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Effects of a probiotic intervention in acute canine gastroenteritis - A controlled clinical trial

Authors:
  • Norwegian University of Life Sciences (NMBU), Campus Adamstuen, Oslo, Norway

Abstract and Figures

To evaluate the effect of a probiotic product in acute self-limiting gastroenteritis in dogs. Thirty-six dogs suffering from acute diarrhoea or acute diarrhoea and vomiting were included in the study. The trial was performed as a randomised, double blind and single centre study with stratified parallel group design. The animals were allocated to equal looking probiotic or placebo treatment by block randomisation with a fixed block size of six. The probiotic cocktail consisted of thermo-stabilised Lactobacillus acidophilus and live strains of Pediococcus acidilactici, Bacillus subtilis, Bacillus licheniformis and Lactobacillus farciminis. The time from initiation of treatment to the last abnormal stools was found to be significantly shorter (P = 0.04) in the probiotic group compared to placebo group, the mean time was 1.3 days and 2.2 days, respectively. The two groups were found nearly equal with regard to time from start of treatment to the last vomiting episode. The probiotic tested may reduce the convalescence time in acute self-limiting diarrhoea in dogs.
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PAPER
34 Journal of Small Animal Practice Vol 51 January 2010 © 2010 British Small Animal Veterinary Association
OBJECTIVES: To evaluate the effect of a probiotic product in acute
self-limiting gastroenteritis in dogs.
METHODS: Thirty-six dogs suffering from acute diarrhoea or acute
diarrhoea and vomiting were included in the study. The trial was
performed as a randomised, double blind and single centre study
with stratifi ed parallel group design. The animals were allocated to
equal looking probiotic or placebo treatment by block randomisa-
tion with a fi xed block size of six. The probiotic cocktail consisted
of thermo-stabilised Lactobacillus acidophilus and live strains of
Pediococcus acidilactici, Bacillus subtilis, Bacillus licheniformis and
Lactobacillus farciminis.
RESULTS: The time from initiation of treatment to the last abnormal
stools was found to be signifi cantly shorter (P = 0·04) in the probi-
otic group compared to placebo group, the mean time was 1·3 days
and 2·2 days, respectively. The two groups were found nearly equal
with regard to time from start of treatment to the last vomiting
episode.
CLINICAL SIGNIFICANCE: The probiotic tested may reduce the convales-
cence time in acute self-limiting diarrhoea in dogs.
INTRODUCTION
Acute gastroenteritis is a common com-
plaint in fi rst-opinion small animal prac-
tice. A wide array of disease processes may
affect the gastrointestinal tract causing
vomiting and/or diarrhoea. Usually the
cause will remain unknown as the patient
often spontaneously recovers. Supportive
therapy, including dietary modifi cations
and oral rehydration is frequently used in
handling acute, uncomplicated and non-
bloody diarrhoea (Cave 2002). In such
cases empirical administration of probiotic
products is often considered as an ancillary
treatment, intending to reduce the dura-
tion of the illness.
Probiotic are live microorganisms
which, when administered in adequate
Effects of a probiotic intervention
in acute canine gastroenteritis – a
controlled clinical trial
amounts, should have a positive effect
on human or animal health (FAO/WHO
2006). Although it is known that certain
bacterial strains exert benefi cial effect
to the host, the molecular mechanisms
behind the effect of probiotics are poorly
known in all animal species including
human beings. Possible probiotic mecha-
nisms might be to antagonise pathogenic
bacteria through competition of nutrients
or binding sites, through production of
antimicrobial substances, or modulation
of mucosal immune responses, by stimu-
lating either the innate or the adaptive
immune system (FAO/WHO 2006).
Despite the fact that probiotic products
are becoming increasingly used in small
animal practice, there are few published
studies regarding their clinical effect.
Although there are some studies con-
cerning the clinical effi cacy of probiotic
lactobacilli in chronic enteropathies (Sau-
ter and others 2006, Pascher and others
2008), their effect in acute diarrhoeas has
not yet been investigated.
The aim of the current study was to
evaluate the clinical effect of a probiotic
product applied to dogs diagnosed with
acute self-limiting gastroenteritis.
MATERIALS AND METHODS
Study design
The trial was performed as a randomised,
double blind and single centre study with
stratifi ed parallel group design. The health
condition recorded by a veterinarian was
used as stratifi cation factor (Table 1).
Within each stratum, the animals were
consecutively allocated 1:1 to probiotic or
placebo treatment, by block randomisa-
tion with a fi xed block size of six patients.
