10/28/2026
A 2026 systematic review published in the Journal of the American Veterinary Medical Association (JAVMA) evaluated diagnostic methods for canine adverse food reactions. The review included 59 studies from 16 countries, published between 1986 and 2025.
Key findings
• Serological and salivary tests: IgE-, IgG-, and saliva-based tests showed poor correlation with clinical outcomes, limiting their reliability for diagnosis.
• Cutaneous tests: Standardized patch testing demonstrated the best performance among cutaneous methods, particularly in terms of negative predictive value. However, its practical clinical utility remains limited.
• Cellular tests: Lymphocyte proliferation assays showed the closest agreement with oral food challenge results. These methods warrant further investigation as potential diagnostic biomarkers.
• Molecular and proteomic methods: These approaches have contributed to allergen characterization and our understanding of cross-reactivity but have not replaced established diagnostic methods.
Clinical relevance
The elimination diet test followed by an oral food challenge (EDT+OFC) remains the reference standard for diagnosing canine adverse food reactions. No alternative test has demonstrated sufficient reliability to replace this approach.
Although some diagnostic methods show promise, further research, standardized protocols, and well-designed prospective studies are needed to establish their clinical applicability.
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Reference
Morales-Romero R, Gonzalez-Dominguez MS, Roldán-Villalobos W, Correa-Valencia NM. Systematic review supports the idea that no alternative test presently replaces elimination diet test and oral food challenge to diagnose canine adverse food reactions. J Am Vet Med Assoc. 2026; published online October 23, 2026. doi:10.2460/javma.26.06.0456.
