A scoring index for disease activity in canine inflammatory bowel disease

A Multicenter Observational Study Comparing Survival of Pugs and Dogs of Other Breeds With Protein-Losing Enteropathy

BACKGROUND

Protein-losing enteropathy (PLE) in dogs often carries a guarded prognosis, and it is unclear if survival differs among breeds.

HYPOTHESIS/OBJECTIVES

Survival of pugs with PLE is shorter than that of other breeds of dogs with PLE.

ANIMALS

Forty-seven pugs and 148 dogs of other breeds were diagnosed with PLE at seven United Kingdom (UK) referral hospitals.

METHODS

Retrospective, multicenter observational study. Case records were reviewed to identify dogs diagnosed with PLE. Cox's proportional hazards regression was used to determine variables associated with survival.

RESULTS

Median (interquartile range) survival in pugs with PLE and dogs of other breeds was 104 (22-719) days and 759 (61-1632) days, respectively (p = 0.002). The hazard of death was higher in pugs (hazard ratio [HR]: 1.961; 95% confidence interval [CI]: 1.108-3.741; p = 0.002) than in other dogs. Neutrophil counts in peripheral blood were associated with an increased hazard of death (HR change per 1 × 109/L: 1.045; 95% CI: 1.014-1.077; p = 0.004), whereas cobalamin concentration (HR: 0.995; 95% CI: 0.991-0.999) and cobalamin supplementation (HR: 0.517; 95% CI: 0.271-0.988) were positively associated with decreased hazard of death. A time-dependent effect on survival was identified for serum globulin concentrations, whereby globulin concentration was positively associated with hazard of death in dogs surviving 61-959 days (HR: 1.126; 95% CI: 1.040-1.219) and > 959 days (1.253; 95% CI: 1.048-1.497), but not 0-60 days (HR: 0.949; 95% CI: 0.891-1.011 days).

CONCLUSIONS AND CLINICAL IMPORTANCE

Results of our observational study suggest a worse prognosis for pugs with PLE compared to a selection of dogs of other breeds seen at UK referral centers.

Supplementation of Vitamin K1 in Dogs With Chronic Enteropathy

BACKGROUND

Information regarding measurement and supplementation of vitamin K1 (vitK1) in dogs with chronic enteropathy (CE) is limited.

HYPOTHESIS/OBJECTIVES

Compare vitK1 concentrations of healthy dogs to dogs with CE and determine if supplementation with vitK1 increases vitK1 concentrations compared to placebo.

ANIMALS

Twenty client-owned dogs with CE and 20 healthy university-owned research colony dogs.

METHODS

Prospective, randomized, placebo-controlled study. Dogs with CE were randomly assigned to receive placebo or vitk1 2.5 mg/kg PO q12h for 3 weeks. Vitamin K concentrations were measured pre- and post supplementation using liquid chromatography tandem mass spectrometry and compared to vitK1 concentrations in the healthy cohort.

RESULTS

All healthy dogs had initial vitK1 median concentrations of 0.10 ng/mL (interquartile range [IQR], 0.05), which was similar to dogs that received either placebo (n = 5; 0.10 ng/mL; IQR, 0.05) or vitK1 (n = 7; 0.10 ng/mL; IQR, 0.05) before supplementation. Dogs with CE receiving vitK1 had increased vitK1 concentrations (12.5 ng/mL; IQR, 4.1) after 3 weeks of supplementation compared with baseline (0.10 ng/mL; p < 0.001), placebo group after 3 weeks (0.10 ng/mL; p < 0.0001) and healthy dogs (0.10 ng/mL; p < 0.004).

CONCLUSIONS AND CLINICAL IMPORTANCE

Oral supplementation with vitK1 increased vitK1 concentration in the serum of dogs with CE, but a clinical benefit from increased vitK1 concentrations was not identified. The absence of difference in vitK1 concentrations between healthy and CE dogs before supplementation requires additional investigation.

Prospective Estimation of the Prevalence of Thromboembolism in Dogs With Inflammatory Protein-Losing Enteropathy

BACKGROUND

Inflammatory protein-losing enteropathy (iPLE) is thought to be associated with a hypercoagulable state and may predispose dogs to thromboembolism (TE). However, little information is available regarding the prevalence of TE in dogs with iPLE.

OBJECTIVES

Estimate the prevalence of TE in dogs with iPLE and collect clinical and clinicopathologic data from dogs with iPLE with and without TE.

ANIMALS

Twenty-two client-owned dogs with iPLE.

METHODS

Prospective, descriptive study. Dogs definitively diagnosed with iPLE based on standard diagnostic criteria and histopathology were recruited between January 2019 and February 2024. At the time of gastrointestinal endoscopic examination, dogs with iPLE underwent thoracic and abdominal computed tomography angiography to detect TE. Clinical (e.g., clinical severity, use of corticosteroids) and clinicopathologic (e.g., albumin concentration, coagulation parameters) data were collected from dogs with iPLE with and without TE.

RESULTS

Thromboembolism was found in 3/22 dogs (13.6%, 95% confidence interval: 2.9-34.9) with iPLE. The three dogs with iPLE and TE had thrombi in the left external iliac artery, pulmonary artery of the right caudal lobe, and main portal vein, respectively. The dogs with thrombi in the left external iliac artery or pulmonary artery did not show any clinical signs associated with TE, whereas the dog with portal vein thrombosis had transudative peritoneal effusion.

CONCLUSION AND CLINICAL IMPORTANCE

We estimated the prevalence of TE in dogs with iPLE. In dogs with iPLE, TE could be underestimated because some affected dogs have subclinical TE.

Association of Diet With Treatment Response in Dogs With Chronic Enteropathy: A Retrospective Multicenter Study

BACKGROUND

Hydrolyzed protein diets are commonly used in the first-line approach to the treatment of dogs with naïve-chronic enteropathy (naïve-CE).

OBJECTIVES

To characterize the responses of naïve-CE dogs transitioned to a hydrolyzed diet and to assess the efficacy of an additional dietary trial in dogs with NRE.

ANIMALS

Eighty-one dogs with naïve-CE and 23 dogs with NRE.

METHODS

Retrospective multicenter cohort study including dogs with CE presented to three referral centers from April 2018 to December 2021. Naïve-CE and NRE cases transitioned to hydrolyzed and alternative diets, respectively, were selected, and medical records were reviewed. Clinical response before and 4 weeks after dietary transitions (with or without concurrent therapeutic adjustments) was assessed based on stool-consistency score or Canine Inflammatory Bowel Disease Activity Index (CIBDAI) total score in naïve and NRE cases, respectively.

RESULTS

The transition into a hydrolyzed diet was the only therapeutic change in 20% (16/81). Of these, 88% (14/16) had a decreased stool-consistency score (p < 0.001). From the 23 NRE cases, the transition to an alternative diet was the sole therapeutic adjustment in 70% (16/23). Of these, the total CIBDAI score declined in 69% (11/23; p < 0.001).

CONCLUSIONS AND CLINICAL IMPORTANCE

This study supports the need to feed a hydrolyzed diet in naïve CE cases. In cases classified as NRE, an additional transition into an alternative dietary trial seems beneficial.

Effect of faecal microbial transplantation on clinical outcome, faecal microbiota and metabolome in dogs with chronic enteropathy refractory to diet

Chronic enteropathy (CE) is a common complaint in canine gastroenterology. Recently, faecal microbiota transplantation (FMT) gained attention as a treatment strategy. However, the efficacy and long-term impact of FMT is still unclear. Clinical index (CIBDAI), faecal microbiota and metabolome were monitored in 20 CE dogs refractory to diet before (T0) and 3 months (T3) after FMT. Further data were retrospectively collected up to 1-year after FMT. Significant improvements were observed in CIBDAI, Dysbiosis Index (DI), and primary (PBAs) and secondary (SBAs) faecal bile acids and propionate one month (T1) after FMT (CIBDAI (median and range): T0 5 (1-9) vs. T1 1 (0-5), p < 0.0001; DI (median and range): T0 -0.1 (-5.6 to 3.8) vs. T1 -2.1 (-5.7 to 4.7), p < 0.05; PBAs decreased by 57%, SBAa increased by 41%; propionate increased by 20%). According to CIBDAI, 17 dogs clinically improved up to T3, and 10 dogs remained clinically stable up to one year after FMT. Alpha- and beta-diversity of the faecal microbiota of CE dogs did not differ, neither before nor after FMT, from that of 17 healthy controls. The results highlight that CE dogs refractory to diet with mild clinical signs and dysbiosis may benefit long-term from treatment with FMT.

Closed-loop theranostic microgels for immune microenvironment modulation and microbiota remodeling in ulcerative colitis

Inflammatory bowel disease (IBD) is characterized by the upregulation of reactive oxygen species (ROS) and dysfunction of gut immune system, and microbiota. The conventional treatments mainly focus on symptom control with medication by overuse of drugs. There is an urgent need to develop a closed-loop strategy that combines in situ monitoring and precise treatment. Herein, we innovatively designed the 'cluster munition structure' theranostic microgels to realize the monitoring and therapy for ulcerative colitis (a subtype of IBD). The superoxide anion specific probe (tetraphenylethylene-coelenterazine, TPC) and ROS-responsive nanogels consisting of postbiotics urolithin A (UA) were loaded into alginate and ion-crosslinked to obtain the theranostic microgels. The theranostic microgels could be delivered to the inflammatory site, where the environment-triggered breakup of the microgels and release of the nanogels were achieved in sequence. The TPC-UA group had optimal results in reducing inflammation, repairing colonic epithelial tissue, and remodeling microbiota, leading to inflammation amelioration and recovery of tight junction between the colonic epithelium, and maintenance of gut microbiota. During the recovery process, the local chemiluminescence intensity, which is proportional to the degree of inflammation, was gradually inhibited. The cluster munition of theranostic microgels displayed promising outcomes in monitoring inflammation and precise therapy, and demonstrated the potential for inflammatory disease management.

Effects of a Western Diet on Colonic Dysbiosis, Bile Acid Dysmetabolism and Intestinal Inflammation in Clinically Healthy Dogs

BACKGROUND

Consumption of a high-fat, high-carbohydrate Western-style diet (WD) associated with obesity and inflammation in humans has not been investigated in dogs.

AIMS

To determine the effects of WD on inflammatory indices, microbiome, and fecal bile acids (BAs) in dogs.

ANIMALS

Ten adult clinically healthy dogs.