Patients
A total of 36 dogs, with a mean age of
4·1 years (sd = 3·3), suffering from acute
gastrointestinal disease were included, of
which 21 were in the placebo group and
15 in the probiotic group. Diarrhoea was
H. K. HERSTAD, B. B. NESHEIM*,
T. L A BÉE-LUND, S. LARSENAND
E. SKANCKE§
Journal of Small Animal Practice (2010)
51, 34–38
DOI: 10.1111/j.1748-5827.2009.00853.x
Accepted: 8 September 2009
Petvett Ekeberg Small Animal Clinic, Ekebergveien
177, 1177 Oslo, Norway
*Sørlandets Animal Clinic, branch offi ce Farsund,
Gamle Mosvoldvei 1, 4550 Farsund, Norway
†Department of Food Safety and Infection Biol-
ogy, ‡Centre for Epidemiology and Biostatistics
and §Department of Companion Animal Clinical
Sciences, Norwegian School of Veterinary Sci-
ence, Postboks 8146 Dep, 0033 Oslo, Norway
http://www.bsava.com/
Journal of Small Animal Practice Vol 51 January 2010 © 2010 British Small Animal Veterinary Association 35
Probiotic use in canine gastroenteritis
registered in all dogs, and 22 had simul-
taneous vomiting. Of these 22 dogs 10
were in the probiotic group and 12 in the
placebo group. The dogs were examined
by different veterinarians at the small ani-
mal out-patient clinic at the Norwegian
School of Veterinary Science. Patients
with clinical symptoms of more than two
weeks duration and patients treated with a
probiotic product within one month prior
to the study were excluded. Hospitalised
patients, including those in need of sup-
portive treatments such as fl uid therapy,
were also excluded. Patients fulfi lling the
inclusions criteria were randomised to
treatment after the owners had given con-
sent for participation.
Clinical symptoms were more fre-
quently localised to the large intestine
than to the small intestine, no signifi -
cant difference was observed between the
groups. The patients in both groups were
found equal with regard to all observed
clinical symptoms and possible factors
associated with their appearance (Table 2).
Before starting treatment the mean dura-
tion of clinical signs was 3·3 days (range:
0·5 to 10·0) in the probiotic group and
2·8 days (range: 0·5 to 7·0) in the placebo
group. The difference was not signifi cant
(P-value 0·58).
Trial treatment
The probiotic used in this study, ZooLac
Propaste (Chem Vet A/S Denmark), con-
tains per millilitre: 2·85 billions live strains
of Lactobacillus farciminis (porcine origin),
Pediococcus acidilactici (unknown origin),
Bacillus subtilis (soil origin) and Bacillus
licheniformis (soil origin) and 1·35 billions
thermo-stabilised Lactobacillus acidophilus
MA 64/4E (human origin). The probiotic
and the placebo were equal looking, and
contained the same pasta-base with vege-
table oil, lecithin and a stabiliser (E551b).
The dose of probiotic and placebo was
adjusted to the animals’ weight (1 to 10
kg = 1 ml, 10 to 25 kg = 2 ml, 25 to 50 kg
= 3 ml). The medication was administered
three times daily, starting with a double
dose, until normalisation of the stools,
all in line with recommendations by the
manufacturer. Two patients in each group
were treated with trimethoprim sulfadiazin
(Tribrissen vet; Schering-Plough) without
a well-considered medical indication.
Trial procedure
The patients were recommended not to
eat within 24 to 36 hours after the initial
treatment dose. The owners were given
written instruction related to feeding and
administration of the trial medication.
Follow-up visits were arranged four and
eight days after start of treatment where
the owner informed about faecal quality,
vomiting, administration of probiotic/pla-
cebo, food intake, date and time for the
last abnormal – and fi rst normal stool.
The time for the last abnormal stool and
rst normal stool was recorded in half (ca
12 hours) and whole (24 hours) day. These
data were used for the further statistics.
According to the information achieved
during these interviews, the overall com-
pliance regarding both eating instruction
and administration of the medication was
satisfactory.
Faecal samples for bacterial and parasi-
tological examination were collected from
33 and 17 patients, respectively. The dis-
tribution between the probiotic and pla-
cebo groups was 15 and 18 samples for
bacteriological; and 8 and 9 samples for
parasitological examination, respectively.
Faecal analysis included MgSO4-fl otation
for parasites and parasite egg examination,
and routine bacteriologic culturing for
Salmonella species, Campylobacter species
and other aerobic, anaerobic and facul-
tative anaerobic bacteria. At the time of
inclusion, no faecal parasites or Salmonella
species were detected in any of the faecal
samples collected, while Campylobacter
upsaliensis was isolated from two dogs,
both belonging to the probiotic group.
No attempt was made to isolate the pro-
biotic strain from the treated dogs, neither
during nor after completing the study.
Table I. Material description. Health
condition related to treatment group.
