Feline exocrine pancreatic insufficiency : a retrospective study of 150 cases

BACKGROUND : Little information is available about the clinical presentation and response to treatment of cats with exocrine pancreatic insufficiency (EPI). OBJECTIVES : To describe the signalment, clinical signs, concurrent diseases, and response to treatment of cats with EPI. ANIMALS : One hundred and fifty cats with EPI. METHODS : Retrospective case series. RESULTS : Questionnaires were sent to 261 veterinarians, and 150 (57%) were returned with data suitable for statistical analysis. The median age of the cats with EPI was 7.7 years. The median body condition score was 3 of 9. Ninety-two of 119 cats (77%) had hypocobalaminemia, and 56 of 119 cats (47%) had increased and 6 of 119 cats (5%) had decreased serum folate concentrations. Clinical signs included weight loss (91%), unformed feces (62%), poor hair coat (50%), anorexia (45%), increased appetite (42%), lethargy (40%), watery diarrhea (28%), and vomiting (19%). Eighty-seven cats (58%) had concurrent diseases. Treatment response was reported to be good in 60%, partial in 27%, and poor in 13% of 121 cats. Trypsin-like immunoreactivity <4 lg/L was associated with a positive response to treatment (OR, 3.2; 95% CI, 1.5–7.0; P = .004). Also, cobalamin supplementation improved the response to treatment (OR, 3.0; 95% CI, 1.4–6.6; P = .006). CONCLUSIONS AND CLINICAL IMPORTANCE : Exocrine pancreatic insufficiency in cats often has a different clinical presentation than in dogs. The age range for EPI in cats is wide, and many cats can be ≤5 years of age. Most cats respond well to appropriate treatment for EPI, and cobalamin supplementation appears to be necessary for a good response.Some of the results of this study were presented at the 2012 American College of Veterinary Internal Medicine Forum, New Orleans, LA.http://www.sherpa.ac.uk/romeo/issn/0891-6640/am2017Production Animal Studie

Homocysteine in dogs with systemic inflammatory response syndrome

OBJECTIVES - To compare serum concentrations of homocysteine (Hcy) in dogs fitting the criteria for the systemic inflammatory response syndrome (SIRS) and healthy dogs, and compare these values to commonly measured B-vitamins. METHODS – Study dogs were classified into noninfectious SIRS or sepsis groups and blood was drawn on Day 1 of the patient’s hospitalization for the measurement of Hcy, folate and cobalamin concentrations. Hcy was measured in 51 clinically normal dogs to serve as the control group. RESULTS - A statistically significant difference was found between the Hcy concentrations of the healthy group when compared to noninfectious SIRS and sepsis groups. Hcy values were not correlated with folate, cobalamin or APPLEfast severity scores. Hcy concentrations were significantly lower in sick dogs when compared to the control group, which is dissimilar to the human population. CLINICAL SIGNIFCANCE - The clinical significance of Hcy changes in critically ill dogs is currently unknown.http://aac.asm.orghb2014ab201

A pilot study to assess tolerability of early enteral nutrition via esophagostomy tube feeding in dogs with severe acute pancreatitis

Background: The putative role of the gut in amplification of systemic inflammation in acute pancreatitis is gaining credence, and intraluminal nutrition has been shown to decrease inflammation in experimental models of pancreatitis. Prepyloric feeding often is used in people with acute pancreatitis, but has not been evaluated in dogs. Hypothesis: Early intervention with enteral nutrition (EN) delivered proximal to the pylorus will be well tolerated in dogs with acute pancreatitis and provide justification for further larger trials. Animals: Ten dogs with severe acute pancreatitis in an open-label, prospective pilot study. Methods: Dogs were treated with plasma transfusion and standard care, and then consecutively assigned to receive either EN via esophagostomy tube feeding or parenteral nutrition (PN). Outcome was used to determine optimal study size for future studies, and complications were compared between the 2 groups. Results: A significantly greater number of vomiting or regurgitating episodes occurred in dogs receiving PN. The dogs receiving EN did not demonstrate any noticeable postprandial pain. There were more catheter-related complications in the PN group. There was no difference in outcome between the 2 treatments, and 43 dogs for each treatment would be required in future studies to determine a difference in outcome. Conclusions and Clinical Relevance: Early EN delivered proximal to the pylorus is well tolerated in dogs with severe pancreatitis and resulted in fewer complications than PN. Prospective trials in a larger cohort are justified to fully establish the potential benefit of early EN, preferably compared with minimal enteral nutrition

Effects of the Probiotic VSL#3 in Dogs with Inflammatory Bowel Disease.