METHODS

A dietary trial compared the effects of two home-prepared diets: a high-fiber, low-fat control diet (CD) to a diet containing the macronutrient composition of WD (low-fiber, high fat). Dietary treatments were given sequentially for three feeding periods, each lasting 1 month. Outcome measures included molecular/microbiologic testing of colonic biopsies, histopathology, inflammatory biomarkers, and quantification of fecal BA following each feeding period.

RESULTS

Cell markers of apoptosis (TUNEL-positive cells: CD1, 0.36% ± 0.2%; WD, 0.79% ± 0.5%; CD2, 0.42% ± 0.3%; 95% CI) and inflammation (NF-ĸB area: CD1, 8.09% ± 3.3%; WD, 11.58% ± 3.4%; CD2 7.25% ± 3.8%; 95% CI), as well as serum high-sensitivity C-reactive protein (CD1, 2.0 ± 0.4 ng/mL; WD, 2.76 ± 0.23 ng/mL; CD2, 2.29 ± 0.25 ng/mL; 95% CI), were increased (p < 0.05) in dogs fed WD versus CD. Other perturbations seen with WD ingestion included altered (p < 0.05) colonic mucosal bacteria (bacterial counts: CD1, 301.5 ± 188.5; WD, 769.8 ± 431.9; CD2, 542.1 ± 273.9; 95% CI) and increased (p < 0.05) fecal cholic acid (median and interquartile range/IQR: CD1, 9505 [2384-33 788] peak heights; WD, 34 131 [10 113-175 909] peak heights) and serum myeloperoxidase (CD1, 46.98 ± 16.6 ng/mL; WD, 82.93 ± 33.6 ng/mL; CD2, 63.52 ± 29.5 ng/mL; 95% CI).

CONCLUSIONS AND CLINICAL IMPORTANCE

WD fed to clinically healthy dogs promotes colonic dysbiosis, altered fecal BA, and low-grade inflammation independent of obesity.

Chronic Enteropathy and Vitamins in Dogs

Chronic enteropathy (CE) or chronic inflammatory enteropathy is a group of diseases with multiple and different etiologies characterized by chronic gastrointestinal signs such as vomiting, diarrhea, anorexia, weight loss for more than 3 weeks, and inflammatory cell infiltration, such as lymphoplasmacytic cells in the intestinal mucosal lamina propria. The diagnosis was histologically confirmed after excluding other diseases such as parasitic infections, tumors, pancreatitis, exocrine pancreatic insufficiency, metabolic diseases, and endocrine diseases, such as hypoadrenocorticism. Nutritional management depends on several important functions, such as digestion and absorption processes, digestive enzymes and nutritional transporters, and barrier functions. Intestinal dysbiosis may have been found to be involved in various functions. Recently, cobalamin (vitamin B12) and vitamin D have been considered negative prognostic factors in dogs with CE. Cobalamin supplementation ameliorates clinical disease severity in dogs with CE, and vitamin D supplementation ameliorates hypocalcemia in dogs with CE and hypoalbuminemia. Therefore, the aim of this review is to provide an overview of CE and present treatment and nutritional management strategies for CE and prognostic vitamins.

An extensively hydrolysed protein-based extruded diet in the treatment of dogs with chronic enteropathy and at least one previous diet-trial failure: a pilot uncontrolled open-label study

BACKGROUND

Canine chronic enteropathies (CE) are a group of disorders defined by persistent or recurrent clinical signs of gastrointestinal disease without a primary neoplastic, metabolic, parasitic, or other infectious cause. In this prospective, multicentre, uncontrolled, open-label study, a commercial dry diet with a protein source of extensively hydrolysed poultry feather was assessed in the management of dogs with CE that had not responded to previous dietary and antibacterial therapies. Dogs with moderate or marked protein-losing enteropathy were excluded. After screening, dogs entered stage 1 and started the test diet. Gastrointestinal endoscopy was performed, and only dogs with histopathological evidence of small intestinal inflammation confirming CE could continue to stage 2 of the trial. The test diet was fed for 10 weeks throughout stages 1 and 2, and the primary outcome measure was clinical success defined as a reduction in canine inflammatory bowel disease activity index (CIBDAI) of ≥ 75%. Secondary outcomes included body condition score (BCS, scale 1-9) and faecal consistency score (scale 1-5). Results (median [range]) for dogs with confirmed CE that participated in both study stages are reported.

RESULTS

A total of 15 dogs commenced stage 1, and 13 of these progressed to stage 2 (age 4.2 [1.1-7.1] years; BCS 3 (2-4); previous diet therapies 2 [1-3]) of which two were withdrawn at week 5 for protocol deviations. CIBDAI scores decreased from 9 (7-16; n = 13) at baseline to 2 (1-11; n = 13) at week 2 (P < 0.001), 2 (0-6; n = 13) at week 5 (P < 0.001), and 1 (0-3; n = 11) at week 10 (P < 0.001). Treatment success was achieved by 8/13 dogs at week 5 and 10/11 dogs at week 10. Faecal score (n = 11) and BCS (n = 11) improved between baseline (1 [1-3] and 3 [3-4], respectively; P < 0.001) and week 10 (4 [3-5] and 4 [3-5], respectively; P < 0.001).

CONCLUSIONS

Dogs with CE that had failed to respond to previous dietary and antibacterial therapy showed clinical improvement within 10 weeks when fed a dry extruded diet with a single protein source hydrolysed to amino acids and oligopeptides, without concurrent immunosuppressant treatment.

Chronic enteropathy in dogs affects the quality of life in both dogs and their owners-are veterinarians proficient in handling the caregiver burden?

Introduction

Chronic disease is generally known to affect dogs' quality of life (QoL) as well as being associated with increased strain on their owners. Gastrointestinal (GI) disease is a common problem in companion animal practice, yet little is known about the QoL of dogs with chronic enteropathy (CE) and how their owners and veterinarians assess it.

Methods

The aim of this study was to explore: (i) how dog owners and veterinarians observed and evaluated QoL for dogs with chronic GI disease, (ii) how having a dog with CE affected the owner's QoL, and (iii) characteristics of the communication and relationship between the dog owner and veterinarian. Twenty owners of dogs with CE and 20 companion animal veterinarians were included in this qualitative, interview-based, exploratory study.

Results

Owners evaluated QoL based on their dog's apparent emotional state, the presence of clinical signs, or restrictions in their daily life. In their assessments, veterinarians looked at the presence or absence of normal behavior, but also at disease severity and the emotional state of the dog. The majority of owners experienced many concerns and burdens that impacted their own QoL, including daily logistical challenges, implementing therapeutic regimens such as diet restriction, administering multiple daily medications, and the strain of nursing responsibilities on the owner-dog relationship. Dog owners generally felt that communication with their veterinarians was good, while veterinarians found the communication laborious and time-consuming.

Discussion

In general, owners and veterinarians were aligned in their QoL assessments, and the majority of veterinarians relied heavily on the owners' input and observations. However, assessments were not done in a standardized fashion among either group. Logistical challenges of having a dog with a chronic GI disease often lead to lifestyle changes for the owners, including altering working hours and cancelling holidays or other social arrangements. Having a dog with CE therefore affected the owners' QoL even when the dogs were clinically stable. Providing owners with written material about the condition in addition to medical and feeding regimen instructions may help the owner, improve compliance, and decrease the non-billable hours the veterinarian must spend communicating with the owner about their dog's CE.

Harnessing the microbiome: probiotics, antibiotics and their role in canine and feline gastrointestinal disease

Unfavourable alterations of the host microbial environment, known as dysbiosis, have been identified in many canine and feline gastrointestinal (GI) diseases. As a result, normalisation of microbial composition and function has become an important therapeutic target. Given the complex and individualistic interplay between the resident microbiota, host and environment, a multimodal approach is often necessary when addressing dysbiosis in dogs and cats with GI disease. Systemic antibiotics are often empirically used to treat acute and chronic GI diseases. However, with modern genomic techniques demonstrating the profound negative effect antibiotics can have on the GI microbiota and the rapid emergence of resistant bacteria globally, there has been an increased focus on identifying antibiotic alternatives for use in small animal practice. Biotics, such as prebiotics, probiotics and synbiotics, are of growing interest due to their potential supportive effect on the microbiota. This article reviews the evidence for the use of biotics in canine and feline GI disease, highlighting how judicious use of antibiotics and targeted probiotic supplementation can enhance patient outcomes by promoting a balanced gut microbial environment.

Comparative Evaluation of Lipid Profile, C-Reactive Protein and Paraoxonase-1 Activity in Dogs with Inflammatory Protein-Losing Enteropathy and Healthy Dogs

Chronic inflammation alters lipoprotein metabolism and causes changes in the serum concentrations of lipids, C-reactive protein (CRP), and paraoxonase-1 activity (PON-1), an enzyme that may act as a local detoxifier, antioxidant, and immunomodulator in the gastrointestinal tract. Scarce information is available in dogs with protein-losing enteropathy secondary to chronic enteropathy (iPLE). The first aim was to describe and compare the lipid profiles, CRP concentrations and PON-1 activities in healthy dogs and in dogs with iPLE. The second aim was to evaluate correlations among clinicopathological, histologic data and lipid profiles in dogs with iPLE. Serum samples from 51 iPLE and 40 healthy dogs were used to study albumin, total protein, CRP, PON-1 activity, cholesterol, triglycerides and lipoprotein classes. Serum concentrations of albumin, total protein, cholesterol, PON-1 activity, and high-density and very-low-density lipoproteins were lower in iPLE dogs compared to healthy controls, while those of triglycerides, low-density lipoproteins, chylomicrons and CRP were higher. Significant correlations between the lipid profile and the existing chronic enteropathy activity index were not found. High-density and low-density lipoproteins correlated with CRP and PON-1. Triglycerides were significantly higher in dogs with both inflammation and lymphangiectasia. The results need to be confirmed in further studies.

Duodenal and colonic mucosal S100A8/A9 (calprotectin) expression is increased and correlates with the severity of select histologic lesions in dogs with chronic inflammatory enteropathy

BACKGROUND

Calprotectin, a damage-associated molecular pattern protein of the S100/calgranulin family, is a potential marker of gastrointestinal inflammation in dogs and mainly originates from activated macrophages and granulocytes. Increased calprotectin concentrations are reported in feces and serum samples from dogs with chronic inflammatory enteropathy (CIE), but mucosal calprotectin expression has not been extensively investigated in canine CIE. Thus, we aimed to evaluate gastrointestinal mucosal concentrations of calprotectin in 62 dogs (44 dogs with CIE compared to 18 healthy Beagles) using a particle-enhanced turbidimetric immunoassay method. Additionally, we assessed the relationship of gastric, duodenal, jejunal, ileal, and colonic mucosal calprotectin levels with the clinical disease severity (canine clinical inflammatory bowel disease activity index, CIBDAI), histopathologic findings, clinical outcome, and serum albumin concentrations to further evaluate the potential of calprotectin as a biomarker for CIE.

