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Glucocorticoids, Cyclosporine, Azathioprine, Chlorambucil, and Mycophenolate in Dogs and Cats. Vet Clin North Am Small Anim Pract 2022; 52:797-817. [DOI: 10.1016/j.cvsm.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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2
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Tamura Y, Terakado K, Neo S, Igarashi H, Hisasue M. Successful treatment with oral alfacalcidol supplementation for nutritional hypocalcaemia with protein‐losing enteropathy in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yu Tamura
- Veterinary Teaching Hospital Azabu University Sagamihara Kanagawa Japan
| | | | - Sakurako Neo
- Laboratory of Clinical Diagnosis School of Veterinary Medicine Azabu University Sagamihara Kanagawa Japan
| | - Hirotaka Igarashi
- Laboratory of Small Animal Internal Medicine School of Veterinary Medicine Azabu University Sagamihara Kanagawa Japan
| | - Masaharu Hisasue
- Laboratory of Small Animal Internal Medicine School of Veterinary Medicine Azabu University Sagamihara Kanagawa Japan
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Cyclosporine Treatment in Cats with Presumed Chronic Pancreatitis-A Retrospective Study. Animals (Basel) 2021; 11:ani11102993. [PMID: 34680012 PMCID: PMC8532754 DOI: 10.3390/ani11102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine, an immunosuppressive drug, has been suggested as an alternative treatment when other drugs that suppress inflammation are ineffective or unsuitable. However, no published studies have investigated its efficacy in cats with CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine as a treatment for pancreatitis in cats with presumed CP. All cats had a history and clinical signs suggestive of CP and blood samples showed abnormally high concentrations of feline pancreas-specific lipase (Spec fPL) on at least two occasions. This is common in CP. All cats were treated with cyclosporine for at least three weeks. Nineteen cats, aged 6.9–17.5 years, were included. Daily treatment with cyclosporine resulted in an improvement of serum Spec fPL concentrations which indicates that the pancreatic inflammation likely had improved. The study has several limitations, including different treatment durations and doses, lack of biopsies to confirm CP and the treatment effect was not compared with an untreated control group. Despite the limitations, our results suggest that cyclosporine treatment decreases serum Spec fPL concentrations and may be effective in the management of feline chronic pancreatitis. Abstract Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine has been suggested as an alternative treatment when other immunosuppressive treatments are insufficient or contraindicated. However, no published studies have investigated its efficacy on feline CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine on supranormal serum feline pancreas-specific lipase (Spec fPL) concentrations in cats with presumed CP. Inclusion criteria were history and clinical signs suggestive of CP, serum Spec fPL concentrations above 5.3 μg/L (reference range 0–3.5 μg/L, equivocal range 3.6–5.3 μg/L) on at least two occasions and treatment with cyclosporine for at least three weeks. Serum Spec fPL was analyzed at Idexx Laboratories, Kornwestheim, Germany. Nineteen cats, aged 6.9–17.5 years (median 11.6), were included. No pancreatic biopsies were available. Median (range) serum Spec fPL concentration was 14.2 μg/L (6.1–43.3) at baseline and 6.7 μg/L (0.9–23.6) at follow-up. Cyclosporine treatment (5.0–7.9 mg/kg orally SID) was associated with a significant reduction in serum Spec fPL concentrations (p < 0.001) at follow-up after 23–206 days (median 35). Body weight decreased significantly between inclusion and follow-up (p = 0.013). Significant improvement of clinical signs could not be measured (p = 0.781). This study has several limitations, including unstandardized treatment length and dose, no control group and lack of pancreatic biopsies. Despite the limitations, our results suggest that cyclosporine treatment reduces supranormal serum Spec fPL concentrations in cats with presumed CP.
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Foreman M, Cherubini GB. Dexamethasone Can Be Safely and Effectively Used for Treatment of Masticatory Muscle Myositis in Dogs. Top Companion Anim Med 2021; 44:100538. [PMID: 33933701 DOI: 10.1016/j.tcam.2021.100538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022]
Abstract
Dexamethasone is the glucocorticoid of choice in many human inflammatory and immune-mediated conditions, given its reported effectiveness and limited side effect profile. In veterinary medicine, the glucocorticoid of choice is prednisone, however the safety of longer-term use of dexamethasone has not previously been studied. The aim of this study was to evaluate the safety, effectiveness and side effects of dexamethasone use as the glucocorticoid treatment for masticatory muscle myositis in dogs - an immune-mediated inflammatory condition. 93% of dogs showed a clinical improvement within two weeks of treatment, and 100% by ten weeks. 35% of dogs showed adverse reactions, however these were all mild and resolved with tapering of the dexamethasone dose. In conclusion, dexamethasone can be safely and effectively used for the treatment of masticatory muscle myositis in dogs, and should be considered for use in these cases, either alone or alongside additional immunosuppressive medications. Side effects are mild and resolve with tapering of the dexamethasone dose.
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Affiliation(s)
- Max Foreman
- Department of Neurology and Neurosurgery, Dick White Referrals, Six Mile Bottom, Cambs, UK.
| | - Giunio Bruto Cherubini
- Department of Neurology and Neurosurgery, Dick White Referrals, Six Mile Bottom, Cambs, UK
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Treese JS, Nolte I, Bach JP. Chronic enteropathy in dogs - retrospective case analysis and results of an owner survey. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:94-103. [PMID: 33902118 DOI: 10.1055/a-1354-0630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Chronic gastrointestinal diseases in dogs are common and often require intensive diagnostic work-up and lifelong therapy. In this study, a survey of owners of affected dogs was conducted in parallel with a retrospective case analysis from the clinic's documentation system. MATERIAL AND METHODS The records of dogs with gastrointestinal symptomatology and exclusion of an extraintestinal cause, presented from January 2011 to October 2018, were acquired from the clinic's case system and analysed. Patient owners were interviewed using a questionnaire regarding diagnosis, treatment, course of the disease and improvement in the dog's quality of life as a result of treatment. To gain a better understanding of influencing factors for the different subtypes of chronic enteropathy, differentiation was made into feed-responsive (FRE), antibiotic-responsive (ARE), immunosuppressant-responsive (IRE), and nonresponsive enteropathy (NRE) according to the success of different therapeutic approaches. RESULTS Of 125 patient owners contacted, 81 participated in the study. The majority of the 81 dogs had FRE (45; 55.6 %), 11 (13.6 %) dogs had ARE, 23 (28.4 %) had IRE and 2 (2.5 %) had NRE. At the disease onset, dogs in the FRE and ARE groups were significantly younger than those in the IRE group. Interviews with dog owners showed that veterinary recommendations had not been consistently implemented, particularly in dogs in the FRE group. Successful treatment resulted in significant improvement in the quality of life in patients in all 3 groups according to owner assessment, with no differences between the groups. CONCLUSION AND CLINICAL RELEVANCE The majority of the contacted dog owners agreed to participate in the survey. A retrospective case analysis in combination with an owner survey is helpful to elicit the owners' assessment of their dog's treatment and disease course and to reveal starting points for improved owner compliance.
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Affiliation(s)
- Julia S Treese
- Small Animal Clinic, Veterinary University Hannover, Foundation
| | - Ingo Nolte
- Small Animal Clinic, Veterinary University Hannover, Foundation
| | - Jan-Peter Bach
- Small Animal Clinic, Veterinary University Hannover, Foundation
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Allenspach K, Iennarella-Servantez C. Canine Protein Losing Enteropathies and Systemic Complications. Vet Clin North Am Small Anim Pract 2020; 51:111-122. [PMID: 33131913 DOI: 10.1016/j.cvsm.2020.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Canine protein-losing enteropathies occur commonly in small animal practice, and their management is often challenging with a long-term survival rate of only about 50%. Recent studies have investigated prognostic factors that may determine outcome in individual cases. In particular, systemic complications such as hypercoagulability, vitamin D3 deficiency, and tryptophan deficiency may play an important role and should be investigated in severely affected cases in order to maximize outcome.
