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Background Dietary interventions are thought to modify gut microbial communities in healthy individuals. In dogs with chronic enteropathies, resolution of dysbiosis, along with remission of clinical signs, is expected with treatment. Hypothesis/Objective To evaluate changes in the fecal microbiota in dogs with food‐responsive chronic enteropathy (FRE) and in healthy control (HC) dogs before and after an elimination dietary trial with an animal protein‐free diet (APFD). Animals Dogs with FRE (n = 10) and HC (n = 14). Methods Dogs were fed the APFD for 60 days. Fecal microbiota was analyzed by Illumina 16S rRNA sequencing and quantitative polymerase chain reaction (PCR). Results A significantly lower bacterial alpha‐diversity was observed in dogs with FRE compared with HC dogs at baseline, and compared with FRE dogs after the trial. Distinct microbial communities were observed in dogs with FRE at baseline compared with HC dogs at baseline and compared with dogs with FRE after the trial. Microbial communities still were different in FRE dogs after the trial compared with HC dogs at baseline. In HC dogs, the fecal microbiota did not show a significant modification after administration of the APFD. Conclusion and Clinical Importance Our results suggest that, in FRE dogs, treatment with the APFD led to a partial recovery of the fecal microbiota by significantly increasing microbiota richness, which was significantly closer to a healthy microbiota after the treatment. In contrast, no changes were detected in the fecal microbiota of HC dogs fed the same APFD.

Background Protein‐losing enteropathy (PLE) in dogs often carries a guarded prognosis, and it is unclear if survival differs among breeds. Hypothesis/Objectives Survival of pugs with PLE is shorter than that of other breeds of dogs with PLE. Animals Forty‐seven pugs and 148 dogs of other breeds were diagnosed with PLE at seven United Kingdom (UK) referral hospitals. Methods Retrospective, multicenter observational study. Case records were reviewed to identify dogs diagnosed with PLE. Cox's proportional hazards regression was used to determine variables associated with survival. Results Median (interquartile range) survival in pugs with PLE and dogs of other breeds was 104 (22–719) days and 759 (61–1632) days, respectively (p = 0.002). The hazard of death was higher in pugs (hazard ratio [HR]: 1.961; 95% confidence interval [CI]: 1.108–3.741; p = 0.002) than in other dogs. Neutrophil counts in peripheral blood were associated with an increased hazard of death (HR change per 1 × 109/L: 1.045; 95% CI: 1.014–1.077; p = 0.004), whereas cobalamin concentration (HR: 0.995; 95% CI: 0.991–0.999) and cobalamin supplementation (HR: 0.517; 95% CI: 0.271–0.988) were positively associated with decreased hazard of death. A time‐dependent effect on survival was identified for serum globulin concentrations, whereby globulin concentration was positively associated with hazard of death in dogs surviving 61–959 days (HR: 1.126; 95% CI: 1.040–1.219) and > 959 days (1.253; 95% CI: 1.048–1.497), but not 0–60 days (HR: 0.949; 95% CI: 0.891–1.011 days). Conclusions and Clinical Importance Results of our observational study suggest a worse prognosis for pugs with PLE compared to a selection of dogs of other breeds seen at UK referral centers.

The aim of this retrospective single-center study was to evaluate which factors, including expression of P-glycoprotein (P-gp), a membrane-bound protein involved in multiple drug resistance, could predict the response to treatment in canine immunosuppressant-responsive enteropathy (IRE). Dogs with IRE or non-responsive enteropathy (NRE) that were examined from 2005 to 2014 were included and were divided into two groups (IRE vs. NRE). Signalment, history, and clinical and laboratory findings were collected. P-glycoprotein immunohistochemistry was carried out on duodenal biopsies of both groups stored in our biobank, and immunophenotyping and molecular clonality were performed on the NRE samples. Ninety-two dogs were enrolled, 73 IRE (79.3%) and 19 NRE (20.7%), with a prevalence of pure breed (78.3% vs. 21.7%) and male dogs (p < 0.001). Factors associated with a worse prognosis were previous treatment with steroids (p = 0.033) and lower serum total protein concentration (p = 0.005). Clonality testing on the NRE duodenal biopsies showed 5/16 clonal responses, assuming a latent undiagnosed lymphoma as a possible cause of the NRE.

