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Giardiosis and colitis in a dog. A. D. J. Watson. Australian Vet. J. September 1980; doi: 10.1111/j.1751-0813.1980.tb02640.x. Quote: An 18-month-old Cavalier King Charles Spaniel with recurrent diarrhoea for 2 months had signs suggesting dysfunction of small and large bowel. No helminth ova, protozoa or fat were found on faecal examination. Proctoscopy, barium enema examination and colonic biopsy revealed mucosal colitis. Biopsied small intestine was histologically normal but Giardia trophozoites were numerous in fluid aspirated from the duodenum. Absorption of d-xylose was normal. Giardiosis and idiopathic colitis were diagnosed. Clinical signs abated after 2 courses of metronidazole administration.

Colitis in the dog. Barry Bush. In Pract. October 1995; doi: 10.1136/inpract.17.9.410. Quote: Colitis denotes inflammatory bowel disease affecting the large bowel, including the rectum. It accounts for about a third of all cases of chronic diarrhoea in the dog and presents with a number of diagnostically valuable clinical features. Inflammatory bowel disease can also affect the small intestine and both regions may be involved concurrently, resulting in a mixture of signs. ... In a series of 527 cases of idiopathic chronic colitis investigated by the author between 1979 and 1990 (unpublished data), a quarter of the dogs belonged to just two breeds - the German shepherd dog and golden retriever (as illustrated below). Idiopathic chronic colitis also occurred frequently in the collie breeds (especially the rough collie and Shetland sheepdog), small terriers (cairn, Jack Russell, West Highland white and, in particular, the Yorkshire terrier), spaniels (especially the Cavalier King Charles), and poodles (with prevalence increasing with size).

Mega-oesophagus secondary to acquired myasthenia gravis. P. S. Yam, G. D. Shelton, J. W. Simpson. J. Sm. Anim. Pract. April 1996; doi: 10.1111/j.1748-5827.1996.tb01957.x Quote: Fifteen dogs (including one Cavalier King Charles spaniel) with confirmed adult onset idiopathic megaoesophagus, in which no generalised muscle weakness was observed, were tested for the presence of acetylcholine receptor antibodies. Of these, six (including the CKCS) were found to have values greater than 0–6 nmol/litre, previously determined to be diagnostic of acquired myasthenia gravis. The mean serum titre value for these dogs was 5–59 nmol/litre (range 0–78 to 8–72 nmol/litre). It appears that a significant proportion of dogs presenting with megaoesophagus have myasthenia gravis and, if a prompt diagnosis and appropriate treatment can be instituted, clinical signs may improve. ... The CKCS (Case #2), a 1 year old male, had clinical signs of dysphagia, regurgitation, and coughing; his diagnosis was focal myasthenia gravis (MG); his serum AChR antibody titre was 3.3 nmol/litre.

Intestinal permeability and function in dogs with small intestinal bacterial overgrowth. H. C. Rutgers, R. M. Batt, F. J. Proud, S. H. Søorensen, C. M. Elwood, G. Petrie, L. A. Matthewman, M. A. Forster-van Hijfte, A. Boswood, M. Entwistle, R. H. Fensome. J. Sm. Anim. Pract. September 1996; doi: 10.1111/j.1748-5827.1996.tb02443.x. Quote: Small intestinal bacterial overgrowth (SIBO) has been reported to occur commonly in dogs with signs of chronic intestinal disease. There are usually few intestinal histological changes, and it is uncertain to what extent bacteria cause mucosal damage. The aim of this study was to apply a differential sugar absorption test for intestinal permeability and function to the objective assessment of intestinal damage in dogs with SIBO. Studies were performed on 63 dogs with signs of chronic small and, or, large bowel disease, in which SIBO (greater than 105 total or greater than 104 anaerobic colony forming units/ml) was diagnosed by quantitative culture of duodenal juice obtained endoscopically. None of the dogs had evidence of intestinal pathogens, parasites, systemic disease or pancreatic insufficiency. Differential sugar absorption was performed by determining the ratios of urinary recoveries of lactulose/rhamnose (L/R ratio, which reflects permeability) and D-xylose/3-O-methylglucose (X/G ratio, which reflects intestinal absorptive function) following oral administration. Dogs with SIBO comprised 28 different breeds, including 18 German shepherd dogs [and 4 cavalier King Charles spaniels, the second highest number]. SIBO was aerobic in 18/63 dogs (29 per cent), and anaerobic in 45/63 (71 per cent). Histological examination of duodenal biopsies showed no abnormalities in 75 per cent, and mild to moderate lymphocytic infiltrates in 25 per cent of the dogs. The L/R ratio was increased (greater than 0–12) in 52 per cent, and the X/G ratio reduced (less than 0–60) in 33 per cent of the dogs. Differential sugar absorption was repeated in 11 dogs after their four weeks of oral antibiotic therapy. The L/R ratio declined in all 11 dogs (mean ± SD pre: 0–24 ± 0–14; post: 0–16 ± 0–11; P<0–05), but changes in the X/G ratio were more variable. These findings show that SIBO is commonly associated with mucosal damage, not detected on histological examination of intestinal biopsies, and that changes in intestinal permeability following oral antibiotics may be used to monitor response to treatment.

Differential diagnosis and treatment of acute diarrhoea in the dog and cat. Ian Battersby, Andrea Harvey. In Pract. September 2006; doi: 10.1136/inpract.28.8.480. Quote: Acute and chronic diarrhoea are both very common complaints in first-opinion small animal practice. Diarrhoea is defined as an increase in the frequency, fluidity or volume of faeces. It is a primary sign of intestinal disease, although it may also be a manifestation of other systemic diseases. Diarrhoea can occur as a consequence of small or large intestinal disease, but it is not uncommon for both to be present. Information gained from the clinical history can aid differentiation between diarrhoea of large and small intestinal origin. This article focuses on the acute presentation, although the differential diagnoses do overlap with chronic diarrhoea. It reviews the causes and sets out an approach to the investigation and management of patients. As well as discussing what treatments may or may not be appropriate, it gives some guidance on what to do if an infectious aetiology, such as parvovirus, is suspected.

Molecular-phylogenetic characterization ofmicrobial communities imbalances in the small intestine of dogswith infammatory bowel disease. Panagiotis G. Xenoulis, Blake Palculict, Karin Allenspach, Jörg M. Steiner, Angela M. Van House, Jan S. Suchodolski. Microbiology Ecology. December 2008;66(3):579-589. Quote: An association between luminal commensal bacteria and inflammatory bowel disease (IBD) has been suggested in humans, but studies investigating the intestinal microbial communities of dogs with IBD have not been published. The aim of this study was to characterize differences of the small intestinal microbial communities between dogs with IBD [including a cavalier King Charles spaniel] and healthy control dogs. Duodenal brush cytology samples were endoscopically collected from 10 dogs with IBD and nine healthy control dogs. DNA was extracted and 16S rRNA gene was amplified using universal bacterial primers. Constructed 16S rRNA gene clone libraries were compared between groups. From a total of 1240 selected clones, 156 unique 16S rRNA gene sequences were identified, belonging to six phyla: Firmicutes (53.4%), Proteobacteria (28.4%), Bacteroidetes (7.0%), Spirochaetes (5.2%), Fusobacteria (3.4%), Actinobacteria (1.1%), and Incertae sedis (1.5%). Species richness was significantly lower in the IBD group (P=0.038). Principal component analysis indicated that the small intestinal microbial communities of IBD and control dogs are composed of distinct microbial communities. The most profound difference involved enrichment of the IBD dogs with members of the Enterobacteriaceae family. However, differences involving members of other families, such as Clostridiaceae, Bacteroidetes and Spirochaetes, were also identified. In conclusion, canine IBD is associated with altered duodenal microbial communities compared with healthy controls.

Expression of Toll-like receptor 2 in duodenal biopsies from dogs with inflammatory bowel disease is associated with severity of disease. L.A. McMahon, A.K. House, B. Catchpole, J. Elson-Riggins, A. Riddle, K. Smith, D. Werling, I.A. Burgener, K. Allenspach. Vet. Immunology & Immunopathology. May 2010;135(1-2):158-163. Quote: There is growing evidence that aberrant innate immune responses towards the bacterial flora of the gut play a role in the pathogenesis of canine inflammatory bowel disease (IBD). Toll-like receptors (TLR) play an important role as primary sensors of invading pathogens and have gained significant attention in human IBD as differential expression and polymorphisms of certain TLR have been shown to occur in ulcerative colitis (UC) and Crohn's disease (CD). The aim of the current study was to evaluate the expression of two TLR important for recognition of commensals in the gut. TLR2 and TLR4 mRNA expression in duodenal biopsies from dogs with IBD was measured and correlated with clinical and histological disease severity. Endoscopic duodenal biopsies from 20 clinical cases [including three cavalier King Charles spaniels] and 7 healthy control dogs were used to extract mRNA. TLR2 and TLR4 mRNA expression was assessed using quantitative real-time PCR. TLR2 mRNA expression was significantly increased in the IBD dogs compared to controls, whereas TLR4 mRNA expression was similar in IBD and control cases. In addition, TLR2 mRNA expression was mildly correlated with clinical severity of disease, however, there was no correlation between TLR2 expression and histological severity of disease.

