)被诊断为CAFR的证据为强、中、弱(附加文件2:表S2)。

 

As in dogs with this syndrome, the age of onset of cutaneous signs in cats with CAFRs varied greatly between and within reports (Additional file 2: Table S2; Fig. 1b). For example, signs were described as occurring as early as 4months and as late as 15years of age in a single study. Altogether, the mean age of sign onset of feline CAFRs was 3.9years. A development of cutaneous signs by 6months of age was reported in 6/70 cats (9%) in seven articles , while that by 1 year of age was described in 16/70 cats (23%) in the same articles.

与患有该综合征的犬一样，患有CAFRs的猫皮肤病变的发病年龄在报告与报告之间存在很大差异(补充文件2:表S2;图1 b)。例如，在一项研究中，症状最早出现在4个月，最晚出现在15岁。总的来说，猫出现症状的平均年龄为3.9岁。在7篇文章中，6/70只猫(9%)在6个月时出现皮肤症状，而在同一篇文章中，16/70只猫(23%)在1岁时出现皮肤症状。

 

The median female-to-male ratio of cats diagnosed with a CAFR was 1.5, with only two studies having females seeming over-represented (a ratio of 2.0; Additional file 2: Table S2; Fig. 2).

被诊断患有CAFR的猫的雌雄比例中值为1.5，只有两项研究的雌性比例似乎过高(比例为2.0;附加文件2:表S2;图2)。

 

Outside of the domestic shorthaired cat that was ubiquitously listed, Persian, Siamese, and Burmese cats represented 10 (5%), 8 (4%) and 4 (2%) of all felines with CAFR, respectively. Only three articles had compared affected breeds with those of the then local population, and there were no breeds appearing predisposed across reports (Additional file 2: Table S2).

除了所有文章都提到的家养短毛猫外，波斯猫、暹罗猫和缅甸猫分别占所有患有CAFR猫的10只(5%)、8只(4%)和4只(2%)。只有三篇文章将患犬犬种与当时在当地的犬种进行了比较，在报告中没有出现易患病犬种(附加文件2:表S2)。

 

Nearly all cats with CAFRs exhibited manifestations of pruritus . A single cat was described as having nonpruritic cervical nodules (Additional file 2: Table S2).

几乎所有瘙痒症的患猫都表现出瘙痒症状。1只猫被描述为患有非瘙痒性颈部结节(附加文件2:表S2)。

 

The pruritus was described as generalized only in a small percentage (5 to 12%) of cats in two reports . Tallying all cases together, the face/head was pruritic in half of the cats reported (111/210 [53%]). Other areas commonly found to be pruritic were the ears (18 to 54% of cats published in seven articles ), the ventrum (25 to 66% of cats in six studies ) and the feet (6 to 33% of cats in six reports . As in dogs, the perineum was not an area frequently pruritic in cats with a CAFR, however (10 to 15% of cats in three articles).

在两份报告中，只有5%到12%的猫有瘙痒症状。汇总所有病例，半数的猫(111/210[53%])出现了面部/头部瘙痒。其他通常被发现的瘙痒部位包括耳部(7篇文章中有18 - 54%的猫)、腹部(6篇研究中有25 - 66%的猫)和爪部(6篇报告中有6 - 33%的猫)。与犬一样，猫有CAFR时，猫的会阴部不是一个经常发生瘙痒的区域(三篇文章中有10 - 15%的猫有这种症状)。

 

There was much heterogeneity in the reporting of skin lesions of feline CAFRs, as in dogs with this syndrome. In studies with more than one cat, the most commonly described clinical presentations were a presumed self-induced, often-symmetric alopecia (40 to 100% of cats in nine articles), a head-and-neck erosive/ulcerative/ crusted dermatitis (30 to 65% of cats in three such studies), the papulo-crusted miliary dermatitis (21 to 40% of cats in seven articles ) or variants of eosinophilic diseases (6 to 23% of cats in five reports). In the most recent studies, cats were diagnosed as having a concurrent non-flea-associated hypersensitivity/ AD in 19 to 100% of included cases.