Canine chronic inflammatory enteropathy (CIE) has been associated with coagulation abnormalities, predisposing affected dogs to a hypercoagulable state and potential thromboembolic events. This study aimed to evaluate the coagulation status in dogs with CIE using a viscoelastic point-of-care device, a Viscoelastic Coagulation Monitor (VCM Vet®). A retrospective review of medical records identified 38 dogs diagnosed with CIE that underwent VCM Vet® testing. Coagulation profiles were classified as hypercoagulable, normocoagulable, or hypocoagulable. The results demonstrate that 81.5% of dogs exhibited hypercoagulability, and significant associations were found between the coagulation status and the type of CIE. Hypercoagulability was more commonly found in immunosuppressive-responsive enteropathy (IRE) cases. Albumin and cobalamin were significantly higher in food-responsive enteropathy, whereas the canine chronic enteropathy clinical activity index (CCECAI) was significantly higher in immunosuppressive-responsive enteropathy and non-responsive enteropathy. One dog with protein-losing enteropathy (PLE) was suspected of having developed possible pulmonary thromboembolism. These findings reinforce previous reports of hypercoagulability in CIE and suggest that VCM Vet® is a valuable and easy tool to assess coagulation abnormalities in a clinical setting. Further investigation is warranted to evaluate the clinical implications of hypercoagulability in CIE and the potential role of anticoagulant therapy in disease management.

Diagnosing chronic inflammatory enteropathies (CIE) in cats and differentiation from intestinal lymphoma (IL) using currently available diagnostics is challenging. Intestinally expressed S100/calgranulins, measured in fecal samples, appear to be useful non-invasive biomarkers for canine CIE but have not been evaluated in cats. We hypothesized S100/calgranulins to play a role in the pathogenesis of feline chronic enteropathies (FCE) and to correlate with clinical and/or histologic disease severity. This retrospective case-control study included patient data and gastrointestinal (GI) tissues from 16 cats with CIE, 8 cats with IL, and 16 controls with no clinical signs of GI disease. GI tissue biopsies were immunohistochemically stained using polyclonal α-S100A8/A9 and α-S100A12 antibodies. S100A8/A9+ and S100A12+ cells were detected in all GI segments, with few significant differences between CIE, IL, and controls and no difference between diseased groups. Segmental inflammatory lesions were moderately to strongly correlated with increased S100/calgranulin-positive cell counts. Clinical disease severity correlated with S100A12+ cell counts in cats with IL (ρ = 0.69, p = 0.042) and more severe diarrhea with colonic lamina propria S100A12+ cells with CIE (ρ = 0.78, p = 0.021) and duodenal S100A8/A9+ cells with IL (ρ = 0.71, p = 0.032). These findings suggest a role of the S100/calgranulins in the pathogenesis of the spectrum of FCE, including CIE and IL.

Purpose of Review The purpose is to make aware of the existence of the rare and exclusive small intestine (SI) diseases, namely cryptogenic multifocal ulcerating stenosing enteropathy (CMUSE) or chronic non-specific multiple ulcers of the small intestine (CNSU) and non-granulomatous ulcerating jejunoileitis (NGUJI). The article will elucidate their epidemiology, pathogenesis, clinical features, diagnosis, differentiating features and management. Recent Findings Recent papers have published the clinical features and diagnostic criteria of CMUSE/CNSU and NGUJI. CNSU/CMUSE is caused by gene mutations involved in the prostaglandin pathways. Although capsule endoscopy can detect these lesions, it carries a risk of retention. TNF antagonists and azathioprine have shown response in few cases. Summary CMUSE/CNSU and NGUJI are uncommon diseases that cause relapsing SI obstruction and bleed due to short-segment strictures and multiple shallow ulcers. This article focuses on current knowledge and novel insights regarding their pathogenesis, genetics, clinical features, diagnostic criteria and management. Multicentric clinical and genetic studies are the need of the hour.

Chronic enteropathy in dogs represents a significant clinical challenge that often requires innovative therapeutic strategies for effective management. This case study investigated the simultaneous use of budesonide, cannabidiol (CBD) oil and probiotics. Budesonide represents a corticoid therapy primarily used in human medicine for autoimmune diseases. Cannabidiol oil is one of the cannabinoids that does not affect sensory perception and is known for its anti-inflammatory properties. Probiotics help maintain gut microbiota balance as a treatment modality for chronic enteropathy in dogs. This report details the clinical symptoms, diagnosis, and treatment plan, highlighting the positive response seen in the patient. The findings suggested that the combination of budesonide, CBD oil, and probiotics may be a beneficial strategy for the treatment of chronic enteropathy in dogs.