Diagnosis and Management of Protein-losing Enteropathies. Stanley L. Marks. WSAVA. 2007. Quote: "Protein-losing enteropathy (PLE) is a syndrome caused by a variety of gastrointestinal diseases causing the enteric loss of albumin and globulin. Intestinal inflammation, infiltration, ulceration, blood loss, and primary or secondary lymphangiectasia are well documented causes of PLE. If left untreated, the final outcome of PLE is panhypoproteinemia with decreased intravascular oncotic pressure and the development of abdominal and pleural effusion, peripheral oedema, and death. An important sequel to PLE includes thromboembolic disease secondary to the loss of antithrombin. Protein-losing enteropathy is uncommon in cats, and most cats with PLE are diagnosed with intestinal lymphoma or severe IBD."

A Retrospective Study in 21 Shiba Dogs with Chronic Enteropathy. Aki Ohmi, Koichi Ohno, Kazuyuki Uchida, Hiroyuki Nakayama, Yuko Koshino-Goto, Kenjiro Fukushima, Masashi Takahashi, Ko Nakashima, Yasuhito Fujino, Hajime Tsujimoto. . Vet. Med. Sci. January 2011;73(1):1-5. Quote: "We retrospectively studied the clinical and laboratory features and outcomes of chronic enteropathy in Shiba dogs. Among 99 dogs with chronic enteropathy, 21 Shiba dogs (21%) were included in the study (odds ratio, 7.14) [and 3 cavalier King Charles spaniels]. No significant differences were seen in signalment, clinical signs, symptoms or laboratory profiles between the Shiba and non-Shiba groups. Severe histopathological lesions in the duodenum were a common finding in the Shiba group. The median overall duration of survival in the Shiba group was 74 days, while that of the dogs in the non-Shiba group could not be determined because more than half of the cases remained alive at the end of this study. The difference between the groups was statistically significant (P<0.0001). The 6-month and 1-year survival rates for the Shiba group were 46% and 31%, respectively. Conversely, the 6-month, 1-year and 3-year survival rates for the non-Shiba group were 83%, 74% and 67%. The results obtained here demonstrated that the Shiba dog is predisposed to chronic enteropathy and shows severe duodenum lesions and poor outcomes, indicating a breed-specific disease."

Hypercoagulability in Dogs with Protein-Losing Enteropathy. L.V. Goodwin, R. Goggs, D.L. Chan, K. Allenspach. J. Vet. Intern. Med. March 2011:25:273-277. Quote: "Background: Dogs with protein-losing enteropathy (PLE) have previously been reported to present with thromboembolism; however, the prevalence and pathogenesis of hypercoagulability in dogs with PLE have not been investigated so far. Hypothesis: Dogs with PLE are hypercoagulable compared with healthy control dogs. Animals: Fifteen dogs with PLE [one was a cavalier King Charles spaniel]. Thirty healthy dogs served as controls (HC). Methods: A prospective study was performed including 15 dogs with PLE. All dogs were scored using the canine chronic enteropathy activity index (CCECAI). Thromboelastography (TEG) and other measures of coagulation were evaluated. Recalcified, unactivated TEG was performed and reaction time (R), kinetic time (K), alpha angle (a), and maximum amplitude (MA) values were recorded. Nine dogs were reassessed after initiation of immunosuppressive treatment. Results: All dogs with PLE in the study were hypercoagulable with decreased R (PLE: median 7.8, range [2.4–11.2]; HC: 14.1 [9.1–20.3]), decreased K (PLE: 2.5 [0.8–5.2]; HC: 8.25 [4.3–13.1]), increased a (PLE: 56.7 [38.5–78.3]; HC: 25.6 [17–42.4]), and increased MA (PLE: 68.2 [54.1–76.7]; HC: 44.1, [33.5–49]) (all P o .001). Median antithrombin (AT) concentration was borderline low in PLE dogs; however, mean serum albumin concentration was severely decreased (mean 1.67 g/dL 5.1, reference range 2.8–3.5 g/dL). Despite a significant improvement in serum albumin and CCECAI, all 9 dogs with PLE were hypercoagulable at re-examination. Conclusions and Clinical Importance: The hypercoagulable state in dogs with PLE cannot be solely attributed to loss of AT. Despite good clinical response to treatment, dogs remained hypercoagulable and could therefore be predisposed to thromboembolic complications." 

Breed-independent toll-like receptor 5 polymorphisms show association with canine inflammatory bowel disease. A. Kathrani, A. House, B. Catchpole, A. Murphy, D. Werling, K. Allenspach. Tissue Antigens. August 2011;78(2):94-101. Quote: Inflammatory bowel disease (IBD) is thought to be the most common cause of vomiting and diarrhoea in dogs. Although IBD can occur in any canine breed, certain breeds are more susceptible. We have previously shown that polymorphisms in the TLR4 and TLR5 (toll-like receptor) genes are significantly associated with IBD in German Shepherd dogs (GSDs). In order to allow for the development of novel diagnostics and therapeutics suitable for all dogs suffering from IBD, it would be useful to determine if the described polymorphisms are also significantly associated with IBD in other breeds. Therefore, the aim of this study was to investigate whether polymorphisms in the canine TLR4 and TLR5 genes are associated with IBD in other non-GSD canine breeds. The significance of the previously identified non-synonymous single nucleotide polymorphisms (SNPs) in the TLR4 (T23C, G1039A, A1571T and G1807A) and TLR5 genes (G22A, C100T and T1844C) were evaluated in a case-control study using a SNaPSHOT multiplex reaction. Sequencing information from 85 unrelated dogs with IBD consisting of 38 different breeds [including two cavalier King Charles spaniels] was compared with a breed-matched control group consisting of 162 unrelated dogs [including three cavalier King Charles spaniels]. Indeed, as in the GSD IBD population, the two TLR5 SNPs (C100T and T1844C) were found to be significantly protective for IBD in other breeds (P = 0.023 and P = 0.0195 respectively). Our study suggests that the two TLR5 SNPs, C100T and T1844C could play a role in canine IBD as these were found to be protective factors for this disease in 38 different canine breeds. Thus, targeting TLR5 in the canine system may represent a suitable way to develop new treatment for IBD in dogs.

Gene expression of selected signature cytokines of T cell subsets in duodenal tissues of dogs with and without inflammatory bowel disease. Silke Schmitz, Oliver A. Garden, Dirk Werling, Karin Allenspach. Vet. Immunology & Immuno-pathology. March 2012;146(1):87-91. Quote: Inflammatory bowel disease (IBD) is a common cause of chronic diarrhoea in dogs. In people, specific cytokine patterns attributed to T cell subsets, especially T helper cell [Th]1, Th17 and regulatory T(reg) cells have emerged in IBD. In contrast, no specific involvement of a distinct T cell subset has been described so far in canine IBD. Thus, the aim of the present study was to assess gene expression of signature cytokines in duodenal tissues from 18 German shepherd dogs with IBD (group 1), 33 dogs of other breeds [including three cavalier King Charles spaniels] with IBD (group 2) and 15 control dogs (group 3). Relative quantification of IL-17A, IL-22, IL-10, IFNy and TGFβ was performed. Expression of IL-17A was significantly lower in groups 1 and 2 compared to group 3 (p = 0.014), but no difference in the expression of IL-22 (p = 0.839), IFNγ (p = 0.359), IL-10 (p = 0.085) or TGFβ (p = 0.551) across groups was detected. Thus, no clear evidence for the involvement of Th-17 signature cytokines in canine IBD at the mRNA level could be shown. The contribution of specific T cell subsets to the pathogenesis of canine IBD warrants further investigation.