RESULTS

Mucosal calprotectin concentrations in dogs with CIE were significantly higher in the duodenum (median: 276.2 μg/g) and colon (median: 298.2 μg/g) compared to healthy controls (median: 94.3 μg/g, P = 0.0039; and median: 112.0 μg/g, P = 0.0061). Similar numerical differences in the ileum and cecum were not statistically significant, and mucosal calprotectin concentrations correlated significantly among the different gastrointestinal segments. Histologic lesion severity was linked to mucosal calprotectin concentrations for inflammatory and structural histology criteria in the duodenum and colon (all P < 0.05). Higher mucosal calprotectin levels in the duodenum and across all segments correlated with lower serum albumin concentrations (both P < 0.05); duodenal mucosal calprotectin concentrations were more than sixfold higher in hypoalbuminemic dogs (median: 1441 µg/g, n = 4) than normoalbuminemic dogs (median: 227 µg/g, n = 40). There was no significant association of mucosal calprotectin levels with CIBDAI scores or individual clinical outcomes.

CONCLUSIONS

These results show that duodenal and colonic mucosal calprotectin concentrations are increased in dogs with CIE, providing further supporting evidence for the diagnostic potential of fecal calprotectin (presumably reflecting mucosal) concentrations and in dogs with CIE. Further longitudinal research is needed to assess changes in mucosal calprotectin concentrations with clinical response to treatment vs. mucosal disease remission and to determine the clinical utility of fecal calprotectin concentrations to diagnose and monitor dogs with CIE in clinical practice.

Long-term evaluation of the initial response to therapy in 60 dogs with chronic inflammatory enteropathy

BACKGROUND

Dogs with chronic inflammatory enteropathy (CIE) are typically classified into food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunomodulator-responsive enteropathy (IRE), and nonresponsive enteropathy (NRE) based on response to therapy(ies). Reassessment of initial categorization (especially IRE and NRE) is lacking.

OBJECTIVES

Investigate validity of categorization scheme when reassessed at least 1 year after diagnosis.

ANIMALS

Sixty client-owned dogs with CIE.

METHODS

Retrospective study. Clinical information was gathered from records and owners from time of diagnosis (TD), time of initial response (TIR), and at least 1 year after diagnosis (T≥1y). Category change was defined as a switch between groups.

RESULTS

Median disease activity index (CIBDAI) at TD was 9 and reduced significantly to 1 at T≥1y (P < .0001). At TIR, dogs were categorized as: FRE 27/60 (45%, 95% binomial confidence intervals [CI], 0.32-0.58), IRE 30/60 (50%, CI 0.37-0.63), ARE 0/60 (0%), NRE 3/60 (5%, CI -0.01 to 0.11). Seventeen of 27 (63%) FRE dogs had previously had at least 1 unsuccessful diet trial. At T≥1y, categorization changed to FRE 44/60 (73%, CI 0.62-0.85), IRE 14/60 (23%, CI 0.13-0.34), ARE 0/60 (0%), NRE 2/60 (3%, CI -0.01 to 0.08). Group changes were found for 24/60 (40%) dogs, largest change was from IRE to FRE (19/24, 79%). Immunosuppressive dosages were administered as sole treatment in 1/30 (3%) IRE dogs at TIR.

CONCLUSIONS AND CLINICAL IMPORTANCE

Chronic inflammatory enteropathy categorization based on initial response to therapy needs reassessment after 1 year. Frequent change from IRE to FRE suggests that dogs initially categorized as IRE might have been initially categorized as FRE if multiple dietary trials had been performed. In our study, antibiotics were not needed to achieve satisfying clinical responses.

Characterization of faecal microbiota and serum inflammatory markers in dogs diagnosed with chronic enteropathy or small-cell lymphoma: a pilot study

Dogs diagnosed with chronic enteropathy (CE) or small-cell lymphoma (SCL) exhibit marked differences in faecal microbiota and organic acid profiles compared with healthy dogs, as well as immune abnormalities in intestinal mucosal tissue. However, few studies have analysed trace organic acids, such as succinic acid, which have been suggested to be associated with IBD in humans. Therefore, in this study, we compared the faecal microbiota and organic acid profiles as well as serum inflammatory markers between dogs with disease (n = 11; 6 with CE and 5 with SCL) and healthy controls (n = 16). We also performed machine learning and correlation analysis to obtain more detailed insights into the characteristics of affected dogs. These results revealed that dogs with CE and SCL had lower levels of Erysipelotrichaceae (e.g. Turicibacter and Allobaculum), exhibited abnormalities in the succinic acid metabolism (i.e. succinic acid accumulation and decreased levels of Phascolarctobacterium as succinic acid-utilising bacteria) and increased levels of pathobiont bacteria such as Escherichia-Shigella. Additionally, the presence of Dubosiella was significantly negatively correlated with Canine Inflammatory Bowel Disease Activity Index scores. These findings are expected to aid the development of microbiome-based medications and/or supplements, although further verification is needed.

Faecal Short-Chain, Long-Chain, and Branched-Chain Fatty Acids as Markers of Different Chronic Inflammatory Enteropathies in Dogs

Chronic inflammatory enteropathies (CIEs) are classified based on treatment trials, and new methods are being sought for earlier differentiation and characterization. Giardia infection (GIA) is one of the first differential diagnoses and may be present in CIE-affected dogs. The aim of this study was to evaluate the faecal characteristics and faecal fatty acid profile (short, medium, long, and branched-chain fatty acids) in dogs with food-responsive enteropathy (FRE), immunosuppressant-responsive enteropathy (IRE), and dogs infected with Giardia compared to healthy control (HC) animals as a potential non-invasive indicator of intestinal health that helps in the differentiation of CIEs. The C16:1n-7 percentage (p = 0.0001) and C16:1n-7/C16:0 ratio (p = 0.0001) served to differentiate between HC, FRE, and IRE. IRE dogs presented lower levels of short-chain fatty acids (∑SCFAs) (p = 0.0008) and acetic acid (C2) (p = 0.0007) compared to the other three groups and lower propionic acid (C3) (p = 0.0022) compared to HCs. IRE and GIA presented higher faecal fat content (p = 0.0080) and ratio of iso/anteiso branched-chain fatty acids (BCFAs) compared to HC and FRE. Correlations between some fatty acids and desaturation indices with the canine inflammatory bowel disease activity index and faecal characteristics were observed, suggesting that these compounds could play an important role in the pathogenesis of these diseases.

Serum D-Lactate Concentrations in Dogs with Inflammatory Bowel Disease

The D-enantiomer of lactic acid (D-lactate) is normally produced from bacterial fermentation in the gastrointestinal tract in mammals. In humans, increased D-lactate concentrations are related to gastrointestinal disease, including short bowel syndrome and malabsorptive syndrome. Similarly, increased D-lactate concentrations have been described in calves affected by diarrhea, in cats with gastrointestinal diseases, and in dogs with parvoviral enteritis. The purpose of the present study was to measure the serum D-lactate concentrations in dogs with inflammatory bowel disease (IBD). We retrospectively reviewed data from the database of the VTH of Perugia University, and dogs affected by IBD with serum samples stored at -80 °C were considered eligible for inclusion. A total of 18 dogs with IBD and 10 healthy dogs were included in the study. The dogs with IBD were divided into three subcategories based on the severity of the disease. Serum D-lactate concentrations (μM) were determined using a commercially available colorimetric assay kit (D-Lactate Colorimetric Assay Kit; Catalog #K667-100, BioVision Inc., Milpitas, CA, USA). Our results showed no significant difference (p > 0.05) in the serum concentrations of D-lactate between dogs with various degrees of IBD and healthy dogs. However, the wide variability of the D-lactate concentrations in dogs with IBD and evidence of increased serum D-lactate concentrations in dogs with confirmed dysbiosis encourage further studies on this topic to understand potential factors influencing the serum D-lactate concentrations in dogs affected by IBD.

Microbiota of healthy dogs demonstrate a significant decrease in richness and changes in specific bacterial groups in response to supplementation with resistant starch, but not psyllium or methylcellulose, in a randomized cross-over trial

Even though dietary fibres are often used as prebiotic supplements in dogs, the effect of individual types of fibres on canine microbiota composition is unknown. The objective of this study was to assess changes in faecal microbiota richness, diversity and taxonomic abundance with three different fibre supplements in dogs. These were psyllium husk, resistant starch from banana flour and methylcellulose. They were administered to 17 healthy dogs in a cross-over trial after transition to the same complete feed. Faecal scores and clinical activity indices were recorded, and faecal samples were collected before and at the end of supplementation, as well as 2 weeks after each supplement (washout). Illumina NovaSeq paired-end 16S rRNA gene sequencing was performed on all samples. After quality control and chimera removal, alpha diversity indices were calculated with QIIME. Differences in specific taxa between groups were identified using Metastats. Methylcellulose significantly increased faecal scores but had no effect on microbiota. Psyllium resulted in minor changes in the abundance of specific taxa, but with questionable biological significance. Resistant starch reduced microbiota richness and resulted in the most abundant changes in taxa, mostly a reduction in short-chain fatty acid-producing genera of the phylum Bacillota, with an increase in genera within the Bacteroidota, Pseudomonadota, Actinomycetota and Saccharibacteria. In conclusion, while psyllium and methylcellulose led to few changes in the microbiota composition, the taxonomic changes seen with resistant starch may indicate a less favourable composition. Based on this, the type of resistant starch used here cannot be recommended as a prebiotic in dogs.

Peripheral and intestinal T lymphocyte subsets in dogs with chronic inflammatory enteropathy

BACKGROUND

Dysregulated T lymphocyte response is thought to play a key role in chronic intestinal inflammation (CIE).

OBJECTIVES

To evaluate the presence of changes in peripheral and intestinal T lymphocyte subsets and to describe potential immune and inflammatory biomarkers in dogs with CIE.

ANIMALS

Sixteen healthy dogs and 26 dogs were diagnosed with CIE.