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Affiliation(s)
- Karin Allenspach
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 South Riverside Drive, Ames, IA 50010, USA.
| | - Chelsea Iennarella-Servantez
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 South Riverside Drive, Ames, IA 50010, USA
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Günther C, Steffen F, Alder DS, Beatrice L, Geigy C, Beckmann K. Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid-responsive meningitis-arteritis. Vet Rec 2020; 187:e7. [PMID: 33638531 PMCID: PMC7456679 DOI: 10.1136/vr.105683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/17/2019] [Accepted: 01/29/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Relapses in steroid-responsive meningitis-arteritis (SRMA) are frequently observed but specific treatment protocols to address this problem are sparsely reported. Standard treatment includes prolonged administration of glucocorticoids as monotherapy or in combination with immunosuppressive drugs. The aim of this study was to assess the safety and efficacy of cytosine arabinoside (CA) in combination with glucocorticoids for treatment of SRMA relapses in 12 dogs on a retrospective basis. METHODS Dogs with recurrent episodes of SRMA and treated with a combination of CA and prednisolone were included. Information about clinical course, treatment response and adverse events was collected from medical records. Ethical approval was not required for this study. RESULTS Ten dogs (10/12) responded well to the treatment with clinical signs being completely controlled. One dog is in clinical remission, but still under treatment. One dog (8%) showed further relapse. Mean treatment period was 51 weeks. Adverse events of variable severity (grade 1-4/5) were documented in all dogs during treatment according to the veterinary cooperative oncology group grading. Three dogs developed severe adverse events. Laboratory findings showed marked changes up to grade 4. Diarrhoea and anaemia were the most often observed adverse events (6), followed by dermatitis (4), alopecia (3) and pneumonia (3). Including blood chemistry changes (13), 50 adverse events were found in total. CONCLUSION Treatment with CA and glucocorticoids resulted in clinical remission in 10/12 dogs, but a high incidence of adverse events occurred requiring additional measures. All adverse events could be managed successfully in all cases.
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Affiliation(s)
- Christian Günther
- Clinic of Small Animal Surgery/Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Frank Steffen
- Clinic of Small Animal Surgery/Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Daniela S Alder
- Clinic of Small Animal Surgery/Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Neurology/Neurosurgery, Southern Counties Veterinary Specialists LLP, Ringwood, Hampshire, UK
| | - Laura Beatrice
- Department fur Kleintiere, Oncology, Universitat Zurich, Zurich, Switzerland
| | - Caroline Geigy
- Department fur Kleintiere, Oncology, Universitat Zurich, Zurich, Switzerland
- Departmend of Internal Medicine, Marigin - Zentrum für Tiermedizin, Feusisberg, Switzerland
| | - Katrin Beckmann
- Clinic of Small Animal Surgery/Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Department fur Kleintiere, Oncology, Universitat Zurich, Zurich, Switzerland
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Karlovits S, Manz A, Allenspach K, Walter I, Kummer S, Tichy A, Richter B, Burgener IA, Luckschander-Zeller N. Ki-67/CD3 ratio in the diagnosis of chronic inflammatory enteropathy in dogs. J Vet Intern Med 2019; 34:92-97. [PMID: 31825538 PMCID: PMC6979107 DOI: 10.1111/jvim.15680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/26/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND T cells play a key role in the pathogenesis of chronic inflammatory enteropathy (CIE) in dogs. Cluster of differentiation 3 (CD3) antigen serves as a marker for T cells. In human medicine, Ki-67 is an indicator for cell growth but there are only a few studies in dogs with CIE. OBJECTIVE To investigate Ki-67 in relation to T cells as a marker for CIE in dogs. ANIMALS Eleven dogs with CIE and 6 healthy beagle controls (CO). METHODS Retrospective case-control study. Dogs were clinically assessed by the Canine Chronic Enteropathy Clinical Activity Index (CCECAI). Duodenal mucosal biopsy samples were endoscopically obtained for histopathologic examination by means of the World Small Animal Veterinary Association score. Double-labeled immunofluorescence was used to investigate colocalization of Ki-67 and CD3 in epithelium and lamina propria (LP) of villi and crypts. RESULTS Dogs with CIE had significantly higher clinical score (median, 5.0; interquartile range [IQR], 3-7) compared to CO (all 0; P < .001). The Ki-67/CD3 double-positive cells were significantly increased in the LP of the crypt region of CIE dogs (0.63 cells/mm2 ; IQR, 0-0.54) versus CO (0.08 cells/mm2 ; IQR, 0-0.26; P = .044). A significant correlation was found between CCECAI and the Ki-67/CD3 ratio in the LP of the crypt region (r = 0.670; P = .012) in dogs with CIE. CONCLUSIONS AND CLINICAL IMPORTANCE The Ki-67/CD3 ratio is upregulated in the LP crypt region of dogs with CIE and it correlates with clinical severity. Therefore, Ki-67/CD3 could be a useful tool for detection of CIE.
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Affiliation(s)
- Sonja Karlovits
- Department for Companion Animals and Horses, Clinic for Small Animal Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Anita Manz
- Department for Companion Animals and Horses, Clinic for Small Animal Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Ingrid Walter
- VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria.,Department for Pathobiology, Institute of Pathology, University of Veterinary Medicine, Vienna, Austria
| | - Stefan Kummer
- VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Richter
- Department for Pathobiology, Institute of Pathology, University of Veterinary Medicine, Vienna, Austria
| | - Iwan A Burgener
- Department for Companion Animals and Horses, Clinic for Small Animal Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Nicole Luckschander-Zeller
- Department for Companion Animals and Horses, Clinic for Small Animal Internal Medicine, University of Veterinary Medicine, Vienna, Austria
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Ullal T, Ambrosini Y, Rao S, Webster CRL, Twedt D. Retrospective evaluation of cyclosporine in the treatment of presumed idiopathic chronic hepatitis in dogs. J Vet Intern Med 2019; 33:2046-2056. [PMID: 31393054 PMCID: PMC6766481 DOI: 10.1111/jvim.15591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 07/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background The etiology of idiopathic chronic hepatitis (ICH) in dogs is poorly understood, but evidence supports an immune‐mediated pathogenesis in some dogs. Objectives To describe a case series of dogs with presumed ICH treated with cyclosporine (CsA) with or without concurrent medications and to document the incidence of biochemical remission and factors associated with failure to attain remission. Animals Forty‐eight client‐owned dogs diagnosed with presumed ICH, treatment of which included CsA. Methods Two‐institution, retrospective case series of dogs between 2010 and 2017. All dogs were treated with CsA with or without concurrent medications for ≥2 weeks. Data were collected from medical records. Results Biochemical remission (<1.1 times the upper limit of normal for alanine aminotransferase activity) was attained in 79% of dogs (38/48). Median dose of CsA at remission was 7.9 mg/kg/d (range, 2.5‐12.7 mg/kg/d) and median time to remission was 2.5 months (range, 0.75‐18 months). Concurrent hepatoprotectant treatment was not associated with likelihood of remission. Clinical score, ascites, hypoalbuminemia, hyperbilirubinemia, prolonged coagulation times, dose, and duration of treatment were not associated with the probability of remission or time to remission. Common adverse effects of CsA were gastrointestinal signs in 38% (18/48) and gingival hyperplasia in 25% (12/48) of treated dogs. Conclusion and Clinical Importance A treatment regimen including CsA and frequent hepatoprotectant use resulted in biochemical remission of ICH in most dogs. None of the evaluated factors, including hepatoprotectant use, were significantly associated with likelihood of remission. Future prospective studies are indicated to evaluate CsA monotherapy in ICH dogs.
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Affiliation(s)
- Tarini Ullal
- Colorado State University, Fort Collins, Colorado
| | - Yoko Ambrosini
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts
| | - Sangeeta Rao
- Colorado State University, Fort Collins, Colorado
| | - Cynthia R L Webster
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts
| | - David Twedt
- Colorado State University, Fort Collins, Colorado
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Kathrani A, Lezcano V, Hall EJ, Jergens AE, Seo YJ, Mochel JP, Atherly T, Allenspach K. Interleukin-13 and interleukin-33 mRNA are underexpressed in the duodenal mucosa of German Shepherd dogs with chronic enteropathy. J Vet Intern Med 2019; 33:1660-1668. [PMID: 31169944 PMCID: PMC6639532 DOI: 10.1111/jvim.15544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/20/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A recent genome-wide association study in German Shepherd dogs (GSDs) with chronic enteropathy (CE) has identified polymorphisms in the Th2 cytokine genes. HYPOTHESIS/OBJECTIVE To determine if the expression of the Th2 cytokines, interleukin-13 (IL-13) and interleukin-33 (IL-33), is altered in the duodenal mucosa of GSDs with CE compared to non-GSDs with CE and healthy dogs. ANIMALS Twenty client-owned dogs diagnosed with CE (10 GSDs and 10 non-GSDs) at the Bristol Veterinary School and 8 healthy Beagle dogs from the Iowa State University Service Colony. METHODS Retrospective study using archived paraffin-embedded duodenal biopsy samples. A novel RNA in situ hybridization technology (RNAscope) was used to hybridize IL-13 and IL-33 mRNA probes onto at least 10 sections from duodenal biopsy samples for each dog. RNAscope signals were visualized using a microscope and semi-quantitative assessment was performed by a single operator. RESULTS Based on duodenal villus, subvillus, epithelial, and lamina propria average expression scores, GSDs with CE had significantly lower IL-13 and IL-33 mRNA expression compared to non-GSDs with CE (IL-13, P < .04; IL-33, P < .02) and healthy Beagle dogs (IL-13, P < .02; IL-33, P < .004). CONCLUSIONS AND CLINICAL IMPORTANCE Similar to human patients with ulcerative colitis, a subtype of human inflammatory bowel disease, these data indicate that Th2 cytokines may be involved in the pathogenesis of CE in GSDs.