猫与犬的皮肤病变报告有很大的异质性。研究中有超过一个猫,最常见的临床表现是一个假定的自我诱发因素,通常为对称性脱毛(40 - 100%的猫，9个文章),头颈糜烂/溃疡/结痂性皮炎(30 - 65%的猫，三个文章),在丘疹型结痂的粟粒状皮炎(21 - 40%的猫，七个文章)或各种嗜酸性疾病(6- 23%的猫，五个报告)。在最近的研究中，有19 - 100%的病例被诊断出同时存在非跳蚤相关的过敏反应/ AD。

 

Limitations

局限性

Several factors could limit the generalization of the findings to the population of dogs and cats with CAFRs. For example, the studies included spanned more than 30 years, and the methods, strictness, precision, and nomenclature of diagnoses evolved both over time and geographical areas, thus leading to some possible confusion. Furthermore, some of the manifestations of CAFRs (e.g., Malassezia dermatitis) were not recognized until the late 1980’s. The lack of comparison of signalment data with the then local companion animal population— and the relatively low number of affected individuals of rarer breeds in some studies—prevents an accurate assessment of age, sex and breed predispositions. The lack of reporting of long-known manifestations of CAFRs might lead to the erroneous perception that some diseases (e.g., food-induced urticaria) are rarer than in reality. Finally, some studies were limited to dogs with AD, and this could be a source of publication bias favoring the over-diagnosis of food-induced AD (FIAD). Of importance is that we could not separate cases with a bona fide FIAD from those with a CAFR with a concurrent yet not food-related AD.

有几个因素可能会限制搜寻CAFR患猫患犬数量。例如，这些研究跨越了30多年，诊断的方法、严格性、精确性和命名法随着时间和地理区域的变化而变化，从而导致了一些可能的混淆。此外，一些CAFRs的表现(如马拉色菌性皮炎)直到20世纪80年代末才被发现。在一些研究中，由于缺乏与当时当地伴侣动物数量的比较以及稀有患病品种个体数量相对较低，因此无法准确评估年龄、性别和品种的倾向。缺乏对长期已知的CAFRs表现的报告可能会导致一种错误的认识，即某些疾病(如食物引起的荨麻疹)比实际更罕见。最后，一些研究仅限于AD患犬，这可能是发表偏倚的一个来源，有利于过度诊断食物诱发的AD (FIAD)。重要的是，我们不能把真正的FIAD的病例与有CAFR但同时没有食物诱发性AD的病例分开。

 

Conclusion and implication for practitioners

结论与启示

In summary, CAFRs affect dogs and cats of nearly all ages and both genders, with the onset of clinical signs likely occurring later in cats than in dogs. Almost 40% of dogs develop cutaneous manifestations of AFR by one year of age, while this happens in about half that in cats. There are four canine breeds (German shepherd dogs, Labrador, and golden retrievers and West Highland white terriers) that account for over four of ten dogs with CAFR, but there is no reliable evidence of unique canine and feline breed predispositions to develop CAFRs.

综上所述，CAFR影响几乎所有年龄和性别的猫犬，猫出现临床症状的时间可能比犬晚。近40%的犬在一岁时出现AFR的皮肤表现，而猫只有大约一半出现这种情况。有四种犬种(德国牧羊犬、拉布拉多犬、金毛猎犬和西高地白㹴犬)占了CAFR患犬的十种犬种中的四种以上，但是没有可靠的证据表明特有CAFR犬种和猫种患病倾向。

 

Most dogs and cats with CAFRs appear to be pruritic, making this symptom a sensitive—albeit nonspecific— sign for such syndrome. While dogs with CAFR are affected more often with a generalized pruritus than cats with the same diagnosis, cats have more pruritic faces,heads and necks than dogs; other commonly pruritic areas in dogs and cats with CAFRs are the ears, ventrum, and feet. In contrary to current beliefs, the perineum is not usually the target of pruritic manifestations in either species.

大多数患有CAFR的猫犬都表现出瘙痒症状，这使得这种症状成为一种敏感但非特异性的症状。与有相同症状的猫相比，患有CAFR的犬更容易出现全身性瘙痒，但猫比犬更容易出现面部、头部和颈部瘙痒;患有CAFR的犬和猫的其他常见瘙痒部位是耳部、腹部和爪部。与当前的观念相反，在任何物种中，会阴部通常无瘙痒表现。

 

In dogs, the most often reported cutaneous manifestations of an AFR are recurrent bacterial and yeast skin infections, otitis externa and AD, which can all coexist in the same patient. In cats, CAFRs manifest as the expected syndromes associated with hypersensitivities, such as a usually-symmetric self-induced alopecia, a head (face)-and-neck self-traumatic dermatitis, the miliary dermatitis and variants of eosinophilic diseases.

在犬中，最常见的AFR皮肤表现是反复发作的细菌和酵母菌皮肤感染、外耳炎和AD，这些症状可以同时出现在同一个病例上。在猫中，CAFR表现为与与过敏反应相关的综合征，如通常为对称性自发性脱毛、头部(面部)和颈部自我损伤性皮炎、粟粒性皮炎和各种嗜酸性粒细胞性疾病。