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Jablonski SA, Mazepa ASW, Tolbert MK. Use of octreotide for the treatment of protein-losing enteropathy in dogs: Retrospective study of 18 cases. J Vet Intern Med 2024; 38:145-151. [PMID: 38038236 PMCID: PMC10800202 DOI: 10.1111/jvim.16966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND More than 50% of dogs with protein-losing enteropathy (PLE) fail to respond to standard therapies. Octreotide, a somatostatin analogue, is used in cases of intestinal lymphangiectasia (IL) in humans with some success. OBJECTIVES Describe the use of octreotide in dogs with PLE including reason for and details of prescription, adverse effects, and apparent response. ANIMALS Eighteen dogs with PLE, 13 with histopathology available. Ninety-two percent (12/13) had IL diagnosed on biopsy. All 13 dogs had intestinal inflammatory infiltrates noted. METHODS Multicenter, retrospective, descriptive study. Cases were volunteered for inclusion by individual attending veterinarians who reported the use of octreotide in cases of PLE. RESULTS In 16/18 (89%) cases octreotide was prescribed to PLE dogs with a clinical suspicion or confirmed diagnosis of IL that were refractory to standard therapies. Median serum albumin at the time of octreotide prescription was 1.7 g/dL (range, 1.0-3.1 g/dL). The median dose of octreotide prescribed was 20 μg/kg, SQ, daily with a range of 4-39 μg/kg, SQ, daily. Adverse effects were noted in 3/18 (17%, 95% CI [4%, 41%]) of dogs; discontinuation of the drug was necessary in 1 dog. Improvement in clinical signs was noted in 6/12 (50%, 95% CI [21%, 79%]). CONCLUSIONS AND CLINICAL IMPORTANCE Octreotide was most commonly prescribed to dogs with PLE and suspected or confirmed IL that had failed to respond to standard therapies. Though a benefit to PLE dogs cannot be confirmed, octreotide was well tolerated by the majority of dogs at the doses prescribed in this study.
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Affiliation(s)
- Sara A. Jablonski
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast LansingMichiganUSA
| | | | - M. Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
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McAtee R, Schmid SM, Tolbert MK, Hetzel S, Suchodolski JS, Pritchard JC. Effect of esomeprazole with and without a probiotic on fecal dysbiosis, intestinal inflammation, and fecal short-chain fatty acid concentrations in healthy dogs. J Vet Intern Med 2023; 37:2109-2118. [PMID: 37776099 PMCID: PMC10658524 DOI: 10.1111/jvim.16886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Proton pump inhibitors can cause diarrhea and a transient increase in fecal dysbiosis index in dogs. It is unknown if concurrent probiotic administration mitigates these effects. OBJECTIVE/HYPOTHESIS To assess the fecal Canine Microbial Dysbiosis Index (CMDI), fecal short chain fatty acid (SCFA), and fecal calprotectin concentrations in dogs administered esomeprazole with and without a probiotic. ANIMALS Eleven healthy dogs. METHODS Prospective, within-subjects before and after study. All dogs received 7-day courses of esomeprazole (1 mg/kg PO q 24h) alone followed by esomeprazole with a probiotic (15 billion CFU/kg), separated by a 4-week washout period. Data were compared between phases using mixed effects ANOVA or generalized estimating equations with post-hoc Holm adjustment for 2-way comparisons. RESULTS Compared to baseline (mean CMDI -2.66, SD 3.04), fecal CMDI was not different with esomeprazole administration alone (mean CMDI -1.48, SD 3.32, P = .08), but there was a significant increase (Diff 3.05, 95% CI [1.37, 4.74], P < .001, Effect size 2.02) when esomeprazole and a probiotic were administered concurrently (mean CMDI 0.39, SD 2.83). CMDI was significantly higher when esomeprazole was administered with a probiotic than alone (Diff 1.87, 95% CI [0.19, 1.87], P = .02, Effect size 1.24). Fecal calprotectin and SCFA concentrations did not differ between phases. The occurrence of vomiting and diarrhea was not different from baseline when esomeprazole was administered alone (36%/27%) or with a probiotic (46%/9%). CONCLUSIONS AND CLINICAL IMPORTANCE In healthy dogs, concurrent administration of a probiotic is unlikely to lessen adverse effects associated with esomeprazole administration.
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Affiliation(s)
- Rae McAtee
- Department of Medical SciencesUniversity of Wisconsin‐Madison School of Veterinary MedicineMadisonWisconsinUSA
| | - Sarah M. Schmid
- Department of Small Animal Clinical SciencesUniversity of Tennessee Knoxville College of Veterinary MedicineKnoxvilleTennesseeUSA
| | - M. Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical SciencesSchool of Veterinary Medicine & Biomedical Sciences, Texas A&M UniversityCollege StationTexasUSA
| | - Scott Hetzel
- Department of Biostatistics and Medical InformaticsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical SciencesSchool of Veterinary Medicine & Biomedical Sciences, Texas A&M UniversityCollege StationTexasUSA
| | - Jessica C. Pritchard
- Department of Medical SciencesUniversity of Wisconsin‐Madison School of Veterinary MedicineMadisonWisconsinUSA
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Grady K, Ernst E, Secoura PL, Price J, Birkenheuer A, Vaden SL, Lidbury J, Gould E, Steiner JM, Tolbert MK. Gastric pH and serum gastrin concentration in age-matched healthy dogs and dogs with chronic kidney disease. J Vet Intern Med 2023; 37:2119-2124. [PMID: 37874019 PMCID: PMC10658589 DOI: 10.1111/jvim.16907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Gastric hyperacidity and hypergastrinemia are purported to cause gastric ulceration in dogs with chronic kidney disease (CKD); however, no published studies have evaluated gastric pH with serum gastrin concentrations in dogs with CKD. HYPOTHESIS To compare mean intragastric pH, mean percent pH distribution, and serum gastrin concentrations in dogs with CKD to age-matched, healthy dogs. We hypothesized there would be no difference in mean gastric pH or serum gastrin between groups. ANIMALS Thirteen dogs with CKD; 10 aged-matched healthy dogs. METHODS Prospective, case-control study. Serum chemistry, complete blood count, urinalysis, and serum gastrin concentrations were evaluated in all dogs before radiographic-assisted gastric placement of a pH capsule. Forty-eight-hour continuous gastric pH monitoring was performed in all dogs. Serum gastrin concentration, mean pH, and mean percentage time that gastric pH was strongly acidic (pH <1 and pH <2) were compared between groups using a repeated measures mixed-model ANOVA. RESULTS No significant differences were observed between groups for any pH measurements, including mean ± SD gastric pH (CKD, 2.37 ± 0.87; healthy, 2.39 ± 0.99; P > .05). Serum gastrin concentrations were not significantly different between groups (median [range]: CKD, 10.5 ng/dL [<10-17.1]; healthy, 10.9 ng/dL [<10-15]; P > .05). CONCLUSIONS AND CLINICAL IMPORTANCE Our client-owned dogs with CKD did not have lower gastric pH or higher serum gastrin concentrations compared to healthy dogs. Our results suggest that prophylactic gastric acid suppression in dogs with CKD is not warranted unless other clinical indications for use are present.
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Affiliation(s)
- Kylie Grady
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Eli Ernst
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
- Present address:
Care CenterDaytonOhioUSA
| | - Patricia L. Secoura
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Josh Price
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineUniversity of TennesseeKnoxvilleTennesseeUSA
| | - Adam Birkenheuer
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Shelly L. Vaden
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Jonathan Lidbury
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Emily Gould
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Joerg M. Steiner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - M. Katherine Tolbert
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
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Ellis C, Odunayo A, Tolbert MK. The use of metronidazole in acute diarrhea in dogs: a narrative review. Top Companion Anim Med 2023; 56-57:100824. [PMID: 37884173 DOI: 10.1016/j.tcam.2023.100824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 10/28/2023]
Abstract
Acute diarrhea is a common reason for non-wellness veterinary visits in dogs. Treatment for acute diarrhea usually consists of supportive care with nutritional intervention, fluid therapy, anthelmintics, and often an antibiotic - commonly metronidazole in North America. The empirical use of metronidazole for acute diarrhea in dogs has been a common practice in veterinary medicine for many decades; however, recent studies evaluating its use suggest it may be inappropriately utilized in many cases. Herein, we review the evidence evaluating the use of metronidazole and other antibiotics in acute diarrhea in the human and veterinary literature. Recommendations on the use of metronidazole and other antibiotics as well as other therapeutic considerations in the treatment of acute diarrhea are also provided.
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Affiliation(s)
- Connor Ellis
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA.
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Mabry K, Davis MS, Gould E, Gogal RM, Steiner JM, Tolbert MK, Hill TL. Assessment of gastrointestinal health in racing Alaskan sled dogs using capsule endoscopy and inflammatory cytokines. J Small Anim Pract 2023; 64:574-580. [PMID: 37211353 DOI: 10.1111/jsap.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/30/2023] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Exercise-induced gastrointestinal syndrome occurs in dogs and people and might compromise athlete performance by increasing intestinal permeability and causing gastrointestinal erosions. Racing sled dogs often receive acid suppressant prophylaxis which decreases the incidence of gastric erosions induced by exercise. The objectives were to quantify intestinal injury by measuring serum pro-inflammatory cytokine concentrations before and after exercise and to evaluate gastrointestinal mucosa using video capsule endoscopy after exercise. MATERIALS AND METHODS Prospective study of 12 racing Alaskan sled dogs receiving approximately 1 mg/kg omeprazole once daily from the day before the race until race completion. Blood was drawn before and 8 to 10 hours after an endurance race for the quantification of cytokines. Gastrointestinal tract mucosa was assessed with video capsule endoscopy immediately post-race. RESULTS Eight of nine dogs (89%; 95% confidence interval 52 to 100%) had gastric erosions; all dogs (100%, 95% confidence interval 63 to 100%) had small intestinal erosions. Most of the dogs (seven of nine) had straw or foreign material present. Cytokine levels were not different from before to after the race. CLINICAL SIGNIFICANCE Video capsule endoscopy identified gastrointestinal tract mucosal erosions after exercise in all dogs receiving once-daily omeprazole treatment, though other causes for the lesions besides exercise are possible.
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Affiliation(s)
- K Mabry
- Internal Medicine, South Carolina Veterinary Specialists and Emergency Care, Columbia, SC, 29210, USA
| | - M S Davis
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, 74078, USA
| | - E Gould
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, 77843, USA
| | - R M Gogal
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia, Athens, GA, 30605, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, 77843, USA
| | - M K Tolbert
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, 77843, USA
| | - T L Hill
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA
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Zhang Y, Kirk CA, Tolbert MK, Steiner JM, Donohoe D, Murphy M, Springer C, Witzel-Rollins A. Impact of fatty acid composition on markers of exocrine pancreatic stimulation in dogs. PLoS One 2023; 18:e0290555. [PMID: 37624816 PMCID: PMC10456140 DOI: 10.1371/journal.pone.0290555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic pancreatitis in dogs is typically managed with a low-fat diet. Human research suggests that consumption of medium-chain triglycerides (MCT) may lessen pancreatic enzyme release compared to consumption of long-chain fatty acids (LCFA). Twelve healthy adult colony dogs were fed a meal of cod and rice with either 3% metabolizable energy (ME) fat (control), high MCT (25% ME MCT oil, 25% ME butter), high saturated LCFA (50% ME butter), or high unsaturated LCFA (50% ME canola oil) in a 4-period by 4-treatment crossover design. Serum concentrations of canine pancreatic lipase immunoreactivity, gastrin, cholesterol, triglycerides, and serum activities of amylase and DGGR lipase (1,2-o-dilauryl-rac-glycero-3-glutaric acid-(69-methylresorufin) ester lipase) were measured at times 0 (fasted), 30, 120 and 180 minutes post-prandially. Following a 3-or 4-day wash-out period, each dog was assigned a new diet and the process was repeated for all treatments. Data were analyzed as a repeated-measures mixed model ANOVA. Post-hoc pairwise comparisons were run using Tukey-Kramer adjusted p-values. Shapiro-Wilk tests were used to evaluate residual normality. All statistical assumptions were sufficiently met. Statistical significance was defined as P<0.05. Of the markers tested, only serum triglyceride concentrations were affected by treatment, with consumption of high MCT resulting in lower triglycerides than both LCFA groups at times 120 and 180 minutes (P<0.0001). As expected, the high MCT group had higher triglycerides compared to the control group (P<0.0001). The type of dietary fat consumed had little acute impact on most markers of exocrine pancreatic stimulation in healthy dogs.