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Affiliation(s)
| | - Victor Lezcano
- College of Veterinary Medicine, Tuskegee University, Tuskegee, Alabama
| | - Edward J Hall
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Albert E Jergens
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Yeon-Jung Seo
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | | | - Todd Atherly
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Karin Allenspach
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
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Makielski K, Cullen J, O'Connor A, Jergens AE. Narrative review of therapies for chronic enteropathies in dogs and cats. J Vet Intern Med 2019; 33:11-22. [PMID: 30523666 PMCID: PMC6335544 DOI: 10.1111/jvim.15345] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 10/05/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The optimal medical treatment for chronic enteropathy (CE) in dogs and cats is controversial. Sequential treatment using diet, antimicrobials, and immunosuppressive drugs is the most common strategy used by clinicians. OBJECTIVES To review the evidence for the effectiveness of dietary, drug, and alternative health interventions for inducing clinical remission in dogs and cats with CE. ANIMALS Retrospective study of dogs and cats with a diagnosis of chronic enteropathy. METHODS MEDLINE and Centre for Agriculture and Bioscience International (CABI) databases (1950 to March 2017) were searched for randomized controlled trials (RCTs), observational studies, and case series. The primary outcome was induction of clinical remission. All studies were evaluated using the quality of evidence grading guidelines (I-IV), which assign a score defining the strength and quality of the evidence. RESULTS Twenty-two studies (11 RCTs in dogs and 2 in cats and 9 cohort studies or case series) met the inclusion criteria for inducing remission of gastrointestinal (GI) signs. Of the 13 RCTs achieving grade I scores, 10 studies (totaling 218 dogs and 65 cats) compared single treatment: diet (n = 3), immunosuppressives (n = 3), antimicrobials (n = 2), anti-inflammatory drugs (n = 1), and probiotics (n = 1). Three case series (grade III) reported clinical remission using an elimination diet fed to 55 cats and use of enrofloxacin to induce remission in dogs with granulomatous colitis (2 studies totaling 16 dogs). CONCLUSIONS AND CLINICAL IMPORTANCE The current evidence for treatment of CE is much greater in dogs than in cats. There is sufficient strong evidence to recommend the use of therapeutic GI diets, glucocorticoids, enrofloxacin, or some combination of these in dogs with CE. Therapeutic GI diets and glucocorticoids are most useful in cats with CE.
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Affiliation(s)
- Kelly Makielski
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowa
| | - Jonah Cullen
- Department of Veterinary Diagnostic and Production Animal MedicineCollege of Veterinary Medicine, Iowa State UniversityAmesIowa
| | - Annette O'Connor
- Department of Veterinary Diagnostic and Production Animal MedicineCollege of Veterinary Medicine, Iowa State UniversityAmesIowa
| | - Albert E. Jergens
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowa
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Allenspach KA, Mochel JP, Du Y, Priestnall SL, Moore F, Slayter M, Rodrigues A, Ackermann M, Krockenberger M, Mansell J, Luckschander N, Wang C, Suchodolski J, Berghoff N, Jergens AE. Correlating Gastrointestinal Histopathologic Changes to Clinical Disease Activity in Dogs With Idiopathic Inflammatory Bowel Disease. Vet Pathol 2018; 56:435-443. [DOI: 10.1177/0300985818813090] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prior studies have failed to detect a convincing association between histologic lesions of inflammation and clinical activity in dogs with inflammatory bowel disease (IBD). We hypothesized that use of a simplified histopathologic scoring system would improve the consistency of interpretation among pathologists when describing histologic lesions of gastrointestinal inflammation. Our aim was to evaluate the correlation of histopathologic changes to clinical activity in dogs with IBD using this new system. Forty-two dogs with IBD and 19 healthy control dogs were enrolled in this retrospective study. Endoscopic biopsies from the stomach, duodenum, ileum, and colon were independently scored by 8 pathologists. Clinical disease activity was scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), depending on the individual study center. Summative histopathological scores and clinical activity were calculated for each tissue (stomach, duodenum, ileum, and colon) and each tissue histologic score (inflammatory/morphologic feature). The correlation between CCECAI/CIBDAI and summative histopathologic score was significant ( P < .05) for duodenum ( r = 0.42) and colon ( r = 0.33). In evaluating the relationship between histopathologic scores and clinical activity, significant ( P < .05) correlations were observed for crypt dilation ( r = 0.42), lamina propria (LP) lymphocytes ( r = 0.40), LP neutrophils ( r = 0.45), mucosal fibrosis ( r = 0.47), lacteal dilation ( r = 0.39), and villus stunting ( r = 0.43). Compared to earlier grading schemes, the simplified scoring system shows improved utility in correlating histopathologic features (both summative histology scores and select histologic scores) to IBD clinical activity.
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Affiliation(s)
- Karin A. Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jonathan P. Mochel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Yingzhou Du
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Simon L. Priestnall
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK
| | | | | | - Aline Rodrigues
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Mark Ackermann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | | | - Joanne Mansell
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | | | - Chong Wang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jan Suchodolski
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Nora Berghoff
- College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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Keyte S. Differential diagnosis and management of haematochezia in dogs and cats. IN PRACTICE 2018. [DOI: 10.1136/inp.k3922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Peiravan A, Bertolini F, Rothschild MF, Simpson KW, Jergens AE, Allenspach K, Werling D. Genome-wide association studies of inflammatory bowel disease in German shepherd dogs. PLoS One 2018; 13:e0200685. [PMID: 30028859 PMCID: PMC6054420 DOI: 10.1371/journal.pone.0200685] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 05/14/2018] [Indexed: 12/12/2022] Open
Abstract
Canine Inflammatory Bowel Disease (IBD) is considered a multifactorial disease caused by complex interactions between the intestinal immune system, intestinal microbiota and environmental factors in genetically susceptible individuals. Although IBD can affect any breed, German shepherd dogs (GSD) in the UK are at increased risk of developing the disease. Based on previous evidence, the aim of the present study was to identify single nucleotide polymorphisms (SNPs), which may confer genetic susceptibility or resistance to IBD using a genome-wide association study (GWAS). Genomic DNA was extracted from EDTA blood or saliva samples of 96 cases and 98 controls. Genotyping of cases and controls was performed on the Canine Illumina HD SNP array and data generated was analyzed using PLINK. Several SNPs and regions on chromosomes 7,9,11 and 13 were detected to be associated with IBD using different SNP-by-SNP association methods and FST windows approach. Searching one Mb up-and down-stream of the most significant SNPs, as identified by single SNP analysis as well as 200Kb before and after the start and the end position of the associated regions identified by FST windows approach, we identified 63 genes. Using a combination of pathways analysis and a list of genes that have been reported to be involved in human IBD, we identified 16 candidate genes potentially associated with IBD in GSD.