METHODS

Prospective case-control study evaluating peripheral and intestinal T lymphocytes using flow cytometry and inflammatory markers obtained from complete blood cell counts.

RESULTS

Dogs with CIE had higher peripheral activated T helper (Th) lymphocytes (87/μL [18-273] CIE, 44/μL [16-162] healthy control (HC, P = .013) and regulatory T cells (Treg; 108/μL [2-257] CIE, 34/μL [1-114] HC, P = .004). In the intestinal epithelium, CIE dogs presented lower percentages of Th (4.55% [1.75-18.67] CIE, 8.77% [3.79-25.03] HC, P = .002), activated Th cells (0.16% [0.02-0.83] CIE, 0.33% [0.05-0.57] HC, P = .03) and CD4/CD8 ratio (0.08 [0.02-0.39] CIE, 0.21 [0.07-0.85] HC, P = .003). Conversely, higher percentage of activated T cytotoxic cells (20.24% [3.12-77.12] CIE, 12.32% [1.21-39.22] HC, P = .04) and interferon-gamma (IFN-γ) producing T lymphocytes (7.36% [0.63-55.83] CIE, 1.44% [0.00-10.56] HC, P = .01) within the epithelium was observed. In the lamina propria the percentage of Treg lymphocytes was higher (6.02% [1.00-21.48] CIE, 3.52% [0.18-10.52] HC, P = .02).

CONCLUSIONS AND CLINICAL IMPORTANCE

Systemic and intestinal immune alterations occur in dogs with CIE suggesting that blood IFN-γ producing T lymphocytes and the systemic immune-inflamation index (SII) could potentially serve as biomarkers for the disease.

Efficacy and tolerance of oral versus parenteral cyanocobalamin supplement in hypocobalaminaemic dogs with chronic enteropathy: a controlled randomised open-label trial

OBJECTIVES

Determine comparative tolerance of daily oral and weekly parenteral cobalamin supplementation, in hypocobalaminaemic dogs with chronic enteropathy. Determine whether oral is as effective as parenteral supplementation at achieving eucobalaminaemia, in hypocobalaminaemic dogs with protein-losing enteropathy, severe hypocobalaminaemia or high canine inflammatory bowel disease activity index at inclusion.

MATERIALS AND METHODS

Thirty-seven client-owned dogs with hypocobalaminaemia and clinical signs of chronic enteropathy were prospectively enrolled in three UK referral centres. Dogs were randomly allocated to daily oral for 12 weeks or weekly parenteral cobalamin supplementation for 6 weeks and one additional dose 4 weeks later. Serum cobalamin, body condition score, canine inflammatory bowel disease activity index and bodyweight were assessed at inclusion, weeks 7 and 13. Serum methylmalonic acid concentration was evaluated at inclusion and at week 13. Owners completed treatment adherence, palatability, tolerance and satisfaction questionnaires at week 13.

RESULTS

Nineteen dogs completed the study. All dogs orally supplemented achieved normal or increased cobalaminaemia at weeks 7 and 13. There was no statistical difference in cobalamin concentration at week 13 in dogs treated with oral or parenteral supplementation, regardless of presence of protein-losing enteropathy, severity of hypocobalaminaemia or canine inflammatory bowel disease activity index at inclusion. Serum methylmalonic acid concentration was not significantly different between oral and parenteral groups, neither were treatment adherence, satisfaction, and tolerance scores at week 13.

CLINICAL SIGNIFICANCE

Oral is as effective and as well-tolerated as parenteral cobalamin supplementation in hypocobalaminaemic dogs with chronic enteropathy and severe clinical or biochemical phenotypes, and should be considered as a suitable treatment option regardless of disease severity.

Oxidative stress in dogs with chronic inflammatory enteropathy treated with allogeneic mesenchymal stem cells

The search for new biomarkers in patients with chronic inflammatory enteropathy (CIE) is ongoing in the human and veterinary medicine fields. Oxidative stress biomarkers (malondialdehyde [MDA], reduced glutathione [GSH], and albumin) have been studied in humans with chronic enteropathies, but among them, only albumin has been studied in dogs with CIE. Moreover, the effect of mesenchymal stem cell (MSCs) treatment with or without prednisone on these parameters has never been studied in dogs with CIE. These parameters were compared between healthy dogs (n = 12) and dogs with CIE, and before and 1, 3, 6, and 12 months after the treatment with MSCs alone (n = 9) or together with prednisone (n = 11). The relationship between the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) and oxidative stress was evaluated. Albumin was the only parameter that significantly differed between dogs with CIE and healthy dogs (p = 0,037). Differences were observed only in albumin values after combined treatment with MSCs and prednisone. No differences were observed in MDA and GSH after treatment with MSCs with or without prednisone. Albumin could help stage canine CIE, as well as its prognosis, as has already been demonstrated, although it is essential to evaluate this parameter for its antioxidant capacity, and therefore it could be a good biomarker of oxidative stress in this pathology. However, the treatment with MSCs seems unable to modify any of the analyzed oxidative stress parameters.

Kibble diet is associated with higher faecal glucocorticoid metabolite concentrations in zoo-managed red wolves (Canis rufus)

The red wolf (Canis rufus) is a critically endangered canid that exists solely because of the establishment of the ex situ population in the late 1980s. Yet, the population under human care suffers from gastrointestinal (GI) disease in captivity. While the cause of GI disease is unknown, it is speculated that environmental factors can influence GI health of zoo-managed red wolves. The goal of the present study was to investigate the relationship between faecal glucocorticoid metabolite (FGM) concentrations, a biomarker for stress, and environmental factors for zoo-managed red wolves. Faecal samples were collected from 14 adult wolves three times a week for 5 to 12 months. Using a single-antibody cortisol enzyme immunoassay, FGM concentrations were quantified. Environmental factors were collected for each participating wolf on dietary type, sex, type of public access to enclosure, density (enclosure size [ft2]/number of wolves living in enclosure) and a monthly average status of GI health. Red wolves that ate a commercial kibble diet had both higher FGM concentrations over time and higher baseline FGM concentrations compared to individuals that received commercial kibble mixed with commercial meat. Density, public access or GI health were not related to FGM concentration; however, males had higher baseline FGM concentrations compared to female red wolves. Our findings suggest that management conditions, particularly diet, can strongly influence FGM concentration in the zoo-managed red wolf population. Findings from this study highlight the importance of management choices on individual welfare. Maintaining a healthy captive population of red wolves is imperative for the persistence of the species, including successful future reintroductions.

Faecal microbiome transplantation improves clinical signs of chronic idiopathic large bowel diarrhoea in working dogs

BACKGROUND

Chronic diarrhoea is a common clinical sign in dogs with chronic enteropathy, and psyllium husk has been shown to improve clinical signs in affected dogs. The aim of this study was to investigate whether faecal microbiome transplant has a similar effect in alleviating clinical signs in dogs with chronic large bowel diarrhoea.

METHOD

Thirty large-breed working dogs with chronic large bowel diarrhoea were divided into a psyllium group (PG) and a faecal microbiome transplant group (FMTG). To the PG, 16 g/day of psyllium husk was administered for 30 days. The FMTG received faecal microbiome transplantation (FMT) once via enema. A daily log of faecal characteristics was kept, and the dogs' canine inflammatory bowel disease index (CIBDAI) and body condition scores (BCS) were determined. A Wilcoxon-Mann-Whitney test was used to compare group results. In addition, the Kaplan-Meier test was used to evaluate the occurrence rate of 1 day or more of diarrhoea and 2 days or more of diarrhoea by day 30.

RESULTS

The sample had a mean age of 3.9 ± 2.1 years and a bodyweight of 25.3 ± 6.8 kg. The FMTG showed a more rapid onset of CIBDAI improvement but no difference in other measures. At 30 days, the FMTG showed a greater improvement in bodyweight and BCS, but no differences were observed in faecal scores, defaecation frequency and time of appearance of episodes of diarrhoea. Time played a significant positive role in the results observed across both groups (p < 0.05).

LIMITATIONS

This study did not compare the microbiomes of the dogs before and after treatment, so the role of specific types of bacteria cannot be determined.

CONCLUSION

Psyllium husk and FMT had similar effects in improving clinical signs of chronic large bowel diarrhoea.

Fuzapladib in a randomized controlled multicenter masked study in dogs with presumptive acute onset pancreatitis

BACKGROUND

Currently, no specific treatment is available for acute onset pancreatitis (AP), and management relies on symptomatic and supportive standard of care (SOC). Fuzapladib is a novel leukocyte function-associated antigen type-1 (LFA-1) activation inhibitor, blocking activation and subsequent adhesion and migration of neutrophils, potentially decreasing the risk of pancreatitis progression and systemic inflammation.

OBJECTIVE

Evaluate the safety and clinical response of dogs with AP after 3 days of administration of fuzapladib.

ANIMALS

Sixty-one client-owned dogs with presumptive AP.

METHODS

Randomized, masked, and placebo controlled multicenter study. Sixty-one dogs with AP were included for safety assessment, whereas 35 evaluable cases (fuzapladib, n = 16; placebo, n = 19) were included for clinical evaluation. Clinical improvement was assessed based on the change in the modified clinical activity index (MCAI) score on Day 3 compared to Day 0. Secondary variables included canine acute pancreatitis clinical severity index (CAPCSI) scores and serum concentrations of canine pancreatic lipase immunoreactivity, cytokines, and C-reactive protein.

RESULTS

Fuzapladib was well tolerated by all treated dogs. Mean change in MCAI scores was significantly higher in the fuzapladib-treated (-7.75) than the placebo group (-5.68; P = .02, 95% confidence interval [CI] for the difference, -4.33, -0.35), suggesting clinical improvement in fuzapladib-treated dogs. No significant difference was found in any of the secondary variables between groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Administration of fuzapladib to dogs was safe, and a favorable response was detected in 2 clinical activity scores. Effects of fuzapladib on survival and duration of hospitalization were not studied.

Serum/Faecal S100A12, CRP and lactoferrin can be used to distinguish ınfectious and non-ınfectious canine diarrhoea

OBJECTIVES

This study aimed to evaluate the diagnostic efficacies of selected inflammatory and intestinal biomarkers in cases of infectious and non-infectious diarrhoea in dogs.