Gastrointestinal disorders in dogs with excessive licking of surfaces. Becuwe-Bonnet V, Belanger M-C, Frank D, Parent J, Helie P. J.Vet.Behavior. July 2012;7(4):194-204. Quote: "Excessive licking of surfaces (ELS) refers to licking of objects and surfaces in excess of duration, frequency, or intensity as compared with that required for exploration. This behavior is a nonspecific sign and may be the consequence of several conditions. The objectives of our prospective clinical study were to characterize ELS behavior in dogs and to examine the extent to which it may be a sign of an underlying gastrointestinal (GI) pathology as opposed to a primarily behavioral concern. Nineteen dogs presented with ELS were included in the licking group and 10 healthy dogs were assigned to a control group. Behavioral, physical, and neurological examinations were performed before a complete evaluation of the GI system. Treatment was recommended on the basis of diagnostic findings. Following initialization of treatment, dogs were then monitored for 90 days during which their licking behavior was recorded. GI abnormalities were identified in 14 of 19 dogs in the licking group. These abnormalities included eosinophilic and/or lymphoplasmacytic infiltration of the GI tract, delayed gastric emptying, irritable bowel syndrome, chronic pancreatitis, gastric foreign body, and giardiasis. Significant improvement in both frequency and duration of the basal ELS behavior was observed in 10 of 17 dogs (59%). Resolution of ELS occurred in 9 of 17 dogs (53%). Based on video analysis, it was found that ELS dogs were not significantly more anxious than the dogs in control group in the veterinary context. In conclusion, GI disorders should be considered in the differential diagnosis of canine ELS."

Prospective Medical Evaluation of 7 Dogs Presented with Fly Biting. D. Frank, MC Bélanger, V. Bécuwe-Bonnet, J. Parent. 22nd ECVIM-CA Congress. Can Vet J. 2012 December;53(12):1279–1284. (See, also, J.Vet.Intern.Med. Nov. 2012; 26(6):1505–1538.) Quote: "Fly snapping, fly-biting or jaw snapping are names given to a syndrome in which dogs appear to be watching something then suddenly leaping and snapping at it. Fly-biting dogs are generally referred to neurologists or behaviourists because the abnormalities are often interpreted as focal seizures or as obsessive compulsive disorder (OCD). There is one published case report of fly biting presumably caused by dietary intolerance in a Cavalier King Charles Spaniel. The aims of this case series were 1) to characterize fly biting, 2) perform a complete medical evaluation of dogs presented with fly biting, and 3) evaluate the outcome of this behaviour following appropriate treatment of the underlying medical condition.Seven dogs presented for fly-biting behaviour (FB) were assessed. ... Our study group included 4 neutered males and 3 females (2 intact, 1 spayed). Four breeds (2 cavalier King Charles spaniels; 1 miniature schnauzer; 1 Boston terrier; 1 Bernese mountain dog), and 2 mixed breeds, both listed as crosses of Bernese mountain dogs were presented.  ... All dogs underwent a complete medical and behavioural history as well as physical and neurological examinations. Further investigation was performed if an abnormality was found on examination or if the history was suggestive of an underlying problem. Based on clinical presentation, physical examination, neurologic examination, and laboratory test results, a diagnosis was made and a specific treatment recommended. Response to treatment was monitored and evaluated following phone conversations with owners at day 30, 60 and 90 from onset of treatment. Many gastrointestinal disorders were found in FB dogs which included eosinophilic and lymphoplasmacytic infiltration of the stomach and small bowel, delayed gastric emptying and gastroeosophageal reflux. Complete resolution of the FB was observed in 5/6 dogs diagnosed and specifically treated for the underlying gastrointestinal (GI) disease [including one cavalier King Charles spaniel]. One dog [cavalier King Charles spaniel] was diagnosed with Chiari malformation and responded temporarily to pain management. In conclusion, this prospective case series indicates that fly biting behaviour may be caused by an underlying medical disorder, GI disease being the most common. Resolution of this behaviour is possible following specific treatment of the underlying medical condition."

Decreased Immunoglobulin A Concentrations in Feces, Duodenum, and Peripheral Blood Mononuclear Cells of Dogs with Inflammatory Bowel Disease. J. Vet. Inter. Med. January 2013;27(1):47-55. Quote: Background: Although immunoglobulin A (IgA) plays a key role in regulating gut homeostasis, its role in canine inflammatory bowel disease (IBD) is unknown. Hypothesis: IgA expression may be altered in dogs with IBD, unlike that observed in healthy dogs and dogs with other gastrointestinal diseases. Animals: Thirty-seven dogs with IBD {including three cavalier King Charles spaniels], 10 dogs with intestinal lymphoma, and 20 healthy dogs. Methods: Prospective study. IgA and IgG concentrations in serum, feces, and duodenal samples were measured by ELISA. IgA+ cells in duodenal lamina propria and IgA+ CD21+ peripheral blood mononuclear cells (PBMCs) were examined by immunohistochemistry and flow cytometry, respectively. Duodenal expression of the IgA-inducing cytokine transforming growth factor β (TGF-β), B cell activating factor (BAFF), and a proliferation-inducing ligand (APRIL) was quantified by real-time RT-PCR. Results: Compared to healthy dogs, dogs with IBD had significantly decreased concentrations of IgA in fecal and duodenal samples. The number of IgA+ CD21+ PBMCs and IgA+ cells in duodenal lamina propria was significantly lower in dogs with IBD than in healthy dogs or dogs with intestinal lymphoma. Duodenal BAFF and APRIL mRNA expression was significantly higher in IBD dogs than in the healthy controls. Duodenal TGF-β mRNA expression was significantly lower in dogs with IBD than in healthy dogs and dogs with intestinal lymphoma. Conclusions and Clinical Importance: IBD dogs have decreased IgA concentrations in feces and duodenum and fewer IgA+ PBMCs, which might contribute to development of chronic enteritis in dogs with IBD.

Protein-losing entropathy in a dog. Leah Simons. Cornell Univ. eCommons. September 2013. Quote: Case History: A four year old female spayed Cavalier King Charles Spaniel presented to the Cornell University Hospital for Animals for a six week history of small bowel diarrhea, decreased appetite, intermittent vomiting, and weight loss. She had a four day history of worsening panhypoproteinemia, hypocholestrolemia, ascites, and pleural effusion. Clinical Findings: The patient presented with ascites, peripheral edema, a left sided II/VI systolic murmur and a body condition score of 3/9. Diagnostic Findings: Initial diagnostics performed at the referring veterinarian showed hypoalbuminemia, hypoglobulinemia, hypocholestrolemia, hypomagnesemia, hypocalcemia, a nonregenerative anemia, a metabolic alkalosis, a normal urinalysis, and an elevated Spec cPL. These tests ruled down protein losing nephropathy as a source for protein loss. Additional blood work was performed upon presentation to Cornell which showed a normal cobalamin, normal fecal analysis ruling down parasitic causes, normal bile acids ruling down hepatic causes, normal PT and APTT clotting times, a metabolic alkalosis, and normal ionized electrolyte values. Radiographs from the referring veterinarian showed abdominal and pleural effusion and an increased bronchointerstitial pattern. An abdominal ultrasound showed a hyperechoic peritoneal mesentery, jejunal lymphadenopathy, slightly thickened small intestines, a questionable diffuse hepatopathy, and no apparent cause for the panhypoproteinemia. Fine needle aspirates of the liver were performed to rule down liver disease and lymphoma and endoscopic biopsies of the stomach and duodenum were performed showing mild lymphocytic plasmacytic gastritis and enteritis. Problem List: The patient’s major problems were panhypoproteinemia, hypocholesterolemia, chronic small bowel diarrhea, vomiting, weight loss, ascites, pleural effusion, peripheral edema, and a II/VI left sided systolic heart murmur. Treatment: The dog was treated for inflammatory bowel disease with an anti-thrombotic medication, steroids, dietary modification, metronidazole, B12 injections, and a gastroprotectant.

Micronized/ultramicronized palmitoylethanolamide displays superior oral efficacy compared to nonmicronized palmitoylethanolamide in a rat model of inflammatory pain. Daniela Impellizzeri, Giuseppe Bruschetta, Marika Cordaro, Rosalia Crupi, Rosalba Siracusa, Emanuela Esposito, Salvatore Cuzzocrea. Neuroinflammation. August 2014; doi: 10.1186/s12974-014-0136-0. Quote: Background: The fatty acid amide palmitoylethanolamide (PEA) has been studied extensively for its anti-inflammatory and neuroprotective actions. The lipidic nature and large particle size of PEA in the native state may limit its solubility and bioavailability when given orally, however. Micronized formulations of a drug enhance its rate of dissolution and reduce variability of absorption when orally administered. The present study was thus designed to evaluate the oral anti-inflammatory efficacy of micronized/ultramicronized versus nonmicronized PEA formulations. Methods: Micronized/ultramicronized PEA was produced by the air-jet milling technique, and the various PEA preparations were subjected to physicochemical characterization to determine particle size distribution and purity. Each PEA formulation was then assessed for its anti-inflammatory effects when given orally in the carrageenan-induced rat paw model of inflammation, a well-established paradigm of edema formation and thermal hyperalgesia. Results: Intraplantar injection of carrageenan into the right hind paw led to a marked accumulation of infiltrating inflammatory cells and increased myeloperoxidase activity. Both parameters were significantly decreased by orally given micronized PEA (PEA-m; 10 mg/kg) or ultramicronized PEA (PEA-um; 10 mg/kg), but not nonmicronized PeaPure (10 mg/kg). Further, carrageenan-induced paw edema and thermal hyperalgesia were markedly and significantly reduced by oral treatment with micronized PEA-m and ultramicronized PEA-um at each time point compared to nonmicronized PeaPure. However, when given by the intraperitoneal route, all PEA formulations proved effective. Conclusions: These findings illustrate the superior anti-inflammatory action exerted by orally administered, micronized PEA-m and ultramicronized PEA-um, versus that of nonmicronized PeaPure, in the rat paw carrageenan model of inflammatory pain.

