Managing Non-Responsive Chronic Enteropathies

Presentation Description / Summary: Chronic enteropathies (CE) are common reasons for dog owners to seek veterinary care. Although the majority of affected dogs respond to standard therapeutic protocols, CE can be very challenging and frustrating to treat. With a reported prevalence of non-responsive enteropathy (NRE) in 5-27% of dogs with CE, new therapeutic options are highly desired. Recent reports on the negative effects of antibiotics on the intestinal microbiota and metabolome as well as the risk of translational spreading of antimicrobial resistance genes between species limits the treatment options even further. Reports on successful treatment of dogs with NRE using fecal microbiota transplantation (FMT) or bile acid sequestrants have recently been published. Bile acid dysmetabolism has been recognized in dogs with CE during the last decade, but clinical guidelines on treatment of bile acid diarrhea using bile acid sequestrants are lacking. This presentation will present novel research on pathophysiology, diagnostic tools and treatment of dogs with NRE using FMT and/or bile acid sequestrants. Program Agenda: • The link between the microbiome, response to FMT and regulation of bile acids • Which diagnostic tests can be useful when picking suitable candidates for treatment? • Treatment of choice - FMT or bile acid sequestrants? When and how

Learner Outcomes: 1. The learner will be able to describe the adverse events related to treatment of NRE using FMT or bile acid sequestrants. 2. The learner will be able to evaluate the safety of long-term treatment. 3. The learner will understand how to interpret relevant diagnostic tests that can help guiding the learner in choosing therapy.