METHODS

A total of 60 dogs, 12 healthy (Control Group) and 48 with diarrhoea were used. Viral, Bacterial, Parasitic (infectious) and Nutritional diarrhoea (non-infectious) subgroups (n: 12) were formed according to the aetiology, on the basis of clinical and laboratory examinations. Selected inflammatory and intestinal biomarkers (Calgranulin, S100A12; Lactoferrin, LCTF; C-reactive protein, CRP) were measured both in serum and faecal samples.

RESULTS

Compared to the Control and Nutritional Diarrhoea groups, the infectious diarrhoea groups had higher serum S100A12, LCTF, CRP, blood urea nitrogen, creatinine (CR), alanine transaminase and alkaline phosphatase, and lower glucose (GLU), sodium (Na) and potassium (K) concentrations (p < 0.05); Viral and Parasitic Diarrhoea groups had lower serum albumin (ALB) and total protein (TP) concentrations (p < 0.05). Faecal S100A12, LCTF and CRP concentrations were higher in infectious diarrhoea groups compared to the Control and Nutritional Diarrhoea groups (p < 0.05). Faecal LCTF and CRP concentrations were higher in the Bacterial Diarrhoea group than in the Viral and Parasitic Diarrhoea groups (p < 0.05).

CLINICAL SIGNIFICANCE

It was determined that serum (area under curve, AUC: 0.842 and 0.956) and faecal (AUC: 0.975 and 0.786) S100A12 and CRP concentrations in viral diarrhoea; serum (AUC: 0.956) and faecal (AUC: 0.992) LCTF concentrations in bacterial diarrhoea have diagnostic values in the diagnosis of the presence of intestinal inflammation and damage and can be used in the differential diagnosis of infectious and non-infectious diarrhoea.

Efficacy of an elemental diet in achieving clinical remission in dogs with chronic enteropathy

BACKGROUND

Diet may induce clinical remission in dogs with chronic enteropathy (CE). Elemental diets (EDs), providing protein as amino acids, modulate intestinal immunity and microbiome in rodents and humans.

HYPOTHESIS

Evaluate the impact of an amino acid-based kibble (EL) on CE clinical activity and gastrointestinal (GI)-relevant variables.

ANIMALS

Client-owned dogs (n = 23) with inadequately controlled CE.

METHODS

Prospective, uncontrolled clinical trial. Diagnostic evaluation including upper and lower GI endoscopy was performed before study entry. Canine chronic enteropathy clinical activity index (CCECAI), serum biomarkers, and fecal microbiome were evaluated before and after 2 weeks of EL. Dogs with stable or improved CE remained in the study for another 6 weeks. Pre- and post-EL clinical and microbiological variables were compared statistically using a mixed model.

RESULTS

After 2 weeks of EL, 15 of 22 dogs (68%; 95% confidence interval [CI], 47%-84%) consuming the diet were classified as responders with a median (range) decrease in CCECAI from 6 (3-12) to 2 (0-9; P < .001). Fourteen of 15 responders and 2/7 nonresponders at 2 weeks completed the trial; all 16 were experiencing adequate control at week 8 with a median CCECAI of 2 (0-3). In total, 16/23 dogs (70%; 95% CI, 49%-84%) were responders. Feeding EL caused shifts in fecal bacterial communities, which differed between responders and nonresponders. Serum biomarker concentrations were unchanged throughout the study apart from serum alkaline phosphatase activity.

CONCLUSIONS

Exclusive feeding of EL improved clinical signs in 16 of 23 dogs with uncontrolled CE. Fecal microbiome shifts were associated with response to diet and may represent a mechanism for clinical improvement.

Presence of Gastrointestinal Paraneoplastic Syndrome at Diagnosis in Dogs With Cutaneous Mast Cell Tumors and Its Influence on Disease-Free Interval and Survival

Paraneoplastic syndrome (PNS) is a combination of signs unrelated to the physical presence of a tumor and/or its metastases. Its presence may result in poorer clinical outcomes and prognosis. Gastrointestinal ulceration is a well-known PNS in animals with cutaneous MCT. This retrospective study analyzed the occurrence of gastrointestinal (GI) PNS at the time of diagnosis. Using medical records, we attempted to correlate the occurrence of these GI signs with clinical and histologic criteria, as well as to evaluate their influence on the disease-free interval (DFI) and survival (ST) over a 6-year follow-up period (2013-2020). The medical records of 41 dogs with a confirmed diagnosis of cutaneous MCT treated between 2013 and 2014 were included. All dogs underwent surgical biopsy or tumor excision, endoscopic and histologic examination to evaluate possible GI lesions. The presence and severity of GI signs were recorded. Clinical data such as the history of recurrence, number of tumors, tumor size, presence of ulceration, local pruritus, edema and erythema, histopathological classification, and mitotic index were extracted from medical records. Clinical signs relating to the GI system were observed in 41.5% of the dogs and were classified as mild in 94.1% at the time of diagnosis. Endoscopic examination of the upper digestive tract showed evidence of inflammation, but histologic examination of the mucosa showed no serious lesions in any case. There was no significant association between the occurrence of clinical GI signs and any of the variables studied. Follow-up issues meant that only 38 dogs were included for evaluation of the ST and 32 for DFI analysis. DFI was 25.1 months for dogs with GI signs and 14.8 months for dogs without GI signs. At the end of the study, 71.1% of patients had died. Survival time for dogs with GI signs was 54.9 months and 48 months for dogs without GI signs. Over the 6 years of the study, no differences were observed between the ST and the DFI, and the presence or absence of GI PNS at the time of diagnosis.

Prevalence of Clostridioides difficile in Canine Feces and Its Association with Intestinal Dysbiosis

The role of Clostridioides (C.) difficile as an enteropathogen in dogs is controversial. In humans, intestinal bile acid-dysmetabolism is associated with C. difficile prevalence. The relationship between fecal qPCR-based dysbiosis index (DI) and especially the abundance of bile acid-converting Clostridium hiranonis with the presence of C. difficile in dogs was explored across the following 4 cohorts: 358 fecal samples submitted for routine diagnostic work-up, 33 dogs with chronic enteropathy, 14 dogs with acute diarrhea, and 116 healthy dogs. Dogs that tested positive for C. difficile had significantly higher DI (median, 4.4 (range from 0.4 to 8.6)) and lower C. hiranonis (median, 0.1 (range from 0.0 to 7.5) logDNA/g) than dogs that tested negative for C. difficile (median DI, -1 (range from -7.2 to 8.9); median C. hiranonis abundance, 6.2 (range from 0.1 to 7.5) logDNA/g; p < 0.0001, respectively). In 33 dogs with CE and 14 dogs with acute diarrhea, the treatment response did not differ between C. difficile-positive and -negative dogs. In the group of clinically healthy dogs, 9/116 tested positive for C. difficile, and 6/9 of these had also an abnormal DI. In conclusion, C. difficile is strongly linked to intestinal dysbiosis and lower C. hiranonis levels in dogs, but its presence does not necessitate targeted treatment.

Protective Effects of Bacillus subtilis HH2 against Oral Enterotoxigenic Escherichia coli in Beagles

This study evaluated the protective effect of Bacillus subtilis HH2 on beagles orally challenged with enterotoxigenic Escherichia coli (ETEC). We assessed the physiological parameters and the severity of diarrhea, as well as the changes in three serum immunoglobulins (IgG, IgA, and IgM), plasma diamine oxidase (DAO), D-lactate (D-LA), and the fecal microbiome. Feeding B. subtilis HH2 significantly reduced the severity of diarrhea after the ETEC challenge (p < 0.05) and increased serum levels of IgG, IgA, and IgM (p < 0.01). B. subtilis HH2 administration also reduced serum levels of DAO at 48 h after the ETEC challenge (p < 0.05), but no significant changes were observed in D-LA (p > 0.05). Oral ETEC challenge significantly reduced the richness and diversity of gut microbiota in beagles not pre-fed with B. subtilis HH2 (p < 0.05), while B. subtilis HH2 feeding and oral ETEC challenge significantly altered the gut microbiota structure of beagles (p < 0.01). Moreover, 14 days of B. subtilis HH2 feeding reduced the relative abundance of Deinococcus-Thermus in feces. This study reveals that B. subtilis HH2 alleviates diarrhea caused by ETEC, enhances non-specific immunity, reduces ETEC-induced damage to the intestinal mucosa, and regulates gut microbiota composition.

Fecal Calprotectin Concentrations in Cats with Chronic Enteropathies

Diagnosis of feline chronic inflammatory enteropathies (CIE) and the differentiation from small cell intestinal lymphoma (SCL) can be challenging. Intestinally expressed calprotectin (S100A8/A9 protein complex) appears to be part of the complex pathogenesis of feline chronic enteropathies (FCE). Fecal calprotectin is a non-invasive biomarker for intestinal inflammation in humans and dogs but has not yet been evaluated in cats. We hypothesized that fecal calprotectin (fCal) concentrations are increased in FCE, correlate with clinical and/or histologic disease severity, and distinguish cases of CIE from SCL. This case-control study included fecal samples and patient data from cats with CIE (n = 34), SCL (n = 17), other gastrointestinal (GI) diseases (n = 16), and cats with no clinical signs of GI disease (n = 32). fCal concentrations were measured using the immunoturbidimetric fCal turbo assay (Bühlmann Laboratories). Compared to healthy cats, fCal concentrations were significantly increased in CIE, SCL, and other diseases (all p < 0.0001), but were not different between these three groups (all p > 0.05), or between cats with extra-GI diseases and healthy controls. These findings suggest that fCal may have utility as a clinical biomarker for FCE but not for intestinal disease differentiation. It further supports the role of calprotectin in the pathogenesis of the spectrum of FCE, which includes CIE and SCL.

Changes of Enterocyte Morphology and Enterocyte: Goblet Cell Ratios in Dogs with Protein-Losing and Non-Protein-Losing Chronic Enteropathies

This study aimed to assess the morphometry of enterocytes as well as the goblet cell-to-enterocyte ratio in different intestinal segments of dogs with chronic enteropathies (CE). Histopathological intestinal samples from 97 dogs were included in the study (19 healthy juveniles, 21 healthy adults, 24 dogs with protein-losing enteropathy (PLE), and 33 CE dogs without PLE). Healthy adult small intestinal enterocytes showed progressively reduced epithelial cell height in the aboral direction, while juvenile dogs showed progressively increased epithelial cell height in the aboral direction. CE dogs had increased epithelial cell height in the duodenum, while PLE dogs had decreased epithelial cell heights compared to healthy adult dogs. Both the CE and PLE dogs showed decreased enterocyte width in the duodenal segment, and the ileal and colonic enterocytes of CE dogs were narrower than those of healthy adult dogs. CE dogs had a lower goblet cell-to-enterocyte ratio in the colon segment compared to healthy dogs. This study provides valuable morphometric information on enterocytes during canine chronic enteropathies, highlighting significant morphological enterocyte alterations, particularly in the small intestine, as well as a reduced goblet cell-to-enterocyte ratio in the colon of CE cases compared to healthy adult dogs.