Breed, gender and age pattern of diagnosis for veterinary care in insured dogs in Japan during fiscal year 2010. Mai Inoue, A. Hasegawa, Y. Hosoic, K. Sugiurad. Prev. Vet. Med. April 2015;119(1–2):54–60. Quote: We calculated the annual prevalence of diseases of 18 diagnostic categories in the insured dog population in Japan, using data from 299,555 dogs [including 5,743 cavalier King Charles spaniels] insured between April 2010 and March 2011. The prevalence was highest for dermatological disorders (22.6% for females and 23.3% for males), followed by otic diseases (16.4% for females and 17.2% for males) and digestive system disorders (15.7% for females and 16.4% for males). The prevalence of cardiovascular, urinary, neoplasia and endocrine disorders, increased with age; infectious diseases and injuries showed a high prevalence at young ages, and the prevalence of musculoskeletal and respiratory disorders showed a bimodal peak at young and old ages. A large variation in prevalence was observed between breeds for dermatological, otic, digestive, ophthalmological and cardiovascular disorders. ... Cavalier King Charles Spaniel had an annual prevalence of 21% for digestive system disorders.

Prevalence of disorders recorded in Cavalier King Charles Spaniels attending primary-care veterinary practices in England. Jennifer F Summers, Dan G O’Neill, David B Church, Peter C Thomson, Paul D McGreevy, David C Brodbelt. Canine Genetics & Epidemiology. April 2015;2:4. Quote: Background: Concerns have been raised over breed-related health issues in purebred dogs, but reliable prevalence estimates for disorders within specific breeds are sparse. Electronically stored patient health records from primary-care practice are emerging as a useful source of epidemiological data in companion animals. This study used large volumes of health data from UK primary-care practices participating in the VetCompass animal health surveillance project to evaluate in detail the disorders diagnosed in a random selection of over 50% of dogs recorded as Cavalier King Charles Spaniels (CKCSs). Confirmation of breed using available microchip and Kennel Club (KC) registration data was attempted. Results: In total, 3624 dogs were recorded as CKCSs within the VetCompass database of which 143 (3.9%) were confirmed as KC-registered via microchip identification linkage of VetCompass to the KC database. 1875 dogs (75 KC registered and 1800 of unknown KC status, 52% of both groups) were randomly sampled for detailed clinical review. Clinical data associated with veterinary care were recorded in 1749 (93.3%) of these dogs. The most common specific disorders recorded during the study period were heart murmur (541 dogs, representing 30.9% of study group), diarrhoea of unspecified cause (193 dogs, 11.0%), dental disease (166 dogs, 9.5%), otitis externa (161, 9.2%), conjunctivitis (131, 7.4%) and anal sac infection (129, 7.4%). The five most common disorder categories were cardiac (affecting 31.7% of dogs), dermatological (22.2%), ocular (20.6%), gastrointestinal (19.3%) and dental/periodontal disorders (15.2%). Discussion and conclusions: Study findings suggest that many of the disorders commonly affecting CKCSs are largely similar to those affecting the general dog population presented for primary veterinary care in the UK. However, cardiac disease (and MVD in particular) continues to be of particular concern in this breed. Further work: This work highlights the value of veterinary practice based breed-specific epidemiological studies to provide targeted and evidence-based health policies. Further studies using electronic patient records in other breeds could highlight their potential disease predispositions.

Prognostic factors in dogs with protein-losing enteropathy. K. Nakashima, S. Hiyoshi, K. Ohno, H. Tsujimoto. Vet. J. May 2015;205(1):1-6. Quote: "Canine protein-losing enteropathy (PLE) is associated with severe gastrointestinal disorders and has a guarded to poor prognosis although little information is available regarding factors affecting prognosis. The purpose of this study was to identify the prognostic factors for survival of dogs with PLE. Ninety-two dogs diagnosed with PLE from 2006 to 2011 were included in a retrospective cohort study. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Variables recorded at the time of diagnosis were statistically analysed for possible prognostic factors in a univariate and multivariate Cox proportional hazard model. In the multivariate analysis, the predictors for mortality in dogs with PLE were more highly scored in terms of canine inflammatory bowel disease activity index (CIBDAI) (P = 0.0003), clonal rearrangement of lymphocyte antigen receptor genes (P = 0.003), and elevation of blood urea nitrogen (BUN) (P = 0.03). Using histopathological diagnosis, both small- and large-cell lymphomas were associated with significantly shorter survival times than chronic enteritis (CE) and intestinal lymphangiectasia (IL). Normalization of CIBDAI and plasma albumin concentration within 50 days of initial treatment was associated with a longer survival time. In conclusion, CIBDAI, clonal rearrangement of lymphocyte antigen receptor genes, histopathological diagnosis, and response to initial treatments would be valuable in separating the underlying causes and could be important in predicting prognosis in dogs with PLE."

Gonadectomy effects on the risk of immune disorders in the dog: a retrospective study. Crystal R. Sundburg, Janelle M. Belanger, Danika L. Bannasch, Thomas R. Famula, Anita M. Oberbauer. Vet. Res. December 2016;12:278. Quote: Background: Gonadectomy (spay or neuter or castration) is one of the most common procedures performed on dogs in the United States. Neutering has been shown to reduce the risk for some diseases although recent reports suggest increased prevalence for structural disorders and some neoplasias. The relation between neuter status and autoimmune diseases has not been explored. This study evaluated the prevalence and risk of atopic dermatitis (ATOP), autoimmune hemolytic anemia (AIHA), canine myasthenia gravis (CMG), colitis (COL), hypoadrenocorticism (ADD), hypothyroidism (HYPO), immune-mediated polyarthritis (IMPA), immune-mediated thrombocytopenia (ITP), inflammatory bowel disease (IBD), lupus erythematosus (LUP), and pemphigus complex (PEMC), for intact females, intact males, neutered females, and neutered males. Pyometra (PYO) was evaluated as a control condition. Results: Patient records (90,090) from the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis from 1995 to 2010 were analyzed in order to determine the risk of immune-mediated disease relative to neuter status in dogs. Neutered dogs had a significantly greater risk of ATOP, AIHA, ADD, HYPO, ITP, and IBD than intact dogs with neutered females being at greater risk than neutered males for all but AIHA and ADD. Neutered females, but not males, had a significantly greater risk of LUP than intact females. Pyometra was a greater risk for intact females. Conclusions: The data underscore the importance of sex steroids on immune function emphasizing a role of these hormones on tissue self-recognition. Neutering is critically important for population control, reduction of reproductive disorders, and offers convenience for owners. Despite these advantages, the analyses of the present study suggest that neutering is associated with increased risk for certain autoimmune disorders and underscore the need for owners to consult with their veterinary practitioner prior to neutering to evaluate possible benefits and risks associated with such a procedure. ... Six of the autoimmune diseases evaluated showed an increased prevalence in neutered dogs, supporting the concept that neutering may have a detrimental effect on a canine’s health and immune function. Lupus was the only disease that did not show increased prevalence in neutered dogs of both sexes compared to intact dogs. These findings indicate the importance of sex steroids on immune function and suggest a role of these hormones on self-recognition.