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Affiliation(s)
- Atiyeh Peiravan
- Department of Pathology and Pathogen Biology, Royal Veterinary College, University of London, North Mymms, United Kingdom
| | - Francesca Bertolini
- Department of Animal Science, Iowa State University, Ames, Iowa, United States of America
| | - Max F. Rothschild
- Department of Animal Science, Iowa State University, Ames, Iowa, United States of America
| | - Kenneth W. Simpson
- College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Albert E. Jergens
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Karin Allenspach
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Dirk Werling
- Department of Pathology and Pathogen Biology, Royal Veterinary College, University of London, North Mymms, United Kingdom
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15
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Segev G, Cowgill LD. Treatment of acute kidney injury associated with cyclosporine overdose in a dog using hemodialysis and charcoal hemoperfusion. J Vet Emerg Crit Care (San Antonio) 2018; 28:163-167. [PMID: 29419935 DOI: 10.1111/vec.12694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/04/2016] [Accepted: 04/27/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the management of cyclosporine overdose using hemodialysis and hemoperfusion in a dog. CASE SUMMARY A 6-year-old, spayed female Australian Shepherd was presented for treatment of cyclosporine overdose and acute kidney injury. Five days prior to presentation, the dog had been diagnosed by its referring veterinarian with immune-mediated thrombocytopenia. Treatment was initiated with prednisone, but since no response was noted, azathioprine (50 mg PO q 24 h) and cyclosporine (6 mg/kg IV q 24 h) were added. On day 4, an overdose of cyclosporine (33 mg/kg IV) was administered accidentally. Upon presentation, serum biochemistry panel revealed azotemia [creatinine, 521.6 μmol/L (5.9 mg/dL); BUN, 59.3 mmol/L (166 mg/dL)], increased activities of liver enzymes, and hyperbilirubinemia. Due to the presumed diagnosis cyclosporine overdose and acute kidney injury, a combined hemodialysis and charcoal hemoperfusion treatment was planned. Hemosorba CH-350 charcoal hemoperfusion cartridge was placed in series upstream in the extracorporeal circuit from the hemodialyzer. A 3-hour treatment was performed and a total of 0.74 L/kg of blood was processed. Pretreatment blood cyclosporine concentration was 960 nmol/L (1154 ng/mL) and decreased to 440 nmol/L (529 ng/mL) posttreatment (54% fractional reduction, 18% per hour). Thirty-one hours following treatment, blood cyclosporine concentration was 220 nmol/L (265 ng/mL; 1.5% decrease per hour). Twelve days following presentation to our hospital, the dog was euthanized due to lack of response to medical management. NEW OR UNIQUE INFORMATION PROVIDED Combined hemodialysis and charcoal hemoperfusion treatment can significantly reduce blood cyclosporine concentrations following acute intoxication or overdosage, and should be considered as an option for decontamination in such cases.
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Affiliation(s)
- Gilad Segev
- School of Veterinary Medicine, the Hebrew University of Jerusalem, Israel, Rehovot, Israel
| | - Larry D Cowgill
- the Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616
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16
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Mochel JP, Jergens AE, Kingsbury D, Kim HJ, Martín MG, Allenspach K. Intestinal Stem Cells to Advance Drug Development, Precision, and Regenerative Medicine: A Paradigm Shift in Translational Research. AAPS JOURNAL 2017; 20:17. [PMID: 29234895 PMCID: PMC6044282 DOI: 10.1208/s12248-017-0178-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/21/2017] [Indexed: 12/23/2022]
Abstract
Recent advances in our understanding of the intestinal stem cell niche and the role of key signaling pathways on cell growth and maintenance have allowed the development of fully differentiated epithelial cells in 3D organoids. Stem cell-derived organoids carry significant levels of proteins that are natively expressed in the gut and have important roles in drug transport and metabolism. They are, therefore, particularly relevant to study the gastrointestinal (GI) absorption of oral medications. In addition, organoids have the potential to serve as a robust preclinical model for demonstrating the effectiveness of new drugs more rapidly, with more certainty, and at lower costs compared with live animal studies. Importantly, because they are derived from individuals with different genotypes, environmental risk factors and drug sensitivity profiles, organoids are a highly relevant screening system for personalized therapy in both human and veterinary medicine. Lastly, and in the context of patient-specific congenital diseases, orthotopic transplantation of engineered organoids could repair and/or replace damaged epithelial tissues reported in various GI diseases, such as inflammatory bowel disease, cystic fibrosis, and tuft enteropathy. Ongoing translational research on organoids derived from dogs with naturally occurring digestive disorders has the potential to improve the predictability of preclinical models used for optimizing the therapeutic management of severe chronic enteropathies in human patients.
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Affiliation(s)
- Jonathan P Mochel
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, 2448 Lloyd, 1809 S Riverside Dr., Ames, Iowa, 50011-1250, USA.
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, 50011-1250 Ames, Iowa, USA
| | - Dawn Kingsbury
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, 50011-1250 Ames, Iowa, USA
| | - Hyun Jung Kim
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, 78712, USA
| | - Martín G Martín
- Department of Pediatrics, University of California Los Angeles, California, Los Angeles, 90095-1782, USA
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, 50011-1250 Ames, Iowa, USA
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17
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Sattasathuchana P, Allenspach K, Lopes R, Suchodolski JS, Steiner JM. Evaluation of Serum 3-Bromotyrosine Concentrations in Dogs with Steroid-Responsive Diarrhea and Food-Responsive Diarrhea. J Vet Intern Med 2017. [PMID: 28626891 PMCID: PMC5508308 DOI: 10.1111/jvim.14742] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background The clinical usefulness of serum 3‐BrY concentrations for subclassifying dogs with food‐responsive diarrhea (FRD) and steroid‐responsive diarrhea (SRD) has not been studied. Hypothesis/Objectives To compare serum 3‐BrY concentrations in dogs with FRD, dogs with SRD, and healthy control dogs. Animals 38 dogs with FRD, 14 dogs with SRD, and 46 healthy dogs. Methods Prospective study. Measurement of 3‐BrY concentration in serum samples was performed by gas chromatography/mass spectrometry. Results There was no association of peripheral eosinophilia in dogs with FRD, SRD, and healthy control dogs (P = 0.069). There was no significant correlation between peripheral eosinophil counts and serum 3‐BrY concentrations (ρ = −0.15, P = 0.13). Serum 3‐BrY concentrations in dogs with SRD (median [range] = 3.27, 0.9–26.23 μmol/L) were significantly higher than in dogs with FRD (median [range] = 0.99, 0.62–8.82 μmol/L; P = 0.007) or in healthy dogs (median [range] = 0.62, 0.62–1.79 μmol/L; P < 0.001). Also, serum 3‐BrY concentrations in dogs with FRD were significantly higher than in healthy dogs (P = 0.025). There was no significant correlation between the canine chronic enteropathy clinical activity index and serum 3‐BrY concentrations (ρ = 0.17, P = 0.23). Conclusions and Clinical Importance Measurement of serum 3‐BrY concentrations, but not the peripheral eosinophil count, is helpful for detecting dogs with SRD and FRD.
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Affiliation(s)
- P Sattasathuchana
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.,Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - K Allenspach
- Department of Veterinary Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - R Lopes
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J S Suchodolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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18
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Allenspach K, Rizzo J, Jergens AE, Chang YM. Hypovitaminosis D is associated with negative outcome in dogs with protein losing enteropathy: a retrospective study of 43 cases. BMC Vet Res 2017; 13:96. [PMID: 28390394 PMCID: PMC5385077 DOI: 10.1186/s12917-017-1022-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 04/03/2017] [Indexed: 11/24/2022] Open
Abstract
Background Hypovitaminosis D has previously been shown to be prevalent amongst dogs with protein losing enteropathy (PLE). The hypothesis of this study was that Low 25-hydroxyvitamin D (25(OH) D) serum concentrations could be a risk factor for negative outcome in dogs with PLE. Forty-three dogs diagnosed with PLE (2005–2014) and which serum Vitamin D serum concentrations were collected and archived at −80 Degrees C were analyzed. Post-diagnostic communication with referring veterinarians was made to determine outcome of PLE dogss: Dogs which died due to PLE within 4 months after diagnosis (negative outcome group, n = 22) and dogs alive or which died due to another disease at the end point of the study (1 year after diagnosis, good outcome group, n = 21). Serum samples taken at the time of diagnosis were analysed for ionized calcium (iCa) concentrations and serum 25(OH) D concentration. Results Clinical (CCECAI) scores, age at PLE diagnosis, and iCa concentrations were not significantly different between dog groups. A significantly greater (p < 0.001) number of PLE dogs treated with hydrolyzed or elimination diet alone showed good outcome as compared to the PLE negative outcome group. Median serum 25(OH) D concentration was significantly (p = 0.017) lower in dogs with negative outcome versus PLE dogs with good outcome. Using logistic regression analysis, 25(OH) D serum concentration was shown to be a statistically significant factor for outcome determination. Cox regression analysis yielded a hazard ratio of 0.974 (95% CI 0.949, 0.999) per each one nmol/l increase in serum 25(OH) D concentration. Conclusions Low serum 25(OH) D concentration in PLE dogs was significantly associated with poor outcome. Further studies are required to investigate the clinical efficacy of Vitamin D (cholecalciferol) as a potential therapeutic agent for dogs with PLE.