Prognostic value of increased intraepithelial lymphocytes and lymphocytic clonality in dogs with chronic enteropathy or small-cell lymphoma

The clinical significance of severe infiltration of small intraepithelial lymphocytes (IEL) and the results of polymerase chain reaction for antigen receptor rearrangement (PARR) in dogs with chronic enteropathy (CE) and small-cell lymphoma (SCL) are controversial. This cohort study aimed to evaluate the prognostic significance of the IEL and PARR results in dogs with CE or SCL. Although definitive diagnostic histopathological criteria for SCL in dogs have yet to be established, dogs with the histopathological findings of severe IEL infiltration were diagnosed with SCL in this study. One hundred and nineteen dogs were recruited, with 23 dogs classified as having SCL and 96 dogs as having CE. The positive rate of PARR was 59.6 % (71/119) in the duodenum and 57.7 % (64/111) in the ileum. Subsequently, three dogs with SCL and four dogs with CE developed large-cell lymphoma (LCL). The median overall survival (OS) of dogs with SCL was 700 days (range, 6-1410 days), and that of dogs with CE was not reached. In the log-rank test, shorter OS was observed in cases with histopathological SCL (P = 0.035), clonal TCRγ rearrangement in the duodenum (P = 0.012), and clonal IgH rearrangement in the ileum (P < 0.0001). The Cox proportional hazards model adjusted for sex and age showed that histopathological SCL (hazard ratio [HR] 1.74; 95 % confidence interval [CI], 0.83-3.65), duodenal clonal TCRγ rearrangement (HR, 1.80; 95 % CI, 0.86-3.75), and ileal clonal IgH rearrangement (HR, 2.28; 95 % CI, 0.92-5.70) could shorten overall survival, although their 95 % CIs included 1.0. These results indicate that severe IEL infiltration could be a useful histopathological feature for diagnosing SCL, and clonality-positive results could be a negative prognostic factor in dogs with CE. Furthermore, the development of LCL should be carefully monitored in dogs with CE and SCL..

The Intestinal Microbiome in Dogs with Chronic Enteropathies and Cobalamin Deficiency or Normocobalaminemia-A Comparative Study

Cobalamin deficiency is a common sequela of chronic enteropathies (CE) in dogs. Studies comparing the intestinal microbiome of CE dogs with cobalamin deficiency to those that are normocobalaminemic are lacking. Therefore, our aim was to describe the fecal microbiome in a prospective, comparative study evaluating 29 dogs with CE and cobalamin deficiency, 18 dogs with CE and normocobalaminemia, and 10 healthy control dogs. Dogs with cobalamin deficiency were also analyzed after oral or parenteral cobalamin supplementation. Overall microbiome composition (beta diversity) at baseline was significantly different in CE dogs with cobalamin deficiency when compared to those with normocobalaminemia (p = 0.001, R = 0.257) and to healthy controls (p = 0.001, R = 0.363). Abundances of Firmicutes and Actinobacteria were significantly increased (q = 0.010 and 0.049), while those of Bacteroidetes and Fusobacteria were significantly decreased (q = 0.002 and 0.014) in CE dogs with cobalamin deficiency when compared to healthy controls. Overall microbiome composition in follow-up samples remained significantly different after 3 months in both dogs receiving parenteral (R = 0.420, p = 0.013) or oral cobalamin supplementation (R = 0.251, p = 0.007). Because cobalamin supplementation, in combination with appropriate therapy, failed to restore the microbiome composition in the dogs in our study, cobalamin is unlikely to be the cause of those microbiome changes but rather an indicator of differences in underlying pathophysiology that do not influence clinical severity but result in a significant aggravation of dysbiosis.

Molecular Prevalence and Risk Factors of Campylobacter Infection in Puppies in the Nairobi Metropolitan Region, Kenya

Campylobacter species are widely distributed pathogens; however, data on its epidemiology in puppies remain scanty, especially in Kenya. A cross-sectional study was conducted in the Nairobi Metropolitan Region to determine molecular prevalence and associated risk factors of Campylobacter species infection in puppies. A total of 260 rectal swabs were collected from puppies from breeding kennels, shelters, and the University of Nairobi Veterinary Teaching and Referral Hospital. The samples were subjected to polymerase chain reaction (PCR) assays for identification of Campylobacter species. Data on potential risk factors associated with puppy exposure were collected using a semistructured questionnaire. Multivariable mixed effects logistic regression analyses were performed with kennels as random effects. Campylobacter species were detected in 64 of the 260 sampled puppies yielding an overall prevalence of 24.6%. Multivariable results showed that puppies from shelters, puppies from kennels that are washed daily, puppies with a recent history of vomiting, and those treated with antibiotics in the past month were significantly associated with the presence of Campylobacter species. Being a kenneled puppy and having had concurrent bacterial infections were identified as protective factors. This study provides molecular evidence of puppy exposure to Campylobacter species which could have impact on puppy health and highlights the need to develop awareness and management strategies to potentially reduce the risk of transmitting this pathogen among puppies, to humans, and other animals.

Clinical Effects of Faecal Microbiota Transplantation as Adjunctive Therapy in Dogs with Chronic Enteropathies—A Retrospective Case Series of 41 Dogs

Chronic enteropathies (CE) are common in dogs, but not all affected dogs respond to standard therapy. Successful responses to faecal microbial transplantation (FMT) in dogs with non-responsive CE have been reported in two case series. The objective of this retrospective study was to describe the clinical effects of FMT as an adjunctive therapy in a larger population of dogs with CE. Forty-one dogs aged 0.6–13.0 years (median 5.8) under treatment for CE at one referral animal hospital were included. Dogs were treated with 1–5 (median 3) FMTs as a rectal enema at a dose of 5–7 g/kg body weight. The canine inflammatory bowel disease activity index (CIBDAI) was compared at baseline versus after the last FMT. Stored faecal samples (n = 16) were analysed with the dysbiosis index. CIBDAI at baseline was 2–17 (median 6), which decreased to 1–9 (median 2; p < 0.0001) after FMT. Subsequently, 31/41 dogs responded to treatment, resulting in improved faecal quality and/or activity level in 24/41 and 24/41 dogs, respectively. The dysbiosis index at baseline was significantly lower for good responders versus poor responders (p = 0.043). Results suggest that FMT can be useful as an adjunctive therapy in dogs with poorly responsive CE.

Association of folate concentrations with clinical signs and laboratory markers of chronic enteropathy in dogs

BACKGROUND

Serum folate is considered a biomarker of chronic enteropathy (CE) in dogs, but few studies have examined associations with markers of CE.

HYPOTHESIS/OBJECTIVES

To evaluate serum folate concentrations in dogs with and without CE and associations with sample hemolysis and selected markers of CE. We hypothesized that hypofolatemia would be more common in dogs with CE and associated with hypocobalaminemia, higher CIBDAI, and hypoalbuminemia.

ANIMALS

Six hundred seventy-three dogs with available serum folate measurements performed at an academic veterinary hospital between January 2016 and December 2019.

METHODS

Medical records were retrospectively reviewed to categorize cases as CE or non-CE and record clinical details and laboratory markers. Relationships between serum folate, cobalamin, and CE variables were assessed using chi-square, Kruskal-Wallis, or Spearman's correlation tests.

RESULTS

Of the 673 dogs, 99 CE were compared to 95 non-CE. In the overall cohort, serum folate concentration did not correlate with sample hemolysis (P = .75). In the CE subset, serum folate and cobalamin concentrations were positively associated (rho = 0.34, FDR = 0.02). However, serum folate concentrations (median [25th, 75th percentiles]) were higher (CE: 12.1 (8.9, 16.1), non-CE: 10.4 (7.2, 15.5); P = .04) and cobalamin concentrations were lower (CE: 343 (240, 597), non-CE: 550 (329, 749); P = .001) in the CE vs non-CE group. Serum folate was not associated with markers of CE, but serum cobalamin was associated with albumin (P = .04) and cholesterol (P = .03).

CONCLUSIONS AND CLINICAL IMPORTANCE

Hypofolatemia is an inferior biomarker of CE compared to hypocobalaminemia.

The effects of melatonin on the concentrations of inflammatory cytokines and proteins, serotonin, cortisol and melatonin in ovariohysterectomised female dogs

BACKGROUND

Ovariohysterectomy (OHE) induces inflammation and stress in female dogs. The anti-inflammatory effects of melatonin have been reported in several studies.

OBJECTIVES

The goal of this study was to assess the effects of melatonin on the concentrations of melatonin, cortisol, serotonin, α-1-acid glycoprotein (AGP), serum amyloid A (SAA), c-reactive protein (CRP), interleukin-10 (IL-10), interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) before and after OHE.

METHODS

The total number of animals was 25 and aligned in 5 groups. Fifteen dogs were divided into three groups (n = 5): melatonin, melatonin+anaesthesia and melatonin+OHE and received melatonin (0.3 mg/kg, p.o.) on days -1, 0, 1, 2 and 3. Ten dogs were assigned to the control and OHE groups (n = 5) without melatonin treatment. OHE and anaesthesia were performed on day 0. Blood samples were obtained via jugular vein on days -1, 1, 3 and 5.

RESULTS

Melatonin and serotonin concentrations significantly increased in the melatonin, melatonin+OHE and melatonin+anaesthesia groups compared with the control group, while cortisol concentration decreased in the melatonin+OHE group compared with the OHE group. The concentrations of acute-phase proteins (APPs) and inflammatory cytokines significantly increased after OHE. The CRP, SAA and IL-10 concentrations decreased significantly in the melatonin+OHE group compared with the OHE group. The concentrations of cortisol, APPs and proinflammatory cytokines increased significantly in the melatonin+anaesthesia group compared with the melatonin group.

CONCLUSIONS

The oral administration of melatonin before and after OHE help controlling the high levels of inflammatory APPs, cytokines and cortisol induced by OHE in female dogs.

Utility of 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin)-ester-lipase for monitoring dogs with chronic pancreatitis

BACKGROUND

The utility of 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin)-ester-(DGGR)-lipase activity (DLA) in monitoring clinical progression of chronic pancreatitis (CP) in dogs is unknown.