Nuclear Glycogen Inclusions in Canine Parietal Cells. S. Silvestri, E. Lepri, C. Dall’Aglio, M. C. Marchesi, G. Vitellozzi. Vet. Pathology. January 2017. Quote: Nuclear glycogen inclusions occur infrequently in pathologic conditions but also in normal human and animal tissues. Their function or significance is unclear. To the best of the authors’ knowledge, no reports of nuclear glycogen inclusions in canine parietal cells exist. After initial observations of nuclear inclusions / pseudoinclusions during routine histopathology, the authors retrospectively examined samples of gastric mucosa from dogs presenting with gastrointestinal signs for the presence of intranuclear inclusions/pseudoinclusions and determined their composition using histologic and electron-microscopic methods. ... The main represented breeds with nuclear inclusions in our sample population were mixed-breed dogs and Cavalier King Charles Spaniels. ... In 24 of 108 cases (22%), the authors observed various numbers of intranuclear inclusions / pseudoinclusions within scattered parietal cells. ... the main represented breeds were mixed-breed dogs (26%, 5/19), followed by Cavalier King Charles Spaniels (11%, 2/19). ... Nuclei were characterized by marked karyomegaly and chromatin margination around a central optically empty or slightly eosinophilic area. The intranuclear inclusions/pseudoinclusions stained positive with periodic acid–Schiff (PAS) and were diastase sensitive, consistent with glycogen. Several PAS-positive/diastase-sensitive sections were further examined by transmission electron microscopy, also using periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) staining to identify polysaccharides. Ultrastructurally, the nuclear inclusions were composed of electron-dense particles that were not membrane bound, without evidence of nuclear membrane invaginations or cytoplasmic organelles in the nuclei, and positive staining with PA-TCH-SP, confirming a glycogen composition. No cytoplasmic glycogen deposits were observed, suggesting that the intranuclear glycogen inclusions were probably synthesized in loco. Nuclear glycogen inclusions were not associated with gastritis or colonization by Helicobacter-like organisms (P > .05). Our findings suggest that nuclear glycogen inclusions in canine parietal cells could be an incidental finding. Nevertheless, since nuclear glycogen is present in several pathologic conditions, further investigations could be warranted to determine their true significance.

A Randomized Controlled Study Comparing Da Xiang Lian Wan to Metronidazole in the Treatment of Stress Colitis in Shelter/Rescued Dogs. Margaret P Fowler, Deng-Shan Shiau, Huisheng Xie. Am. J.Trad.l Chinese Vet. Med.  February 2017; 12(1):45-54. Quote: Traditional Chinese Veterinary Medicine (TCVM), which can include treatment with Chinese herbal medicine, is being used increasingly in Western medicine to treat a variety of diseases in dogs. With the increased interest in Chinese herbal medicines, evidence-based research to prove efficacy and safety of these traditional medicines is necessary. The objective of this research was to compare the effectiveness of the Chinese herbal medicine, Da Xiang Lian Wan (DXLW), to the Western pharmaceutical, metronidazole, in the treatment of stress colitis in sheltered/rescued dogs utilizing a randomized controlled study with a hypothesis that successful treatment with DXLW would not be less than metronidazole. Fifty-six dogs were randomly assigned to either metronidazole treatment group or DXLW treatment group. Each medication was administered orally twice daily at recommended clinical doses for a maximum of 10 doses. The results indicate that dogs in the metronidazole treatment group had an 89% response rate (normal stools) within the 10 dose protocol while the DXLW group had a 97% positive response rate (p < 0.05, non-inferiority test). This study demonstrates that DXLW is as effective as metronidazole in resolving stress colitis in sheltered dogs and can be an effective alternative treatment for patients that do not respond to metronidazole or cannot tolerate it.

A dysbiosis index to assess microbial changes in fecal samples of dogs with chronic inflammatory enteropathy. MK AlShawaqfeh, B Wajid, Y Minamoto, M Markel, JA Lidbury, JM Steiner, E Serpedin, JS Suchodolski. FEMS Microbiology Ecology. October 2017; doi: 0.1093/femsec/fix136. Quote: Recent studies have identified various bacterial groups that are altered in dogs with chronic inflammatory enteropathies (CE) compared to healthy dogs. The study aim was to use quantitative [polymerase chain reaction] PCR (qPCR) assays to confirm these findings in a larger number of dogs, and to build a mathematical algorithm to report these microbiota changes as a dysbiosis index (DI). Fecal DNA from 95 healthy dogs and 106 dogs with histologically confirmed CE was analyzed. ... The most common breeds in the diseased group were mixed breeds (n = 14), German Shepherd dogs (n = 11), Boxer (n = 7), Labrador Retrievers (n = 6) and Cavalier King Charles Spaniel (n = 5). ... Samples were grouped into a training set and a validation set. Various mathematical models and combination of qPCR assays were evaluated to find a model with highest discriminatory power. The final qPCR panel consisted of eight bacterial groups: total bacteria, Faecalibacterium, Turicibacter, Escherichia coli, Streptococcus, Blautia, Fusobacterium and Clostridium hiranonis. The qPCR-based DI was built based on the nearest centroid classifier, and reports the degree of dysbiosis in a single numerical value that measures the closeness in the l2 – norm of the test sample to the mean prototype of each class. A negative DI indicates normobiosis, whereas a positive DI indicates dysbiosis. For a threshold of 0, the DI based on the combined dataset achieved 74% sensitivity and 95% specificity to separate healthy and CE dogs.

Pharmaceutical Prescription in Canine Acute Diarrhoea: A Longitudinal Electronic Health Record Analysis of First Opinion Veterinary Practices. David A. Singleton, P. J. M. Noble, Fernando Sánchez-Vizcaíno, Susan Dawson, Gina L. Pinchbeck, Nicola J. Williams, Alan D. Radford, Philip H. Jones. Front. Vet. Sci. July 2019; doi: 10.3389/fvets.2019.00218. Quote: Canine acute diarrhoea is frequently observed in first opinion practice, though little is known about commonly used diagnostic or therapeutic management plans, including use of antimicrobials. This retrospective observational study utilised electronic health records augmented with practitioner-completed questionnaires from 3,189 cases (3,159 dogs) collected from 179 volunteer veterinary practices between April 2014 and January 2017. We used multivariable analysis to explore factors potentially associated with pharmaceutical agent prescription, and resolution of clinical signs by 10 days post-initial presentation. Use of bacteriological and/or parasitological diagnostic tests were uncommon (3.2% of cases, 95% confidence interval, CI, 2.4–4.0), though systemic antimicrobials were the most commonly prescribed pharmaceutical agents (49.7% of cases, 95% CI 46.1–53.2). ... Metronidazole represented the most commonly prescribed systemic antimicrobial (47.0% of antimicrobial prescribing cases, 95% CI 41.0–53.1). ... Such prescription was associated with haemorrhagic diarrhoea (odds ratio, OR, 4.1; 95% CI 3.4–5.0), body temperature in excess of 39.0°C, or moderate/severe cases (OR 1.3, 95% CI 1.1–1.7). Gastrointestinal agents (e.g., antacids) were prescribed to 37.7% of cases (95% CI 35.4–39.9), and were most frequently prescribed to vomiting dogs regardless of presence (OR 46.4, 95% CI 19.4–110.8) or absence of blood (OR 17.1, 95% CI 13.4–21.9). Endoparasiticides/ endectocides were prescribed to 7.8% of cases (95% CI 6.8–9.0), such prescription being less frequent for moderate/ severe cases (OR 0.5, 95% CI 0.4–0.7), though more frequent when weight loss was recorded (OR 3.4, 95% CI 1.3–9.0). Gastrointestinal nutraceuticals (e.g., probiotics) were dispensed to 60.8% of cases (95% CI 57.1–64.6), these cases less frequently presenting with moderate/severe clinical signs (OR 0.6, 95% CI 0.5–0.8). Nearly a quarter of cases were judged lost to follow-up (n=754). Insured (OR 0.7, 95% CI 0.5–0.9); neutered (OR 0.4, 95% CI 0.3–0.5), or vaccinated dogs (OR 0.3, 95% CI 0.3–0.4) were less commonly lost to follow-up. Of remaining dogs, clinical signs were deemed resolved in 95.4% of cases (95% CI 94.6–96.2). Provision of dietary modification advice and gastrointestinal nutraceuticals alone were positively associated with resolution (OR 2.8, 95% CI 1.3–6.1); no such associations were found for pharmaceutical agents, including antimicrobials. Hence, this study supports the view that antimicrobials are largely unnecessary for acute diarrhoea cases; this being of particular importance when considering the global threat posed by antimicrobial resistance.

Congenital pleuroperitoneal hernia presenting as gastrothorax in five cavalier King Charles spaniel dogs. M. Rossanese, M. Pivetta, N. Pereira, R. Burrow. J. Sm. Anim. Pract. November 2019;60(11):701-704. Quote: Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia (PIPDH) with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life-threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated.