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Affiliation(s)
- Yunyi Zhang
- Department of Small Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, United States of America
| | - Claudia A. Kirk
- Department of Small Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, United States of America
| | - M. Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Jörg M. Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Dallas Donohoe
- Department of Nutrition, The University of Tennessee, Knoxville, Tennessee, United States of America
| | - Maryanne Murphy
- Department of Small Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, United States of America
| | - Cary Springer
- Research Computing Support, Office of Information Technology, The University of Tennessee, Knoxville, Tennessee, United States of America
| | - Angela Witzel-Rollins
- Department of Small Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, United States of America
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Sung CH, Pilla R, Chen CC, Ishii PE, Toresson L, Allenspach-Jorn K, Jergens AE, Summers S, Swanson KS, Volk H, Schmidt T, Stuebing H, Rieder J, Busch K, Werner M, Lisjak A, Gaschen FP, Belchik SE, Tolbert MK, Lidbury JA, Steiner JM, Suchodolski JS. Correlation between Targeted qPCR Assays and Untargeted DNA Shotgun Metagenomic Sequencing for Assessing the Fecal Microbiota in Dogs. Animals (Basel) 2023; 13:2597. [PMID: 37627387 PMCID: PMC10451198 DOI: 10.3390/ani13162597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
DNA shotgun sequencing is an untargeted approach for identifying changes in relative abundances, while qPCR allows reproducible quantification of specific bacteria. The canine dysbiosis index (DI) assesses the canine fecal microbiota by using a mathematical algorithm based on qPCR results. We evaluated the correlation between qPCR and shotgun sequencing using fecal samples from 296 dogs with different clinical phenotypes. While significant correlations were found between qPCR and sequencing, certain taxa were only detectable by qPCR and not by sequencing. Based on sequencing, less than 2% of bacterial species (17/1190) were consistently present in all healthy dogs (n = 76). Dogs with an abnormal DI had lower alpha-diversity compared to dogs with normal DI. Increases in the DI correctly predicted the gradual shifts in microbiota observed by sequencing: minor changes (R = 0.19, DI < 0 with any targeted taxa outside the reference interval, RI), mild-moderate changes (R = 0.24, 0 < DI < 2), and significant dysbiosis (R = 0.54, 0.73, and 0.91 for DI > 2, DI > 5, and DI > 8, respectively), compared to dogs with a normal DI (DI < 0, all targets within the RI), as higher R-values indicated larger dissimilarities. In conclusion, the qPCR-based DI is an effective indicator of overall microbiota shifts observed by shotgun sequencing in dogs.
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Affiliation(s)
- Chi-Hsuan Sung
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Rachel Pilla
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Chih-Chun Chen
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Patricia Eri Ishii
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Linda Toresson
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, 00014 Helsinki, Finland
- Evidensia Specialist Animal Hospital, 25466 Helsingborg, Sweden
| | - Karin Allenspach-Jorn
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Stacie Summers
- Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
| | - Kelly S. Swanson
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61820, USA
| | - Holger Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, 30545 Hannover, Germany
| | - Teresa Schmidt
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, 30545 Hannover, Germany
| | - Helene Stuebing
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, 80539 Munich, Germany
| | - Johanna Rieder
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, 30545 Hannover, Germany
| | - Kathrin Busch
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, 80539 Munich, Germany
| | - Melanie Werner
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, 8057 Zurich, Switzerland
| | - Anja Lisjak
- Small Animal Clinic of Veterinary Faculty Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Frederic P. Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Sara E. Belchik
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61820, USA
| | - M. Katherine Tolbert
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Jonathan A. Lidbury
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Joerg M. Steiner
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77840, USA; (C.-H.S.)
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Mehra JM, Tolbert MK, Guadiano P, Steiner JM, Moore GE, Lewis MJ. Double-blinded placebo-controlled clinical trial of prophylactic omeprazole in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2023; 37:586-597. [PMID: 36772892 DOI: 10.1111/jvim.16642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/27/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Proton pump inhibitors are administered prophylactically in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion (TL-IVDE). However, their efficacy in decreasing gastrointestinal (GI) complications is unknown. HYPOTHESIS Omeprazole does not decrease the frequency of GI complications compared to placebo in dogs treated surgically for acute TL-IVDE. ANIMALS Thirty-seven client-owned dogs undergoing hemilaminectomy for acute TL-IVDE. METHODS Randomized double-blinded placebo-controlled prospective clinical trial. Dogs received PO placebo or omeprazole at 1 mg/kg q12h for 5 days during hospitalization. Development of GI signs (e.g., diarrhea, vomiting, regurgitation, hematochezia, melena) was recorded daily. Clinicopathologic testing performed during hospitalization and at 2 and 4-week re-evaluations included: fecal occult blood, PCV, blood urea nitrogen/creatinine ratio, fecal calprotectin, canine pancreatic lipase immunoreactivity and fecal alpha-1 proteinase inhibitor concentrations. Omeprazole and placebo groups were compared using chi-squared or Fisher's exact tests. RESULTS Gastrointestinal signs developed in 10/20 (50%) dogs in the omeprazole group and in 7/17 (41%) dogs in the placebo group (P = .59). Diarrhea was common (8/20 omeprazole, 5/17 placebo), hematochezia was rare (1/20 omeprazole, 1/17 placebo); melena was not observed. Clinicopathologic evidence suggestive of bleeding was present in 9/20 dogs treated with omeprazole and in 11/17 dogs that received placebo (P = .23). Fecal occult blood positivity was more common in dogs with GI signs (P = .03). Canine pancreatic lipase immunoreactivity was higher during hospitalization compared to re-evaluations (P = .01). CONCLUSIONS AND CLINICAL IMPORTANCE Short-term, prophylactic omeprazole treatment did not decrease clinically detectable GI complications in dogs with acute TL-IVDE.
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Affiliation(s)
- Jaya M Mehra
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Phillip Guadiano
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - George E Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Melissa J Lewis
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
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Gould EN, Szule JA, Wilson-Robles H, Steiner JM, Lennon EM, Tolbert MK. Esomeprazole induces structural changes and apoptosis and alters function of in vitro canine neoplastic mast cells. Vet Immunol Immunopathol 2023; 256:110539. [PMID: 36592548 DOI: 10.1016/j.vetimm.2022.110539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Histamine-2 receptor antagonists such as famotidine and proton pump inhibitors such as esomeprazole are commonly used in canine MCT disease, but direct effects on dog MCs have not been evaluated. Omeprazole is a proton pump inhibitor which has been demonstrated to cause structural and functional changes to in vitro murine mast cells (MCs). It has not yet been determined if esomeprazole, the commercially available and commonly prescribed S-isomer of omeprazole, has similar effects. Our primary study objective was to evaluate and compare the effects of acid suppressants (esomeprazole and famotidine) on MC ultrastructure, viability, and function in vitro using both healthy and neoplastic MCs. Murine bone marrow derived mast cells (BMMC), human LAD2, and canine C2 and BR cells, were used for these studies, representing a single healthy (i.e., BMMCs) MC model and multiple neoplastic MC models (i.e., LAD2, C2, BR), respectively. The rat basophilic leukemic (RBL-2H3) and canine B cell lymphoma 17-71 cell lines served as granulocytic and agranulocytic control lines for experiments, respectively. The treatment effect of acid suppressants on MC ultrastructure was assessed via both light and transmission electron microscopy. Differences in MC viability was assessed between groups via MTS-based, colorimetric assays and flow cytometry. Degranulation was assessed by quantification of β-hexosaminidase (i.e., LAD2 and RBL-2H3). Esomeprazole-treated MCs of all lines exhibited dramatic time and concentration-dependent alterations in ultrastructure (i.e., increased vacuolization, compromise of cell membrane), increased apoptosis, and altered degranulation responses in comparison to famotidine and vehicle-treated cells. The canine B cell lymphoma cells consistently exhibited either no significant (i.e., cytotoxicity assays) or greatly diminished treatment responses (i.e., apoptosis) compared to MCs. Esomeprazole, but not famotidine, induces significant cytotoxicity, as well as alterations to cell structure and function to multiple lines of in vitro neoplastic MCs. Continued in vitro work investigating the specific mechanisms by which proton pump inhibitors induce these effects, as well as prospective, in vivo work comparing the treatment effects of acid suppressants on canine MCTs, are warranted.
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Affiliation(s)
- Emily N Gould
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA.
| | - Joseph A Szule
- Department of Veterinary Pathobiology, Image Analysis Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4461 TAMU, College Station, TX 77843, USA.
| | - Heather Wilson-Robles
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 408 Raymond Stotzer Parkway, College Station, TX 77845, USA.
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA.
| | - Elizabeth M Lennon
- Department of Small Animal Clinical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104, USA.
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA.
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10
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Langlois DK, Pritchard JC, Tolbert MK, Jergens AE, Block G, Hanzlicek AS, Jaffey JA, Steiner JM, Marsilio S, Jablonski SA. Clinical utility of an immunoglobulin A-based serological panel for the diagnosis of chronic enteropathy in dogs. Vet Med (Auckl) 2023; 37:446-454. [PMID: 36708202 DOI: 10.1111/jvim.16636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/06/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND A panel of IgA-based serologic assays might aid in the diagnosis of chronic enteropathy (CE) in dogs, a syndrome encompassing conditions such as food-responsive enteropathy, immunosuppressant-responsive enteropathy, and inflammatory bowel disease (also referred to as chronic inflammatory enteropathy). However, it is unclear whether these biomarkers discriminate between CE and other types of primary intestinal disorders. OBJECTIVES To evaluate a diagnostic panel that measures serum concentrations of IgA directed against OmpC (ACA), canine calprotectin (ACNA), and gliadin-derived peptides (AGA) in dogs with well-characterized intestinal diseases. ANIMALS Fifty-five dogs with primary intestinal disease. METHODS Serum ACA, ACNA, and AGA concentrations were measured in 30 dogs with CE and 25 dogs with other intestinal diseases (non-CE population), including histoplasmosis, parasitism, E. coli-associated granulomatous colitis, and lymphoma. Serum IgA concentrations were compared among populations, and sensitivities and specificities were calculated using laboratory-provided cut-points. RESULTS Twenty-six of 30 (87%) CE dogs and 21 of 25 (84%) non-CE dogs had abnormal concentrations (intermediate or high) of at least 2 markers; these proportions were not significantly different (P = .99). A serum ACA concentration ≥15 EU/mL was 86.7% (95% confidence interval [CI], 69.3%-96.2%) sensitive and 24.0% (95% CI, 9.4%-45.1%) specific for CE diagnosis. High AGA concentrations were observed in 16 of 25 (64%) non-CE dogs. CONCLUSIONS AND CLINICAL IMPORTANCE The evaluated serologic markers were poorly specific for CE diagnosis, which raises concerns that their use in clinical practice might lead to misdiagnoses and delayed or even detrimental treatments in dogs with non-CE intestinal diseases.
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Affiliation(s)
- Daniel K Langlois
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jessica C Pritchard
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Gary Block
- Ocean State Veterinary Specialists, East Greenwich, Rhode Island, USA
| | | | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, Davis, California, USA
| | - Sara A Jablonski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
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11
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Tolbert MK, Telles NJ, Simon BT, Scallan EM, Price JM, Gould EN, Papich MG, Lidbury JA, Steiner JM, Kathrani A. Gastrointestinal transit time is faster in Beagle dogs compared to cats. J Am Vet Med Assoc 2022; 260:S8-S14. [PMID: 36044730 DOI: 10.2460/javma.22.07.0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize gastrointestinal transit times (GITTs) and pH in dogs, and to compare to data recently described for cats. ANIMALS 7 healthy, colony-housed Beagles. PROCEDURES The GITTs and pH were measured using a continuous pH monitoring system. For the first period (prefeeding), food was withheld for 20 hours followed by pH capsule administration. Five hours after capsule administration, dogs were offered 75% of their historical daily caloric intake for 1 hour. For the second period (postfeeding), food was withheld for 24 hours. Dogs were allowed 1 hour to eat, followed by capsule administration. Both periods were repeated 3 times. The GITTs and pH were compared to published feline data. RESULTS The mean ± SD transit times in dogs for the pre- and postfeeding periods, respectively, were esophageal, 3 ± 5 minutes and 13 ± 37 minutes; gastric, 31 ± 60 minutes and 829 ± 249 minutes; and intestinal, 795 ± 444 minutes and 830 ± 368 minutes. The mean ± SD gastrointestinal pH in dogs for the pre- and postfeeding periods, respectively, were esophageal, 6.6 ± 0.6 and 5.7 ± 1.0; gastric, 3.0 ± 1.4 and 1.8 ± 0.3; intestinal, 7.9 ± 0.3 and 7.7 ± 0.6; first-hour small intestinal, 7.6 ± 0.5 and 7.1 ± 0.4; and last-hour large intestinal, 7.9 ± 0.6 and 7.7 ± 1.0. The first-hour small intestinal pH and total transit times varied between dogs and cats depending on feed period (P = .002 and P = .04, respectively). Post hoc analysis revealed significantly shorter total transit times in dogs prefeeding (P = .005; mean ± SD for cats, 2,441 ± 1,359 minutes; for dogs, 828 ± 439 minutes) and postfeeding (P = .03; mean ± SD for cats, 3,009 ± 1,220 minutes; for dogs, 1,671 ± 513 minutes). Total transit time for dogs was also shorter pre- versus postfeeding (P = .003). CLINICAL RELEVANCE GITT is faster in Beagles compared to cats, but gastrointestinal pH are similar when fed the same diet.