The health condition recorded by the
veterinarian was used as the stratifi -
cation factor
Treatment Health condition Total
Placebo Not depressed 15
Depressed 6
Probiotic Not depressed 12
Depressed 3
Total Not depressed 27
Depressed 9
Table 2 Comparison of the groups regarding initially observed anamnestic fac-
tors
Factor Category Treatment groups Total
Placebo Probiotic
Number of stools None
1–2
3–4
5
0
2
7
12
0
3
3
9
0
5
10
21
Number of vomit-
ing
None
1–2
3–4
5
9
8
3
1
5
4
5
1
14
12
8
2
First symptom Vomiting
Diarrhoea
Vomit & Diarrh
Not given
5
6
1
9
2
7
1
5
7
13
2
14
Fever No
Ye s
15
2
12
0
27
2
Appetite Reduced
Normal
Increased
8
11
0
7
7
1
15
18
1
Change in diet No
Ye s
15
5
12
2
27
7
Antiparasitic
treatment
No
Ye s
7
13
2
13
9
26
Vaccination
(DHPPi)
No
Ye s
2
18
0
15
2
33
Consumption of
spoiled food
No
Ye s
11
9
11
4
22
13
H. K. Herstad and others
36 Journal of Small Animal Practice Vol 51 January 2010 © 2010 British Small Animal Veterinary Association
Statistical analysis
Assumed continuously distributed factors
and variables were expressed as mean values
with 95% confi dence interval constructed
by using the Student procedure (Altman
1991). Standard deviation (sd) is used
as an index of dispersion. Additionally,
variables of the type “time to event” were
expressed by Kaplan & Meier plot (Parmar
and Machin 1995). Because no censoring
occurred, the results are expressed by mean
values as described above and proportional
Hazard ratio with 95% confi dence inter-
val. Categorised data in are given in con-
tingency tables. Prevalence was expressed
in percent with 95% confi dence intervals
constructed by use of the Bernoulli proce-
dure (Agresti 1990). Comparison within
and between groups was performed one
tailed and differences stated as signifi cant if
the P-value was found less or equal to 5%.
Comparison between groups with regard to
“time to event” was performed by using a
Cox proportional hazards model (Parmar
and Machin 1995). Fisher’s exact test was
used for comparison of groups regarding
categorised data. McNemar test was used
for testing changes within groups (Agresti
1990).
RESULTS
The time from start of treatment to the
last abnormal stool (Fig 1A) was found
signifi cantly shorter (P = 0·045; one-
tailed) in the probiotic group compared
to the placebo group (Table 3), the mean
time was 1·3 days (95% CI: 0·5 to 2·1)
and 2·2 days (95% CI: 1·3 to 3·1), respec-
tively. When vomiting and diarrhoea
together were taken into account the time
from start of treatment to last symptom
reported was 1·4 days (95% CI: 0·5 to 2·4)
in the probiotic group and 2·2 days (95%
CI: 1·4 to 3·1) in the placebo group (Fig
1B), and the difference was not signifi cant
(P = 0·055; one-tailed). The difference
between the groups in time from start of
treatment to the fi rst normal stool, was
neither signifi cant (P = 0·14; one-tailed).
The mean time in the probiotic group was
2·9 days (95% CI: 2·1 to 3·7) compared
to 3·4 days (95% CI: 2·6 to 4·2) in the
placebo group. In both groups the num-
ber of stools was signifi cantly reduced (P
0·01; one-tailed) during the fi rst three
days of treatment but there was no signifi -
Table 3. Proportional hazard ratio with 95% confi dence interval related to “Abnormal stools after start of treatment”,
“Normal stools after start of treatment” and “Vomiting after start of treatment”
Treatment Abnormal stools after star t of treatment Normal stools after start of treatment Vomiting after start of tr eatment
Probiotic (placebo) 0,81 0,90 0,96
0,57 – 1,09 0,63 – 1,24 0,63 – 1,48
FIG 1. Number of days from star t of treatment to (A) last abnormal stool and (B) last symptom
reported. The results are given as Kaplan & Meir plots and express the probability of reported
event at the given day
Journal of Small Animal Practice Vol 51 January 2010 © 2010 British Small Animal Veterinary Association 37
Probiotic use in canine gastroenteritis
cant difference between the two groups (P
0·19; one-tailed).
The two groups were found nearly
equal regarding mean duration of vomit-
ing with 0·9 days (95% CI: 0·5 to 1·3)
and 1·2 days (95% CI: 0·2 to 2·2) in the
probiotic group and the placebo group,
respectively. The number of vomiting epi-
sodes was signifi cantly reduced (P 0·01)
in both groups during the fi rst three days
of treatment, but the difference between
the groups was not signifi cant (P 0·16;
one-tailed).