OBJECTIVE

To examine the association of DLA with clinical signs of CP, as assessed by a CP clinical severity score (CPCSS).

ANIMALS

Twenty-four dogs.

METHODS

This is a retrospective study. Chronic pancreatitis was diagnosed based on clinical signs and DLA > 250 U/L and monitored using CPCSS and DLA.

RESULTS

The study included 134 visits (median, 10 visits/dog; range, 2-11). Mild-moderate (CPCSS, 0-3) and severe (CPCSS, ≥4) disease were documented in 94 (70%) and 40 (30%) visits, respectively. In emergency visits (n = 44; 33%) CPCSS (median, 5; range, 0-15) and DLA (median, 534 U/L; range, 63-7133) were higher (P < .001 and P = .003, respectively) than in scheduled ones (n = 90; 67%; median, 1; range, 0-6 and median, 384 U/L; range, 49-3747, respectively). DGGR-lipase activity was associated (P = .009) with the CPCSS, with a lower activity documented in mild-moderate CPCSS (median 391 U/L; range, 49-3747), compared to severe score (median, 558 U/L; range, 63-7133). DGGR-lipase activity was significantly, but weakly, correlated with CPSS (r = 0.233, P = .007). DGGR-lipase activity inefficiently discriminated mild-moderate vs severe CP (area under the receiver operator characteristics curve, 0.64; 95% confidence interval, 0.53-0.75; P = .012), with DLA cutoff of 428 U/L corresponding to sensitivity of 65% and specificity of 63%.

CONCLUSIONS AND CLINICAL IMPORTANCE

Increased DLA is associated with emergency revisits in dogs with CP, possibly reflecting acute flare-ups. DGGR-lipase activity was associated with the CPCSS over the follow-ups but could not differentiate disease severity.

Analysis of fecal microbial profiles in dogs with intestinal lymphangiectasia

Intestinal lymphangiectasia (IL) is a common complication in dogs. This study analyzed intestinal microbiota using 16S rRNA amplicon analysis as candidate factors that strongly influence the small intestinal lymphatic vessels in dogs with and without IL. Twelve dogs were included, of which six were diagnosed with lymphoplasmacytic enteritis, four with small-cell lymphoma, and two with large-cell lymphoma. Seven of these dogs had IL, whereas five did not. First, the microbial diversity analyzed by Faith pd index was significantly decreased in dogs with IL compared to dogs without IL. Then, the relative amounts of each bacterial taxa were compared between dogs with and without IL using Linear discriminant analysis effect size analysis. At the genus level, the Ruminococcus gnavus group significantly increased in dogs with IL compared to dogs without IL. A total of four genera, including Ruminococcus torques group and Faecalibacterium, which produce butyrate, significantly decreased in dogs with IL. This study showed decreased intestinal bacterial diversity and several alterations of intestinal microbiota, including a decrease in butyrate-producing bacteria in dogs with IL, compared to dogs without IL.

Evaluation of Host Constitutive and Ex Vivo Coccidioidal Antigen-Stimulated Immune Response in Dogs with Naturally Acquired Coccidioidomycosis

The early innate immune response to coccidioidomycosis has proven to be pivotal in directing the adaptive immune response and disease outcome in mice and humans but is unexplored in dogs. The objectives of this study were to evaluate the innate immune profile of dogs with coccidioidomycosis and determine if differences exist based on the extent of infection (i.e., pulmonary or disseminated). A total of 28 dogs with coccidioidomycosis (pulmonary, n = 16; disseminated, n = 12) and 10 seronegative healthy controls were enrolled. Immunologic testing was performed immediately, without ex vivo incubation (i.e., constitutive), and after coccidioidal antigen stimulation of whole blood cultures. Whole blood cultures were incubated with a phosphate-buffered solution (PBS) (negative control) or a coccidioidal antigen (rCTS1 (105-310); 10 µg/mL) for 24 h. A validated canine-specific multiplex bead-based assay was used to measure 12 cytokines in plasma and cell culture supernatant. Serum C-reactive protein (CRP) was measured with an ELISA assay. Leukocyte expression of toll-like receptors (TLRs)2 and TLR4 was measured using flow cytometry. Dogs with coccidioidomycosis had higher constitutive plasma keratinocyte chemotactic (KC)-like concentrations (p = 0.02) and serum CRP concentrations compared to controls (p < 0.001). Moreover, dogs with pulmonary coccidioidomycosis had higher serum CRP concentrations than those with dissemination (p = 0.001). Peripheral blood leukocytes from dogs with coccidioidomycosis produced higher concentrations of tumor necrosis factor (TNF)-α (p = 0.0003), interleukin (IL)-6 (p = 0.04), interferon (IFN)-γ (p = 0.03), monocyte chemoattractant protein (MCP)-1 (p = 0.02), IL-10 (p = 0.02), and lower IL-8 (p = 0.003) in supernatants following coccidioidal antigen stimulation when compared to those from control dogs. There was no detectable difference between dogs with pulmonary and disseminated disease. No differences in constitutive or stimulated leukocyte TLR2 and TLR4 expression were found. These results provide information about the constitutive and coccidioidal antigen-specific stimulated immune profile in dogs with naturally acquired coccidioidomycosis.

Changes in Faecal and Plasma Amino Acid Profile in Dogs with Food-Responsive Enteropathy as Indicators of Gut Homeostasis Disruption: A Pilot Study

Dogs suffering from food-responsive enteropathy (FRE) respond to an elimination diet based on hydrolysed protein or novel protein; however, studies regarding the amino acid profile in FRE dogs are lacking. The aim of this pilot study was to evaluate whether the plasma and faecal amino acid profiles differed between control and FRE dogs and whether these could serve as indicators of severity of illness. Blood, faecal samples, body condition score, and severity of clinical signs based on the canine inflammatory bowel disease activity index were collected before starting the elimination diet. FRE dogs had lower proportions of plasma Asparagine, Histidine, Glycine, Cystine, Leucine, and branched-chain/aromatic amino acids; however, Phenylalanine increased. In faecal samples, Cystine was greater whereas Phenylalanine was lesser in sick dogs compared to control. Leucine correlated negatively with faecal humidity (r = -0.66), and Leucine and Phenylalanine with faecal fat (r = -0.57 and r = -0.62, respectively). Faecal Phenylalanine (r = 0.80), Isoleucine (r = 0.75), and Leucine (r = 0.92) also correlated positively with total short-chain fatty acids, whereas a negative correlation was found with Glycine (r = -0.85) and Cystine (r = -0.61). This study demonstrates the importance of Leucine and Phenylalanine amino acids as indicators of the disease severity in FRE dogs.

Clinical utility of an immunoglobulin A-based serological panel for the diagnosis of chronic enteropathy in dogs

BACKGROUND

A panel of IgA-based serologic assays might aid in the diagnosis of chronic enteropathy (CE) in dogs, a syndrome encompassing conditions such as food-responsive enteropathy, immunosuppressant-responsive enteropathy, and inflammatory bowel disease (also referred to as chronic inflammatory enteropathy). However, it is unclear whether these biomarkers discriminate between CE and other types of primary intestinal disorders.

OBJECTIVES

To evaluate a diagnostic panel that measures serum concentrations of IgA directed against OmpC (ACA), canine calprotectin (ACNA), and gliadin-derived peptides (AGA) in dogs with well-characterized intestinal diseases.

ANIMALS

Fifty-five dogs with primary intestinal disease.

METHODS

Serum ACA, ACNA, and AGA concentrations were measured in 30 dogs with CE and 25 dogs with other intestinal diseases (non-CE population), including histoplasmosis, parasitism, E. coli-associated granulomatous colitis, and lymphoma. Serum IgA concentrations were compared among populations, and sensitivities and specificities were calculated using laboratory-provided cut-points.

RESULTS

Twenty-six of 30 (87%) CE dogs and 21 of 25 (84%) non-CE dogs had abnormal concentrations (intermediate or high) of at least 2 markers; these proportions were not significantly different (P = .99). A serum ACA concentration ≥15 EU/mL was 86.7% (95% confidence interval [CI], 69.3%-96.2%) sensitive and 24.0% (95% CI, 9.4%-45.1%) specific for CE diagnosis. High AGA concentrations were observed in 16 of 25 (64%) non-CE dogs.

CONCLUSIONS AND CLINICAL IMPORTANCE

The evaluated serologic markers were poorly specific for CE diagnosis, which raises concerns that their use in clinical practice might lead to misdiagnoses and delayed or even detrimental treatments in dogs with non-CE intestinal diseases.

Characterization of the Fecal and Mucosa-Associated Microbiota in Dogs with Chronic Inflammatory Enteropathy

Canine chronic inflammatory enteropathy implicates multifactorial pathogenesis where immunological dysregulation and gut microbiota changes have a central role. Most sequencing-based taxonomic studies have been focused on the fecal microbiota. However, the analysis of these samples does not provide complete information regarding the composition of the small intestine affected by this canine disease. Therefore, in this study, we aimed to characterize the intestinal bacterial microbiota in dogs with inflammatory bowel disease (IBD) (n = 34) by means of duodenal biopsies and fecal samples collected at the time of the diagnosis and to compare those to a group of healthy dogs (n = 12) using the 16S ribosomal RNA (16S rRNA) gene-targeted sequencing (Illumina MiSeq platform). Our study showed that IBD dogs presented differences in the fecal bacterial communities when compared with healthy dogs, with a lower relative abundance of Prevotellaceae (p = 0.005), Prevotella (p = 0.002), and Prevotellaceae Ga6A1 group (0.006); Erysipelotrichales (p = 0.019), Candidatus Stoquefichus (p < 0.001), Erysipelotrichaceae (p = 0.011), and Allobaculum (p = 0.003); Lachnospiraceae NK4A136 group (p = 0.015), Sellimonas (p = 0.042), Oscillospirales (p = 0.037), Oscillospiraceae UCG-005 (p < 0.001), Faecalibacterium (p = 0.028), and Fournierella (p = 0.034); Acidaminococcales, Acidaminococcaceae, and Phascolarctobacterium (p = 0.001); Aeromonadales (p = 0.026), Succinivibrionaceae (p = 0.037), and Succinivibrio (p = 0.031). On the other hand, a higher relative abundance of Enterococcaceae (Enterococcus; p = 0.003), Streptococcaceae (Streptococcus, p = 0.021), Enterobacterales (p = 0.027), Enterobacteriaceae (p = 0.008), and Escherichia-Shigella (p = 0.011) was detected. Moreover, when evaluating α-diversity, the dogs with IBD showed lower diversity in terms of richness and abundance of species (observed species [p = 0.031] and Shannon index [p = 0.039]). Furthermore, fecal microbiota in dogs with IBD was significantly different from healthy dogs (p = 0.006). However, only a few taxa relative abundance shifts (lower Rubrobacteria, Rubrobacterales, Rubrobacteriaceae, and Rubrobacter [p = 0.002]; Cyanobacteria [p = 0.010], Vampirivibrionia, Obscuribacterales, and Obscuribacteraceae [p = 0.005]; Neisseriaceae [p = 0.004] and Conchiformibius [p = 0.003]) were observed when assessing duodenal-associated microbiota of dogs with IBD. Thus, even if the bowel inflammation mainly affects the small intestine in the IBD-affected dogs of the study, fecal specimens may constitute a better sample due not only to their easy availability but also in terms of searching for bacterial taxa as biomarkers for canine IBD. The use of different diets in the study can also have a partial influence on the microbiota composition. Future studies encompassing multi-omics approaches should evaluate the functionality in both levels to unravel the pathophysiology of canine IBD.