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Affiliation(s)
- K Allenspach
- Department of Clinical Sciences and Services, University of London, North Mymms, Hertfordshire, UK. .,Department of Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, 50011, USA.
| | - J Rizzo
- Department of Clinical Sciences and Services, University of London, North Mymms, Hertfordshire, UK
| | - A E Jergens
- Research Support Office, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Y M Chang
- Department of Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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19
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Cummings FO, Rizzo SA. Treatment of presumptive primary immune-mediated thrombocytopenia with mycophenolate mofetil versus cyclosporine in dogs. J Small Anim Pract 2017; 58:96-102. [DOI: 10.1111/jsap.12621] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
- F. O. Cummings
- Practice Limited to Internal Medicine; Louisville Kentucky 40223 USA
| | - S. A. Rizzo
- Practice Limited to Internal Medicine; Louisville Kentucky 40223 USA
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20
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21
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Huang HP, Lien YH. Effects of a structured exercise programme in sedentary dogs with chronic diarrhoea. Vet Rec 2016; 180:224. [PMID: 27941060 DOI: 10.1136/vr.103902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/03/2022]
Abstract
The aim of this investigation was to evaluate the effects of a structured exercise programme in sedentary dogs with chronic diarrhoea. Twenty-two dogs were enrolled in the study. All dogs received oral prednisolone (1 mg/kg/day for 14 days, followed by a tapering dosage) for 10 weeks. After four weeks of prednisolone treatment, dogs were assigned to either the exercise or control group (n=11 each). Owners of dogs in the exercise group were instructed to guide their dogs in structured exercise training (low-intensity to moderate-intensity aerobic and resistance exercise three to five days per week). After 10 weeks of prednisolone treatment with concomitant 6 weeks of complementary exercise, the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) score had decreased significantly in the exercise group (from 8.8±1.5 at the start of the exercise programme to 2.4±1.5; P<0.001); no such change was observed in the control group (from 9.2±0.9 to 9.2±1.1). CIBDAI scores differed significantly between the groups at the end of the 10-week study period (P<0.001). The exercise programme affected all six CIBDAI parameters significantly; bodyweight (P<0.001, adjusted r2=0.722) was most affected. A structured exercise programme may have positive effects on clinical symptoms in sedentary dogs with chronic diarrhoea.
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Affiliation(s)
- H-P Huang
- Institute of Veterinary Clinical Science, Veterinary School, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 100, Taiwan
| | - Y-H Lien
- Azu Clinic for Animals, No. 92, Section 1, Kin-Shan South Road, Taipei 100, Taiwan
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22
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Dandrieux JRS. Inflammatory bowel disease versus
chronic enteropathy in dogs: are they one and the same? J Small Anim Pract 2016; 57:589-599. [DOI: 10.1111/jsap.12588] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/18/2016] [Accepted: 07/11/2016] [Indexed: 12/13/2022]
Affiliation(s)
- J. R. S. Dandrieux
- Faculty of Veterinary and Agricultural Sciences, Translational Research and Animal Clinical Trial Study (TRACTS) Group; The University of Melbourne; Werribee 3030 Victoria Australia
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23
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Westermarck E. Chronic Diarrhea in Dogs: What Do We Actually Know About It? Top Companion Anim Med 2016; 31:78-84. [DOI: 10.1053/j.tcam.2016.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
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24
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Segarra S, Martínez-Subiela S, Cerdà-Cuéllar M, Martínez-Puig D, Muñoz-Prieto A, Rodríguez-Franco F, Rodríguez-Bertos A, Allenspach K, Velasco A, Cerón J. Oral chondroitin sulfate and prebiotics for the treatment of canine Inflammatory Bowel Disease: a randomized, controlled clinical trial. BMC Vet Res 2016; 12:49. [PMID: 26965834 PMCID: PMC4785639 DOI: 10.1186/s12917-016-0676-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 03/07/2016] [Indexed: 01/29/2023] Open
Abstract
Background Canine inflammatory bowel disease (IBD) is a chronic enteropathy of unknown etiology, although microbiome dysbiosis, genetic susceptibility, and dietary and/or environmental factors are hypothesized to be involved in its pathogenesis. Since some of the current therapies are associated with severe side effects, novel therapeutic modalities are needed. A new oral supplement for long-term management of canine IBD containing chondroitin sulfate (CS) and prebiotics (resistant starch, β-glucans and mannaoligosaccharides) was developed to target intestinal inflammation and oxidative stress, and restore normobiosis, without exhibiting any side effects. This double-blinded, randomized, placebo-controlled trial in dogs with IBD aims to evaluate the effects of 180 days administration of this supplement together with a hydrolyzed diet on clinical signs, intestinal histology, gut microbiota, and serum biomarkers of inflammation and oxidative stress. Results Twenty-seven client-owned biopsy-confirmed IBD dogs were included in the study, switched to the same hydrolyzed diet and classified into one of two groups: supplement and placebo. Initially, there were no significant differences between groups (p > 0.05) for any of the studied parameters. Final data analysis (supplement: n = 9; placebo: n = 10) showed a significant decrease in canine IBD activity index (CIBDAI) score in both groups after treatment (p < 0.001). After treatment, a significant decrease (1.53-fold; p < 0.01) in histologic score was seen only in the supplement group. When groups were compared, the supplement group showed significantly higher serum cholesterol (p < 0.05) and paraoxonase-1 (PON1) levels after 60 days of treatment (p < 0.01), and the placebo group showed significantly reduced serum total antioxidant capacity (TAC) levels after 120 days (p < 0.05). No significant differences were found between groups at any time point for CIBDAI, WSAVA histologic score and fecal microbiota evaluated by PCR-restriction fragment length polymorphism (PCR-RFLP). No side effects were reported in any group. Conclusions The combined administration of the supplement with hydrolyzed diet over 180 days was safe and induced improvements in selected serum biomarkers, possibly suggesting a reduction in disease activity. This study was likely underpowered, therefore larger studies are warranted in order to demonstrate a supplemental effect to dietary treatment of this supplement on intestinal histology and CIBDAI.
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Affiliation(s)
- Sergi Segarra
- R&D Bioiberica SA, Pça. Francesc Macià 7, 08029, Barcelona, Spain.
| | - Silvia Martínez-Subiela
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071, Murcia, Spain
| | - Marta Cerdà-Cuéllar
- Centre de Recerca en Sanitat Animal (CReSA), IRTA, Campus de la Universitat Autònoma de Barcelona, 08193, Bellaterra, Cerdanyola del Vallès, Spain
| | | | - Alberto Muñoz-Prieto
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071, Murcia, Spain
| | - Fernando Rodríguez-Franco
- Department of Animal Medicine and Surgery, Faculty of Veterinary Science, Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - Antonio Rodríguez-Bertos
- Department of Animal Medicine and Surgery, Faculty of Veterinary Science, and Health Surveillance Centre (VISAVET), Complutense University of Madrid (UCM), 28040, Madrid, Spain
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, EN6 1NB, UK
| | - Alfonso Velasco
- R&D Bioiberica SA, Pça. Francesc Macià 7, 08029, Barcelona, Spain
| | - José Cerón
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071, Murcia, Spain
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25
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Allenspach K, Culverwell C, Chan D. Long-term outcome in dogs with chronic enteropathies: 203 cases. Vet Rec 2016; 178:368. [PMID: 26811439 DOI: 10.1136/vr.103557] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/04/2022]
Affiliation(s)
- K Allenspach
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, North Mymms, Hertfordshire AL9 7TA, UK
| | - C Culverwell
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, North Mymms, Hertfordshire AL9 7TA, UK
| | - D Chan
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, North Mymms, Hertfordshire AL9 7TA, UK
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26
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Affiliation(s)
- Karin Allenspach
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield AL9 7PT, UK.
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27
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Pérez-Merino EM, Usón-Casaús JM, Zaragoza-Bayle C, Duque-Carrasco J, Mariñas-Pardo L, Hermida-Prieto M, Barrera-Chacón R, Gualtieri M. Safety and efficacy of allogeneic adipose tissue-derived mesenchymal stem cells for treatment of dogs with inflammatory bowel disease: Clinical and laboratory outcomes. Vet J 2015; 206:385-90. [PMID: 26526522 DOI: 10.1016/j.tvjl.2015.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/01/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
Mesenchymal stem cells (MSCs) have shown immunomodulatory and anti-inflammatory effects in experimental colitis, and promising clinical results have been obtained in humans with Crohn's disease and ulcerative colitis. The aim of this study was to determine the safety and feasibility of adipose tissue-derived MSC (ASC) therapy in dogs with inflammatory bowel disease (IBD). Eleven dogs with confirmed IBD received one ASC intravascular (IV) infusion (2 × 10(6) cells/kg bodyweight). The outcome measures were clinical response based on percentage reduction of the validated Clinical Inflammatory Bowel Disease Activity Index (CIBDAI) and Canine Chronic Enteropathy Clinical Activity Index (CCECAI), as well as normalisation of C-reactive protein (CRP), albumin, folate and cobalamin serum concentrations at day 42 post-treatment. The Wilcoxon test was used to compare variables before and after treatment. No acute reaction to ASC infusion and no side effects were reported during follow-up in any dog. Six weeks post-treatment, the CIBDAI and CCECAI decreased significantly and albumin, cobalamin and folate concentrations increased substantially. Differences in CRP concentrations pre- and post-treatment were not significant (P = 0.050). Clinical remission (defined by a reduction of initial CIBDAI and CCECAI >75%) occurred in 9/11 dogs at day 42. The two remaining dogs showed a partial response with reduction percentages of 69.2% and 71.4%. In conclusion, a single IV infusion of allogeneic ASCs was well tolerated and appeared to produce clinical benefits in dogs with severe IBD.