Chronic Enteropathy In Canines: Prevalence, Impact And Management Strategies. Julien Rodolphe Samuel Dandrieux, Caroline Sarah Mansfield. Vet. Med:Res. & Repts. December 2019;10:203-214. Quote: In this article, the studies about the prevalence of chronic enteropathy are reviewed as well as the information regarding short- and long-term prognosis for dogs treated with the three most common therapies; these include dietary modification, antibiotics, and immunosuppressants. ... The five breeds with the highest annual prevalence for gastrointestinal disease included French bulldog (22.0%, CI: 21.0–23.0), cavalier King Charles spaniel (21.0%, CI: 19.9–22.0), Yorkshire terrier (19.4%, CI: 18.7–20.2), golden retriever (18.6%, CI: 17.8–19.4), and Pembroke Welsh corgi (17.9%, CI: 16.8–18.9). ... Although the data available are limited, most studies support a good to excellent long-term response in dogs that have a successful food trial, whereas the response is poor with antibiotics or on-going treatment is required to retain remission. There is a risk of antimicrobial resistance developing with inappropriate use of antimicrobials such as in these situations. The published information highlights the need for alternative strategies to antibiotic treatment to manipulate the GI microbiome, and in the final part of this article studies on the use of probiotic for the treatment of chronic enteropathy are reviewed. Chronic vomiting and diarrhoea are common clinical signs in dogs, but as we review in this article, there is little information on how frequent this problem really is both in general or referral veterinary practice. Furthermore, of the three main treatment options, including change of diet, treatment with antibiotics or immune suppressive drugs, only dogs responding to a diet change have a long-term response. This highlights the need for new strategies to treat dogs not responding to a diet change. In the last part of this article, we review the information for the use of probiotics as an alternative treatment to antibiotics. We highlight that there is currently not enough information on probiotics to determine how useful they can be and future research in their use is needed.

A retrospective study of 237 dogs hospitalized with suspected acute hemorrhagic diarrhea syndrome: Disease severity, treatment, and outcome. Nana Dupont, Lisbeth Rem Jessen, Frida Moberg, Nathali Zyskind, Camilla Lorentzen, Charlotte Reinhard Bjørnvad. J. Vet. Intern. Med. February 2021; doi: 10.1111/jvim.16084. Quote: Background: Few studies have investigated management and outcome in dogs with acute hemorrhagic diarrhea syndrome (AHDS), and there is a paucity of data on dogs with concurrent signs of sepsis. Objectives: To report outcome in dogs with suspected AHDS according to disease severity and antimicrobial treatment, and to evaluate effect of fluid resuscitation on clinical criteria. Animals: Two hundred thirty-seven dogs hospitalized with suspected AHDS. ... Seventy breeds were represented. The 4 most prevalent breeds were Labrador Retriever (10.9%), small mix breed (8.4%), Miniature Schnauzer (5.5%), and Cavalier King Charles Spaniel (5.0%). ... Methods: Retrospective study based on medical records. Disease severity was evaluated using AHDS index, systemic inflammatory response syndrome (SIRS) criteria, and serum C-reactive protein (CRP) according to 3 treatment groups: No, 1, or 2 antimicrobials. Results: Sixty‐two percent received no antimicrobials, 31% received 1 antimicrobial, predominantly aminopenicillins, and 7% received 2 antimicrobials. At admission, median AHDS index was 13 (interquartile range, 11-15), which decreased significantly after the first day's hospitalization for all groups. Compared with no antimicrobials (7%), more dogs had ≥2 SIRS criteria in the antimicrobial groups (15% and 36%, respectively). C-reactive protein (CRP) correlated positively with AHDS index at hospitalization. Across treatment groups, rehydration markedly reduced number of clinical SIRS criteria. Survival to discharge was 96%, lower for dogs receiving 2 antimicrobials (77%). Conclusions and Clinical Importance: The majority of dogs hospitalized with suspected AHDS improve rapidly with symptomatic treatment only, despite signs of systemic disease on initial presentation. The often-used SIRS criteria might be a poor proxy for identifying dogs with AHDS in need of antimicrobial treatment, in particular when hypovolemic. The role of CRP in clinical decision‐making or prognostication warrants further investigation.

Acute manifestation of a rare congenital right-sided pleuroperitoneal hernia after a high-altitude flight. S.S.K. Tso, Y. Indrawirawan, R.B.S. Turner. Aust. Vet. Pract. April 2021;51(1):2-10. Quote: An 8-week-old female entire Cavalier King Charles spaniel developed acute respiratory distress immediately after a 2-hour flight. Thoracic radiographs and full body computerised tomography revealed a right-sided pleuroperitoneal hernia with most of the alimentary tract, the right caudate liver lobe, and the right kidney located within the right pleural cavity. Most of the small intestine was markedly dilated with gas, causing marked diffuse atelectasis. The hernia was treated successfully surgically, and post-operative recovery was uncomplicated. The puppy was discharged approximately 24 hours after surgery.

The effect of assisted enteral feeding on treatment outcome in dogs with inflammatory protein-losing enteropathy. Lavinia Economu, Yu-mei Chang, Simon L. Priestnall, Aarti Kathrani. J. Vet. Intern. Med. May 2021; doi: 10.1111/jvim.16125. Quote: Background: The effect of assisted enteral feeding on treatment outcome in dogs with protein-losing enteropathy (PLE) is unknown. Objectives: To determine if dogs with inflammatory PLE that had an enteral feeding tube placed had better outcome vs dogs with inflammatory PLE without a feeding tube. Animals: Fifty-seven dogs with inflammatory PLE [includimg 5 cavalier King Charles spaniels (8.8%)]. Methods: A retrospective study at a UK referral hospital identified dogs with inflammatory PLE using a standard diagnostic criterion. Positive outcome was defined as survival greater than 6 months or death unrelated to PLE and negative outcome as death related to PLE within 6 months of diagnosis. Several variables were assessed to identify factors for positive outcome using logistic regression. Results: Thirty-five (61%) and 22 (39%) dogs had a positive and negative outcome at 6 months, respectively. Of the 21 dogs that had a feeding tube placed within 5 days of gastrointestinal biopsy, 16 (76%) had a positive outcome and 5 (24%) had a negative outcome. Dogs treated with dietary treatment alone and dogs with an enteral feeding tube were significantly associated with a positive outcome. When stratified by treatment, assisted enteral feeding was significantly associated with a positive outcome in dogs treated with concurrent immunosuppressive treatment, but there was insufficient data to evaluate dogs treated with dietary treatment alone. Conclusions and Clinical Importance: Assisted enteral feeding in dogs with inflammatory PLE could be associated with improved treatment outcome, especially in those receiving immunosuppressive treatment, and should be considered in the treatment plan of these dogs.

Intestinal Complication With Myxomatous Mitral Valve Diseases in Chihuahuas. R. Araki, K. Iwanaga, Kazunori Ueda, M. Isaka. Front. Vet. Sci. November 2021; doi: 10.3389/fvets.2021.777579. Quote: The effects of cardiac disease on the intestine have been reported in humans but not in dogs. We investigated the effects of myxomatous mitral valve disease (MMVD), which is capable of causing congestion and tissue hypoperfusion, on the intestine in Chihuahuas, a breed frequently encountered in clinical practice as the preferred breed for MMVD. ... We hypothesized that intestinal mucosal injury could be a complication of MMVD in dogs and that the markers of intestinal mucosal injury would be significantly increased in dogs with MMVD. ... The main objective of our study was to clarify the relationship between MMVD and intestinal mucosal injury using intestinal mucosal injury markers such as I-FABP and D-lactate. ... In this study, 69 Chihuahuas were divided into four groups based on echocardiography and chest radiography: 19 healthy Chihuahuas (H) and 50 Chihuahuas with MMVD classified according to the ACVIM consensus (stage B1, B2, C/D). In all the cases, serum intestinal fatty acid-binding protein (I-FABP) and D/L-lactate concentrations, markers of intestinal mucosal injury, were measured. I-FABP was significantly higher in stage C/D Chihuahuas than in other groups (p < 0.05), and stage B2 was significantly higher than H (p < 0.05). D-lactate was significantly increased in stages B2 and C/D compared to H and stage B1. L-lactate was significantly higher in stage C/D Chihuahuas than in any other group (p < 0.05), and stage B2 was significantly higher than that in H and stage B1. Intestinal mucosal injury risk was significantly higher in Chihuahuas with heart failure due to MMVD, suggesting that the risk could increase with worsening heart disease. This is the first study to investigate the intestinal complications of MMVD, and further investigations a needed in the future. ... This study showed that intestinal mucosal injury markers such as I-FABP and D-Lactate increased with the severity of MMVD in Chihuahuas and that Chihuahuas with MMVD who had heart failure were at particular risk for intestinal mucosal injury. This study is the first to investigate the relationship between heart disease and intestinal mucosa in Chihuahuas and demonstrate a potential relationship between MMVD morbidity and intestinal mucosal cell injury. ... In the future, if I-FABP is studied in dogs and a cutoff value can be established, it could become a new prognostic factor for heart failure in dogs.