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Affiliation(s)
- M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Naila J Telles
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - Elizabeth M Scallan
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - Joshua M Price
- Research Computing Support, University of Tennessee, Knoxville, TN
| | - Emily N Gould
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Aarti Kathrani
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London,UK
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12
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Praczko D, Tinkle AK, Arkenberg CR, McClelland RL, Creevy KE, Tolbert MK, Barnett BG, Chou L, Evans J, McNulty KE, Levine JM. Development and evaluation of a survey instrument to assess veterinary medical record suitability for multi-center research studies. Front Vet Sci 2022; 9:941036. [PMID: 35990265 PMCID: PMC9389294 DOI: 10.3389/fvets.2022.941036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Here we describe the development and evaluation of a survey instrument to assess the research suitability of veterinary electronic medical records (EMRs) through the conduct of two studies as part of the Dog Aging Project (DAP). In study 1, four reviewers used the instrument to score a total of 218 records in an overlapping matrix of pairs to assess inter-rater agreement with respect to appropriate format (qualification), identification match (verification), and record quality. Based upon the moderate inter-rater agreement with respect to verification and the relatively large number of records that were incorrectly rejected the instrument was modified and more specific instructions were provided. In study 2, a modified instrument was again completed by four reviewers to score 100 different EMRs. The survey scores were compared to a gold standard of board-certified specialist review to determine receiver operating curve statistics. The refined survey had substantial inter-rater agreement across most qualification and verification questions. The cut-off value identified had a sensitivity of 95 and 96% (by reviewer 1 and reviewer 2, respectively) and a specificity of 82% and 91% (by reviewer 1 and reviewer 2, respectively) to predict gold standard acceptance or rejection of the record. Using just qualification and verification questions within the instrument (as opposed to full scoring) minimally impacted sensitivity and specificity and resulted in substantial time savings in the review process.
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Affiliation(s)
- Dora Praczko
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
- *Correspondence: Dora Praczko
| | - Amanda K. Tinkle
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Crystal R. Arkenberg
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Robyn L. McClelland
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Kate E. Creevy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - M. Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Brian G. Barnett
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Lucy Chou
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jeremy Evans
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Kellyn E. McNulty
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Dog Aging Project Consortium
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jonathan M. Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
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13
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Duxbury S, Sorah E, Tolbert MK. Evaluation of proton pump inhibitor administration in hospitalized dogs in a tertiary referral hospital. J Vet Intern Med 2022; 36:1622-1627. [PMID: 35866265 PMCID: PMC9511098 DOI: 10.1111/jvim.16491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although proton pump inhibitors (PPIs) are commonly administered to hospitalized dogs, prescribing patterns and appropriateness of use require continued investigation. HYPOTHESIS/OBJECTIVE Describe prescription patterns and appropriateness of use associated with PPIs in hospitalized dogs at a single tertiary care facility. We hypothesized that the majority of prescriptions would not comply with current guidelines for the rational use of acid suppressants. ANIMALS Two hundred randomly selected hospitalized dogs. METHODS Retrospective evaluation of the medical records associated with a randomly selected sample of hospitalized dogs that received PPIs between January 2013 and December 2018. RESULTS A total of 12 610 dogs were admitted for first-time hospitalization between January 2013 and December 2018. Forty percent of these dogs (5062/12610) were prescribed a PPI PO or IV. Of the 200 randomly selected records, an adequate indication for use was identified in 27% of dogs (54/200). Of the dogs surviving to discharge, 54% (95/175) were discharged with a PPI and 51.6% (49/95) of those were prescribed an inadequate dose. CONCLUSIONS AND IMPORTANCE Our findings support other studies in which the majority of PPI prescriptions for hospitalized dogs at a tertiary care hospital lacked an appropriate indication. Furthermore, analysis of the prescribing patterns of dispensed PPIs identified a frequent occurrence of dosages considered inadequate, raising concern for ineffective treatment even with appropriate indications of use. With growing concern of adverse effects associated with PPI and other acid suppressant administration in human and veterinary medicine, rational use of these medications following consensus guidelines should be emphasized and treatment should be reserved for dogs with historical, physical examination, clinicopathologic, and imaging findings supportive of an appropriate indication for use.
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Affiliation(s)
- Samantha Duxbury
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Emily Sorah
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - M Katherine Tolbert
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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14
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Schwartz SM, Urfer SR, White M, Megquier K, Shrager S, Akey JM, Benton B, Borenstein E, Castelhano MG, Coleman AE, Creevy KE, Crowder K, Wilfond BS, Dunbar MD, Fajt VR, Fitzpatrick AL, Jeffery U, Jonlin EC, Kaeberlein M, Karlsson EK, Kerr KF, Levine JM, Ma J, McClelland RL, Promislow DEL, Ruple A, Schwartz SM, Shrager S, Snyder‐Mackler N, Tolbert MK, Urfer SR, Wilfond BS, Ruple A. Lifetime prevalence of malignant and benign tumors in companion dogs: cross‐sectional analysis of Dog Aging Project (DAP) baseline survey. Vet Comp Oncol 2022; 20:797-804. [PMID: 35574975 PMCID: PMC10089278 DOI: 10.1111/vco.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/25/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
Although cancer is widely regarded as a major contributor to canine morbidity and mortality, its frequency in companion dogs has only infrequently been characterised. We analysed cross-sectional data from the baseline survey of owners of 27 541 living companion dogs enrolled in the Dog Aging Project as of 31 December 2020 to estimate the lifetime prevalence of malignant and benign tumours and several potentially-associated characteristics. Survey questions elicited information on history of 'cancer or tumors' including organ site and histologic type. Owners reported 819 malignant tumours (56% sited in the skin, muscle or other soft tissue) and 404 benign tumours (69% sited in the skin, muscle or other soft tissue). The lifetime prevalence of malignant tumours (29.7/1000 dogs) was approximately double the lifetime prevalence of benign tumours (14.7/1000 dogs). Lifetime prevalence of both malignant and benign tumours increased with dog age at survey completion. There were no statistically discernable differences in age-adjusted lifetime prevalence of malignant (prevalence ratio (PR) = 0.93 [95% confidence interval (CI) 0.82, 1.07] or benign tumours (PR = 1.10, 95% CI 0.91, 1.34) in mixed vs. purebred dogs. The lifetime prevalence of malignant tumours increased with increasing dog size class; compared to toy and small dogs, the age-adjusted PRs (95% CIs) for medium, standard, large, and giant dogs were 1.65 (1.28, 2.11), 2.92 (2.35, 3.64), 3.67 (2.92, 4.62) and 2.99 (1.23, 4.02), respectively. Similar though less pronounced patterns in relation to dog size class were observed for benign tumours. Ongoing prospective data collection will permit future studies on risk factors for canine tumour incidence.
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Affiliation(s)
- Stephen M. Schwartz
- Epidemiology Program, Fred Hutchinson Cancer Research Center Seattle WA
- Department of Epidemiology University of Washington Seattle WA
| | - Silvan R. Urfer
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA
| | - Michelle White
- Program in Molecular Medicine University of Massachusetts Medical School Worcester MA
- The Broad Institute of Harvard and MIT Cambridge MA
| | | | - Sandi Shrager
- Department of Biostatistics University of Washington Seattle WA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Audrey Ruple
- Department of Population Health Sciences Virginia‐Maryland College of Veterinary Medicine, Virginia Tech Blacksburg VA
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15
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Odunayo A, Galyon G, Price J, Hecht S, Tolbert MK. Evaluation of a long-acting injectable formulation of omeprazole in healthy dogs. J Vet Intern Med 2022; 36:1416-1421. [PMID: 35546514 PMCID: PMC9308438 DOI: 10.1111/jvim.16440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of a single intramuscular adminsitration of long-acting omeprazole (LA-OMEP) in increasing gastric pH in dogs. HYPOTHESIS We hypothesized that LA-OMEP would meet in healthy dogs the clinical goals defined for human patients for treatment of gastroduodenal ulceration. ANIMALS Nine healthy research dogs. METHODS Prospective experimental study. Dogs were given a 4 mg/kg intramuscular injection of LA-OMEP. Intragastric pH was continuously recorded on treatment days 0 to 7. Daily mean pH and mean percentage time (MPT) intragastric pH was ≥3 or ≥4 were determined. RESULTS The mean onset of action for the LA-OMEP was 98.11 min (SD 46.39). The mean number of days the dogs' pH met established goals for MPT pH ≥3 was 5.5 days (range, 3-7) and 5.25 days for MPT pH ≥4 (range, 3-7). Long-acting omeprazole met the human clinical goals pH ≥3 for 72 hours in 8/8 of the dogs and MPT pH ≥4 for 96 hours in 7/8 of dogs. CONCLUSIONS AND CLINICAL IMPORTANCE The LA-OMEP formulation produced gastric acid suppression in healthy dogs for an average of 5 days and up to 7 days, after a single intramuscular injection. No major adverse effects were observed.
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Affiliation(s)
- Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | - Gina Galyon
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Joshua Price
- Office of Information and Technology, University of Tennessee, Knoxville, Tennessee, USA
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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16
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Lennon EM, Webster CRL, Forman M, Jergens A, Steiner JM, Tolbert MK, Block G, Langlois DK, Heilmann R, Wood M, Murray L, Webb C, Forcada Y, Twedt D, Wennogle S, Marsilio S, Flatland B, Honeckman A, Jaffey JA, Richter K. Letters to the Editor. J Am Vet Med Assoc 2022; 260:493. [PMID: 35213325 DOI: 10.2460/javma.260.5.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | | | - Marnin Forman
- Cornell University Veterinary Specialists, Stamford, CT
| | | | | | | | - Gary Block
- Ocean State Veterinary Specialists, East Greenwich, RI
| | | | | | | | | | - Craig Webb
- Colorado State University, Fort Collins, CO
| | | | | | | | | | | | | | - Jared A Jaffey
- Midwestern University College of Veterinary Medicine, Glendale, AZ
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17
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Slead TS, Gremillion CL, Cohen EB, Tolbert MK. Esophageal varices in dogs: A retrospective case series. J Vet Intern Med 2022; 36:493-499. [PMID: 35001429 PMCID: PMC8965243 DOI: 10.1111/jvim.16355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Esophageal varices (EV) are abnormally dilated veins in the esophagus caused by alterations of blood flow or pressure. Esophageal variceal hemorrhage is a major complication of hepatic disease in humans, but a lack of information exists regarding associated adverse events in dogs. Objective To describe the clinical manifestations and associated etiologies and outcomes of dogs with EV. Animals Twenty‐five client‐owned dogs with EV diagnosed via computed tomography (CT), endoscopy, or fluoroscopy. Methods Retrospective case series. Cases were identified by review of the hospital imaging records database between 2010 and 2020. Signalment, clinical signs, and outcomes were documented. When present, additional collateral vasculature was also recorded. Cases were subcategorized into suspected etiology based upon the anatomic location or absence of an attributable underlying disease process, as well as the direction of blood flow. Results Twenty‐four of 25 cases were identified via CT, with a prevalence of 0.012% (24/1950 total studies). Presenting clinical signs were nonspecific, and more likely because of the underlying cause as opposed to complications secondary to EV themselves. Etiologic anatomic locations were similar in occurrence between the abdomen (N = 14) and thorax (N = 11). All cases with an abdominal etiologic location had presumed or confirmed portal hypertension and 9/11 cases with a thoracic etiologic location had pulmonary, caval, or systemic hypertension. No cases died or were euthanized as a direct result of EV or associated hemorrhage. Conclusions and Clinical Importance Esophageal varices are rarely reported in dogs and commonly identified concurrently with portal, pulmonary, and caval hypertension. Hemorrhage is not a common clinical manifestation of EV.
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Affiliation(s)
- Tanner S Slead
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Christine L Gremillion
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA.,Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Eli B Cohen
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - M Katherine Tolbert
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA.,Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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18
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Tolbert MK, Murphy M, Gaylord L, Witzel-Rollins A. Dietary management of chronic enteropathy in dogs. J Small Anim Pract 2022; 63:425-434. [PMID: 34991182 DOI: 10.1111/jsap.13471] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/17/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022]
Abstract
Chronic idiopathic enteropathy is a clinical condition defined by the exclusion of infectious, metabolic or neoplastic causes of gastrointestinal signs and is categorised by a response to treatment including management with diet change, immunosuppressant medication or interventions that directly target the microbiome (e.g. antibiotics, faecal transplantation or probiotics). Animals that fail these therapies are categorised as non-responsive or refractory chronic idiopathic enteropathy. This specific categorisation implies that nutritional intervention is only needed for a subset of patients with enteropathy. However, often dogs with chronic idiopathic enteropathy are malnourished, have nutrient malabsorption or have gastrointestinal inflammation that occurs as a result of a breakdown in tolerance to luminal antigens including microorganism or dietary components. Thus, all dogs with chronic idiopathic enteropathy benefit from a nutritional assessment and targeted nutritional intervention. Among dogs presenting for chronic idiopathic enteropathy, the response rate to diet alone is roughly 50% in the referral population giving the impression that the overall response could be even higher especially when more than one nutritional intervention is attempted and strict adherence is maintained. The objectives of this review article are to outline the nutritional approach to a dog with chronic idiopathic enteropathy, including the nutritional assessment, and to highlight areas for nutritional intervention.
