Food Allergy in Companion Animals: Integrating Traditional Diagnostics with Emerging Approaches

Food allergy is an exaggerated immune response, mediated by Immunoglobulin E (IgE) or by cells, to food antigens. Dogs and cats may present with both dermatological and gastrointestinal manifestations, although non-seasonal pruritus is the most common clinical sign. Despite advances in understanding the immunopathogenesis of this condition, the elimination–provocation test remains the gold standard for diagnosis. However, new diagnostic approaches, like molecular allergen macroarrays and lymphocyte proliferation assays, may complement traditional strategies, opening new perspectives for accurate diagnosis. For long-term management, strict avoidance of offending allergens is essential, but emerging therapeutic interventions, including immunotherapy using food components and targeted modulation of the gut–skin axis, are promising for improving clinical outcomes. This review summarizes current knowledge and highlights innovative approaches that can transform the diagnosis and management of food allergy in companion animals.