Chronic Enteropathy in Dogs — Epidemiologic Aspects and Clinical Characteristics of Dogs Presenting at Two Swedish Animal Hospitals. Johanna Holmberg, Lena Pelander, Ingrid Ljungvall, Caroline Harlos, Thomas Spillmann, Jens Häggström. Animals. June 2022; doi: 10.3390/ani12121507. Quote: Information about prevalence and breed predisposition of canine chronic enteropathy (CE)is limited. The aim of this retrospective study was to investigate period prevalence, breed disposition, clinical features, diagnostic results, and treatment response of CE in dogs presenting at two Swedish animal hospitals during 2013–2018. A medical record search was performed to identify CE dogs including those with ≥3 visits because of gastrointestinal disease and/or that had undergone gastroduodenoscopy/colonoscopy during 2013–2018. Dog characteristics, case history, physical examination, laboratory variables, therapeutic protocol, and treatment response were recorded. Inclusion criteria for CE were met by 814 dogs [including 31 (3.8%) cavalier King Charles spaniels (CKCS)]. Period prevalence of CE was 1.1% of total number of dogs. Breeds with the highest relative risk included Norwegian Lundehund, West Highland White Terrier, Miniature Poodle, Border Terrier, Rottweiler, Boxer, CKCS, French Bulldog, and Shetland Sheepdog. Median age at presentation was 3.8 (IQR 1.8–6.8) years. French Bulldogs and Miniature Schnauzers presented at a younger age (<2.5 years) compared to other breeds. In a subset of dogs, serum hypoalbuminemia (116/662, 17.5%), hypocobalaminemia (98/647, 15.1%), and increased C-reactive protein (CRP) concentrations (145/267, 54.3%) were diagnosed. Treatment outcome was classified in 72.9% of dogs and characterized as immunosuppressant-responsive (55.2%), food-responsive (11.4%), non-responsive (5.2%), and antibiotic-responsive (1.1%). Non-responsive dogs were more likely to present with anemia hypoproteinemia/ albuminemia, increased CRP, and ascites. In conclusion, the prevalence of dogs with CE at Swedish hospitals agreed with earlier reports, but risk breeds differed slightly and, compared to other breeds, a younger age of CE onset was found in two breeds. The largest proportion of dogs was immunosuppressant-responsive and the smallest antibiotic-responsive.

Incidence of relapse of inflammatory protein-losing enteropathy in dogs and associated risk factors. Jodie Green, Aarti Kathrani. J. Vet. Intern. Med. October 2022; doi: 10.1111/jvim.16561. Quote: Background: Dogs with inflammatory protein-losing enteropathy (iPLE) that attain remission may be at risk of subsequent relapse. Objectives: To determine the incidence of relapse of iPLE in dogs that have previously attained complete clinical and biochemical remission and identify associated risk factors. Animals: Seventy-five client-owned dogs diagnosed with iPLE [including 5 (6.7%) cavalier King Charles spaniels, the second most numerous breed]. Methods: Medical records of dogs diagnosed with iPLE based on histopathology of intestinal biopsy specimens between March 2010 and March 2020 were retrospectively reviewed. Variables were recorded from the time of investigation at histopathologic diagnosis and subsequent follow-up information was obtained from the records of referring veterinarians. Results: Twenty-three dogs (31%) achieved sustained remission without documentation of relapse for at least 2 years. Nineteen dogs (25%) achieved remission, but then subsequently relapsed within 2 years of histopathologic diagnosis, and 33 dogs (44%) never achieved remission with disease-associated death occurring a median of 19 (range, 3-114) days after histopathologic diagnosis. Dogs that achieved remission and subsequently relapsed had significantly higher poor dietary compliance, as defined by frequent scavenging or changing from the recommended diet compared to dogs with sustained remission. Conclusions: Inflammatory PLE is associated with a high rate of relapse in dogs. Ensuring owners adhere to dietary recommendations might help prevent subsequent relapse in dogs with iPLE that attain initial remission.

The effect of puppyhood and adolescent diet on the incidence of chronic enteropathy in dogs later in life. Kristiina A. Vuori, Manal Hemida, Robin Moore, Siru Salin, Sarah Rosendahl, Johanna Anturaniemi, Anna Hielm-Björkman. Sci. Rpts. February 2023; doi: 10.1038/s41598-023-27866-z. Quote: Diet has a key role in the homeostasis of the gut microenvironment, influencing the microbiome, the gut barrier, host immunity and gut physiology. Yet, there is little information on the role of early diet in the onset of inflammatory gastrointestinal disorders later in life, especially in dogs. Therefore, the aim of the present cross-sectional, epidemiological study with longitudinal data, was to explore associations of companion dogs’ early life diet style and food items with owner-reported chronic enteropathy (CE) incidence in later life. ... [CE was defined to include] inflammatory bowel disease (IBD), chronic gastrointestinal symptoms and/or food ‘allergies’ resulting in chronic gastrointestinal symptoms. ... We studied the effect of the general feeding style as PCA component scores (RC1 non-processed meat-based diet [(raw red meat, organ meats, fish, eggs, tripe, bones and cartilage, vegetables, berries and fruits)] in inverse association with ultra-processed carbohydrate-based food, RC2 home cooked diet (including grain products, vegetables, fish, egg, organ meat but not red meats, RC3 human food leftovers and table scraps [(cooked potato, non-sour milk products, cooked poultry and fish, processed meat (for example sausages), cooked rice and grain products, blood pancakes and liver casserole)] on later CE incidence as binary dependent variables using multivariate logistic regression. ... Food frequency questionnaire data from Finnish companion dogs was analyzed using principal component analysis and logistic regression. ... Thus, the valid samples for the age categories PU [aged 2 to 6 months] and YO [aged 6 to 18 months] [having CE were] N=1,016 [PU] and N=699 [YO], respectively. ... Controls [defined as not having CE were N = 3,665 PU and N = 3,227 YO.] ... Prevalence of owner-reported CE symptoms was 21.7% in the puppies (2–6 months) and 17.8% in the adolescent dogs (6–18 months). ... We found that feeding a non-processed meat-based diet and giving the dog human meal leftovers and table scraps during puppyhood (2–6 months) and adolescence (6–18 months) were protective against CE later in life. Especially raw bones and cartilage as well as leftovers and table scraps during puppyhood and adolescence, and berries during puppyhood were associated with less CE. In contrast, feeding an ultra-processed carbohydrate-based diet, namely dry dog food or “kibble” during puppyhood and adolescence, and rawhides during puppyhood were significant risk factors for CE later in life. ... Diet choices during puppyhood and adolescence are modifiable factors which, according to our results, might lessen or increase CE incidence later in the dog’s life. Our study provides proactive dog owners with information on healthy diets and of what food items to use and to avoid. The key findings from the present study confirm the tested hypothesis as we found a significant association between companion dog puppyhood and adolescence diet and the tendency to develop CE in adulthood. Feeding NPMD, even as an addition to UPCD, and giving the dog human meal leftovers and table scraps were found to be protective against CE later in life. Especially raw bones and cartilage, berries and leftovers were found to be beneficial. Therefore, we conclude that providing a variety of fresh, “real” foods for the dog especially during puppyhood, but also at young age, was identified as a significant potential protective factor of CE incidence later in life. On the contrary, feeding mainly or exclusively UPCD, namely dry dog food or “kibble”, during puppyhood and adolescence, or rawhides at least a couple of times in a month during puppyhood were found to be significant potential risk factors for CE later in life. A home-cooked diet was not significantly associated with CE incidence later in life in this study.