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Affiliation(s)
- M K Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA
| | - M Murphy
- College of Veterinary Medicine, Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, 37996, USA
| | - L Gaylord
- Whole Pet Provisions, PLLC, Fuquay-Varina, NC, 27526, USA
| | - A Witzel-Rollins
- College of Veterinary Medicine, Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, 37996, USA
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19
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Mouttham L, Castelhano MG, Akey JM, Benton B, Borenstein E, Castelhano MG, Coleman AE, Creevy KE, Crowder K, Dunbar MD, Ernst HR, Fajt VR, Fitzpatrick AL, Garrison SJ, Herndon RS, Jaramilla D, Jeffery U, Jonlin EC, Kaeberlein M, Karlsson EK, Kerr KF, Levine JM, Ma J, McClelland RL, Prescott JO, Promislow DEL, Ruple A, Schwartz SM, Shrager S, Snyder-Mackler N, Tinkle AK, Tolbert MK, Urfer SR, Wilfond BS. Purpose, Partnership, and Possibilities: The Implementation of the Dog Aging Project Biobank. Biomark Insights 2022; 17:11772719221137217. [PMID: 36468152 PMCID: PMC9716607 DOI: 10.1177/11772719221137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Biobanks have been supporting longitudinal prospective and retrospective studies by providing standardized services for the acquisition, transport, processing, storage, and distribution of high-quality biological material and associated data. Here, we describe how the Dog Aging Project (DAP), a large-scale longitudinal study of the domestic dog ( Canis familiaris) with translational applications for humans, developed a biobank of canine biospecimens and associated data. Design and methods: This was accomplished by working with the Cornell Veterinary Biobank, the first biobank in the world to receive accreditation to ISO 20387:2018—General Requirements for Biobanking. The biobank research team was involved in the early collection stages of the DAP, contributing to the development of appropriate workflows and processing fit-for-purpose biospecimens. In support of a dynamic strategy for real-time adjustment of processes, a pilot phase was implemented to develop, test, and optimize the biospecimen workflows, followed by an early phase of collection, processing, and banking of specimens from DAP participants. Results: During the pilot and early phases of collection, the DAP Biobank stored 164 aliquots of whole blood, 273 aliquots of peripheral blood mononuclear cells, 130 aliquots of plasma, and 70 aliquots of serum, and extracted high molecular weight genomic DNA suitable for whole-genome sequencing from 109 whole blood specimens. These specimens, along with their associated preanalytical data, have been made available for distribution to researchers. Conclusion: We discuss the challenges and opportunities encountered during the implementation of the DAP Biobank, along with novel strategies for promoting biobanking sustainability such as partnering with a DAP quality assurance manager and a DAP marketing and communication specialist and developing a pilot grant structure to fund small innovative research projects.
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Affiliation(s)
- Lara Mouttham
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Joshua M Akey
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Brooke Benton
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elhanan Borenstein
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Santa Fe Institute, Santa Fe, NM, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Kyle Crowder
- Department of Sociology, University of Washington, Seattle, WA, USA
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Matthew D Dunbar
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Holley R Ernst
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Virginia R Fajt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Susan J Garrison
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Reba S Herndon
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Debra Jaramilla
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Unity Jeffery
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Erica C Jonlin
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, USA
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elinor K Karlsson
- Bioinformatics and Integrative Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kathleen F Kerr
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Jing Ma
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Jena O Prescott
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Daniel EL Promislow
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Department of Biology, University of Washington, Seattle, WA, USA
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sandi Shrager
- Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Noah Snyder-Mackler
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School for Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Amanda K Tinkle
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Silvan R Urfer
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Benjamin S Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, WA, USA
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20
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Hoffman JM, Tolbert MK, Promislow DEL. Demographic factors associated with joint supplement use in dogs from the Dog Aging Project. Front Vet Sci 2022; 9:906521. [PMID: 35958315 PMCID: PMC9361857 DOI: 10.3389/fvets.2022.906521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/04/2022] [Indexed: 01/29/2023] Open
Abstract
Osteoarthritis (OA) is one of the most prevalent age-related chronic conditions that afflict companion dogs, and multiple joint supplements are available to prevent or treat OA, though the efficacy of these treatments is controversial. While the demographic factors that are associated with OA diagnosis are well established, the factors that are associated with joint supplement use are not as well studied. Using data collected from the Dog Aging Project, we analyzed owner survey responses regarding joint supplement administration and OA diagnosis for 26,951 adult dogs. In this cross-sectional analysis, logistic regression models and odds-ratios (OR) were employed to determine demographic factors of dogs and their owners that were associated with joint supplement administration. Forty percent of adult dogs in our population were given some type of joint supplement. Perhaps not surprisingly, dogs of older age, larger size, and those that were ever overweight were more likely to receive a joint supplement. Younger owner age, urban living, owner education, and feeding commercial dry food were associated with a reduced likelihood of administration of joint supplements to dogs. Interestingly, mixed breed dogs were also less likely to be administered a joint supplement (OR: 0.73). Dogs with a clinical diagnosis of OA were more likely to receive a joint supplement than those without a reported OA diagnosis (OR: 3.82). Neutered dogs were more likely to have a diagnosis of OA, even after controlling for other demographic factors, yet their prevalence of joint supplement administration was the same as intact dogs. Overall, joint supplement use appears to be high in our large population of dogs in the United States. Prospective studies are needed to determine if joint supplements are more commonly administered as a preventative for OA or after an OA clinical diagnosis.
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Affiliation(s)
- Jessica M Hoffman
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Daniel E L Promislow
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States.,Department of Biology, University of Washington, Seattle, WA, United States
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21
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Telles NJ, Simon BT, Scallan EM, Gould EN, Papich MG, He Y, Lee MT, Lidbury JA, Steiner JM, Kathrani A, Katherine Tolbert M. Evaluation of gastrointestinal transit times and pH in healthy cats using a continuous pH monitoring system. J Feline Med Surg 2021; 24:954-961. [PMID: 34878315 DOI: 10.1177/1098612x211062096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to characterize gastrointestinal (GI) transit times and pH in healthy cats. METHODS GI transit times and pH were measured in six healthy, colony-housed, purpose-bred spayed female cats using a continuous, non-invasive pH monitoring system in a sequential order design. For the first period ('pre-feeding'), food was withheld for 20 h, followed by oral administration of a pH capsule. Five hours post-capsule administration, cats were meal-fed by offering them their daily allowance of food for 1 h. For the second period ('post-feeding'), food was withheld for 24 h and cats were fed for 1 h, after which a pH capsule was orally administered. Studies in both periods were repeated three times. GI transit times and pH were compared between the two periods. RESULTS The median transit times for the pre- and post-feeding periods, respectively, were: gastric -94 mins (range 1-4101) and 1068 mins (range 484-5521); intestinal -1350 mins (range 929-2961) and 1534 mins (range 442-2538); and GI -1732 mins (range 1105-5451) and 2795 mins (range 926-6563). The median GI pH values for the first and second periods, respectively, were: esophageal -7.0 (range 3.5-7.8) and 4.5 (range 2.9-6.4); gastric -2.7 (range 1.7-6.2) and 2.0 (range 1.1-3.3); intestinal -8.2 (range 7.6-8.7) and 7.8 (range 6.7-8.5); first-hour small intestinal -8.2 (range 7.4-8.7) and 8.3 (range 7.9-8.6); and last-hour large intestinal -8.5 (range 7.0-8.9) and 7.8 (range 6.3-8.7). Gastric (P <0.0020) and intestinal pH (P <0.0059) were significantly increased in the pre-feeding period compared with the post-feeding period. CONCLUSIONS AND RELEVANCE Gastric and intestinal pH differed significantly when the capsule was administered 5 h prior to feeding compared with 1 h after feeding. Transit times for both periods showed high degrees of intra- and inter-individual variability.
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Affiliation(s)
- Naila J Telles
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Elizabeth M Scallan
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Emily N Gould
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | | | - Yuqing He
- North Carolina State University, Raleigh, NC, USA
| | - Mu-Tien Lee
- North Carolina State University, Raleigh, NC, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | | | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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22
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Mehra JM, Tolbert MK, Moore GE, Lewis MJ. Clinical Features and Risk Factors for Gastrointestinal Complications in Dogs Treated Surgically for Thoracolumbar Intervertebral Disc Extrusion. Front Vet Sci 2021; 8:785228. [PMID: 34938796 PMCID: PMC8685323 DOI: 10.3389/fvets.2021.785228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/08/2021] [Indexed: 01/25/2023] Open
Abstract
Gastrointestinal (GI) complications and their clinical implications are poorly characterized in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion (TL-IVDE). The objective of this retrospective study was to characterize GI signs (including vomiting, diarrhea, melena, and hematochezia) in dogs undergoing hemilaminectomy for acute TL-IVDE. One-hundred and sixteen dogs were included. Frequency, type and severity of GI signs during hospitalization, duration of hospitalization and outcome were obtained from the medical record. Potential risk factors for the development of GI signs were explored using univariable and multivariable analyses. Gastrointestinal signs occurred in 55/116 dogs (47%); 22/55 dogs (40%) had one episode and 21/55 (38%) had ≥5 episodes. Diarrhea was the most common (40/55, 73%) while melena was rare (1/55, 2%). GI signs developed in 8/11 dogs (73%) treated perioperatively with both non-steroidal anti-inflammatories and corticosteroids with or without a washout period and in 25/52 dogs (48%) treated prophylactically with proton pump inhibitors. Median hospitalization was 7 days (4-15 days) vs. 5 days (4-11 days) in dogs with or without GI signs, respectively. Duration of hospitalization was associated with development of any GI signs, diarrhea and more severe GI signs (p = 0.001, 0.005, 0.021, respectively). Pre-operative paraplegia with absent pain perception was identified on univariable analysis (p = 0.005) and longer anesthetic duration on multivariable analysis to be associated with development of more severe GI signs (p = 0.047). In dogs undergoing surgery for acute TL-IVDE, GI signs were common and associated with duration of hospitalization and anesthesia. The influence of specific medications and neurologic severity on development of GI signs requires further investigation.
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Affiliation(s)
- Jaya M. Mehra
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - M. Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | - George E. Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Melissa J. Lewis
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
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23
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Langlois DK, Tolbert MK, Webb CB, Lennon EM, Flatland B, Wennogle SAJ, Block G, Jergens AE, Heilmann RM, Murray L, Wood M, Honeckman A, Webster CRL, Twedt DC, Forman M, Marsilio S, Forcada Y, Jaffey JA, Richter K, Steiner JM. Letter regarding "Utility of the combined use of 3 serologic markers in the diagnosis and monitoring of chronic enteropathies in dogs". J Vet Intern Med 2021; 35:2567-2569. [PMID: 34825412 PMCID: PMC8692214 DOI: 10.1111/jvim.16303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Daniel K Langlois
- Department of Small Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, East Lansing, Michigan, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Craig B Webb
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
| | - Elizabeth M Lennon
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Bente Flatland
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Sara A Jablonski Wennogle
- Department of Small Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, East Lansing, Michigan, USA
| | - Gary Block
- Ocean State Veterinary Specialists, East Greenwich, Rhode Island, USA
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA
| | - Romy M Heilmann
- Department of Small Animal Medicine, University of Leipzig, College of Veterinary Medicine, Leipzig, Germany
| | - Louise Murray
- Internal Medicine Department, Animal Specialty Center, Yonkers, New York, USA
| | - Michael Wood
- Department of Medical Sciences, University of Wisconsin, School of Veterinary Medicine, Madison, Wisconsin, USA
| | | | - Cynthia R L Webster
- Department of Clinical Science, Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA
| | - David C Twedt
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
| | - Marnin Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Sina Marsilio
- Department of Veterinary Medicine and Epidemiology, University of California - Davis, School of Veterinary Medicine, Davis, California, USA
| | - Yaiza Forcada
- Veterinary Information Network, Davis, California, USA
| | - Jared A Jaffey
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, Arizona, USA
| | | | - Joerg M Steiner
- Department of Small Animal Clinical Sciences, Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
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24
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Sims CS, Nagle J, Tolbert MK, Anderson K, Linder K, Neel J. Correlation of cytology to histology in a case of canine granulomatous colitis in a Boxer dog. Vet Clin Pathol 2021; 50 Suppl 1:83-87. [PMID: 34664295 DOI: 10.1111/vcp.13058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/18/2021] [Accepted: 06/29/2021] [Indexed: 12/17/2022]
Abstract
A 2-year-old castrated male mixed breed dog presented to the North Carolina State Veterinary Teaching Hospital for chronic diarrhea with hematochezia and weight loss. Cytology performed on a rectal scraping revealed macrophages containing magenta, light pink, and variably blue granular inclusions, and phagocytosed material concerning for infectious organisms. Histopathology was consistent with granulomatous colitis and identified intra-histiocytic bacterial organisms, confirmed by fluorescent in situ hybridization (FISH)-tissue culture-confirmed Escherichia coli. Based on these findings, a diagnosis of granulomatous colitis was made. The patient was successfully treated with oral enrofloxacin, and near-complete remission of signs was achieved within 6 weeks. This report describes a case of granulomatous colitis in a mixed breed dog, and is the first published description of the cytologic features of this uncommon disease, offering a valuable cytologic-histologic correlation. In this case, the cytology was helpful in identifying features consistent with granulomatous colitis and prioritizing the differential diagnoses and diagnostic plan.
