© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.
Ready, fire, aim: Putting diagnosis before treatment (Proceedings)
Inflammatory bowel disease is signified by gastrointestinal signs over 3 weeks duration with incomplete response to dietary trials and anthelminthics, histologic lesions of mucosal inflammation on biopsy and clinical response to immunomodulatory therapies.
Inflammatory bowel disease (IBD)
Gastrointestinal signs over 3 weeks duration with incomplete response to dietary trials and anthelminthics, histologic lesions of mucosal inflammation on biopsy and clinical response to immunomodulatory therapies. www.wsava.org/StandardizationGroup.htm.
Only dogs in which histologic evidence of inflammation is found without an apparent underlying cause can be diagnosed as chronic idiopathic enteropathy. German et al. JVIM vol. 17, 2003
Food responsive diarrhea (FRD)
Schreiner NM et al. JVIM vol. 22, 2008
CC: daily or intermittent diarrhea, vomiting (or both), and/or weight-loss
Rule-out 2nd GI: CBC, biochemical profile, urinalysis, fecal analysis, folate/cobalamin, abd U/S
Responded to Elimination Diet alone within 10 days.
Probiotics in FRD Dogs?
Sauter et al. J Anim Physiol Nutr vol. 90, 2006
Elimination Diet + 4 weeks of Probiotic cocktail (Lactobacillus spp.) supplementation improved clinical signs – attitude, appetite, activity, fecal frequency and consistency.
Steroid responsive diarrhea (idiopathic IBD)
Schreiner NM et al. JVIM vol. 22, 2008
CC: daily or intermittent diarrhea, vomiting (or both), and/or weight-loss
Rule-out 2nd GI: CBC, biochemical profile, urinalysis, fecal analysis, folate/cobalamin, abd U/S
No clinical improvement within 1 week trial of Elimination Diet alone
Rx: Prednisolone
1 mg/kg PO BID for 10 days
0.5 mg/kg PO BID for 10 days
0.5 mg/kg PO SID for 10 days
0.5 mg/kg PO q48hrs for remainder of study
Antibiotic responsive diarrhea
Tylosin-responsive diarrhea
Westermarck et al. JVIM vol. 19, 2005
Sig: middle-aged, large breed dogs
CC: Chronic or intermittent diarrhea > 1 year
Rule-out: Parasites, EPI, IBD, SIBO, Salmonella, Campylobacter, Yersinia, Lawsoni, Clostridium perfringens and Clostridium difficile.
Rx: Tylosin eliminated diarrhea within 3 days
Discontinue Tylosin = return of diarrhea within 30 days
Minimally responsive to Prednisone or Probiotic alone
Enrofloxacin, metronidazole, amoxicillin-responsive diarrhea
Sig: Boxers and English Bulldogs
CC: Chronic large bowel diarrhea, tenesmus, weight-loss
Minimally responsive to prednisone, azathioprine, sulfasalazine, metronidazole alone
Histopathology = histiocytic ulcerative colitis (HUC)
Rx = enrofloxacin alone or in combination with metronidazole + amoxicillin
Resolution of clinical signs and weight gain within 2-12 days, some dogs tapered off medication completely.
Tritrichomonas foetus
Gookin et al. JVIM vol. 20, 2006; Kather et al. JVIM vol. 21, 2007
Sig: Purebred kittens/cats (Bengal) from shelters/catteries
CC: Chronic or recurrent large intestinal diarrhea, mucus, tenesmus, increased frequency
Minimally responsive to metronidazole, fenbendazole, furazolidone, paromomycin
Diagnosis: PCR
Rx: Ronidazole 30-50mg/kg PO BID, 14 days (lower dose led to relapse in 2-20 weeks)
