Treatment response and long term follow up in nineteen dogs diagnosed with chronic enteropathy in Australia

Abstract

Chronic enteropathy (CE) in dogs is common worldwide, but little data is available from Australia. The aim of this study was to describe treatment response and long‐term outcome in a cohort of dogs with CE. Dogs were prospectively enrolled at Murdoch University and the University of Melbourne. After diagnostic investigation to rule out diseases other than CE, dogs underwent sequential therapeutic trials until achieving a clinical response (diet then antibiotics, and finally immunosuppressants). Success was defined as 75% reduction of clinical severity for a minimum of five weeks. A total of 21 dogs were enrolled, and 19 completed the study. One dog was euthanised for lack of response to treatment and one excluded for lack of owner compliance. Most dogs responded to diet (n = 10), followed by antibiotics (n = 7) and immunosuppressants (n = 2). Long‐term remission (median 21.1 months, [3.0‐44.7]) was achieved in eight out of ten dietary responders without additional treatment. In contrast, only two dogs with antibiotic response remained in long‐term remission, of which one needed on‐going antibiotic treatment. Longer term remission was achieved in the two dogs treated with immunosuppressants with on‐going low dose therapy. This study concludes that most dogs referred for CE in Australia respond to dietary treatment (even after previous dietary interventions), and remission is long‐term compared to dogs treated with an antibiotic. Furthermore, the need for long‐term antibiotics in some dogs to maintain response may lead to antibiotic resistance. This study supports adequate dietary trials for CE in dogs, and a need for alternative second‐line treatments.

<p>Chronic Enteropathy In Canines: Prevalence, Impact And Management Strategies</p>

“…The poor long-term outcome in IRE and ARE dogs was also reported in a large study from the UK with significantly better outcome in dogs with FRE than ARE or IRE 4. Similar results are reported in a study from Australia with better outcome in dogs with FRE than ARE although the study was underpowered 53…”

“…Finally, 7 studies reported outcomes in dogs with CE with a follow-up period greater than 6 months (Table 4). Most studies reported a good long term outcome in dogs responding to diet with remission rates of over 66% 46,49,51–53. The effect of diet could not be assessed in one study as the diet was not changed in all dogs and additional treatment was used concomitantly 50.…”

Catching a glimpse of the bacterial gut community of companion animals: a canine and feline perspective

“…However, there is no standard treatment that offers the best strategy to adopt for this scope. Indeed, typical treatments involve sequential trials starting with the less invasive diet, followed by antibiotics and ultimately immune‐suppressive drugs in non‐responsive dogs or cats (Dandrieux, 2016; Dandrieux et al ., 2019).…”

“…However, if the effectiveness of the use of antibiotics has been reported in case of infections, their real benefit to treat CE is uncertain since antibiotics are surrounded by many contradictions. Indeed, the employment of antibiotics can expose animals to risk factors such as a significant decline of the intestinal microbial biodiversity, reduction of beneficial bacteria and development of antibiotic‐resistant microorganisms (Suchodolski et al ., 2009; Dandrieux et al ., 2019; Werner et al ., 2020). Metronidazole and/or tylosin are the most commonly prescribed antibiotics to treat GI diseases (Mondo et al ., 2019).…”

“…Furthermore, tylosin treatment induced a significant decrease in commensal taxa such as Fusobacterium , Faecalibacterium , Blautia and C. hiranonis , while Enterococcaceae and Peptostreptococcaceae increased probably due to their intrinsic or acquired antimicrobial resistance, thus arguing against the hypothesis that tylosin may elicit a beneficial effect in the restoration of a dysbiotic microbiota (Manchester et al ., 2019). In addition, different studies reported that CE response to antibiotics is short‐lasting after cessation of the treatment with a high number of relapsing cases within a month (Dandrieux et al ., 2019). Based on these findings, other solutions such as prebiotics, probiotics or synbiotics may be preferred for CE treatment.…”