Gastrointestinal angiodysplasias diagnosed using video capsule endoscopy in 15 dogs. Alice Defarges, Jenny Stiller, Jeffrey A. Solomon. J. Vet. Intern. Med. March 2023; doi: 10.1111/jvim.16677. Quote: Background: Angiodysplasia (AGD) is rarely diagnosed in dogs with gastrointestinal bleeding (GIB) and is reported in case reports in dogs. ... Gastrointestinal (GI) vascular malformations, referred to as angiodysplasia (AGD) or vascular ectasia, are aberrations in the typical architecture of blood vessels; arterial, venous, and capillary vessels can be affected. Disruption of these fragile dilated mucosal vessels induces bleeding. AGD can affect any segment of the GI tract. ... A lesion of AGD was defined by the presence of a clearly demarcated, bright-red, flat lesion, consisting of tortuous and clustered capillary dilatations within the mucosal layer. ... Objective: Describe signalment, clinical and diagnostic features of dogs with gastrointestinal (GI) AGD diagnosed by video capsule endoscopy (VCE). Animals: Dogs with overt or suspected GIB which underwent VCE. ... The use of VCE has become more popular in dogs as a minimally invasive tool to detect GIB.  This procedure is well tolerated in dogs and yields a diagnosis in over 75% of dogs with overt GIB. Because repeating VCE is less expensive and invasive than conventional endoscopy and surgical exploration, it is also a promising test for intermittent GIB. ... The objective of this retrospective study was to report the signalment, clinical and diagnostic features of AGD diagnosed by VCE in a large cohort of dogs with suspected or overt GIB. Methods: Dogs for which a VCE was submitted for overt or suspected GIB from 2016 to 2021 were selected retrospectively. Medical records and full-length VCE recordings where AGDs were initially detected, were reviewed by 2 trained internists. AGD was considered definitive if 2 readers detected it. Signalment, clinical signs, blood work, medications, concurrent diseases, findings of previous conventional endoscopy, and surgical exploration (if applicable) of dogs with AGD were recorded. Results: Definitive AGD was diagnosed in 15 of 291 (5%) dogs (12 males, 3 females) [including one cavalier King Charles spaniel]. Twelve (80%) had overt GIB, 11 (73%) had hematochezia, and 6 (40%) had microcytic and hypochromic anemia. AGD was missed by conventional endoscopy in 9/9 dogs and exploratory surgery in 3/3 dogs. Thirteen capsules were administered by mouth (1 incomplete study), and 2 via endoscopy directly into the duodenum. AGD was visualized in the stomach of 3 dogs, in the small intestine of 4, and in the colon of 13 dogs. Conclusion and Clinical Importance: Although rare, AGD should be considered in dogs with suspected GIB after a negative conventional endoscopy or surgical exporation. Video capsule endoscopy appears to be a sensitive test to identify AGD within the GI tract.

An undernutrition screening score for dogs with protein-losing enteropathy: A prospective multicenter study. Florence E. Wootton, Christopher S. F. K Hoey, Glynn Woods, Silke Salavati Schmitz, Jenny Reeve, Jennifer Larsen, Aarti Kathrani. J. Vet. Intern. Med. July 2023; doi: 10.1111/jvim.16794. Quote: Background: The impact of undernutrition in dogs with protein-losing enteropathy (PLE) caused by inflammatory enteritis, intestinal lymphangiectasia, or both and which variables are most predictive of outcome are unknown. Objectives: Develop an undernutrition screening score (USS) for use at the time of diagnosis of PLE in dogs, which is predictive of outcome. Animals: Fifty-seven dogs with PLE prospectively recruited from 3 referral hospitals in the United Kingdom. ... There were 50 purebred dogs (88%) and 7 crossbreeds (12%). The most common breeds were Cavalier King Charles spaniel (n=4), Staffordshire bull terrier (n=4), border collie (n=4), miniature schnauzer (n=3), and pug (n=3). ... Methods: An USS based on the presence and severity of 5 variables: appetite, weight loss, and body, muscle, and coat condition and scored out of 15, with higher scores reflecting worse undernutrition, was calculated at the time of diagnosis. Follow-up information was obtained for at least 6 months. Results: Dogs that failed to achieve clinical remission within 6 months had higher USS at diagnosis compared with dogs that achieved remission (median, 7.5; range, 2-14 and median, 5; range, 0-14, respectively). The USS at diagnosis gave an area under the receiver operating characteristic curve (AUC) of 0.656 for predicting nonclinical remission within 6 months, whereas a score consisting of just epaxial muscle loss and coat condition resulted in a larger AUC of 0.728. Conclusions and Clinical Importance: Of the 5 variables assessed in the USS, a combination of epaxial muscle loss and coat condition was most predictive of not achieving clinical remission within 6 months in dogs with PLE. Additional studies will help determine the effect of changes in USS and the 5 associated variables after diagnosis on outcome variables in these dogs.

Target trial emulation: Do antimicrobials or gastrointestinal nutraceuticals prescribed at first presentation for acute diarrhoea cause a better clinical outcome in dogs under primary veterinary care in the UK? Camilla Pegram, Karla Diaz-Ordaz, Dave C. Brodbelt, Yu-Mei Chang, Sarah Tayler, Fergus Allerton, Lauren Prisk, David B. Church, Dan G. O’Neill. PlosONE, October 2023; doi: 10.1371/journal.pone.0291057. Quote: arget trial emulation applies design principles from randomised controlled trials to the analysis of observational data for causal inference and is increasingly used within human epidemiology. Veterinary electronic clinical records represent a potentially valuable source of information to estimate real-world causal effects for companion animal species. ... Despite the lack of evidence for clinical effectiveness, antimicrobial prescription has been reported in over 50% of dogs with acute uncomplicated diarrhoea within 10 days of first veterinary presentation. ... This study employed the target trial framework to evaluate the usefulness on veterinary observational data. Acute diarrhoea in dogs was used as a clinical exemplar. Inclusion required dogs aged ≥ 3 months and < 10 years, presenting for veterinary primary care with acute diarrhoea during 2019. Treatment strategies were: 1. antimicrobial prescription compared to no antimicrobial prescription and 2. gastrointestinal nutraceutical prescription compared to no gastrointestinal nutraceutical prescription. The primary outcome was clinical resolution (defined as no revisit with ongoing diarrhoea within 30 days from the date of first presentation). Informed from a directed acyclic graph, data on the following covariates were collected: age, breed, bodyweight, insurance status, comorbidities, vomiting, reduced appetite, haematochezia, pyrexia, duration, additional treatment prescription and veterinary group. Inverse probability of treatment weighting was used to balance covariates between the treatment groups for each of the two target trials. The risk difference (RD) of 0.4% (95% CI -4.5% to 5.3%) was non-significant for clinical resolution in dogs treated with antimicrobials compared with dogs not treated with antimicrobials. The risk difference (RD) of 0.3% (95% CI -4.5% to 5.0%) was non-significant for clinical resolution in dogs treated with gastrointestinal nutraceuticals compared with dogs not treated with gastrointestinal nutraceuticals. ... In these antimicrobial-treated cases, metronidazole was the most commonly prescribed systemic antimicrobial (47.0% of antimicrobial prescribing cases), followed by clavulanic acid potentiated amoxicillin (22.7%). Antimicrobial resistance (AMR) is considered one of the most serious and imminent health-related problems worldwide, with indiscriminate antimicrobial use reportedly exacerbating the issue. As well as intra-species concerns with AMR, companion animals may act as a source of antimicrobial resistant enteric bacteria or resistance genes for their owners, given common closely shared owner-animal environments. Metronidazole specifically can also have long-term detrimental implications for the gut microbiome and metabolome, particularly in relation to bile acid dysfunction. Therefore, given the current available evidence, high prescription rates of antimicrobials for acute diarrhoea is concerning. ... This study successfully applied the target trial framework to veterinary observational data. The findings show that antimicrobial or gastrointestinal prescription at first presentation of acute diarrhoea in dogs causes no difference in clinical resolution. The findings support the recommendation for veterinary professionals to limit antimicrobial use for acute diarrhoea in dogs.

Large duodenal hyperplastic polyp causing haematemesis and melena in a dog. Odyssefs Patouchas, Tim Charlesworth, Matthew Best. Vet. Rec. September 2024; doi: 10.1002/vrc2.1005. Quote: A 5-year-8-month-old, female, neutered Cavalier King Charles Spaniel presented with a 7-day history of melena, intermittent haematemesis, mild lethargy and normal appetite. Following hospitalisation and supportive treatment with intravenous fluid therapy and medications, the clinical signs improved. On abdominal ultrasound, a proximal duodenal mass was seen. Gastrointestinal endoscopy identified an intraluminal duodenal mass lesion and endoscopic biopsies were obtained. Cytology from ultrasound-guided fine-needle aspirates and histology from endoscopic biopsies were suggestive of an epithelial duodenal polyp. Surgical resection via duodenotomy was performed, and the dog was discharged the following day with complete resolution of the clinical signs. The histological diagnosis was compatible with a hyperplastic polyp, not previously reported in this location. Little is known in terms of clinical signs, diagnostic options and prognosis following resection. In a follow-up consult and abdominal ultrasound 351 days later, there was no polyp regrowth or recurrence of clinical signs. ... In conclusion, hyperplastic polyps can occur in the canine small intestine and should be considered as a rare differential diagnosis in cases of haematemesis andmelena. Diagnosis can be achieved either with cytology via ultrasound-guided fineneedle aspirates or histologically via endoscopic biopsies.

A Nutritional Approach to Leaky Gut Syndrome in Dogs & Cats. Ruth Roberts. Innovative Vet. Care J.. May 2025.