Gastric helicobacters in cats

Gastric Helicobacter species associated with dogs, cats and pigs: significance for public and animal health

This article focuses on the pathogenic significance of Helicobacter species naturally colonizing the stomach of dogs, cats and pigs. These gastric "non-Helicobacter (H.) pylori Helicobacter species" (NHPH) are less well-known than the human adapted H. pylori. Helicobacter suis has been associated with gastritis and decreased daily weight gain in pigs. Several studies also attribute a role to this pathogen in the development of hyperkeratosis and ulceration of the non-glandular stratified squamous epithelium of the pars oesophagea of the porcine stomach. The stomach of dogs and cats can be colonized by several Helicobacter species but their pathogenic significance for these animals is probably low. Helicobacter suis as well as several canine and feline gastric Helicobacter species may also infect humans, resulting in gastritis, peptic and duodenal ulcers, and low-grade mucosa-associated lymphoid tissue lymphoma. These agents may be transmitted to humans most likely through direct or indirect contact with dogs, cats and pigs. Additional possible transmission routes include consumption of water and, for H. suis, also consumption of contaminated pork. It has been described that standard H. pylori eradication therapy is usually also effective to eradicate the NHPH in human patients, although acquired antimicrobial resistance may occasionally occur and porcine H. suis strains are intrinsically less susceptible to aminopenicillins than non-human primate H. suis strains and other gastric Helicobacter species. Virulence factors of H. suis and the canine and feline gastric Helicobacter species include urease activity, motility, chemotaxis, adhesins and gamma-glutamyl transpeptidase. These NHPH, however, lack orthologs of cytotoxin-associated gene pathogenicity island and vacuolating cytotoxin A, which are major virulence factors in H. pylori. It can be concluded that besides H. pylori, gastric Helicobacter species associated with dogs, cats and pigs are also clinically relevant in humans. Although recent research has provided better insights regarding pathogenic mechanisms and treatment strategies, a lot remains to be investigated, including true prevalence rates, exact modes of transmission and molecular pathways underlying disease development and progression.

Focal intestinal lipogranulomatous lymphangitis in 10 dogs

OBJECTIVES

To describe the clinical and pathological features of canine focal lipogranulomatous lymphangitis, to evaluate its underlying infectious cause and to compare it with human Crohn's disease.

METHODS

Retrospective review of case records with a histopathological diagnosis of focal lipogranulomatous lymphangitis. Bacterial and fungal colonisation was evaluated using fluorescence in situ hybridisation and histochemical staining, respectively. A comparison with Crohn's disease was performed by a human pathologist.

RESULTS

Ten dogs were evaluated. The historical complaints were predominantly chronic diarrhoea (10/10) and vomiting (5/10). The biochemical abnormalities included hypoalbuminaemia (6/10) and hypocobalaminaemia (4/6). Abdominal sonography revealed a thickened distal ileum±ileocolic junction. Colonoscopy showed a swollen caecal ostium and oedematous caecum in 7/10 dogs. A stenotic ileo-colic opening prevented endoscopic intubation in all dogs. Histology from the resected lesions revealed granulomatous inflammation involving the muscularis and serosa. Fluorescence in situ hybridization demonstrated invasive bacteria in 2/10 dogs. Post-resection, all dogs received metronidazole and tapering immunosuppressive doses of prednisolone. Remission (median 17 months) was achieved in 8/10 dogs.

CLINICAL SIGNIFICANCE

Focal lipogranulomatous lymphangitis is a rare and severe form of canine inflammatory bowel disease with preferential localisation to the ileum and the ileocolic junction. An underlying infectious aetiology was not identified.

The effect of orally administered ranitidine and once-daily or twice-daily orally administered omeprazole on intragastric pH in cats

BACKGROUND

Gastric acid suppressants frequently are used in cats with acid-related gastric disorders. However, it is not known if these drugs effectively increase intragastric pH in cats.

OBJECTIVES

To examine the effects of PO administered ranitidine and omeprazole on intragastric pH in cats and to compare the efficacy of once-daily versus twice-daily dosage regimens for omeprazole.

ANIMALS

Eight domestic shorthair cats.

METHODS

Using a randomized 4-way cross-over design, cats were given enteric-coated omeprazole granules (1.1-1.3 mg/kg q24h and q12h), ranitidine (1.5-2.3 mg/kg q12h), and placebo. Intragastric pH was monitored continuously for 96 hours using the Bravo(™) system, starting on day 4 of treatment, followed by a median washout period of 12 days. Mean percentage of time pH was ≥3 and ≥4 was compared among groups using repeated measures ANOVA.

