Diagnostic Performance of Immunoglobulin E Serology, Prick Test and Patch Test With Food Allergens in Dogs With Atopic Dermatitis and Adverse Food Reactions Using the Double-Blind Placebo-Controlled Food Challenge as Gold Standard.

IgE serology, prick test, and patch test perform poorly for identifying food allergens in dogs with atopic dermatitis.

This prospective study evaluated the diagnostic performance of three commonly used allergy tests—IgE serology, intradermal prick test, and patch test—for identifying causative food allergens in dogs with atopic dermatitis (AD) and adverse food reactions (AFRs). Twelve dogs with confirmed AD and AFRs underwent double-blind placebo-controlled food challenges (DBPCFCs) with eight food items, which served as the gold standard for identifying offending foods. The same eight food allergens were tested using IgE serology, prick test, and patch test prior to DBPCFCs. Across all three modalities and their combinations, diagnostic performance was poor. Sensitivity ranged from 3% to 60.6%, specificity from 54.8% to 98.4%, positive predictive value (PPV) from 25% to 66.7%, and negative predictive value (NPV) from 64.1% to 72.3%. Likelihood ratio analysis revealed that only the prick test reached a weakly informative positive likelihood ratio (3.81); all other values fell outside clinically useful ranges. These results indicate that neither individually nor in combination do these tests reliably identify specific food triggers in canine AD patients. The study highlights a critical limitation in current diagnostic approaches to food allergy in dogs and reinforces that dietary elimination trials followed by DBPCFC remain the most rigorous method for diagnosing AFRs. Clinicians should exercise caution when interpreting serology and skin testing results for food allergens in dogs with suspected AFRs.

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