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Affiliation(s)
- E M Pérez-Merino
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Extremadura, 10003 Cáceres, Spain.
| | - J M Usón-Casaús
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Extremadura, 10003 Cáceres, Spain
| | - C Zaragoza-Bayle
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Extremadura, 10003 Cáceres, Spain
| | - J Duque-Carrasco
- Veterinary Teaching Hospital, Veterinary Faculty, University of Extremadura, 10003 Cáceres, Spain
| | | | | | - R Barrera-Chacón
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Extremadura, 10003 Cáceres, Spain
| | - M Gualtieri
- Department of Health Animal Science and Food Safety, Section of Surgery, Veterinary Faculty, Via Celoria, 10. 20133 Milan, Italy
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28
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Bachtel JC, Pendergraft JS, Rosychuk RAW, Gustafson DL, Hansen RJ, Lunghofer PJ. Comparison of the stability and pharmacokinetics in dogs of modified ciclosporin capsules stored at −20°C and room temperature. Vet Dermatol 2015; 26:228-e50. [PMID: 26178603 DOI: 10.1111/vde.12222] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jeremy C. Bachtel
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Jennifer S. Pendergraft
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Rodney A. W. Rosychuk
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Daniel L. Gustafson
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Ryan J. Hansen
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Paul J. Lunghofer
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
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29
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Haas E, Rütgen BC, Gerner W, Richter B, Tichy A, Galler A, Bilek A, Thalhammer JG, Saalmüller A, Luckschander-Zeller N. Phenotypic characterization of canine intestinal intraepithelial lymphocytes in dogs with inflammatory bowel disease. J Vet Intern Med 2014; 28:1708-15. [PMID: 25250556 PMCID: PMC4895640 DOI: 10.1111/jvim.12456] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 07/29/2014] [Accepted: 08/12/2014] [Indexed: 01/08/2023] Open
Abstract
Background Many dogs suffering from inflammatory bowel disease (IBD) are presented to veterinary clinics. These patients are diagnosed based on a history of chronic gastrointestinal signs and biopsy‐confirmed histopathologic intestinal inflammation. Intestinal intraepithelial lymphocytes (IEL) are part of the first line of defense in the gastrointestinal immune system. Alterations in IEL subsets may play a role in the pathogenesis of IBD. Hypothesis The aim of this study was to characterize the phenotypes of IEL in dogs with IBD compared with healthy control dogs. Animals Intestinal intraepithelial lymphocytes subpopulations of control dogs (n = 5) obtained from endoscopic biopsies (EB) were compared to those obtained from full thickness biopsies (FTB) on the same day. In addition, the phenotypes of IEL from FTB of control dogs (n = 10) were compared with EB of IBD dogs (n = 10). Each participant was scored clinically using the canine inflammatory bowel disease activity index (CIBDAI), and all samples were graded histopathologically. Three‐color flow cytometry of isolated IEL was performed using monoclonal antibodies against T‐ and B‐lymphocyte subpopulations. Results No significant differences in the composition of IEL subpopulations were found in control dogs based on method of biopsy. The IBD dogs had significantly higher CIBDAI and histopathologic scores compared with control dogs and their IEL contained a significantly higher frequency TCRγδ T‐cells. Conclusions and Clinical Importance Endoscopic biopsies provide suitable samples for 3‐color flow cytometry when studying canine intestinal IEL and IBD patients show significant changes of major T‐cell subsets compared to healthy control dogs.
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Affiliation(s)
- E Haas
- Department for Companion Animals and Horses, Small Animal Clinic, Internal Medicine, University of Veterinary Medicine, Vienna, Austria
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Riggs C, Archer T, Fellman C, Figueiredo AS, Follows J, Stokes J, Wills R, Mackin A, Bulla C. Analytical validation of a quantitative reverse transcriptase polymerase chain reaction assay for evaluation of T-cell targeted immunosuppressive therapy in the dog. Vet Immunol Immunopathol 2014; 156:229-34. [PMID: 24422229 DOI: 10.1016/j.vetimm.2013.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cyclosporine is an immunosuppressive agent that inhibits T-cell function by decreasing production of cytokines such as interleukin-2 (IL-2) and interferon-γ(IFN-γ). In dogs, there is currently no reliable analytical method for determining effective cyclosporine dosages in individual patients. Our laboratory has developed a quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) assay that measures IL-2 and IFN-γ gene expression, with the goal of quantifying immunosuppression in dogs treated with cyclosporine. This study focuses on analytical validation of our assay, and on the effects of sample storage conditions on cyclosporine-exposed samples. Heparinized whole blood collected from healthy adult dogs was exposed to a typical post-treatment blood concentration for cyclosporine(500 ng/mL) for 1 h, and then stored for 0, 24, and 48 h at both room temperature and 4 ◦C.The study was then repeated using a cyclosporine concentration of 75 ng/mL, with sample storage for 0, 24, and 48 h at 4 ◦C. Cytokine gene expression was measured using RT-qPCR,and assay efficiency and inter- and intra-assay variability were determined. Storage for upto 24 h at room temperature, and up to 48 h at 4 ◦C, did not significantly alter results compared to samples that were processed immediately. Validation studies showed our assay to be highly efficient and reproducible and robust enough to be feasible under standard practice submission conditions.
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Okanishi H, Yoshioka R, Kagawa Y, Watari T. The clinical efficacy of dietary fat restriction in treatment of dogs with intestinal lymphangiectasia. J Vet Intern Med 2014; 28:809-17. [PMID: 24673630 PMCID: PMC4238835 DOI: 10.1111/jvim.12327] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/16/2013] [Accepted: 01/14/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Intestinal lymphangiectasia (IL), a type of protein-losing enteropathy (PLE), is a dilatation of lymphatic vessels within the gastrointestinal tract. Dietary fat restriction previously has been proposed as an effective treatment for dogs with PLE, but limited objective clinical data are available on the efficacy of this treatment. HYPOTHESIS/OBJECTIVES To investigate the clinical efficacy of dietary fat restriction in dogs with IL that were unresponsive to prednisolone treatment or showed relapse of clinical signs and hypoalbuminemia when the prednisolone dosage was decreased. ANIMALS Twenty-four dogs with IL. METHODS Retrospective study. Body weight, clinical activity score, and hematologic and biochemical variables were compared before and 1 and 2 months after treatment. Furthermore, the data were compared between the group fed only an ultra low-fat (ULF) diet and the group fed ULF and a low-fat (LF) diet. RESULTS Nineteen of 24 (79%) dogs responded satisfactorily to dietary fat restriction, and the prednisolone dosage could be decreased. Clinical activity score was significantly decreased after dietary treatment compared with before treatment. In addition, albumin (ALB), total protein (TP), and blood urea nitrogen (BUN) concentration were significantly increased after dietary fat restriction. At 2 months posttreatment, the ALB concentrations in the ULF group were significantly higher than that of the ULF + LF group. CONCLUSIONS AND CLINICAL IMPORTANCE Dietary fat restriction appears to be an effective treatment in dogs with IL that are unresponsive to prednisolone treatment or that have recurrent clinical signs and hypoalbuminemia when the dosage of prednisolone is decreased.