Adverse effects were not observed in
neither of the groups, and all patients
recovered within eight days.
DISCUSSION
According to the authors’ knowledge, this
is the fi rst placebo controlled study evalu-
ating the effect of a probiotic in treatment
of acute, uncomplicated gastrointestinal
disease in dogs. In the present trial, the
probiotic signifi cantly reduced the dura-
tion of diarrhoea, although clinical signs
resolved rapidly in both groups. A reduced
symptomatic period of almost 24 hours
in the patients offered the probiotic, as
observed in this study, is a positive result
of treatment, for both the patient and the
owner.
Two patients in each group were treated
with antibiotics, without a well-consid-
ered medical indication. The patients were
treated with the same type of antibiotics.
This might have infl uenced the general
effect obtained in the study, but not the
comparison between the groups. If this
antibiotic treatment infl uenced the gen-
eral effect, it would only have increased
the dispersion of the effi cacy variable and
made it more diffi cult to obtain signifi cant
differences between the groups.
Acute self-limiting gastrointestinal
disease in dogs is frequently related to
dietary problems, but infectious agents
such as parasites, virus and bacteria may
also be responsible. Osmotic changes and
increased mucosal permeability are usually
the responsible mechanism (Guilford and
others 1996). The patient’s history may
enable the cause to be established, but in
most cases a defi nitive diagnosis followed
by a specifi c treatment, cannot be made.
The dogs included in this study were a
quite diverse group of patients suffering
from diarrhoea and in some cases vomit-
ing of unknown etiologic cause, typical of
patients visiting a fi rst-opinion practice.
Bacterial and parasitic examinations were
all negative with respect to etiologic cause.
Because examinations for parasites were
lacking in18 dogs, we cannot rule out that
some of the dogs might have suffered from
undiagnosed parasitic infections. How-
ever, the negative results from the exam-
ined specimens indicate that parasites
were not a frequent cause of the diarrhoea
in this study. Two of the dogs grew Cam-
pylobacter upsaliensis, but the signifi cance
of this species in dogs is not clear. A study
among Norwegian dogs showed no clear
association between Campylobacter isola-
tion and diarrhoea (Sandberg and others
2002).
Clinical indications for using pro-
biotic preparations in dogs are not well
defi ned and have been adapted from
concepts developed for human beings.
Some studies performed in healthy dogs
have demonstrated positive infl uence of
immune functions after administration
of probiotic bacteria (Benyacoub and
others 2003, Baillon and others 2004).
The clinical effi cacy of probiotics for the
treatment of gastrointestinal disorders in
dogs has only been evaluated in two in
vivo studies, both concerning chronic
diarrhoea. The fi rst study did not show
signifi cantly clinical effects of a probi-
otic cocktail of three canine Lactobacil-
lus species administered to dogs with
food responsive diarrhoea treated with
an elimination diet (Sauter and others
2006). In the second study, dogs suffer-
ing from chronic, non-specifi c dietary
sensitivity showed improved faecal con-
sistency, faecal dry matter and defecation
frequency while treated with the probi-
otic strain Lactobacillus acidophilus DSM
13241 (Pascher and others 2008).
The effect and mechanism of probiot-
ics in acute gastroenteritis in dogs have not
been thoroughly evaluated in contrast to
human medicine where numerous in vivo
studies have been performed. Probiotics
have been shown to signifi cantly shorten
the course of illness in children with
acute diarrhoea and also in patients suf-
fering from traveller’s diarrhoea (Simaka-
chorn and others 2000, Huang and others
2002, McFarland 2007). The study by
Simakachorn and others (2000) included
a thermo-stabilised Lactobacillus acidophi-
lus, which is a major ingredient of the pro-
biotic cocktail used in this study. However,
as the molecular mechanisms behind the
effect of a probiotic are largely unknown,
the effect and function registered in one
animal species or from one bacterium can-
not automatically be extrapolated to other
host species or probiotic strains (Isolauri
and others 2004).
For benefi cial health effects, such as
competitive exclusion of pathogens or
immune regulation, an effective probiotic
has to colonise gut mucosa at least tempo-
rarily (Salminen and others 1998). It has
been assumed that the ability to adhere to
the intestinal mucosa, to some extent, is
host species specifi c, and that the probiotic
product should contain microorganisms
originating from the same host species as
it is aimed to colonise. However, probi-
otic strains of human origin intended for
human use have been shown to adhere to
canine intestinal mucosa indicating that
species-specifi city may not always be nec-
essary for adhesion (Rinkinen and others
2000, 2003). In most cases it is compli-
cated to determine the original source of a
bacterium. According to some recommen-
dations, the specifi city of the action of a
probiotic should be assessed as important,
not the source (FAO/WHO 2006). The
bacterial strains in the probiotic prod-
uct used in our trial were not of canine
origin, and their stay in the intestine has
most likely been transient. The probiotic
still might have had the ability to adhere
to the canine mucosa. Through daily sup-
ply during the treatment period, they
may have resided for suffi cient time and
in adequate numbers to execute a possible
positive effect.