Isolation of Oral Bacteria, Measurement of the C-Reactive Protein, and Blood Clinical Parameters in Dogs with Oral Tumor

Canine oral cancers have a poor prognosis and are related to chronic inflammation. This may pose a risk of secondary bacterial infection. This study aimed to compare the bacteria isolated from oral swab samples, values of C-reactive proteins (CRPs), and clinical blood profiles of dogs with and without oral mass. A total of 36 dogs were divided in three groups: no oral mass (n = 21), oral mass (n = 8), and metastasis groups (n = 7). Significantly, both the clinical groups (the oral mass group and metastasis group) showed anemia, a decrease in the albumin-to-globulin ratio (AGR), and an increase in the neutrophil-to-lymphocyte ratio (NLR), globulin-to-albumin ratio (GAR), CRP, and CRP-to-albumin ratio (CAR) compared to the normal group. CAR showed an increasing trend in the oral mass and metastasis groups (10 times and 100 times, respectively) compared to the no oral mass group (P < 0.001). Neisseria spp. (20.78%) was the main isolated bacteria in all groups. The main genera in the no oral mass group were Neisseria spp. (28.26%), Pasteurella spp. (19.57%), and Staphylococcus spp. (19.57%). Neisseria spp., Staphylococcus spp., Klebsiella spp., and Escherichia spp. were found equally (12.5%) in the oral mass group. Escherichia spp. (26.67%), Pseudomonas spp. (13.33%), and Staphylococcus spp. (13.33%) were the main genera in the metastasis group. Interestingly, Neisseria spp. decreased in the clinical groups (Fisher's exact = 6.39, P=0.048), and Escherichia spp. increased in the metastasis group (Fisher's exact = 14.00, P=0.002). The difference of oral bacteria in clinical dogs compared to healthy dogs may be related to microbiome alterations, and both the clinical groups showed the increment of inflammatory biomarkers. This suggested that further studies should be conducted on the correlation between the specific bacteria, CRP, blood clinical parameters, and type of canine oral mass.

Canine chronic enteropathy—Current state-of-the-art and emerging concepts

Over the last decade, chronic inflammatory enteropathies (CIE) in dogs have received great attention in the basic and clinical research arena. The 2010 ACVIM Consensus Statement, including guidelines for the diagnostic criteria for canine and feline CIE, was an important milestone to a more standardized approach to patients suspected of a CIE diagnosis. Great strides have been made since understanding the pathogenesis and classification of CIE in dogs, and novel diagnostic and treatment options have evolved. New concepts in the microbiome-host-interaction, metabolic pathways, crosstalk within the mucosal immune system, and extension to the gut-brain axis have emerged. Novel diagnostics have been developed, the clinical utility of which remains to be critically evaluated in the next coming years. New directions are also expected to lead to a larger spectrum of treatment options tailored to the individual patient. This review offers insights into emerging concepts and future directions proposed for further CIE research in dogs for the next decade to come.

Clinical characteristics of dogs presenting with vomiting as a gastrointestinal sign of chronic enteropathy

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Some dogs with chronic enteropathy (CE) presented with vomiting without diarrhea.

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Vomiting was significantly associated with food-responsive enteropathy.

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Vomiting was significantly associated with higher duodenal eosinophil scores.

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The survival time was the longest in the vomiting group among dogs with CE.

Vomiting is a major gastrointestinal (GI) sign of chronic enteropathy (CE) in dogs. Previous studies have reported clinical characteristics of dogs with CE, who developed diarrhea with or without vomiting as GI signs. However, to characterize clinical features of dogs with CE appropriately, dogs presenting with vomiting without diarrhea should be included in the analysis. Thus, this study aimed to characterize clinical features and outcomes of dogs that presented with vomiting without diarrhea. Based on their presenting GI signs, we retrospectively classified 66 dogs with CE into “Vomiting”, “Diarrhea”, or “Vomiting and diarrhea” groups and compared clinical and histological characteristics of each group. We found that 18 of the 66 dogs with CE (27%) presented with vomiting without diarrhea as a GI sign. Compared to the other 2 groups, the Vomiting group was significantly associated with food-responsive enteropathy (FRE), Beagle, lower clinical severity scores, higher plasma albumin levels, and higher histological scores for eosinophils in the duodenal lamina propria according to the univariate analysis. The multivariate analysis revealed that FRE and higher histological scores for eosinophils in the duodenal lamina propria were significant variables in the Vomiting group. Moreover, the survival time was the longest in the Vomiting group among dogs with CE. These findings are of clinical significance as they indicate that presenting with vomiting without diarrhea may not only be helpful in differentiating FRE from the other types of CE, but also in predicting the prognosis.

Intestinal S100/Calgranulin Expression in Cats with Chronic Inflammatory Enteropathy and Intestinal Lymphoma

Diagnosing chronic inflammatory enteropathies (CIE) in cats and differentiation from intestinal lymphoma (IL) using currently available diagnostics is challenging. Intestinally expressed S100/calgranulins, measured in fecal samples, appear to be useful non-invasive biomarkers for canine CIE but have not been evaluated in cats. We hypothesized S100/calgranulins to play a role in the pathogenesis of feline chronic enteropathies (FCE) and to correlate with clinical and/or histologic disease severity. This retrospective case-control study included patient data and gastrointestinal (GI) tissues from 16 cats with CIE, 8 cats with IL, and 16 controls with no clinical signs of GI disease. GI tissue biopsies were immunohistochemically stained using polyclonal α-S100A8/A9 and α-S100A12 antibodies. S100A8/A9+ and S100A12+ cells were detected in all GI segments, with few significant differences between CIE, IL, and controls and no difference between diseased groups. Segmental inflammatory lesions were moderately to strongly correlated with increased S100/calgranulin-positive cell counts. Clinical disease severity correlated with S100A12+ cell counts in cats with IL (ρ = 0.69, p = 0.042) and more severe diarrhea with colonic lamina propria S100A12+ cells with CIE (ρ = 0.78, p = 0.021) and duodenal S100A8/A9+ cells with IL (ρ = 0.71, p = 0.032). These findings suggest a role of the S100/calgranulins in the pathogenesis of the spectrum of FCE, including CIE and IL.

Case Report: Oral Fecal Microbiota Transplantation in a Dog Suffering From Relapsing Chronic Diarrhea-Clinical Outcome and Follow-Up

The present case report describes the effects of orally administered fecal microbiota transplantation (FMT) (frozen capsules) in a dog suffering from relapsing chronic diarrhea, needing a continuous low prednisolone dose to maintain the condition under acceptable control. Through FMT, we aimed at evaluating the possibility of improving the clinical score and/or reducing/suspending steroid administration. During a first period of strict monitoring (21 days), the canine inflammatory bowel disease activity index (CIBDAI) score passed from mild to clinically insignificant disease. Furthermore, two additional gastrointestinal signs that had been reported, bloating and episodes of painful defecation, rapidly improved (bloating) or even resolved (painful defecation). The patient was then followed for 18 months (to the authors' knowledge, the longest follow-up time ever reported in a dog), during which no serious relapses occurred and no increase in prednisolone dose was necessary. No adverse clinical effects were ever reported during monitoring. The present description provides a further experience increasing those already present in the veterinary literature, in which an agreement on how to use FMT has not yet been achieved although strongly needed and recommended.

Chronic Enteropathy in Dogs-Epidemiologic Aspects and Clinical Characteristics of Dogs Presenting at Two Swedish Animal Hospitals

Information about prevalence and breed predisposition of canine chronic enteropathy (CE) is limited. The aim of this retrospective study was to investigate period prevalence, breed disposition, clinical features, diagnostic results, and treatment response of CE in dogs presenting at two Swedish animal hospitals during 2013−2018. A medical record search was performed to identify CE dogs including those with ≥3 visits because of gastrointestinal disease and/or that had undergone gastroduodenoscopy/colonoscopy during 2013−2018. Dog characteristics, case history, physical examination, laboratory variables, therapeutic protocol, and treatment response were recorded. Inclusion criteria for CE were met by 814 dogs. Period prevalence of CE was 1.1% of total number of dogs. Breeds with the highest relative risk included Norwegian Lundehund, West Highland White Terrier, and Miniature Poodle. Median age at presentation was 3.8 (IQR 1.8−6.8) years. French Bulldogs and Miniature Schnauzers presented at a younger age (<2.5 years) compared to other breeds (p < 0.05). In a subset of dogs, serum hypoalbuminemia (116/662, 17.5%), hypocobalaminemia (98/647, 15.1%), and increased C-reactive protein (CRP) concentrations (145/267, 54.3%) were diagnosed. Treatment outcome was classified in 72.9% of dogs and characterized as immunosuppressant-responsive (55.2%), food-responsive (11.4%), non-responsive (5.2%), and antibiotic-responsive (1.1%). Non-responsive dogs were more likely to present with anemia hypoproteinemia/albuminemia, increased CRP, and ascites (p < 0.05). In conclusion, the prevalence of dogs with CE at Swedish hospitals agreed with earlier reports, but risk breeds differed slightly and, compared to other breeds, a younger age of CE onset was found in two breeds. The largest proportion of dogs was immunosuppressant-responsive and the smallest antibiotic-responsive.