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Affiliation(s)
- H Okanishi
- Laboratory of Comprehensive Veterinary Clinical Studies, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kanagawa, Japan
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Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med 2013; 28:1-20. [PMID: 24341787 PMCID: PMC4895546 DOI: 10.1111/jvim.12265] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/02/2013] [Accepted: 10/28/2013] [Indexed: 11/30/2022] Open
Abstract
Cyclosporine is an immunomodulatory drug used to treat an increasing spectrum of diseases in dogs. Cyclosporine is a calcineurin inhibitor, ultimately exerting its inhibitory effects on T-lymphocytes by decreasing production of cytokines, such as interleukin-2. Although, in the United States, oral cyclosporine is approved in dogs only for treatment of atopic dermatitis, there are many other indications for its use. Cyclosporine is available in 2 oral formulations: the original oil-based formulation and the more commonly used ultramicronized emulsion that facilitates oral absorption. Ultramicronized cyclosporine is available as an approved animal product, and human proprietary and generic preparations are also available. Bioavailability of the different formulations in dogs is likely to vary among the preparations. Cyclosporine is associated with a large number of drug interactions that can also influence blood cyclosporine concentrations. Therapeutic drug monitoring (TDM) can be used to assist in attaining consistent plasma cyclosporine concentrations despite the effects of varying bioavailability and drug interactions. TDM can facilitate therapeutic success by guiding dose adjustments on an individualized basis, and is recommended in cases that do not respond to initial oral dosing, or during treatment of severe, life-threatening diseases for which a trial-and-error approach to dose adjustment is too risky. Pharmacodynamic assays that evaluate individual patient immune responses to cyclosporine can be used to augment information provided by TDM.
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Affiliation(s)
- T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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Dye T, Diehl K, Wheeler S, Westfall D. Randomized, Controlled Trial of Budesonide and Prednisone for the Treatment of Idiopathic Inflammatory Bowel Disease in Dogs. J Vet Intern Med 2013; 27:1385-91. [DOI: 10.1111/jvim.12195] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/11/2013] [Accepted: 08/08/2013] [Indexed: 01/06/2023] Open
Affiliation(s)
- T.L. Dye
- Animal Medical Specialists; VRCC; Englewood CO
| | - K.J. Diehl
- Animal Medical Specialists; VRCC; Englewood CO
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Shen Z, He H, Wu Y, Li J. Cyclosporin a inhibits rotavirus replication and restores interferon-beta signaling pathway in vitro and in vivo. PLoS One 2013; 8:e71815. [PMID: 23990993 PMCID: PMC3749198 DOI: 10.1371/journal.pone.0071815] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 07/02/2013] [Indexed: 12/13/2022] Open
Abstract
Rotavirus (RV) is the most common cause of severe diarrhea among infants and young children. Currently, there is no specific drug available against rotavirus, largely due to the lack of an ideal target molecule which has hampered drug development. Our previous studies have revealed that cyclosporin A (CsA) might be potentially useful as an anti-RV drug. We therefore used both cellular and mouse models to study the immunological safety and effectiveness of CsA as an anti-RV drug. We found that CsA treatment of HT-29 cells before, during, and after viral infection efficiently inhibited Wa strain RV replication and restored IFN-β expression in a HT-29 cell line model. Exploring the underlying mechanisms showed that CsA promoted Interferon Regulatory Factor-5 (IRF-5) expression (a key positive regulator of the type I IFN signaling pathway), but not IRF-1, IRF-3, or IRF-7. Additionally, CsA inhibited SOCS-1 expression (the key negative regulator of IFN-α/β), but not SOCS-2 or SOCS-3. The antiviral effect of CsA was confirmed in an RV-infected neonatal mouse model by evaluation of antigen clearance and assessment of changes in intestinal tissue pathology. Also, no differences in T cell frequency or proliferation between the CsA- and vehicle-treated groups were observed. Thus, both our in vitro and in vivo findings suggest that CsA, through modulating the expression of key regulators in IFN signaling pathway, promote type I IFN-based intracellular innate immunity in RV host cells. These findings suggest that CsA may be a useful candidate to develop a new anti-RV strategy, although further evaluation and characterization of CsA on RV-induced diarrhea are warranted.
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Affiliation(s)
- Zigang Shen
- Institute of Immunology, PLA, Third Military Medical University, Chongqing, PR China
| | - Haiyang He
- Institute of Immunology, PLA, Third Military Medical University, Chongqing, PR China
| | - Yuzhang Wu
- Institute of Immunology, PLA, Third Military Medical University, Chongqing, PR China
- * E-mail: (YW); (JL)
| | - Jintao Li
- Institute of Immunology, PLA, Third Military Medical University, Chongqing, PR China
- * E-mail: (YW); (JL)
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Jung DI, Lee HC, Ha J, Jung HW, Jeon JH, Moon JH, Lee JH, Kim NH, Sur JH, Kang BT, Cho KW. Unsuccessful cyclosporine plus prednisolone therapy for autoimmune meningoencephalitis in three dogs. J Vet Med Sci 2013; 75:1661-5. [PMID: 23955394 PMCID: PMC3942949 DOI: 10.1292/jvms.12-0503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 4-year-old female Maltese (case 1), a 9-year-old castrated male shih tzu (case 2) and
2-year-old female Pomeranian (case 3) presented with neurological signs, such as head
tilt, ataxia, circling and paresis. The three cases were tentatively diagnosed as having
meningoencephalitis of unknown etiology based on computed tomography scan and
cerebrospinal fluid analysis. All patients were managed with cyclosporine plus
prednisolone therapy. The survival times of the three patients were 170, 70 and 21 days,
respectively. After the cases died, we performed necropsy and histopathological
examination for definitive diagnosis. Based on the necropsy, histopathological and
immunohistochemical examinations, cases 1, 2 and 3 were definitely diagnosed as having
necrotizing meningoencephalitis, necrotizing leukoencephalitis and granulomatous
meningoencephalitis, respectively. This case report demonstrated the clinical findings,
brain CT characteristics and histopathological and immunohistochemical features of NME,
NLE and GME in dogs and discussed the reason for the relatively short survival times under
cyclosporine plus prednisolone therapy.
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Affiliation(s)
- Dong-In Jung
- Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University, Jinju 660-701, South Korea
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Abstract
Laboratory tests are an important part of the workup of small intestinal diseases in dogs and cats. Especially in chronic cases, when extragastrointestinal causes need to be ruled out, it is important to adhere to a systematic workup. This article details the newest available data on tests to aid this diagnostic process. Once the diagnosis of a chronic enteropathy is made, there are many laboratory tests that can help in monitoring the disease and providing prognostic information. Several new tests being evaluated for clinical usefulness are discussed.
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Affiliation(s)
- Karin Allenspach
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield AL9 7PT, UK.
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Abstract
Treatment of immune-mediated disease in dogs and cats continues to evolve as new therapies are introduced or adapted from human medicine. Glucocorticoids remain the first-line therapy for many of the immune-mediated or inflammatory diseases of cats and dogs. The focus of this article is to provide an update on some of the common immunosuppressive therapies used in small animal veterinary medicine. The goals of therapy are to induce disease remission through the inhibition of inflammation and the modulation of lymphocyte function.
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Affiliation(s)
- Katrina R Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA.