In this study there was a small but
signifi cantly positive effect of probiotic
treatment in dogs suffering from acute
gastrointestinal disease. To support these
results further controlled, clinical trials,
but also studies including adhesion mech-
anisms and other specifi c properties of the
different strains used in probiotic products
recommended for dogs, need to be done.
Even though the probiotic bacteria do not
become a part of the stable resident fl ora,
H. K. Herstad and others
38 Journal of Small Animal Practice Vol 51 January 2010 © 2010 British Small Animal Veterinary Association
they still might execute a possible positive
effect in the intestine, and should be con-
sidered as a valuable supplement to con-
servative treatment of acute gastroenteritis
in dogs. Prescription of a probiotic food
supplement, reducing the convalescence
time, may satisfy the owner’s expecta-
tions for treatment and thereby hopefully
contribute to increase the compliance of
other treatment instructions, like fasting
and dietary changes. Probiotic therapy
is also a promising option to reduce the
indiscriminate use of antimicrobials often
initiated in cases of acute gastrointestinal
disease in dogs.
Acknowledgement
The probiotic and placebo products
were kindly provided by Chem Vet A/S,
Denmark.
References
AGRESTI, A. (1990) Categorical Data Analysis. John
Wiley & Sons, New York, USA,
ALTMAN, D. G. (1991) Practical Statistics for Medical
Research. Chapman and Hall, London, UK.
BAILLON, M. L., MARSHALL-JONES, Z. V. & BUTTERWICK, R. F.
(2004) Effects of probiotic Lactobacillus acidophi-
lus strain DSM13241 in healthy adult dogs. Ameri-
can Journal of Veterinary Research 65, 338-343
BENYACOUB, J., CZARNECKI-MAULDEN, G. L., CAVADINI, C.,
SAUTHIER, T., ANDERSON, R. E., SCHIFFRIN, E. J. & VON
DER WEID, T. (2003) Supplementation of food with
enterococcus faecium (SF68) stimulates immune
functions in young dogs. Journal of Nutrition 4,
1158-1162
CAVE N. J., MARKS S. L., KASS P. H., MELLI A. C. & BROPHY
M. A. (2002) Evaluation of a routine diagnostic fecal
panel for dogs with diarrhea. Journal of the Ameri-
can Veterinary Medical Association 221, 52-59
GUILFORD W. G.& STROMBECK D. R. (1996) Classifi cation,
pathophysiology, and symptomatic treatment of
diarrheal diseases. In: Strombeck’s Small Animal
Gastroenterology. 3rd edn. Eds W. G. Guilford, S.
Center, D. R. Strombeck, D. Williams and D. J.
Meyer. W. B. Saunders, Philadelpha, PA, USA, pp
351-366
HUANG J. S., BOUSVAROS A., LEE J. W., DIAZ A. & DAVIDSON E.
J. (2002) Effi cacy of probiotic use in acute diarrhea
in children: a meta-analysis. Digestive Diseases
and Science 47, 2625-2634
ISOLAURI E., SALMINEN S. & OUWEHAND A. C. (2004) Probi-
otics. Best Practice and Research Clinical Gastro-
enterology 18, 299-313
MCFARLAND L. V. (2007) Meta-analysis of probiotics for
the prevention of traveler’s diarrhea. Travel Medi-
cine and Infectious Diseases 5, 97-105
PARMAR M. K. B., MACHIN, D. (1995) Sur vival Analysis.
A Practical Approach. John Wiley & Sons, Chich-
ester, UK .
PASCHER M., HELLWEG P., KHOL-PARISINI A. & ZENTEK J. (2008)
Effects of a probiotic Lactobacillus acidophilus
strain on feed tolerance in dogs with non-specifi c
dietary sensitivity. Archives of Animal Nutrition 62,
107-116
RINKINEN M., MÄTTÖ J., SALMINEN S., WESTERMARCK E., OU-
WEHAND A. C. (2000) In vitro adhesion of lactic acid
bacteria to canine small intestinal mucus. Journal of
Animal Physiology and Animal Nutrition 84, 43-47
RINKINEN M., WESTERMARCK E., SALMINEN S. & OUWEHAND A.