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Affiliation(s)
- Cory S Sims
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - Jonathan Nagle
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - M Katherine Tolbert
- Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Katie Anderson
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - Keith Linder
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - Jennifer Neel
- Department of Population Health and Pathobiology, North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
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25
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Pavlova E, Gold RM, Tolbert MK, Lidbury JA. Medical conditions associated with gastroduodenal ulceration or erosion in 168 dogs: 2008-2018. J Vet Intern Med 2021; 35:2697-2704. [PMID: 34596276 PMCID: PMC8692196 DOI: 10.1111/jvim.16275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
Background Many medical conditions are thought to cause gastroduodenal ulceration or erosion (GUE) in dogs. However, evidence for the association between many of these conditions and GUE in dogs is lacking. Objective To identify medical conditions associated with GUE in dogs. Animals One hundred and sixty‐eight dogs with GUE and 168 randomly selected control dogs without evidence of GUE identified on necropsy between January 2008 and September 2018. Methods Patient signalment, blood urea nitrogen (BUN) and serum creatinine concentrations, recently administered ulcerogenic drugs, as well as necropsy findings were recorded. The association between these findings and presence of GUE was assessed by univariable and multivariable analysis. Results In the final multivariable model, the following factors were associated with GUE: Nonsteroidal anti‐inflammatory drug (NSAID) administration (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.3‐17.4; P = .0004), glucocorticoid administration (OR, 3.0; 95% CI, 1.5‐5.9; P = .001), gastrointestinal neoplasia (OR, 13.5; 95% CI, 1.7‐108.0; P = .01) and gastrointestinal mechanical disease (foreign bodies, gastric dilatation, and volvulus; OR, 4.8; 95% CI, 1.2‐19.7; P = .03). Additionally, working dog breeds were predisposed to GUE compared to mixed breed dogs (OR, 2.8; 95% CI, 1.1‐7.4; P = .04). Insufficient clinical data was available to either support or refute a role of other putative risk factors evaluated. Conclusion and Clinical Importance Administration of NSAID or glucocorticoid and gastrointestinal neoplasia or mechanical disease were associated with GUE in dogs. The potential predisposition of working breed dogs for GUE requires further investigation.
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Affiliation(s)
- Elena Pavlova
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Randi M Gold
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Jonathan A Lidbury
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
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26
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Spencer A, Quimby JM, Price JM, MacLane S, Hillsman S, Secoura P, Steiner JM, Katherine Tolbert M. Appetite-stimulating effects of once-daily omeprazole in cats with chronic kidney disease: Double-blind, placebo-controlled, randomized, crossover trial. J Vet Intern Med 2021; 35:2705-2712. [PMID: 34590746 PMCID: PMC8692181 DOI: 10.1111/jvim.16268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cats with moderate to advanced chronic kidney disease (CKD) often display clinical signs such as vomiting and decreased appetite, and frequently receive omeprazole or other acid suppressants despite a lack of evidence to support their use. Hypothesis/Objectives To evaluate the effect of once‐daily PO omeprazole on appetite in cats with CKD. We hypothesized that omeprazole would improve subjective appetite assessments in cats with CKD. Animals Fourteen client‐owned cats with International Renal Interest Society (IRIS) stage 2 or 3 CKD and hyporexia. Methods Cats were prospectively enrolled in a multi‐institutional, double‐blinded, randomized, crossover study to evaluate the effect of a 14‐day trial of once‐daily PO omeprazole (1 mg/kg) or placebo (lactose gel capsule) on vomiting frequency and appetite. A daily log was completed by the owner during all treatment and rest periods to assess appetite using a subjective, qualitative, and 5‐point scoring system. Mixed model analyses of variance were performed to determine if average daily percentage food consumed or appetite score, as measured by subjective owner assessment, differed between treatments. Results Compared to placebo, a negligible but statistically significant difference in percentage of food consumed was observed between treatments (P = .04) with once‐daily omeprazole treatment resulting in a 2.7% increase in food consumption compared to placebo. No significant difference, however, was found in appetite score, body weight, or serum creatinine concentration between treatments. Conclusions and Clinical Importance Once‐daily omeprazole does not markedly increase appetite in cats with CKD and should not be used as a first‐line treatment in the absence of evidence of gastrointestinal ulceration.
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Affiliation(s)
- Ashley Spencer
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Jessica M Quimby
- The Ohio State University, College of Veterinary Medicine, Columbus, Ohio, USA
| | - Josh M Price
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Sally MacLane
- Appalachian Animal Hospital, Piney Flats, Tennessee, USA
| | - Shanna Hillsman
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Patty Secoura
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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27
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Gaier A, Price J, Grubb L, Fitzgerald S, Tolbert MK. A prospective, randomized, masked, placebo-controlled crossover study for the effect of 10 mg omeprazole capsules on gastric pH in healthy dogs. J Vet Intern Med 2021; 35:887-891. [PMID: 33586200 PMCID: PMC7995404 DOI: 10.1111/jvim.16061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022] Open
Abstract
Background Enteric‐coated omeprazole capsules are commonly used as a gastric acid suppressant in dogs. However, the efficacy of this formulation has not been evaluated for clinical use in dogs. Hypothesis/Objectives To evaluate the efficacy of a 10 mg PO omeprazole capsule (TriviumVet) undergoing FDA approval to increase gastric pH in dogs. We hypothesized that encapsulated omeprazole would significantly increase the gastric pH compared to placebo and reach pH goals extrapolated from people for the treatment of esophagitis and duodenal ulceration. Animals Six healthy research dogs. Methods Randomized, blinded, 2‐way crossover study. Dogs were PO administered omeprazole at 0.5 to 1.0 mg/kg or placebo (empty gelatin capsules) twice‐daily for 5 days. The intragastric pH was recorded on days 2 to 5 of treatment. Mean pH and the mean percentage time (MPT) intragastric pH was ≥3 or ≥4 were compared between and within treatment groups. Results Dogs treated with omeprazole had a significantly higher MPT ± SD intragastric pH ≥3 (91.2% ± 11.0%), ≥4 (86.9% ± 13.7%) and mean ± SD pH (5.4 ± 0.8) than dogs treated with placebo (19.7% ± 15.5%, 28.3 ± 20.7, and 2.4 ± 1.0, respectively) (P < .001 for all). Conclusions and Clinical Importance The 10 mg enteric‐coated omeprazole capsule PO administered evaluated in this study is an effective gastric acid suppressant in healthy dogs.
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Affiliation(s)
- Ann Gaier
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Josh Price
- Department of Small Animal, Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | | | | | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Abstract
A range of gastroprotective drugs are available for the treatment of esophagitis and gastroduodenal mucosal injury including acid suppressants (ie, histamine-2 receptor antagonists, proton pump inhibitors), coating agents, prostaglandin analogs, and antacids. Of these, the proton pump inhibitors are the most effective drugs for the medical treatment of upper gastrointestinal injury. However, proton pump inhibitors are not effective for all causes of upper gastrointestinal injury. The choice of gastroprotective drug should be guided by the cause and location of gastrointestinal injury and the potential for adverse effects.
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Affiliation(s)
- M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M College of Veterinary, 4474 TAMU
- College Station, TX 77843-4474, USA.
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29
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Tolbert MK, Spencer A, Lynch AM, Papich MG, Lidbury JA. Capsule endoscopy detects insufficient treatment of gastric bleeding in a dog with chronic hepatitis. Vet rec case rep 2020. [DOI: 10.1136/vetreccr-2020-001238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Ashley Spencer
- Department of Clinical SciencesNorth Carolina State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Alex M Lynch
- Department of Clinical SciencesNorth Carolina State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Mark G Papich
- College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Jonathan A Lidbury
- Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
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Jones SM, Gaier A, Enomoto H, Ishii P, Pilla R, Price J, Suchodolski J, Steiner JM, Papich MG, Messenger K, Tolbert MK. The effect of combined carprofen and omeprazole administration on gastrointestinal permeability and inflammation in dogs. J Vet Intern Med 2020; 34:1886-1893. [PMID: 32893926 PMCID: PMC7517840 DOI: 10.1111/jvim.15897] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
Background Proton pump inhibitors (eg, omeprazole) commonly are administered concurrently with nonsteroidal anti‐inflammatory drugs (NSAIDs; eg, carprofen) as prophylaxis to decrease the risk of gastrointestinal (GI) injury. However, evidence to support this practice is weak, and it might exacerbate dysbiosis and inflammation. Hypothesis/Objectives To evaluate the effect of carprofen alone or combined with omeprazole in dogs. We hypothesized that coadministration of omeprazole and carprofen would significantly increase GI permeability and dysbiosis index (DI) compared to no treatment or carprofen alone. Animals Six healthy adult colony beagle dogs. Methods Gastrointestinal permeability and inflammation were assessed by serum lipopolysaccharide (LPS) concentration, plasma iohexol concentration, fecal DI, and fecal calprotectin concentration in a prospective, 3‐period design. In the first 7‐day period, dogs received no intervention (baseline). During the 2nd period, dogs received 4 mg/kg of carprofen q24h PO for 7 days. In the 3rd period, dogs received 4 mg/kg of carprofen q24h and 1 mg/kg of omeprazole q12h PO for 7 days. Gastrointestinal permeability testing was performed at the end of each period. Data were analyzed using repeated measures mixed model analysis of variance with Tukey‐Kramer post hoc tests (P < .05). Results Serum LPS and plasma iohexol concentrations did not differ between treatments. Fecal calprotectin concentrations differed between treatments (P = .03). The DI varied over time based on the treatment received (P = .03). Coadministration of omeprazole and carprofen significantly increased fecal calprotectin concentration and DI compared to baseline and carprofen alone. Conclusions and Clinical Importance Omeprazole prophylaxis induces fecal dysbiosis and increases intestinal inflammatory markers when coadministered with carprofen to otherwise healthy dogs with no other risk factors for GI bleeding.
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Affiliation(s)
- Susan M Jones
- College of Veterinary Medicine, Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Ann Gaier
- College of Veterinary Medicine, Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Hiroko Enomoto
- College of Veterinary Medicine, Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Patricia Ishii
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Rachel Pilla
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Josh Price
- Office of Information and Technology, University of Tennessee, Knoxville, Tennessee, USA
| | - Jan Suchodolski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Joerg M Steiner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Mark G Papich
- College of Veterinary Medicine, Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Kristen Messenger
- College of Veterinary Medicine, Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Ryan P, Odunayo A, Price J, Hecht S, Hillsman S, Galyon G, Steiner J, Tolbert MK. Comparative analysis of the effect of PO administered acid suppressants on gastric pH in healthy cats. J Vet Intern Med 2020; 34:1879-1885. [PMID: 32885499 PMCID: PMC7517516 DOI: 10.1111/jvim.15887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Proton pump inhibitors (PPIs) are among the most commonly prescribed medications for esophagitis and upper gastrointestinal erosion and ulceration in cats. Newer PPIs such as lansoprazole and esomeprazole are believed to be effective in cats, but the effect of many of these PPIs on gastric pH in cats has not been explored. HYPOTHESIS/OBJECTIVES To evaluate the efficacy of PO esomeprazole, dexlansoprazole, and lansoprazole on intragastric pH in healthy cats. We hypothesized that esomeprazole and lansoprazole would provide superior acid suppression compared to dexlansoprazole and reach pH goals extrapolated from people for the treatment of esophagitis and duodenal ulceration. ANIMALS Twelve healthy research cats. METHODS Randomized, 3-way crossover study. Cats were given esomeprazole and lansoprazole at a dosage of 1 mg/kg PO q12h or dexlansoprazole at 6 mg/kg PO q12h. Intragastric pH was recorded at baseline and for 4 days of treatment. Mean pH and the mean percentage time (MPT) intragastric pH was ≥3 or ≥4 were compared among and within treatment groups. RESULTS Cats treated with lansoprazole had a lower MPT ± SD of intragastric pH ≥3 (8.8 ± 6.8%) and mean ± SD pH (1.6 ± 0.5) than did cats treated with dexlansoprazole (41.2 ± 34.6% and 3.11 ± 1.6, respectively) or esomeprazole (54 ± 33.8% and 4.1 ± 3.9, respectively;P ≤ .04). Esomeprazole was the only treatment that achieved the goals defined for people for the treatment of duodenal ulceration by Day 4 of treatment (MPT ± SD of intragastric pH ≥4 of 77.1 ± 29.2%). CONCLUSIONS AND CLINICAL IMPORTANCE Orally administered esomeprazole might be a superior acid suppressant in cats compared to PO lansoprazole or dexlansoprazole.