RESULTS

Mean ± SD percentage of time intragastric pH was ≥3 and ≥4 was 67.0 ± 24.0% and 54.6 ± 26.4% for twice-daily omeprazole, 24.4 ± 22.8% and 16.8 ± 19.3% for once-daily omeprazole, 16.5 ± 9.0% and 9.6 ± 5.9% for ranitidine, and 9.4 ± 8.0% and 7.0 ± 6.6% for placebo administration. Twice-daily omeprazole treatment significantly increased intragastric pH, whereas pH after once-daily omeprazole and ranitidine treatments did not differ from that of placebo-treated cats.

CONCLUSION AND CLINICAL IMPORTANCE

Only twice-daily PO administered omeprazole significantly suppressed gastric acidity in healthy cats, whereas once-daily omeprazole and standard dosages of ranitidine were not effective acid suppressants in cats.

Gastric Helicobacter spp. in animal models: pathogenesis and modulation by extragastric coinfections

Animal models are used to study complex host, microbial, and environmental influences associated with gastric Helicobacter infection. Evidence that gastric helicobacters are pathogenic in animals first came from ferrets. Felids, nonhuman primates, and many other species also harbor stomach helicobacters. Today, mice are preferred by most researchers for scientific investigation because of cost-efficiencies, rapid reproduction, choice of laboratory reagents, and availability of genetically engineered models. Infection with Helicobacter felis or H. pylori Sydney strain-1 in appropriate mouse strains produces disease with remarkable similarities to H. pylori in humans. Due to recent advances in genetic engineering, in vivo imaging, and system-wide genomics and proteomics, these models will become even more widespread in the future. Recently, it has been shown that extragastric infections can dramatically affect the severity of disease induced by gastric Helicobacter spp. through heterologous immunity. These models provide proof-of-principle for the "African enigma" wherein gastric cancer is underrepresented in low-lying tropical countries with concurrently high H. pylori and internal parasite prevalence. Helicobacter gastritis and carcinogenesis in mouse models may be augmented or ameliorated by other infectious agents depending on the character of the invoked immune response. Knowledge gained from the Human Microbiome Project and other investigations is certain to shed new light on the influence of extragastric bacterial, viral, fungal, and parasitic coinfections on H. pylori-associated peptic ulcer disease and gastric adenocarcinoma.

The efficacy and safety of long-term Helicobacter species quadruple therapy in asymptomatic cats with naturally acquired infection

Owing to rising drug-resistant Helicobacter species infections in people and animals, currently therapies are losing their efficacy; therefore, regimens efficacious in the presence of drug resistance are needed. This study assessed the efficacy and safety of a 14-day quadruple Helicobacter species therapy in cats with naturally acquired infection. Thirteen asymptomatic adult stray cats with Helicobacter species infection (identified by analysis of gastric biopsies using polymerase chain reaction and Helicobacter-specific primers) received omeprazole 0.7mg/kg q 8h plus amoxicillin 20mg/kg q 12h, metronidazole 20mg/kg q 12h and clarithromycin 7.5mg/kg q 12h, for 14 days. Second molecular analysis of gastric biopsies revealed persistence of Helicobacter species DNA in four cats that were negative on quantitative urease testing, cytology and histopathology. Our results suggest that antibiotic regimens that are effective against Helicobacter pylori in people cannot eradicate Helicobacter species in cats with naturally acquired infection, although transient suppression may occur.

Helicobacter species detection and histopathological changes in stray cats from Niterói, Brazil

Tightly coiled bacteria are common inhabitants of the gastric mucosae of cats and there is considerable debate whether feline helicobacters are commensal or pathogenic organisms. To determine the prevalence of Helicobacter species and gastric histopathological findings, gastric mucosa samples of 56 stray cats were collected from cardia, fundus, body, antrum and pylorus at necropsy. The samples were examined by urease test, cytology, histopathology and culture. Helicobacter species were detected in 53 cats (94.6%) by at least one detection method. Urease test results were positive in gastric samples from 50 (89.3%) cats. Cytological and histological evaluations revealed Helicobacter species in 52 (92.8%) and 50 (89.2%) cats, respectively. Helicobacter species organisms were not cultured from any cat. Regardless of the presence of gastric bacteria, most of the cats had mild to moderate gastritis. These data reveal a high prevalence of Helicobacter species in stray cats from Niterói, Brazil.