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Dandrieux JRS, Noble PJM, Scase TJ, Cripps PJ, German AJ. Comparison of a chlorambucil-prednisolone combination with an azathioprine-prednisolone combination for treatment of chronic enteropathy with concurrent protein-losing enteropathy in dogs: 27 cases (2007–2010). J Am Vet Med Assoc 2013; 242:1705-14. [DOI: 10.2460/javma.242.12.1705] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Walker D, Knuchel-Takano A, McCutchan A, Chang YM, Downes C, Miller S, Stevens K, Verheyen K, Phillips A, Miah S, Turmaine M, Hibbert A, Steiner J, Suchodolski J, Mohan K, Eastwood J, Allenspach K, Smith K, Garden O. A Comprehensive Pathological Survey of Duodenal Biopsies from Dogs with Diet-Responsive Chronic Enteropathy. J Vet Intern Med 2013; 27:862-74. [DOI: 10.1111/jvim.12093] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/15/2013] [Accepted: 03/13/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- D. Walker
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A. Knuchel-Takano
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A. McCutchan
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - Y-M. Chang
- Research Office; The Royal Veterinary College; London UK
| | - C. Downes
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - S. Miller
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Stevens
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Verheyen
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A.D. Phillips
- Institute of Child Health; University College London; Royal Free Hospital; London UK
| | - S. Miah
- Institute of Orthopaedics and Musculoskeletal Science; University College London; Royal National Orthopaedic Hospital; Stanmore UK
| | - M. Turmaine
- Division of Biosciences; Medical Sciences Building; University College London; London UK
| | - A. Hibbert
- Department of Comparative Biomedical Sciences; The Royal Veterinary College; Royal College Street; London UK
| | - J.M. Steiner
- Gastrointestinal Laboratory; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX
| | - J.S. Suchodolski
- Gastrointestinal Laboratory; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX
| | - K. Mohan
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - J. Eastwood
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Allenspach
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Smith
- Department of Pathology and Infectious Diseases; The Royal Veterinary Col-lege; Hatfield UK
| | - O.A. Garden
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
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Okanishi H, Sano T, Yamaya Y, Kagawa Y, Watari T. The characteristics of short- and long-term surviving Shiba dogs with chronic enteropathies and the risk factors for poor outcome. Acta Vet Scand 2013; 55:32. [PMID: 23594569 PMCID: PMC3640937 DOI: 10.1186/1751-0147-55-32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 03/24/2013] [Indexed: 11/15/2022] Open
Abstract
Background The objectives of this study were to investigate the differences in the characteristics of short- and long-term surviving dogs, and the factors that predict poor outcome in Shiba dogs with chronic enteropathies (CE). Methods A total of 25 Shiba dogs were included in this study, and classified as either short-term (≤6 months) survivors (Ss; n=16) or long-term (>6 months) survivors (Ls; n=9). The clinical and clinicopathological variables, histopathology, response to therapy, and outcomes were investigated between groups. Furthermore, these factors were tested for their ability to predict poor outcome. Results All CE dogs were diagnosed as having inflammatory bowel disease (IBD) with lymphocytic-plasmacytic enteritis (LPE). Age and canine inflammatory bowel disease activity index (CIBDAI) were significantly higher in the Ss group than in the Ls group (age: p = 0.035, CIBDAI: p = 0.018), as determined via univariate logistic regression analysis. According to receiver operator characteristic (ROC) curve analysis, the best predictors of poor outcome were age and CIBDAI, with the cutoffs determined as 7 years and 9 points, respectively. The majority of the cases (84%) responded to initial treatment; in particular, 75% of dogs in Ss group responded to therapy. The time to response (days) to the initial treatment in the Ss group (median 42.5 days, range: 20-91 days) was significantly shorter than that of the Ls group (median 285 days, range: 196-1026 days). Approximately half (55.5%) of the dogs in the Ls group died due to relapse of CE. Conclusions This study suggested that there is a high risk of early mortality in Shiba dogs with CE, particularly if the dogs are older (>7 years) and have a high CIBDAI score (>9 points). There appears to be a possibility of early mortality even if the initial treatment was efficacious. Furthermore, Shiba dogs with CE that become less responsive to initial therapy in the short-term (approximately 3 months) are more likely to have an early mortality. Thus, it is necessary to follow-up Shiba dogs with CE in the long-term, as approximately half of the long-term survivors eventually died due to a relapse of the signs.
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Thomason J, Lunsford K, Stokes J, Pinchuk L, Wills R, Langston C, Pruett S, Mackin A. The Effects of Cyclosporine on Platelet Function and Cyclooxygenase Expression in Normal Dogs. J Vet Intern Med 2012; 26:1389-401. [DOI: 10.1111/j.1939-1676.2012.01025.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 08/10/2012] [Accepted: 09/10/2012] [Indexed: 11/29/2022] Open
Affiliation(s)
- J. Thomason
- Department of Clinical Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - K. Lunsford
- Department of Clinical Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - J. Stokes
- Department of Basic Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - L. Pinchuk
- Department of Basic Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - R. Wills
- Department of Pathobiology and Population Medicine; College of Veterinary Medicine, Mississippi State University; Mississippi State; MS
| | - C. Langston
- Department of Clinical Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - S. Pruett
- Department of Basic Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
| | - A. Mackin
- Department of Clinical Sciences, College of Veterinary Medicine; Mississippi State University; Mississippi State; MS
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Jergens AE. Feline idiopathic inflammatory bowel disease: what we know and what remains to be unraveled. J Feline Med Surg 2012; 14:445-58. [PMID: 22736679 PMCID: PMC10822384 DOI: 10.1177/1098612x12451548] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Feline idiopathic inflammatory bowel disease (IBD) denotes one form of chronic enteropathy that is immunologically mediated and characterized by persistent or recurrent gastrointestinal (GI) signs and histologic inflammation. Signs of vomiting, diarrhea and weight loss generally predominate, and mucosal inflammation may occur in any portion of the GI tract (especially the small intestine). Affected cats may also have concurrent inflammation in other organs, such as the pancreas and liver, which may impact clinical disease severity. CLINICAL CHALLENGES The exact etiologies of this heterogeneous group of disorders have yet to be determined, though results from basic science and clinical studies suggest that interplay between genetic factors and enteric bacteria is crucial for disease development. The diagnosis is one of exclusion and requires intestinal mucosal biopsy to characterize the type and severity of the inflammatory infiltrate, and to differentiate IBD from other disorders, including alimentary lymphoma. Controversy exists concerning the relative diagnostic accuracy of endoscopic versus full-thickness specimens for the diagnosis of IBD and its differentiation from alimentary lymphoma. AUDIENCE This article is intended to provide veterinary practitioners with a comprehensive clinical update on idiopathic IBD in cats. It reviews the current evidence-based data, the diagnostic approach, the evolving histologic criteria, and treatment options and outcome for feline patients with this syndrome.
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Affiliation(s)
- Albert E Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
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Digestive System, Liver, and Abdominal Cavity. THE CAT 2012. [PMCID: PMC7158306 DOI: 10.1016/b978-1-4377-0660-4.00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Maeda S, Ohno K, Nakamura K, Uchida K, Nakashima K, Fukushima K, Tsukamoto A, Goto-Koshino Y, Fujino Y, Tsujimoto H. Quantification of chemokine and chemokine receptor gene expression in duodenal mucosa of dogs with inflammatory bowel disease. Vet Immunol Immunopathol 2011; 144:290-8. [DOI: 10.1016/j.vetimm.2011.08.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 08/24/2011] [Accepted: 08/29/2011] [Indexed: 10/17/2022]
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Archer TM, Fellman CL, Stokes JV, Pinchuk LM, Lunsford KV, Pruett SB, Langston VC, Mackin AJ. Pharmacodynamic monitoring of canine T-cell cytokine responses to oral cyclosporine. J Vet Intern Med 2011; 25:1391-7. [PMID: 22092633 DOI: 10.1111/j.1939-1676.2011.00797.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 07/01/2011] [Accepted: 08/09/2011] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pharmacodynamic assays measure the immunosuppressive effects of cyclosporine on T-cells and offer an alternative assessment of efficacy in individual patients. OBJECTIVE To assess the immunosuppressive effects of high and low dosage cyclosporine on canine T-cells and to develop a novel testing system for individualized dose adjustment. ANIMALS Seven healthy female Walker hounds. METHODS Experimental study using a paired comparison design. Flow cytometry was used to measure T-cell expression of IL-2, IL-4, and IFN-γ. Cytokine expression 8 days after oral administration of high and low dosages of cyclosporine was compared to baseline and washout values, respectively. The high dosage was initially 10 mg/kg q12h and was then adjusted to attain established immunosuppressive trough blood drug concentrations (>600 ng/mL). The low dosage was 5 mg/kg q24h. RESULTS High dosage cyclosporine resulted in significant decreases in IL-2 and IFN-γ expression (P = .0156, P = .0156), but not IL-4 expression (P = .2188). Low dosage cyclosporine was associated with a significant decrease in IFN-γ expression (P = .0156), while IL-2 expression was not affected (P = .1094). CONCLUSIONS AND CLINICAL IMPORTANCE T-cell function is suppressed at trough blood drug concentrations exceeding 600 ng/mL, and is at least partially suppressed in some dogs at low dosages. Direct evaluation of T-cell function could be an effective, more sensitive alternative to measuring blood drug concentrations for monitoring immunosuppressive therapy.
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Affiliation(s)
- T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA.
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Simpson KW, Jergens AE. Pitfalls and progress in the diagnosis and management of canine inflammatory bowel disease. Vet Clin North Am Small Anim Pract 2011; 41:381-98. [PMID: 21486642 DOI: 10.1016/j.cvsm.2011.02.003] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Inflammatory bowel disease (IBD) is the collective term for a group of chronic enteropathies characterized by persistent or recurrent gastrointestinal (GI) signs and inflammation of the GI tract. The specific steps that lead to IBD and the basis for phenotypic variation and unpredictable responses to treatment are not known. This article examines IBD in dogs, focusing on the interaction between genetic susceptibility and the enteric microenvironment (bacteria, diet), the utility of recently developed histologic criteria, the prognostic indicators, and the standardized approaches to treatment.
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Affiliation(s)
- Kenneth W Simpson
- Veterinary Clinical Sciences, College of Veterinary Medicine, Cornell University, VMC2001, Ithaca, NY 14853, USA.
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