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Affiliation(s)
- Phillip Ryan
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Josh Price
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Shanna Hillsman
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Gina Galyon
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Joerg Steiner
- Department of Small Animal Clinical Sciences, Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
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Smith P, Tolbert MK, Gould E, Taylor A, Knych H, Messenger K. Pharmacokinetics, sedation and hemodynamic changes following the administration of oral transmucosal detomidine gel in cats. J Feline Med Surg 2020; 22:1184-1190. [PMID: 32643979 DOI: 10.1177/1098612x20917305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the pharmacokinetics of oral transmucosal (OTM) detomidine gel in healthy cats and assess its effects on sedation and hemodynamic variables. METHODS Eight adult cats weighing 4.12 kg ± 0.72 received 4 mg/m2 detomidine gel onto the buccal mucosa. Level of sedation, heart rate (HR), blood pressure (BP) and respiratory rate (f R) were assessed at predetermined intervals following administration. Blood samples for plasma detomidine concentrations and venous blood gas variables were collected from a medial saphenous catheter. Plasma detomidine concentrations were analyzed using ultra-high-pressure liquid chromatography with mass spectrometry detection, and pharmacokinetic estimates were obtained with compartmental methods. Data were analyzed using ANOVA and paired t-test or appropriate non-parametric tests. RESULTS Sedation occurred in all cats, and was increased from baseline at 30 mins (P <0.001). Decreases in HR occurred from 15-60 mins, ranging from 140 to 165 beats per min (P <0.001). Blood glucose increased from 101 ± 12 mg/dl to 168 ± 27.3 mg/dl at 60 mins (P = 0.004). Systolic blood pressure decreased from baseline (139 ± 14.8 mmHg) to 103 ± 23.0 mmHg at 60 mins (P = 0.023). All changes abated by 120 mins. Emesis occurred in 7/7 cats within 2 mins of gel administration. Geometric mean (coefficient of variation) for clearance was 220.7 ml/min/kg (35.3 ml/min/kg), volume of distribution was 14.9 l/kg (39.9 l/kg) (both a function of bioavailability) and elimination half-life was 46.9 mins (16.0 mins). Maximum plasma concentrations of 10.5 ng/ml (35.5 ng/ml) detomidine occurred at 36.9 mins (21.5 mins). CONCLUSIONS AND RELEVANCE OTM detomidine gel produced moderate sedation with minimal undesirable side effects in healthy cats, although emesis occurred in all cats. The pharmacokinetic profile supports short-term, minimally invasive sedation in this species. Further studies are warranted to assess its safety and feasibility for use in debilitated cats, or prior to general anesthesia.
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Affiliation(s)
- Preston Smith
- Quartet Veterinary Specialty and Emergency Hospital, Cary, NC, USA
| | - M Katherine Tolbert
- Texas A&M University, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA
| | - Emily Gould
- Texas A&M University, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA
| | | | - Heather Knych
- University of California, Davis, California Animal Health and Food Safety Lab Molecular Biosciences, Davis, CA, USA
| | - Kristen Messenger
- North Carolina State University, Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Kuhl A, Odunayo A, Price J, Hecht S, Marshall K, Steiner J, Tolbert MK. Comparative analysis of the effect of IV administered acid suppressants on gastric pH in dogs. J Vet Intern Med 2020; 34:678-683. [PMID: 32020689 PMCID: PMC7096616 DOI: 10.1111/jvim.15718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/20/2020] [Indexed: 01/12/2023] Open
Abstract
Background Upper gastrointestinal (GI) ulceration and bleeding in critically ill dogs can cause severe anemia and increase morbidity. Acid suppressants using proton pump inhibitors or histamine‐2 receptor blockers administered IV is commonly recommended. Hypothesis/Objectives To evaluate the efficacy of IV administered esomeprazole, pantoprazole, and famotidine constant rate infusion (CRI) on increasing the intragastric pH of dogs. We hypothesized that esomeprazole and famotidine CRI would provide superior acid suppression compared to pantoprazole and reach pH goals for the treatment of GI bleeding. Animals Nine healthy research Beagles. Methods Randomized, 3‐way crossover. Dogs received pantoprazole or esomeprazole at 1 mg/kg IV q12h and famotidine with a loading dose of 1 mg/kg followed by 8 mg/kg IV CRI daily for 3 consecutive days. The intragastric pH was recorded at baseline and for 72 hours of treatment. The mean pH and the mean percentage time (MPT) the intragastric pH was ≥3 or ≥4 were compared among and within treatment groups. Results Significant increases in mean pH (P < 0.0001), MPT ≥3 (P < 0.001), and MPT ≥4 (P = 0.0006) were noted over time with all 3 treatments. The time effect did not differ by treatment for mean pH, MPT ≥3, and MPT ≥4 (P = .29, .56, and .37, respectively); however, only esomeprazole and famotidine CRI achieved the goals established for the treatment of gastroduodenal ulceration in people. Conclusions and Clinical Importance Famotidine CRI and esomeprazole might be superior acid suppressants compared to standard doses of pantoprazole for the first 72 hours of treatment.
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Affiliation(s)
- Amanda Kuhl
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Josh Price
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Kristen Marshall
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Joerg Steiner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A & M University, College Station, Texas
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A & M University, College Station, Texas
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Dickson R, Vose J, Bemis D, Daves M, Cecere T, Gookin JL, Steiner J, Tolbert MK. The effect of enterococci on feline Tritrichomonas foetus infection in vitro. Vet Parasitol 2019; 273:90-96. [PMID: 31454711 DOI: 10.1016/j.vetpar.2019.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022]
Abstract
Tritrichomonas foetus is a common cause of large bowel diarrhea in cats. Probiotics have been suggested to be effective for many intestinal pathogens; however, there are a lack of studies evaluating the effect of probiotics in T. foetus infection. In vitro studies were performed to evaluate the effect of a probiotic containing Enterococcus faecium (Efm) SF68 and a novel probiotic, Enterococcus hirae, on the inhibition of T. foetus growth, adhesion to, and cytotoxicity towards the intestinal epithelium. The effect of enterococci on T. foetus proliferation during co-culture was evaluated throughout log phase T. foetus growth. The previously validated in vitro co-culture model system using porcine intestinal epithelial cells (IPEC-J2) was used to evaluate the effect of enterococci on T. foetus adhesion and cytotoxicity towards intestinal epithelial cells. Cytotoxicity was assessed using fluorescent microscopy and spectrophotometry. Interactions of T. foetus, enterococci, and intestinal epithelial cells were assessed using scanning electron microscopy and immunofluorescence assays (IFA). Enterococcus-induced inhibition of T. foetus growth was demonstrated at concentrations as low as 104 enterococci colony forming units (CFU)/mL and was dependent, in part, on environmental pH and the presence of viable enterococci organisms. T. foetus adhesion, including with a ronidazole-resistant strain, was reduced with pretreatment of intestinal epithelial cells with enterococci but was not significantly affected when enterococci were introduced simultaneously or following T. foetus infection. Compared to Efm, E. hirae more effectively decreased T. foetus adhesion, suggesting its superior potential as a novel probiotic for T. foetus infection. There was no effect of enterococci treatment on T. foetus-induced intestinal epithelial cell cytotoxicity. Our results support further study into the investigation of a possible benefit of enterococci-containing probiotic treatment for prevention of T. foetus infection in at-risk uninfected cats.
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Affiliation(s)
- Rachel Dickson
- The University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States
| | - Julie Vose
- The University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States
| | - David Bemis
- The University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States
| | - Maggie Daves
- The University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States
| | - Thomas Cecere
- Virginia-Maryland College of Veterinary Medicine, Department of Biomedical Sciences and Pathobiology Blacksburg, VA, United States
| | - Jody L Gookin
- North Carolina State University, Department of Clinical Sciences Raleigh, NC, United States
| | - Joerg Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, United States
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, United States.
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Hedges K, Odunayo A, Price JM, Hecht S, Tolbert MK. Evaluation of the effect of a famotidine continuous rate infusion on intragastric pH in healthy dogs. J Vet Intern Med 2019; 33:1988-1994. [PMID: 31294879 PMCID: PMC6766495 DOI: 10.1111/jvim.15558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/26/2019] [Indexed: 11/29/2022] Open
Abstract
Background Famotidine is sometimes administered as a continuous rate infusion (CRI) to treat gastrointestinal ulceration in critically ill dogs. However, clinical studies have not evaluated the efficacy of a famotidine CRI in dogs. Hypothesis/Objectives To evaluate the efficacy of famotidine at raising intragastric pH when it is administered as a CRI in dogs. We hypothesized that CRI treatment with famotidine would meet clinical goals for raising intragastric pH ≥3 and 4. Animals Nine healthy Beagle dogs. Methods Randomized 2‐way crossover. All dogs received 1.0 mg/kg IV q12h famotidine or CRI famotidine at 1.0 mg/kg IV loading dose and 8.0 mg/kg/d for 3 consecutive days. Beginning on day 0 of treatment, intragastric pH monitoring was used to continuously record intragastric pH. Mean percentage times (MPTs) for which intragastric pH was ≥3 and ≥4 were compared between groups using analysis of variance. Results There was a statistically significant difference (P < .05) in MPT ≥3 and ≥4 between the CRI and IV q12h groups on all treatment days. On days 1, 2, and 3, the MPTs ± SD for which pH was ≥3 were 92.1 ± 8.5, 96.3 ± 6.2, and 90.0 ± 15.7 for the CRI treatment group and 49.3 ± 27.3, 42.2 ± 19.6, and 45.8 ± 10.1, respectively, for the twice‐daily group. Conclusions and Clinical Importance These results suggest that a famotidine CRI, but not standard doses of famotidine, achieves the clinical goals established in people to promote healing of gastric tissue injury and offers an alternative to intravenous treatment with proton pump inhibitors in dogs.
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Affiliation(s)
- Katherine Hedges
- University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Adesola Odunayo
- University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Josh M Price
- University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Silke Hecht
- University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
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Vose J, Odunayo A, Price JM, Daves M, Schildt JC, Tolbert MK. Comparison of heparinized saline and 0.9% sodium chloride for maintaining central venous catheter patency in healthy dogs. PeerJ 2019; 7:e7072. [PMID: 31183263 PMCID: PMC6546076 DOI: 10.7717/peerj.7072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background The purpose of this study was to determine whether heparinized saline (HS) would be more effective in maintaining the patency of central venous catheters (CVCs) in dogs compared to 0.9% sodium chloride. This was a prospective randomized blinded study conducted at a University Veterinary Teaching Hospital. Methods A total of 24 healthy purpose-bred dogs were randomized into two groups: a treatment and a control group. A CVC was placed in the jugular vein of each dog. Each dog in the treatment group had their CVC flushed with 10 IU/mL HS, while dogs in the control group had their CVC flushed with 0.9% sodium chloride every 6 h for 72 h. Immediately prior to flushing, each catheter was evaluated for patency by aspiration of blood. The catheter site was also evaluated for phlebitis, and a rectal temperature was obtained in each dog every 6 h. Prothrombin (PT) and activated partial thromboplastin (aPTT) times were evaluated prior to the administration of any flush solution. Results were then compared to values obtained 72 h later. Results All CVCs in both groups were patent after 72 h, which was demonstrated by aspiration of blood and ease of flushing the catheter. Two CVCs in the 0.9% sodium chloride group had a negative aspiration at hour 12 and 36, respectively. One CVC in the HS group had a negative aspiration at hour 18. Signs of phlebitis occurred in three dog: two in the 0.9% sodium chloride group and one in the HS group. No dog was hyperthermic (>103 °F). Two catheters were inadvertently removed by dogs in the HS group during the study. There were no significant differences in catheter patency, incidence of phlebitis, or incidence of negative aspirations between both groups. aPTT and PT values remained within the normal reference range for all dogs in both groups. Ultimately, 0.9% sodium chloride was as effective as 10 IU/mL HS in maintaining the patency of CVCs for up to 72 h in healthy dogs. Further evaluation in clinical patients is warranted.
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Affiliation(s)
- Julieann Vose
- Department of Small Animal Clinical Sciences, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Joshua M Price
- Office of Information Technology, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Maggie Daves
- Department of Small Animal Clinical Sciences, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Julie C Schildt
- Department of Small Animal Clinical Sciences, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
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Golly E, Odunayo A, Daves M, Vose J, Price J, Hecht S, Steiner JM, Hillsman S, Tolbert MK. The frequency of oral famotidine administration influences its effect on gastric pH in cats over time. J Vet Intern Med 2019; 33:544-550. [PMID: 30746763 PMCID: PMC6430900 DOI: 10.1111/jvim.15430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/16/2019] [Indexed: 11/29/2022] Open
Abstract
Background Famotidine is commonly administered to cats. Prolonged famotidine administration results in decreased efficacy in humans, dogs, and cows, but the long‐term effects in cats are unknown. Objectives To compare the effect of 2 oral administration frequencies of famotidine, twice daily (Group 1) and twice daily every second day (Group 2), on intragastric pH and serum gastrin concentrations in cats. We hypothesized a diminished effect on intragastric pH would be observed over time in Group 1 but not Group 2. Animals Sixteen healthy cats. Methods Randomized, 2‐factor repeated measures crossover design. Cats received 0.5‐1.24 mg/kg (median, 0.87 mg/kg) famotidine twice daily or twice daily every second day for 14 consecutive days. Intragastric pH monitoring was used to record intragastric pH on treatment days 1‐3 and 11‐13. Mean pH and mean percentage time (MPT) intragastric pH was ≥3 and 4 were compared between and within treatment groups by analysis of variance. Results Significant treatment group by time interactions were observed for mean intragastric pH, MPT intragastric pH ≥3 and 4 (P = .009, P = .02, P = .005, respectively). Interaction post hoc tests identified significant decreases in mean intragastric pH (P = .001), MPT ≥3 (P = .001), and MPT ≥4 (P = .001) on day 13 compared to day 1 in Group 1 but not in Group 2. Conclusions and Clinical Importance Oral famotidine administration results in a diminished effect on intragastric pH in healthy cats when given twice daily every day.