Helicobacter spp. in cats: association between infecting species and epithelial proliferation within the gastric lamina propria

The aim of this study was to determine whether there is an association between Helicobacter spp. infection of the feline stomach and the presence of gastric lesions and epithelial proliferation within the mucosa of this tissue. The study included 23 pet cats of both sexes and of varied age and breed. Eighteen of these animals were clinically normal and five had a history of chronic vomiting. Samples of the mucosa of the pyloric antrum, corpus and fundus were collected by gastroscopy. The presence of Helicobacter spp. was confirmed by polymerase chain reaction (PCR) or Warthin-Starry (WS) staining and the species of Helicobacter was determined by PCR. Mucosal lesions were evaluated by examination of sections stained by haematoxylin and eosin (HE) and epithelial proliferation was determined by enumerating nucleolar organizer regions (AgNOR). In 20 (87%) cats the presence of Helicobacter spp. was confirmed by both PCR and WS. There was no significant difference in colonization density between the different gastric regions. H. heilmannii was the most frequently identified species (17 of 20 cats), and H. felis was only identified in co-infection (two of 17 cats). One sample that was PCR positive to the genus level for Helicobacter spp. was negative for the four individual species reactions. Histological changes in the lamina propria included mild mononuclear inflammatory infiltration, the presence of lymphoid follicles, fibrosis and glandular degeneration. These changes were most severe in the pyloric antrum. There was significant association between infection with gastric Helicobacter spp. and the presence of lymphoid follicles (P=0.03), and between infection and epithelial proliferation in the antrum (P<0.01), corpus (P<0.001) and fundus (P<0.001).

Factors associated with H. pylori epidemiology in symptomatic children in Buenos Aires, Argentina

AIM

To determine prevalence of H pylori infection in symptomatic children in Buenos Aires, Argentina, and to investigate factors associated with H pylori positivity.

METHODS

A total of 395 children with upper gastrointestinal symptoms referred to the Gastroenterology Unit of the Children Hospital "Sor Maria Ludovica" were evaluated for the presence of H pylori by the (13)C-Urea Breath Test ((13)C-UBT). A questionnaire was applied to the recruited population.

RESULTS

Prevalence of H pylori infection was 40.0% in this population (mean age 9.97 +/- 3.1 years). The factors associated with H pylori positivity were number of siblings (P < 0.001), presence of pet cats (P = 0.03) and birds (P = 0.04) in the household, and antecedents of gastritis among family members (P = 0.01). After multivariate analysis, number of siblings [Odds ratio (OR) = 1.39; 95% CI, 1.20-1.61] and contact with pet cats (OR = 1.76; 95% CI, 1.00-3.09) remained as variables associated with H pylori infection.

CONCLUSION

The prevalence of H pylori infection in children with upper gastrointestinal symptoms in Argentina was similar to that reported in developed countries. Children from families with a higher crowding index and presence of pet cats have a higher risk of being colonized with H pylori.

First report on the occurrence of 'Helicobacter heilmannii' in the stomach of rabbits

Gastric Helicobacter spp. have been described in a wide range of animal species, including dogs, cats, primates, swine, cattle and rodents. However, in lagomorphs--more specifically rabbits--gastric Helicobacter infections have never been reported. Biopsy specimens were collected from different stomach regions of 23 rabbits, including 10 pet rabbits, 10 industrial animals and 3 research animals. These were subjected to a PCR assay for the detection of Helicobacter DNA. Identification up to the species level was based on 16S rRNA sequence analysis and a recently developed multiplex PCR. Seven rabbits (four pet, one research animal and two industrial animals) tested positive in the Helicobacter genus-specific PCR in the stomach, with the corpus being predominantly positive. H. felis and H. salomonis, hitherto presumed to be naturally hosted by cats and dogs, were detected in three animals and one animal, respectively. One of these animals had been completely devoid of any form of contact with cats or dogs. A H. pullorum/H. rappini-like organism (96% 16S rDNA sequence similarity) was found in an industrially held rabbit. The helicobacters of the two remaining rabbits could not be identified up to the species level. To conclude, this is the first report on the occurrence of Helicobacter spp. in the stomach of rabbits. In view of the fact that H. felis and H. salomonis are put forward as having zoonotic potential, further research is necessary to investigate the implications of these findings not only for the rabbit but also for human health.