Dr Ilario Dal Mas qualified from the Faculty of Veterinary Sciences of Milan University (Italy) in 1989 and spend two years in private practice before moving to South Africa in 1992. His first year in the country was spent at the local Faculty of Veterinary Sciences, Onderstepoort, then he moved to Johannesburg where he registered for an MSc with the Department of Physiology, Wits University. While completing his MSc he passed the SAVC board exam in 1996 to practice the Veterinary profession in South Africa. During the same period he started a PhD (Medicine) in the Faculty of Health Sciences (Wits). He obtained his MSc and PhD in 1996 and 2003 respectively. The Maxhealth Vet has done extensive scientific research, published peer reviewed articles and presented original studies at local as well as international congresses, practiced the Veterinary profession in Italy, France and South Africa and worked as Business Development Manager for an important Pet Food Company. He is the founder of Maxhealth Pet Diet C.C. He believes that Maxhealth Pet Diet can play an important role in enhancing the well being of many more beloved pets.
On the use of Maxhealth: In practice with Maxhealth.
The Maxhealth VetAlthough the concept of a Fish based dog food to reduce the incidence of allergies and food-related problems in the canine population is not new, to my knowledge, this is the first time that a "non-imported" formulation of this kind has been developed in South Africa. I worked for a while for an Italian pet food company, which took this concept to the market systematically more than 10 years ago with outstanding results.
As a practicing vet then I could observe the impact of a simple change of diet, on dogs presenting numerous probelms, all of which were documented in a list as a result of years of observation by a group of Italian colleagues and is now accepted as a simple way to identify the sensitive patient.
Most of the imported and locally manufactured dog foods have common animal protein and fat source, which is derivived from the intensive farming industry. This source has been the same over time and the meat industry still makes use of a variety of chemical/pharmacological substances, which may or may not be found as residues or metabolites in meat, meat by-products or fat. Early observations have linked food-related disorders to residues in intensive farming meat but no peer-reviewed studies have ever identified any of these substances as directly or indirectly causing one or more of the listed problems, neither have mechanisms been described or proved. This was an elimination-based observation. When dogs were fed intensive farming meat free diet, most of the problems on the list disappeared. On the other hand most of the dogs were not allergic to a particular animal protein as the elimination diet was still made of the original protein/s. In practice only 3-5% of cases in the affected population have been demonstrated to be truly allergic to a particular animal protein. Pet food companies have overestimated this reality promoting novel protein diets or modified protein diets with variable results. What happens then to the rest on the non-allergic, but presented as allergic dog population? Remember that from the clinical point of view we see the same picture in both, allergic and non-allergic and the treatment (based primarily on steroidal-antiinflammatory medication) also works in both.
Previous clinical experience in this country with fish-based home made diets proved fruitful so the concept had to be extended to a locally manufactured (extruded) fish- based product. Sometimes transfer of experience from other countries may be an advantage but this has to be followed by a thorough period of consistent positive results in the local environment. In June 2010 Maxhealth will be five years old and since its first extrusion it has been used under Veterinary supervison with good results. Word of mouth is the most efficent tool to promote a new food for dogs. Although I spent time visiting colleagues, and still visit new Veterinary Clinics, engaging their interest in Maxhealth is not easy. I still remember when I heard about this concept many years ago and then started using it for my patients. Result were significant, no doubt. One case in particular triggered a lot of thinking (it was 1999 and I was practicing in a town near Venice). A German Shepherd presenting severe perianal fistula pathology. The dog had already surgery performed and the disease was still very bad. I decided to try this new fish and rice formula as most of the times perianal fistula disease is connected to chronic cholitis which ultimately may be linked to a wrong diet. Results were very good, within one month the quality of life of the patient returned to normal. During the past 3 years I had one similar case (see the testimonials page) for which the diet was changed to Maxhealth. Results were also very good and the dog healed completely. A while ago I saw an article by Drs Lombardi RL and Marino DJ (1) where similar observations were investigated and published in the Journal of the American Animal Hospital Association (2008). In this case a famous brand of a Fish and potato diet was used. Fortunately perianal fistula disease is not common.
What is instead a common problem in South Africa is chronic pyoderma (infection of the skin) in white Bull Terriers. This problem seems to be specificly noted in the white Bull Terrier and it may have a genetic trigger (7). I must admit that using Maxhealth in these dogs has made a big difference as some of the patients recovered fully and some others are on occasional antibiotic treatment only. While delivering Maxhealth to one of the clinics I had a confirmation of this by the Vet in charge who told me about one particular white Bull Terrier that recovered fully from his severe chronic skin condition after Maxhealth was introduced. This may be a good research project as not much has been published on this topic.
www.maxhealth.co.za contains all the necessary information to have a broader picture of the Maxhealth concept including testimonials from customers.