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Affiliation(s)
- Elizabeth Golly
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Maggie Daves
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Julie Vose
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Josh Price
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Joerg M Steiner
- Department of Small Animal Clinical Sciences, Gastrointestinal Laboratory, Texas A&M University, College Station, Texas
| | - Shanna Hillsman
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
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Schmid SM, Suchodolski JS, Price JM, Tolbert MK. Omeprazole Minimally Alters the Fecal Microbial Community in Six Cats: A Pilot Study. Front Vet Sci 2018; 5:79. [PMID: 29713638 PMCID: PMC5911808 DOI: 10.3389/fvets.2018.00079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/27/2018] [Indexed: 12/31/2022] Open
Abstract
Although they have historically been thought of as safe medications, proton pump inhibitors such as omeprazole have been associated with an increased risk of enteric, particularly Clostridium difficile, infections in people. In cats, omeprazole is often the first choice acid suppressant prescribed for the treatment of upper gastrointestinal (GI) ulceration and bleeding. Despite this, no studies to date have explored the effect of omeprazole on the feline fecal microbiome and metabolome. Therefore, the purpose of this pilot study was to evaluate the effect of prolonged omeprazole administration on the fecal microbiome and metabolome in healthy cats to identify targets for analysis in a larger subset of cats with GI disease. A within-subjects, before and after, pilot study was performed whereby six healthy adult cats received 60 days of placebo (250 mg lactose PO q 12 h) followed by 5 mg (0.83–1.6 mg/kg PO q 12 h) omeprazole. On days 0, 30, and 60 of placebo and omeprazole therapy, the fecal microbiome and metabolome were characterized utilizing 16S ribosomal RNA sequencing by Illumina and untargeted mass spectrometry-based methods, respectively. Omeprazole administration resulted in no significant changes in the global microbiome structure or richness. However, transient changes were noted in select bacterial groups with omeprazole administration resulting in an increased sequence percentage of Streptococcus, Lactobacillus, Clostridium, and Faecalibacterium spp. and a decreased sequence percentage of Bifidobacterium spp. Significance was lost for all of these bacterial groups after adjustment for multiple comparisons. The fecal concentration of O-acetylserine and aminomalonate decreased with omeprazole therapy, but significance was lost after adjustment for multiple comparisons. The results of this pilot study conclude that omeprazole has a mild and transient impact on the fecal microbiome and metabolome when orally administered to healthy cats for 60 days. Based on the findings of this pilot study, evaluation of the effect of omeprazole specifically on Streptococcus, Lactobacillus, Clostridium, Faecalibacterium, and Bifidobacterium spp. is warranted in cats with primary GI disease.
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Affiliation(s)
- Sarah M Schmid
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, United States
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Josh M Price
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, United States
| | - M K Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, United States
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Tolbert MK, Olin S, MacLane S, Gould E, Steiner JM, Vaden S, Price J. Evaluation of Gastric pH and Serum Gastrin Concentrations in Cats with Chronic Kidney Disease. J Vet Intern Med 2017; 31:1414-1419. [PMID: 28833548 PMCID: PMC5598879 DOI: 10.1111/jvim.14807] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/07/2017] [Accepted: 07/13/2017] [Indexed: 12/22/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a highly prevalent condition in cats. Advanced CKD is associated with hyporexia and vomiting, which typically are attributed to uremic toxins and gastric hyperacidity. However, gastric pH studies have not been performed in cats with CKD. Hypothesis/Objectives To determine if cats with CKD have decreased gastric pH compared to age‐matched, healthy cats. Based on previous work demonstrating an association of hypergastrinemia and CKD, we hypothesized that cats with CKD would have decreased gastric pH compared to healthy, age‐matched control cats. Animals 10 CKD cats; 9 healthy control cats. Methods All cats with concurrent disease were excluded on the basis of history, physical examination, CBC, plasma biochemistry profile, urinalysis, urine culture, serum total thyroxine concentration, and serum symmetric dimethylarginine concentration (controls only) obtained within 24 hours of pH monitoring and assessment of serum gastrin concentrations. Serum for gastrin determination was collected, and 12‐hour continuous gastric pH monitoring was performed in all cats. Serum gastrin concentration, mean pH, and percentage time that gastric pH was strongly acidic (pH <1 and <2) were compared between groups. Results No significant differences in serum gastrin concentrations were observed between groups (medians [range]: CKD, 18.7 ng/dL [<10–659.0]; healthy, 54.6 ng/dL [<10–98.0]; P‐value = 0.713) or of any pH parameters including mean ± SD gastric pH (CKD, 1.8 ± 0.5; healthy, 1.6 ± 0.3; P‐value = 0.23). Conclusions and Clinical Importance These findings suggest that cats with CKD may not have gastric hyperacidity compared to healthy cats and, therefore, may not need acid suppression. Thus, further studies to determine if there is a benefit to acid suppression in cats with CKD are warranted.
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Affiliation(s)
- M K Tolbert
- University of Tennessee College of Veterinary Medicine, Knoxville
| | - S Olin
- University of Tennessee College of Veterinary Medicine, Knoxville
| | - S MacLane
- Appalachian Animal Hospital, Piney Flats, TN
| | - E Gould
- University of Tennessee College of Veterinary Medicine, Knoxville
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX
| | - S Vaden
- North Carolina State University College of Veterinary Medicine, Raleigh, NC
| | - J Price
- University of Tennessee College of Veterinary Medicine, Knoxville
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Gould EN, Corbeil LB, Kania SA, Tolbert MK. Evaluation of surface antigen TF1.17 in feline Tritrichomonas foetus isolates. Vet Parasitol 2017; 244:144-153. [PMID: 28917306 DOI: 10.1016/j.vetpar.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/18/2017] [Accepted: 08/02/2017] [Indexed: 11/17/2022]
Abstract
Tritrichomonas foetus (T. foetus) is a flagellated protozoa that infects the distal ileum and proximal colon of domestic cats, as well as the urogenital tract of cattle. Feline trichomonosis is recognized as a prevalent cause of chronic diarrhea in cats worldwide. The suspected route of transmission is fecal-oral, with cats in densely crowded environments at highest risk for infection. Thus, the recommended strategy for minimizing spread of infection is to identify and isolate T. foetus-positive cats from the general population. Rapid identification of infected cats can be challenging due to the inability to accurately and quickly detect the organism in samples at point of care facilities. Thus, identification of targets for use in development of a novel diagnostic test, as well as a vaccine or therapy for T. foetus infection is a significant area of research. Despite a difference in organ tropism between T. foetus genotypes, evidence exists for conserved virulence factors between feline and bovine T. foetus. The bovine T. foetus surface antigen, TF1.17, is an adhesin that is conserved across isolates. Vaccination with the purified antigen results in amelioration of cytopathogenicity and more rapid clearance of infection in cattle. We previously showed that three feline isolates of T. foetus were positive for TF1.17 antigen so we further hypothesized that TF1.17 is conserved across feline T. foetus isolates and that this antigen would represent an attractive target for development of a novel diagnostic test or therapy for feline trichomonosis. In these studies, we used monoclonal antibodies previously generated against 1.15 and 1.17 epitopes of the bovine T. foetus TF1.17 antigen, to evaluate for the presence and role of TF1.17 in the cytopathogenicity of feline T. foetus. A previously validated in vitro co-culture approach was used to model feline T. foetus infection. Immunoblotting, immunofluorescence assays, and flow cytometric analysis confirmed the presence and surface localization of antigen TF1.17 across all feline T. foetus isolates tested. Antigen TF1.17 was notably absent in the presumably nonpathogenic intestinal trichomonad, Pentatrichomonas hominis, a parasite that can be confused microscopically with T. foetus. Similar to bovine trichomoniasis, TF1.17 was found to promote T. foetus adhesion to the intestinal epithelium. These results support further characterization and development of the TF1.17 antigen as a possible target for the diagnosis and prevention of feline T. foetus infection.
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Affiliation(s)
- E N Gould
- The University of Tennessee College of Veterinary Medicine, Departments of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States
| | - L B Corbeil
- The University of San Diego School of Medicine, San Diego, CA, Department of Pathology, United States
| | - S A Kania
- The University of San Diego School of Medicine, San Diego, CA, Department of Pathology, United States; Department of Biomedical and Diagnostic Sciences, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - M K Tolbert
- The University of Tennessee College of Veterinary Medicine, Departments of Small Animal Clinical Sciences and Biomedical and Diagnostic Sciences, Knoxville, TN, United States.
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Gould E, Klos J, Price J, Harris T, Vaden S, Tolbert MK. Retrospective analysis of the effect of acid-suppressant therapy on clinicopathologic parameters of cats with chronic kidney disease. J Feline Med Surg 2017; 20:520-527. [PMID: 28703633 DOI: 10.1177/1098612x17718132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objectives The aim was to retrospectively evaluate the effects of acid-suppressant therapy in a population of cats with chronic kidney disease (CKD). The study objectives were to evaluate the effects of acid-suppressant therapy on clinicopathologic variables and progression of CKD over time. Methods The databases of two institutions were searched over an 11 year time span for cats fitting inclusion criteria for CKD. A total of 89 cats met the criteria for inclusion and were grouped according to either early (ie, stages 1-2) or advanced (ie, stages 3-4) CKD. Variables were statistically analyzed before and after treatment with either: (1) proton pump inhibitors (PPIs; n = 17), (2) histamine-2 receptor antagonists (H2RAs; n = 30), (3) combined acid-suppressant therapy (PPI + H2RA; n = 6) or (4) no acid-suppressant therapy (n = 36). Shapiro-Wilk testing and Q-Q plots were used to assess normality and variance, respectively. A complete randomized design with a mixed-effects repeated measures ANOVA was used to evaluate for differences in stage, treatment and time, as well as the interaction between these effects. Results A significant increase in blood creatinine concentration was found over time independent of severity of CKD and treatment group ( P = 0.0087). A significant increase in blood sodium concentration (change of 3.12 mmol/l) was found independent of stage in cats receiving PPI therapy ( P = 0.0109). A significant decrease in total blood magnesium (change of 0.15 mmol/l) was detected in two cats with early CKD receiving combined acid suppressants ( P = 0.0025). Conclusions and relevance Results of this retrospective study suggest that cats with CKD receiving PPI therapy may develop alterations in blood sodium concentrations but do not experience more rapid progression of CKD.
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Affiliation(s)
- Emily Gould
- 1 University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Knoxville, TN, USA
| | - Jacob Klos
- 1 University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Knoxville, TN, USA
| | - Josh Price
- 1 University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Knoxville, TN, USA
| | - Tonya Harris
- 2 North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - Shelly Vaden
- 2 North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA
| | - M Katherine Tolbert
- 1 University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Knoxville, TN, USA
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Abstract
Case summary A 7-year-old male castrated domestic short-haired cat was evaluated for a 4 week history of intermittent vomiting, ptyalism, lethargy and weight loss. Serum biochemistry revealed mild mixed hepatopathy. Abdominal ultrasonography identified multiple heterogeneous hepatic masses and a linear, hyperechoic focus with associated reverberation artifact in the wall of the stomach consistent with a gastric ulcer. Serum gastrin concentrations were markedly increased. Cytologic interpretation of a fine-needle aspirate of the hepatic masses was consistent with neuroendocrine neoplasia, and a diagnosis of gastrinoma was established. Deterioration of the cat’s condition, despite at-home acid-suppressant therapy, led to hospitalization. The cat was initially stabilized with intravenous crystalloid fluid therapy, maropitant, pantoprazole and octreotide. A continuous radiotelemetric intragastric pH monitoring system was used to monitor the response of intragastric pH to therapy. Long-term therapy was continued with omeprazole (orally q12h), octreotide (subcutaneously q8h) and thrice-weekly toceranib administered orally. Toceranib therapy led to gastrointestinal upset and was discontinued. Gastric ulceration resolved within 8 weeks, and palliation of clinical signs was achieved for approximately 5 months. Relevance and novel information Including this report, only six cases of feline gastrinoma have been reported in the veterinary literature. Little is known regarding non-surgical therapy, and octreotide has not been previously reported for medical management of feline gastrinoma. Results of intragastric pH monitoring and clinical improvement suggest that medical therapy using octreotide and proton pump inhibitors represents a novel therapeutic option for cats with gastrinoma where surgical excision is not feasible.
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Affiliation(s)
- Michael Lane
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Jeanne Larson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
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Lane MB, Larson JC, Stokes JE, Tolbert MK. Continuous radiotelemetric monitoring of intragastric pH in a dog with peptic ulceration. J Am Vet Med Assoc 2017; 250:530-533. [PMID: 28207313 DOI: 10.2460/javma.250.5.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 6-year-old castrated male Boxer was evaluated for a 5-week history of frequent vomiting, melena, and signs of abdominal pain following accidental ingestion of 5 to ten 15-mg meloxicam tablets (approx ingested dose, 3.1 to 6.2 mg/kg [1.4 to 2.8 mg/lb]). CLINICAL FINDINGS Clinical signs persisted despite 3 weeks of treatment with sucralfate (41.8 mg/kg [19 mg/lb], PO, q 8 h) and omeprazole (0.8 mg/kg [0.36 mg/lb], PO, q 24 h). Results of a CBC and serum biochemical analysis were unremarkable. Abdominal ultrasonography revealed peptic ulceration, and esophagogastroduodenoscopy confirmed the presence of severe proximal duodenal ulceration. TREATMENT AND OUTCOME A radiotelemetric pH-monitoring capsule was placed in the gastric fundus under endoscopic guidance for continuous at-home monitoring of intragastric pH and response to treatment. Treatment was continued with sucralfate (as previously prescribed) and omeprazole at an increased administration frequency (0.8 mg/kg, PO, q 12 h). Intragastric pH was consistently ≥ 3.0 for > 75% of the day during treatment, with the exception of 1 day when a single dose of omeprazole was inadvertently missed. Ulceration and clinical signs completely resolved. CLINICAL RELEVANCE Continuous radiotelemetric monitoring of intragastric pH in the dog of this report was useful for confirming that treatment achieved a predetermined target pH and for demonstrating the impact of missed doses. Duodenal ulceration resolved with twice-daily but not once-daily omeprazole administration. Findings suggested that twice-daily administration of omeprazole may be necessary to achieve this target pH and that a pH ≥ 3.0 for 75% of the day may promote healing of peptic ulcers in dogs.
