Clinical characteristics and long-term outcome of E. coli-associated granulomatous ileocolitis in dogs: five cases (2010-2014)

OBJECTIVES

To describe the clinical characteristics and long-term outcome of Escherichia coli-associated granulomatous ileocolitis in dogs.

METHODS

Retrospective review of medical records from dogs with periodic acid-Schiff positive (PAS+) granulomatous ileocolitis and mucosally invasive E. coli in the ileum and colon. Initial bacterial colonisation was evaluated using fluorescence in situ hybridization (FISH) in all dogs and corroborated with colonic and/or ileal culture, when performed.

RESULTS

Four boxer dogs and 1 French Bulldog with PAS+ granulomatous ileocolitis (GIC) were evaluated. All dogs had chronic diarrhoea refractory to empirical therapy. Ileocolonoscopy revealed mucosal haemorrhage and ulceration in the ileum (3/4) and colon (5/5). E. coli were visualised as clusters within the ileal and colonic mucosa. Complete (CR, 4/5) or partial (PR, 1/5) clinical response to fluoroquinolones was noted in all dogs within 30 days. CR was sustained in three of four dogs (median disease-free interval 40 months, range 16 to 60). Two dogs relapsed while receiving fluoroquinolones. Repeat biopsy isolated multidrug-resistant, mucosally invasive E. coli in the ileum (1/2) and colon (2/2). Targeted antimicrobial therapy was associated with long-term PR (78 months) in both dogs.

CLINICAL SIGNIFICANCE

Concurrent E. coli-associated granulomatous inflammation in the ileum and colon did not impart a poor clinical outcome or lack of response to the conventional standard of care for granulomatous colitis in dogs that were aggressively diagnosed and treated. Clinical outcome was influenced by antimicrobial resistance, with response dependent upon antimicrobial therapy informed by susceptibility testing.

Does invalidation produce loose construing?

This study tested Bannister's (1963) serial invalidation hypothesis that repeated invalidation of a person's judgements loosens conceptual organization. That is, a person's constructs or dimensions of judgement will become more weakly and inconsistently related. Using a variant of Kelly's (1955) repertory grid methodology, thirty university students rated three sets of eight career roles on sixteen constructs. During the ratings of the second set, subjects received both evaluative commentary from the experimenter and objective evidence in the form of fake ratings. Both types of feedback were either invalidating or validating of subjects' judgements on the first eight constructs. The main finding was that invalidation loosened conceptual organization, but only for subjects who initially manifested strong relations among constructs. Subjects who began with weaker construct relations were not significantly affected by type of feedback.

CONSTRUING AND ACTING TOWARD OTHERS

A variant of Kelly's (1965) grid methodology was used to assess the relationship between two construct subsystems, one for construing people and one for establishing policies of action toward them. Twenty-eight students rated 12 personal acquaintances on six elicited personality constructs and on six elicited constructs of action. The main finding was that central personality constructs, those with strong internal relations within the subsystem correlated strongly with central action constructs. Peripheral personality constructs, those with weaker internal relations, tended to correlate more weakly with action constructs. Central personality constructs had strong behavioral implications while peripheral personality constructs had weaker behavioral implications.