C. (2003) Absence of host specifi city for in vitro
adhesion of probiotic lactic acid bacteria to intesti-
nal mucus. Veterinary Microbiology 97, 55-61
SALMINEN S., VON WRIGHT A. MORELLI L., MARTEAU P., BRAS-
SART D., DE VOS W. M., FONDÈN R., SAXELIN M., COLLINS
K., MOGENSEN G., BIRKELAND S., MATILLA-SANDHOLM T.
(1998) Demonstration on safety of probiotics – a
review. International Journal of Food Microbiology
44, 93-106
SANDBERG M., BERGSJØ B., HOFSHAGEN M., SKJERVE E. &
KRUSE H. (2002) Risk factors for Campylobacter
infection in Norwegian dogs and cats. Preventive
Veterinary Medicine 55, 241-253
SAUTER S. N., BENYACOUB J., ALLENSPACH K., GASCHEN F.,
ONTSOUKA E., REUTELER G., CAVADINI C., KNORR R. &
BLUM J. W. (2006). Effects of probiotic bacteria in
dogs with food responsive diarrhea treated with an
elimination diet. Journal of Animal Physiology and
Animal Nutrition 90, 269-277
SIMAKACHORN N., PICHAIPAT V. , R ITHIPORNPAISARN P., KONGKAEW
C., TONGPRADIT P. & VARAVITHYA W. (2000) Clinical evalu-
ation of the addition of lyophilized, heat-killed Lac-
tobacillus acidophilus LB to oral rehydration ther-
apy in the treatment of acute diarrhea in children.
Journal of Pediatric Gastroenterology and Nutrition
30, 68-72
WORLD H EALTH O RGANIZATION: FOOD AND A GRICULTURE ORGANIZA-
TION OF THE UNITED NATIONS. (2006) Probiotics in food.
Health and nutritional properties and guidelines for
evaluation. FAO Food and Nutrition Paper 85, 1-50
... The continued prescribing of metronidazole may be related to a perception that metronidazole administration resolves a patient's diarrhoea in a more timely manner and satisfies an owner's expectation of medication administration. However, there is also a rising concern about veterinary use of antimicrobials and the effects on human health (Herstad et al., 2010;and Prescott, 2019). ...
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PICO question In dogs with acute gastroenteritis, is metronidazole faster, slower, or comparable in resolving clinical signs when compared to probiotic administration? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Five studies total, all were blinded, randomised controlled trials Strength of evidence Moderate Outcomes reported The use of probiotics as a treatment for acute, uncomplicated diarrhoea in dogs may improve clinical signs faster when compared to a placebo, but showed no difference when compared directly to metronidazole. Metronidazole, when compared to a placebo, produced mixed results with one study finding that treatment with metronidazole did significantly reduce the time to resolution of diarrhoea, while another study found the difference with placebo was not significant Conclusion Based on the evidence evaluated, the use of oral metronidazole will not decrease time to resolution of clinical signs in cases of acute, uncomplicated diarrhoea in dogs when compared to probiotic administration and thus should not be a first-line treatment in such cases How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
... In recent years, glucose homeostasis and gut microbiota developed an increasingly recognized connection [7]. Also, the glucose tolerance level is associated with specific microbiota in diabetic patients compared to healthy individuals [8,9]. Many studies have reported that probiotic consumption can regulate inflammation, gut permeability, fat gain, and plasma endotoxin levels and thus significantly decrease fasting glycaemia in patients with diabetes [10,11]. ...
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Aims: Hyperglycemia occurring in the diabetic condition can cause apoptosis via the mitochondrial pathway with higher pro-apoptotic protein expression. Probiotics are viable microorganisms that have anti-diabetic and antioxidant effects. Also, exercise may affect the signaling pathways of skeletal muscle apoptosis. This study examined the aerobic exercise training and probiotic supplementation effects on some apoptotic indices of the soleus muscle in diabetic rats-induced by streptozotocin. Main methods: We examined 32 male Wistar rats (weight: 250-270 g; age: eight weeks old) and divided them into four groups: control, control + probiotics, aerobic training (AT), and AT + probiotics (ATS). The rats in the training groups aerobically exercised using a treadmill five days per week for five weeks. We evaluated the gene expression of Bax, Bcl2, and p53 using the RT-PCR. We also used a one-way ANOVA for statistical analysis and set the significance level at P ≤ 0.05. Key findings: The results showed that the fasting blood sugar was significantly higher in the control and control + probiotics groups (P = 0.008). Moreover, the AT + probiotics group showed lower expression of p53 (P = 0.005), Bax (P = 0.001) and the Bax/Bcl2 ratio (P = 0.001). Conversely, Bcl2 expression was higher after aerobic training and receiving probiotics (P = 0.002). However, the groups revealed no significant difference regarding muscle weight (P = 0.053) and the muscle weight/final body weight ratio of the rats (P = 0.26). Significance: It appears that aerobic exercise training with the use of probiotics prevents apoptosis in the muscle with the down-regulation of blood glucose.