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Tolbert MK, Brand MD, Gould EN. In vitro effects of cysteine protease inhibitors on Trichomonas foetus-induced cytopathic changes in porcine intestinal epithelial cells. Am J Vet Res 2017; 77:890-7. [PMID: 27463553 DOI: 10.2460/ajvr.77.8.890] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of specific cysteine protease (CP) inhibitors on cytopathic changes to porcine intestinal epithelial cells induced by Tritrichomonas foetus isolated from naturally infected cats. SAMPLE T foetus isolates from 4 naturally infected cats and nontransformed porcine intestinal epithelial cells. PROCEDURES T foetus isolates were treated with or without 0.1 to 1.0mM of the CP inhibitors antipain, cystatin, leupeptin, and chymostatin and the vinyl sulfone inhibitors WRR-483 and K11777. In-gel gelatin zymography was performed to evaluate the effects of these inhibitors on CP activity of T foetus isolates. Each treated or untreated isolate was also cocultured with monolayers of porcine intestinal epithelial cells for 24 hours, and cytopathic effects of T foetus were evaluated by light microscopy and crystal violet spectrophotometry. RESULTS Results of in-gel gelatin zymography suggested an ability of WRR-483, K11777, and cystatin to target specific zones of CP activity of the T foetus isolates. These inhibitors had no effect on T foetus growth, and the cytopathic changes to the intestinal epithelium induced by all 4 T foetus isolates were significantly inhibited. CONCLUSIONS AND CLINICAL RELEVANCE This study revealed that certain protease inhibitors were capable of inhibiting regions of CP activity (which has been suggested to cause intestinal cell damage in cats) in T foetus organisms and of ameliorating T foetus-induced cytopathic changes to porcine intestinal epithelium in vitro. Although additional research is needed, these inhibitors might be useful in the treatment of cats with trichomonosis.
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Abstract
Case series summary This case series describes eight cases of invasive tracheal neoplasia that were recognized between the years 1989 and 2014 from a single tertiary referral hospital. This is a disproportionately high number of cases compared with the total number of reports in the current literature. Relevance and novel information Invasive tracheal neoplasia is uncommonly diagnosed in domestic cats. Feline tracheal tumors mimic other upper respiratory diseases making diagnosis challenging. Prognosis is guarded to grave, with most cats surviving less than 1 month after beginning treatment. Severe respiratory distress in cats often warrants humane euthanasia. Appropriate clinical suspicion and awareness can expedite diagnoses leading to prolonged survival rates with appropriate treatments. This case series represents the largest number of feline tracheal tumors reported and also describes the first unique histological presentation of what the authors believe to be a poorly differentiated tracheal carcinoma.
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Affiliation(s)
- James Howard
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Jade Fisher
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
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Tolbert MK, Graham A, Odunayo A, Price J, Steiner JM, Newkirk K, Hecht S. Repeated Famotidine Administration Results in a Diminished Effect on Intragastric pH in Dogs. J Vet Intern Med 2016; 31:117-123. [PMID: 27906465 PMCID: PMC5259645 DOI: 10.1111/jvim.14615] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/10/2016] [Accepted: 10/26/2016] [Indexed: 12/25/2022] Open
Abstract
Background Famotidine is an acid suppressant commonly administered to dogs. Prolonged famotidine use in people results in decreased efficacy, but the effect in dogs is unknown. Hypothesis/Objectives To compare the effect of repeated oral administration of famotidine or placebo on intragastric pH and serum gastrin in dogs. We hypothesized that famotidine would have a diminished effect on intragastric pH on day 13 compared to day 1. Animals Six healthy adult colony Beagles. Methods Randomized, 2‐factor repeated‐measures crossover design. All dogs received oral placebo or 1.0 mg/kg famotidine q12h for 14 consecutive days. Intragastric pH monitoring was used to continuously record intragastric pH on treatment days 1–2 and 12–13. Mean pH as well as mean percentage time (MPT) that intragastric pH was ≥3 or ≥4 were compared between and within groups by analysis of variance. Serum gastrin was measured on days 0, 3, and 12 for each treatment. Results Continued administration of famotidine resulted in a significant decrease in mean pH, MPT ≥3, and MPT ≥4 (P < .0001) on day 12 and 13. This resulted in a mean decrease in pH by 1.63 on days 12 and 13 compared to days 1 and 2. Furthermore, a mean decrease of MPT ≥3 and MPT ≥4 by 33 and 45% was observed for the same time period, respectively. Conclusions and Clinical Importance Continued administration of famotidine results in a diminished effect on intragastric pH in dogs. Caution is advised when recommending long‐term, daily oral administration of famotidine to dogs.
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Affiliation(s)
- M K Tolbert
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - A Graham
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - A Odunayo
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - J Price
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX
| | - K Newkirk
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - S Hecht
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN
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Pasciak AS, Nodit L, Bourgeois AC, Paxton BE, Coan PN, Clark CT, Tolbert MK, Adams JK, Arepally A, Bradley YC. How Sensitive Is the Upper Gastrointestinal Tract to 90Y Radioembolization? A Histologic and Dosimetric Analysis in a Porcine Model. J Nucl Med 2016; 57:1957-1963. [PMID: 27390155 DOI: 10.2967/jnumed.116.176768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/07/2016] [Indexed: 12/26/2022] Open
Abstract
In 90Y radioembolization, nontarget embolization to the stomach or small bowel can result in gastrointestinal injury, a rare but difficult to manage clinical complication. However, dosimetric thresholds for toxicity to these tissues from radioembolization have never been evaluated in a controlled setting. We performed an analysis of the effect of 90Y radioembolization in a porcine model at different absorbed-dose endpoints. METHODS Six female pigs underwent transfemoral angiography and infusion of 90Y-resin microspheres into arteries supplying part of the gastric wall. Esophagogastroduodenoscopy was performed after 4 wk to assess interim gastrointestinal health. Animals were monitored for side effects for 9 wk after 90Y infusion, after which they were euthanized and their upper gastrointestinal tracts were excised for analysis. Histologic sections were used to map microsphere location, and a microdosimetric evaluation was performed to determine the absorbed-dose profile within the gastrointestinal wall. RESULTS 90Y radioembolization dosages from 46.3 to 105.1 MBq were infused, resulting in average absorbed doses of between 35.5 and 91.9 Gy to the gastric wall. No animal exhibited any signs of pain or gastrointestinal distress through the duration of the study. Excised tissue showed 1-2 small (<3.0 cm2) healed or healing superficial gastric lesions in 5 of 6 animals. Histologic analysis demonstrated that lesion location was superficial to areas of abnormally high microsphere deposition. An analysis of microsphere deposition patterns within the gastrointestinal wall indicated a high preference for submucosal deposition. Dosimetric evaluation at the luminal mucosa performed on the basis of microscopic microsphere distribution confirmed that 90Y dosimetry techniques conventionally used in hepatic dosimetry provide a first-order estimate of absorbed dose. CONCLUSION The upper gastrointestinal tract may be less sensitive to 90Y radioembolization than previously thought. Lack of charged-particle equilibrium at the luminal mucosa may contribute to decreased toxicity of 90Y radioembolization compared with external-beam radiation therapy in gastrointestinal tissue. Clinical examples of injury from 90Y nontarget embolization have likely resulted from relatively large 90Y activities being deposited in small tissue volumes, resulting in absorbed doses in excess of 100 Gy.
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Affiliation(s)
- Alexander S Pasciak
- Department of Radiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee .,The Johns Hopkins Hospital, School of Medicine, Baltimore, Maryland
| | - Laurentia Nodit
- Department of Pathology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Austin C Bourgeois
- Department of Radiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.,Department of Radiology, The Medical University of South Carolina, Charleston, South Carolina
| | - Ben E Paxton
- Interventional Radiology, Prescott Radiologists, Prescott, Arizona
| | - Patricia N Coan
- Office of Lab Animal Care, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Christopher T Clark
- Department of Pathology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Joleen K Adams
- Office of Lab Animal Care, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee
| | - Aravind Arepally
- Interventional Radiology, Piedmont Radiology, Atlanta, Georgia; and.,Interventional Radiology, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Yong C Bradley
- Department of Radiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
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Gould E, Clements C, Reed A, Giori L, Steiner JM, Lidbury JA, Suchodolski JS, Brand M, Moyers T, Emery L, Tolbert MK. A Prospective, Placebo-Controlled Pilot Evaluation of the Effect of Omeprazole on Serum Calcium, Magnesium, Cobalamin, Gastrin Concentrations, and Bone in Cats. J Vet Intern Med 2016; 30:779-86. [PMID: 27062346 PMCID: PMC4913587 DOI: 10.1111/jvim.13932] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/19/2016] [Accepted: 02/25/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chronic proton pump inhibitor administration has been associated with electrolyte and cobalamin deficiency, disrupted bone homeostasis, hypergastrinemia, and rebound acid hypersecretion in humans. It is unknown if this occurs in cats. OBJECTIVES Prolonged oral omeprazole results in altered bone mineral density or content, serum calcium, magnesium, cobalamin, and gastrin concentrations in healthy cats. ANIMALS Six healthy adult DSH cats. METHODS In a within subjects, before and after design, cats received placebo followed by omeprazole (0.83-1.6 mg/kg PO q12h) for 60 days each. Analysis of serum calcium, magnesium, cobalamin, and gastrin concentrations was performed on days 0, 30, and 60. Bone density and content were evaluated on days 0 and 60 of each intervention. Continuous data were analyzed using a two-way ANOVA (α = 0.006). On day 60 of omeprazole administration, continuous intragastric pH monitoring was performed in 2 cats to evaluate the effects of abrupt withdrawal of omeprazole. RESULTS No significant changes were detected between treatments for any variables, except serum gastrin, which was significantly higher during omeprazole treatment in comparison to placebo (P = 0.002). Evidence of gastric hyperacidity was seen in both cats in which intragastric pH monitoring was performed following cessation of omeprazole. CONCLUSIONS AND CLINICAL IMPORTANCE Although further studies with larger populations of cats will be needed to draw any definitive conclusions, these preliminary results suggest that prolonged PPI treatment results in hypergastrinemia and abrupt PPI withdrawal might result in RAH in cats.
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Affiliation(s)
- E Gould
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - C Clements
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - A Reed
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - L Giori
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - J M Steiner
- Texas A&M University, Gastrointestinal Laboratory, College Station, TX
| | - J A Lidbury
- Texas A&M University, Gastrointestinal Laboratory, College Station, TX
| | - J S Suchodolski
- Texas A&M University, Gastrointestinal Laboratory, College Station, TX
| | - M Brand
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - T Moyers
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - L Emery
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - M K Tolbert
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
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Tolbert MK, Gookin JL. Mechanisms of Tritrichomonas foetus Pathogenicity in Cats with Insights from Venereal Trichomonosis. J Vet Intern Med 2016; 30:516-26. [PMID: 26946069 PMCID: PMC4913604 DOI: 10.1111/jvim.13920] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/26/2015] [Accepted: 02/09/2016] [Indexed: 12/18/2022] Open
Abstract
Almost 20 years has passed since trichomonosis was first recognized as a potential cause of diarrhea in domestic cats. Despite progress in confirming disease causation, developing means for diagnosis, and identifying approaches to treatment of the infection, we still know very little about how this parasite causes diarrhea. With increasing recognition of resistance of trichomonosis to treatment with 5‐nitroimidazole drugs, new treatment strategies based on an understanding of disease pathogenesis are needed. In this review, lessons learned from the pathogenesis of venereal trichomonosis in people and cattle are applied to clinical observations of trichomonosis in cats in effort to generate insight into areas where further research may be beneficial.
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Affiliation(s)
- M K Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - J L Gookin
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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Abstract
A 7-year-old domestic shorthair cat was evaluated for hyporexia and weight loss following endoscopic placement of an intragastric pH monitoring device. Physical examination of the cat was unremarkable, and its blood work was notable for a mild hypoalbuminemia. The cat's acute hyporexia and weight loss was attributed to discomfort associated with the intragastric pH monitoring device, as has been reported in humans. Endoscopic removal of the intragastric pH monitoring device resulted in gastric perforation. The cat underwent exploratory laparotomy for surgical resection and repair of the perforated area. To our knowledge, this is the first report of gastric perforation secondary to removal of a Bravo pH capsule. Caution may be advised when considering intragastric pH capsule removal in cats.
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Affiliation(s)
- M Katherine Tolbert
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Linden E Craig
- Department of Pathobiology, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
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