Effect of probiotic treatment on the clinical course, intestinal microbiome, and toxigenic Clostridium perfringens in dogs with acute hemorrhagic diarrhea

Abstract

IntroductionThe impact of probiotics on dogs with acute hemorrhagic diarrhea syndrome (AHDS) has not been evaluated so far. The study aim was to assess the effect of probiotic treatment on the clinical course, intestinal microbiome, and toxigenic Clostridium perfringens in dogs with AHDS in a prospective, placebo-controlled, blinded trial.MethodsTwenty-five dogs with AHDS with no signs of sepsis were randomly divided into a probiotic (PRO; Visbiome, ExeGi Pharma) and placebo group (PLAC). Treatment was administered for 21 days without antibiotics. Clinical signs were evaluated daily from day 0 to day 8. Key bacterial taxa, C. perfringens encoding NetF toxin and enterotoxin were assessed on days 0, 7, 21.ResultsBoth groups showed a rapid clinical improvement. In PRO a significant clinical recovery was observed on day 3 (p = 0.008), while in PLAC it was observed on day 4 (p = 0.002) compared to day 0. Abundance of Blautia (p<0.001) and Faecalibacterium (p = 0.035) was significantly higher in PRO on day 7 compared to day 0, while in PLAC the abundance of Faecalibacterium was not significantly higher on any study day and Blautia (p = 0.016) was only significantly higher on day 21 compared to day 0. Abundance of C. perfringens was significantly lower on day 7 (p = 0.011) compared to day 0 in PRO but not in PLAC. Enterotoxin genes were significantly lower in PRO on day 21 (p = 0.028) compared to PLAC. Fecal samples of 57% of all dogs were positive for netF toxin genes on day 0 and the abundance was significantly lower on day 7 compared to day 0 in PRO (p = 0.016) and PLAC (p = 0.031).ConclusionThe probiotic treatment was associated with an accelerated normalization of the intestinal microbiome. Dogs with aseptic AHDS showed a rapid decrease of netF toxin genes and fast clinical recovery in both groups under symptomatic treatment without antibiotics.

The Role of the Canine Gut Microbiome and Metabolome in Health and Gastrointestinal Disease

“…The gene from the newly discovered netF toxin has been detected in the genome of C. perfringens isolated from intestinal biopsies of dogs with AHDS (68). In addition, other studies found a strong correlation between the presence of the netF gene in fecal samples and AHDS (69), and recovery from AHDS was accompanied by a significant decreased in netF gene and C. perfringens abundance (70). Combined, these results suggest that the netF toxin may play a role in the necrotizing lesions present in AHDS.…”

Effect of amoxicillin‐clavulanic acid on clinical scores, intestinal microbiome, and amoxicillin‐resistant Escherichia coli in dogs with uncomplicated acute diarrhea

“…The C. perfringens NetF toxin gene was found in 2 dogs (corresponding to 4% of the fecal samples) and therefore we conclude it is unlikely to have played a substantial role in causing diarrhea in the present study population. In previous studies, a higher abundance of C. perfringens , encoding for NetF toxin gene was detected in dogs AHDS, 49,50 but C. perfringens encoding for NetF toxin gene decreased within a few days even without the use of antibiotics 51 . A recent paper showed a prevalence of 48.1% in dogs with acute hemorrhagic diarrhea whereas only 12.1% of the healthy dogs carried the NetF gene 52 …”

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

“…Acute diarrhea, including acute hemorrhagic diarrhea syndrome is frequently encountered in dogs and cats. This condition is commonly treated with metronidazole, but several recent publications suggest that the disease is typically self-limiting and that probiotic administration can result in as rapid a resolution of clinical signs as antimicrobial therapy (55,56). It has been argued that in the absence of sepsis, antimicrobial therapy is not justified for management of acute diarrhea in small animals (57).…”