What I will try to do now is to take some of the facts/observations of these past 3 years and link them to the practical approach to the patient.
Firstly I can confirm that all the problems listed in the table (food related disorders) have been observed in South African dogs and Maxhealth has positively contributed to improve the quality of life of pets presenting one or more of the listed conditions.
Two new problems have been noted and added to the original list namely: halitosis (bad breath) and intense summer itch.
I always thought that teeth had to be cleaned when a dog present bad breath. Some clients noted a positive change in breath odour after feeding Maxhealth. In other words, always take your pet to the Vet for a check up, periodontal disease are very common in dogs and teeth cleaning may be necessary, but if the mouth is fine try to feed Maxhealth before endorsing the breath fresheners available on the market. This may be a simple expression of a dog that is otherwhise healthy but needs a change of diet.
Intense summer itch is triggered in my opinion by hot environments such as the one we live in. Summer in South Africa can be very hot and definitively longer compared to other countries and the dog's skin (which has no sweat glands) can become more sensitive to consumption of substances such has fat and tallow (cooked fat) commonly present in dog food. Fat provide lots of energy and when not used will accumulated in the body. Lots of energy in hot climates is not necessary. Superfluous fat burning by the body may ultimately overheat the organism transforming a tolerable itch in a nightmare. In fact most of the acute cases of "hot spots", skin pyoderma, are noted during periods of high environmental temperature. Some dog owners report that their pets jump in the swimming pool very often during summer. Feeding a low fat (no added animal fat and tallow) diet may really help. Indeed some of our customers noted lower swimming session frequency after feeding Maxhealth for a period of time. Famous pet food brands are imported (most of them), this means that the formulations are not designed for South Africa only but for all countries and continents. So a dog in Norway or Canada may need more fat in the food to do well in a cold environment. Interestingly human suffering from severe itch are also told to try to cool the skin and personnel working in dog parlours describe how dogs with sensitive skin benefit from a simple bathing at least for few hours after the bath. So the "itchy summer dog" may just benefit from a low fat diet.
While reading relevant literature I came across a recent article on the steroid (prednisolone) sparing effect of essential fatty acid supplementation in the treatment of canine atopic dermatitis (2). Essential fatty acids from fish helped to reduce the dose of prednisolone needed to control the itch. The effect was significant after 60-80 days of supplementation. During the 3 years observing Maxhealth "in action" I came across very difficult cases presenting with severe ongoing pruritus. Specialist Veterinarians had seen some of them and all tests had already been performed, some were on desensitization therapy. Prednisolone though, remained the main treatment. By introducing Maxhealth a positive change was noted after 8 weeks of strict diet. In a few dogs, total remission was achieved. One very bad case took more than 2 years but finally the patient (Bouvier named Basil) was only on Maxhealth. No futher medication were dispensed as Basil, for the first time in his life, was finally itch free and all his coat had grown back. In other cases prednisolone was not completely withdrawn but administerd only occasionally, compared to an almost daily intake. Considering the side effects of steroids, any reduction in dosage and frequency of administration makes a big difference.
Diet we all know plays a major role in the management of pruritus, long term use of Maxhealth may do just that. In my opinion having essential fatty acids Omega 3 naturally present in the fatty component of the diet (fish-based food for dogs) and not supplemented on top of an intensive farming meat and fat based dog food may be much more powerful and natural. This has been investigated in humans and animal models (8, 9, 10)
Omega-3 from fish are more effectively incorporated into plasma lipids than when administered as supplement (8, 9), therefore a fish based diet may be more effective than adding omega-3 to the diet. This could be attributable to differences in physiochemical structure between lipids in fish and in fish oil (10)
Pruritus threshold is another well known concept in dermatology and I came to a simple conclusion while observing patients on Maxhealth. By using the diet over time we really do increase this threshold and that is why itch may decrease or cease. The lowering of this threshold could be attributable to many factors, including pharmacological residues in meat, meat by-products and fat. Once the dog has reached a low threshold, common triggers such as grass (how many dogs have been diagnosed allergic to grass?), flea bite, insect (mosquito bite, spider bite)(12), heat, high humidity, sun, pollen (3,11), house dust mites (4), dog food mites (5) and food allergens (6, 13) could start the itch/scratch cycle. By reading more literature on the subject and looking at described mechanism of dermatological pathology we can note that this particular field of Veterinary Medicine is one of the most challenging areas of our profession. Dermatology as one of my Professors at Veterinary School used to say, is the "grave of any good Vet".