Background Accumulating evidence shows an important relationship between the gastrointestinal (GI) microbiota and host health. Microbial metabolites are believed to play a critical role in host‐microbial interactions. Short‐chain fatty acids (SCFAs) are major end products of bacterial carbohydrate fermentation in the intestinal tract. Decreased concentrations of SCFAs have been observed in humans with GI disease. However, large‐scale clinical data in dogs are lacking. Hypothesis/Objective To evaluate fecal concentrations of SCFAs and the fecal microbiota in healthy control (HC) dogs and dogs with chronic enteropathy (CE). Animals Forty‐nine privately owned HC dogs and 73 dogs with CE. Methods Prospective cohort study. Fecal concentrations of SCFAs were measured using gas chromatography/mass spectrometry. Illumina sequencing and quantitative real‐time polymerase chain reaction were utilized to evaluate the fecal microbiota. Results Fecal concentrations (median [range] μmol/g of dry matter) of acetate were lower (P = .03) in dogs with CE (185.8 [20.1‐1042.1]) than in HC dogs (224.0 [87.7‐672.8]). Propionate were also lower (P < .001) in dogs with CE (46.4 [0.4‐227.9]) than in HC dogs (105.9 [1.6‐266.9]). Moreover, total SCFAs were lower (P = .005) in dogs with CE (268.1 [21.8‐1378.2]) than in HC dogs (377.2 [126.6‐927.0]). Dysbiosis in dogs with CE was characterized by decreased bacterial diversity and richness, distinct microbial community clustering compared with that in HC dogs, and a higher dysbiosis index. Conclusions and Clinical Importance Dogs with CE had an altered fecal SCFA concentration accompanied by significant changes of the fecal microbiota.

Background Tylosin is commonly prescribed to dogs with diarrhea. Orally administered antibiotics may alter the intestinal microbiota, which is responsible for crucial key bile acid (BA) biotransformation reactions. Objectives To prospectively evaluate the impact of tylosin administration on fecal microbiota and unconjugated bile acids (UBAs) over time. Animals Sixteen healthy adult dogs. Methods Prospective, randomized controlled clinical trial. Dogs were randomized to receive 20 mg/kg of tylosin or a placebo capsule PO q12h for 7 days while undergoing daily fecal scoring. Fecal samples were collected on days 0, 7, 21, and 63. The microbiota was assessed using quantitative PCR and 16S rRNA gene sequencing. Unconjugated BAs were assessed using gas chromatography‐mass spectrometry (GC‐MS). Results Fecal scores were unchanged during placebo and tylosin administration. In the placebo group, no significant changes were observed in fecal microbiota or UBA concentrations. Day 7 samples from tylosin‐exposed dogs exhibited decreased bacterial diversity (observed species, Chao1, Shannon, P < .001) characterized by decreases in anaerobes Fusobacteriaceae (linear discriminant analysis [LDA] score, 5.03) and Veillonellaceae (LDA score, 4.85). Primary UBA concentrations were increased at day 21 (median, [range]; 7.42, [0.67‐18.77] μg/kg; P = .04) and day 63 (3.49 [0‐28.43] μg/kg; P = .02) compared to day 0 (.14 [.03‐1.19] μg/kg) in dogs receiving tylosin. At day 63, bacterial taxa were not significantly different compared to day 0, but the extent of microbial recovery was individualized. Conclusions and Clinical Importance Tylosin causes fecal dysbiosis in healthy dogs with corresponding shifts in fecal UBAs. Changes did not uniformly resolve after discontinuation of tylosin.

Background In dogs with protein‐losing enteropathy (PLE), data on the clinical characteristics of food‐responsive PLE (FR‐PLE) remain scarce. Objective To determine the clinical characteristics of FR‐PLE in dogs responsive to ultralow‐fat diet (ULFD) management. Animals Thirty‐three dogs diagnosed with PLE based on standard diagnostic criteria. Methods Retrospective review of medical records. Clinical findings were compared between dogs with FR‐PLE (FR‐PLE group) and those with immunosuppressant‐responsive PLE (IR‐PLE) or nonresponsive PLE (NR‐PLE) (IR/NR‐PLE group). The area under the curve (AUC) of a receiver operating characteristic curve was used to evaluate the ability of factors to differentiate the FR‐PLE and IR/NR‐PLE groups. Survival time was compared between the FR‐PLE and IR/NR‐PLE groups. Results Twenty‐three dogs responded to ULFD management and were diagnosed with FR‐PLE. The canine chronic enteropathy clinical activity index (CCECAI) was significantly lower in the FR‐PLE group than in the IR/NR‐PLE group (P < .001). The AUC of CCECAI for differentiating the FR‐PLE group was 0.935 (95% confidence interval [CI], 0.845‐1.000) with an optimal cutoff value of 8 (sensitivity, 0.826; specificity, 0.889). Survival times were significantly longer in the FR‐PLE group (median, not reached) than in the IR/NR‐PLE group (median, 432 days; P < .001). Conclusions and Clinical Importance Dogs that respond to ULFD management and are diagnosed with FR‐PLE are expected to have a favorable prognosis. Clinical scores, specifically the CCECAI, could be useful for differentiating FR‐PLE from IR‐PLE or NR‐PLE.