Post Doctoral Research Associate Gastrointestinal Laboratory, Texas A&M University, College Station, Texas College Station, Texas, United States
Abstract:
Background: A poor response to standard therapy is common in dogs with chronic enteropathy (CE) and sometimes associated with euthanasia. A recent report suggests that some of these dogs with refractory CE respond to bile acid sequestrants (BAS).
Objectives: characterize fecal and clinical parameters in dogs with refractory CE responding versus not responding to BAS Animals: 24 dogs with refractory CE and 18 healthy dogs
Methods: Retrospective case series. CE dogs were treated with BAS (cholestyramine, colestipole, or colesevelam) as adjunctive therapy after collection of a fecal sample. Canine inflammatory bowel disease activity index (CIBDAI) was compared at baseline and follow-up. Response to BAS was defined as a decrease of CIBDAI within 35 days. Fecal samples were analyzed with the dysbiosis index (DI) and LC-MS/MS for BAs.
Results: 16/24 CE dogs responded favorably to BAS. CIBDAI decreased significantly with (median, (range)) 3 (1-10) units in BAS responders (p < .001), but not in non-responders (p = .13; Wilcoxon matched-pairs signed rank test for both comparisons). BAS responders had increased amount and percentage of fecal primary BAs versus non-responders and healthy dogs (p < .001 and p < .001, Kruskal-Wallis test). The DI was higher and Peptacetobacter hiranonis abundance lower in responders versus non-responders (p = .02 and p = .05, Mann-Whitney test). Conclusions and clinical importance: A subgroup of dogs with refractory CE respond favorably to BAS. The responder were characterized by increased fecal primary BAs and DI, and decreased abundance of P. hiranonis, versus BAS non-responders.
Learning Objectives:
Interpret asessment of fecal tests, as the dysbiosis index and fecal bile acids, to estimate if a dog with chronic diarrhea may be affected with bile acid diarrhea.
Define which treatments that should preceed a treatment trial with bile acid sequestrants.
Understand the potential averse events of bile acid sequetrants and how to monitor for them.