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Acute diarrhea is a very frequent condition affecting dogs; nevertheless, little is known about what happens in the GI tract during such conditions. Proteomics allows the study of proteins present in a specific biologic substrate, and fecal proteomic investigations have been recently implemented to study GI diseases in dogs. In the present study, the fecal protein profiles of eight dogs suffering from acute uncomplicated diarrhea at the time of inclusion was investigated for the first time, and then the same patients were followed, replicating two further evaluations at two subsequent time points (after 2 and 14 days from the first presentation), with the aim of gaining possible new insights regarding the pathologic changes in the gastrointestinal environment during such conditions. Two-dimensional gel electrophoresis (2-DE) was performed, followed by mass spectrometry. Nine spots, corresponding to four (groups of) proteins (i.e., albumin, alkaline phosphatase, chymotrypsin-C-like, and some immunoglobulins), showed significant differences at two or more of the three time points investigated, almost all behaving similarly and decreasing at T1 (2 days after the onset of the condition) and significantly increasing at T2 (14 days after the onset), mainly evidencing a reaction of the organism. Further studies including a greater number of patients and possibly different techniques are needed to confirm the present findings.
Conference Paper
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Epstein-Barr virus (EBV) is a common human virus that was first identified in 1964 in Burkitt's lymphoma cells. It is estimated that over 90% of the population is infected with it, which plays a key role in the emergence and progression of many diseases of various etiology. This virus, after the acute phase of infection, persists in the human body until its death. Primary EBV infection is usually asymptomatic and in many cases occurs in childhood. EBV belongs to oncogenic viruses and is strongly correlated with the occurrence of Burkitt's lymphoma, Hodgkin's disease, nasopharyngeal cancer or post-transplant lymphoproliferative disease. The aim of the conducted research is the detection of the virus in the inhabitants of Szczecin who lead different lifestyles. For this purpose, oral swabs were taken from the residents of Szczecin who are students of the University of Szczecin, and using the ready EXTRACTME DNA SWAB & SEMEN KIT (Blirt company), genetic material in the form of DNA was isolated. Then, the obtained material was subjected to qualitative tests using the Real-Time PCR technique. A total of 47 people samples were examined; the reaction was carried out in duplicate. An increase in fluorescence was observed during the reaction which meant that the results were positive. EBV gene expression is present in part of the samples.
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Canine acute enteropathies (AE) are common morbidities primarily managed with supportive therapy. However, in some cases, unnecessary courses of antibiotics are empirically prescribed. Recent studies in humans have hypothesized the use of antioxidants as a possible alternative and/or support to antimicrobial drugs in uncomplicated cases. Considering the global need to reduce the antibiotic use, the aim of the study was to compare the oxidative burden of the diarrhetic population to that of healthy dogs. Forty-five patients suffering from uncomplicated acute diarrhea (AD) and 30 controls were screened for clinical and biochemical parameters, and serum redox indices (reactive oxygen metabolites, dROMs; serum antioxidant capacity, SAC; oxidative stress index, OSi). The average levels of dROMs in AD dogs were significantly higher (p < 0.001) than in healthy dogs, while SAC did not significantly differ between the two groups. However, the OSi values (ratio between dROMs and SAC) significantly increased (p < 0.001) in AD dogs compared to controls. The study demonstrates that canine AD could induce redox imbalance. Although its role in the etiopathogenesis and evolution of the disease should be further investigated, our results suggest that the improvement of the patient oxidative status, possibly through the dietary administration of antioxidants, could support the management of canine AE, reducing the use of antibiotics.
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Alterations in the composition of the intestinal microbiome, also known as dysbiosis, are the result of many factors such as diet, antibiotics, stress, diseases, etc. There are currently several ways to modulate intestinal microbiome such as dietary modulation, the use of antimicrobials, prebiotics, probiotics, postbiotics, and synbiotics. Faecal microbiota transplantation (FMT) represents one new method of gut microbiota modulation in humans with the aim of reconstructing the intestinal microbiome of the recipient. In human medicine, this form of bacteriotherapy is successfully used in cases of recurrent Clostridium difficile infection (CDI). FMT has been known in large animal medicine for several years. In small animal medicine, the use of FMT is not part of normal practice.
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A 2‐year‐old, male, entire mixed breed dog and a 10‐year‐old, spayed, female mixed breed dog were presented for acute onset of bloody diarrhoea and hypovolaemic shock. Faecal microbiota transplantation was introduced in addition to antibiotics and supportive care after resuscitation. Faecal condition improved after treatment, and both dogs recovered within 3 weeks.