Maxhealth does its job because it is a simple diet, has a non-industrial source of animal proteins and fat and its fat content is very low, virtually trans fats free. This may be the reason why most of the overweight dogs lose weight while on the diet (reported by dog owners). Considering the high level of obesity in our canine population, Maxhealth could be an alternative "light" diet.
A frequently asked question: - Is Maxhealth good or indicated for senior dogs?- My oldest patients was 15 years old (Scottish Terrier) when I told the owner that he was suffering from a food-related problem. The groomer refused to groom the dog, as the coat was so bad and the dog so old. Well, once Maxhealth wasintroduced the owner reported that the behaviour of his beloved Scotty had changed to the point that he started barking again, running to the gate, behaving as a young dog again, the coat improved so much that grooming was resumed and 2 years later (now 17) the dog was still in very good condition his skin now normal. The quality of his life had greatly improved.
Few words about Maxhealth Puppy Junior. This formula was developed to provide nutrition to growing puppies of all breeds. During the past 3 years small, medium and large breeds puppies have grown perfectly on Maxhealth. Furthermore Maxhealth can be used for sensitive puppies. Puppies can become sensitive (itchy) as soon as 2 months of age and I have seen many of them where fleas and other problems were ruled out and did perfectly well after the diet was switched to Maxhealth. Sometime owner noted changes after 1-2 months though, but there is no doubt that a change of diet is necessary in young sensitive patients.
MAXHEALTH IS NOT A PRESCRIPTION DIET AND THE MAXHEALTH VET IS NOT A SPECIALIST VETERINARY DERMATOLOGIST. MAXHEALTH IS A SMART GROWING AND MAINTENANCE FOOD FOR DOGS.
(1) Long-term evaluation of canine perianal fistula disease treated with exclusive fish and potato diet and surgical excision. Lombardi RL & Marino DJ. J. Am. Anim. Hosp. Assoc. 2008; 44: 302-07.
(2) A randomized, controlled study to evaluate the steroid sparing effect of essential fatty acid supplementation in the treatment of canine atopic dermatitis. Saevik BK et al. Vet. Dermatol. 2004; 15: 137-45.
(3) The prevalence of positive intradermal allergy tests in 114 dogs with atopic dermatitis in the Bangkok metropolis, Thailand. Chanthick C., Anaman S., Buathet K. J. Vet. Immunol. Immunopathol. 2008; 126: 256-62
(4) House dust and forage mite allergens and their role in human and canine atopic dermatitis. Nuttal T.J. et al. Vet. Dermatol. 2008; 17: 223-235
(5) Evaluation of storage mite conatmination of commercial dry dog food. Brazis P. et al. Vet. Dermatol. 2008; 19: 209-214
(6) A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland. Picco et al. Vet. Dermatol. 2008; 3: 150-5.
(7) Altered cutaneous expression of beta-defensins in dogs with atopic dermatitis. van Damme C.M., Willemse T., van Dijk A., Haaqsman H.P. Mol Immunol. 2009; 46: 2449-55.
(8)Visioli F., Barassi M.C., Marangoni F. and Galli C. Dietary intake of fish vs. formulations leads to higher plasma concentration on omega-3 fatty acids. Lipids 2003; 38: 415-8.
(9)Torkildsen O., Brunborg L.A., Milde A.M., Mork S.J., Myhr K-M. and Bo L. A salmon based diet protects mice from behavioural changes in the cuprizone model for demyelination. Clinical Nutrition 2009; 28: 83-87.
(10) Elvevoll E.O., Barstad H., Breimo E.S., Brox J.,Eilertsen K.E., Lund T., Olsen J.O. and Osterud B. Enhanced incorporation on omega-3 fatty acids from fish compared with fish oils. Lipids 2006; 41: 1109-14.
(11) Masuda K et al Seasonal atopic dermatitis in dogs sensitive to a major allergen of Japanese cedar (Cryptomeria japonica) pollen. Vet Dermatol. 2002; 13: 53-59
(12) Bevier, DE. Insect and arachnid hypersensitivity. Vet Clin North Am Small Anim Pract. 1999; 29: 1385-1406.
(13) Martin A et al Identification of allergens responsible for canine cutaneous adverse food reaction to lamb, beef and cow’s milk. Vet .Dermatol. 2004; 15: 349-56.