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There is growing evidence that perturbation of the gut microbiome, known as “dysbiosis”, is associated with the pathogenesis of human and veterinary diseases that are not restricted to the gastrointestinal tract. In this regard, recent studies have demonstrated that dysbiosis is linked to the pathogenesis of central neuroinflammatory disorders, supporting the existence of the so-called microbiome-gut-brain axis. The endocannabinoid system is a recently recognized lipid signaling system and termed endocannabinoidome monitoring a variety of body responses. Accumulating evidence demonstrates that a profound link exists between the gut microbiome and the endocannabinoidome, with mutual interactions controlling intestinal homeostasis, energy metabolism and neuroinflammatory responses during physiological conditions. In the present review, we summarize the latest data on the microbiome-endocannabinoidome mutual link in health and disease, focalizing the attention on gut dysbiosis and/or altered endocannabinoidome tone that may distort the bidirectional crosstalk between these two complex systems, thus leading to gastrointestinal and metabolic diseases (e.g., idiopathic inflammation, chronic enteropathies and obesity) as well as neuroinflammatory disorders (e.g., neuropathic pain and depression). We also briefly discuss the novel possible dietary interventions based not only on probiotics and/or prebiotics, but also, and most importantly, on endocannabinoid-like modulators (e.g., palmitoylethanolamide) for intestinal health and beyond.
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The guidelines are the first comprehensive consensus report on veterinary healthcare recommendations for working, assistance, and therapy dogs. This category of canine patients includes a broad assortment of animals, some with well-defined functions and others that provide a more generalized support role. The guidelines discuss recommendations for dogs trained for protection, odor/scent detection, service functions for people with diagnosed disabilities or physical limitations, emotional support, and therapeutic intervention. Although the term is often used to describe dogs providing animal-assisted activities, true therapy dogs provide goal-directed therapy, often under the supervision of a healthcare professional such as an occupational therapist or psychologist. Many working dogs undergo extensive training and have rigorous physical demands placed upon them. These factors make working, assistance, and therapy dogs inherently valuable and impose a need for a high level of primary veterinary care as described in the guidelines. Because working dogs have a particularly close relationship with their handlers, a trust relationship between the practice team and the working-dog client is imperative.
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Objectives—To assess the diagnostic yield of a routine fecal panel and determine whether Clostridium perfringens or C difficile toxin production is associated with acute hemorrhagic diarrheal syndrome (AHDS) in dogs. Design—Case-control study. Animals—260 dogs with diarrhea and 177 dogs with normal feces. Procedure—Medical records were reviewed for results of culture for C difficile, Campylobacter spp, and Salmonella spp; C perfringens fecal enterotoxin (CPE) assay via ELISA or reverse passive latex agglutination (RPLA) assay; fecal endospore enumeration; C difficile toxin A assay; and parasite evaluation. Results—Prevalence of CPE in dogs with diarrhea was 22/154 (14.3%) via ELISA and 47/104 (45.2%) via RPLA assay, versus 9/74 (12%) via ELISA and 26/103 (25%) via RPLA assay in control dogs. Prevalence of C difficile was 47/260 (18%) in dogs with diarrhea and 41/74 (55%) in control dogs. Prevalence of C difficile toxin A was 26/254 (10.2%) in dogs with diarrhea and 0/74 in control dogs. Diagnosis of AHDS was made in 27 dogs; 8 had positive results for CPE, 7 had positive results for toxin A, and 1 had positive results for both toxins. Campylobacter spp were isolated from 13 of 260 (5%) dogs with diarrhea and 21 of 74 (28.4%) control dogs. Salmonella spp were isolated from 3 (1.2%) dogs with diarrhea. Conclusions and Clinical Relevance—Diagnostic value of a fecal panel in dogs with diarrhea appears to be low. (J Am Vet Med Assoc 2002;221:52–59)
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Selected probiotic lactic acid bacteria have several documented health effects. For many of these health effects, adhesion to the intestinal mucosa is of primary importance. In the current study, the adhesive ability to canine small intestinal mucus of four lactic acid bacteria intended for human use, two for animal use and two strains isolated from dogs was assessed. The strains for human use were specifically chosen because they have documented health effects and have been proven to be safe. One strain for human use, Lactobacillus rhamnosus (ATCC 53103), was found to adhere significantly better than all other strains. Pretreatment of the strains with canine jejunal chyme, to simulate digestion, dramatically reduced the adhesion of all strains tested. However, three of the strains intended for human use were still adhering better than the strains from animal origin. The results show that probiotic strains from human origin and intended for human use also adhere to canine intestinal mucus. This warrants further investigation of these strains for use in dogs.