Abstract contenuto negli atti del Convegn

Serum triglyceride and cholesterol concentrations and lipoprotein profiles in dogs with naturally occurring pancreatitis and healthy control dogs

Background: Previous studies have reported an association between hyperlipidemia and pancreatitis in dogs, but details of this association remain poorly defined. Hypothesis/Objectives: To compare serum triglyceride and cholesterol concentrations and lipoprotein profiles between dogs with naturally occurring pancreatitis and healthy dogs. Animals: Seventeen dogs with a clinical diagnosis of pancreatitis (Group 1) and 53 healthy control dogs (Group 2). Methods: Prospective case-control study. Results: In Group 1, 3/17 dogs (18%) had hypertriglyceridemia whereas in Group 2, 4/53 dogs (7.5%) had hypertriglyceridemia (odds ratio [OR], 2.63; 95% confidence interval [CI], 0.52-13.14; P =.35). A significant difference was found in serum triglyceride concentrations between Group 1 (median, 67 mg/dL) and Group 2 (median, 54 mg/dL; P =.002). In Group 1, 4/17 dogs (24%) had hypercholesterolemia, whereas 1/53 (1.9%) dogs in Group 2 had hypercholesterolemia (OR, 16; 95% CI, 1.64-155.5; P =.01). No significant difference was found in serum cholesterol concentrations between Group 1 (median, 209 mg/dL) and Group 2 (median, 227 mg/dL; P =.56). Lipoprotein profiles were significantly different between Group 1 and Group 2 dogs (Eigenvalues, 0.6719; R2 = 1.0; P =.001). Conclusions and Clinical Importance: Most dogs with pancreatitis (&gt;70%) had serum triglyceride and cholesterol concentrations within reference intervals. In the small percentage of dogs that had hypertriglyceridemia, hypercholesterolemia, or both, increases were mild. Important differences were identified in lipoprotein profiles between dogs with pancreatitis and healthy control dogs. Dogs with pancreatitis had higher low-density lipoprotein fractions and lower triglyceride-rich lipoprotein and high-density lipoprotein fractions than healthy dogs. © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine

Serum feline pancreatic lipase immunoreactivity and trypsin-like immunoreactivity concentrations in cats with experimentally induced chronic kidney disease

Background: Serum feline pancreatic lipase immunoreactivity (fPLI) and trypsin-like immunoreactivity (fTLI) concentrations are commonly used in cats for the evaluation of pancreatic disease. The effect of kidney disease on these tests in cats are unknown. Objective: To investigate the effect of experimentally induced chronic kidney disease (CKD) on serum fPLI and fTLI concentrations. Animals: Surplus serum samples from 20 cats with CKD experimentally induced for an unrelated project and a group of healthy control cats. Methods: Serum fTLI and fPLI concentrations were compared between groups. Results: Mean (±SD) serum fTLI concentrations in 20 cats with CKD (117.8 ± 63.6 μg/L) were significantly higher than those in healthy cats (n = 32; 46.9 ± 17.5 μg/L; P <.0001). Serum fTLI concentrations in cats with CKD were above the upper limit of the reference interval in 13 of 20 cats (65%). Serum fPLI concentrations were not significantly different between cats with induced CKD (n = 18; 8.6 μg/L; range, 5.4-9.9 μg/L) and healthy cats (n = 41; 7.4 μg/L; range, 5.0-15.2 μg/L; P =.12). All cats with experimentally induced CKD had serum fPLI concentrations within the reference interval. Conclusions and Clinical Importance: Decreased renal function has a clinically relevant impact on serum fTLI concentrations and potentially could interfere with a diagnosis of exocrine pancreatic insufficiency (EPI). Serum fPLI concentration was not affected by experimentally induced CKD and thus serum fPLI may be used for the diagnosis of pancreatitis in cats with kidney disease. Additional studies are needed to verify these results in cats with naturally occurring CKD. © 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine

Probiotics Restoring the Pattern of Apical Junction Complex Protein (AJC) Expression in the Intestinal Mucosa of Dogs with Inflammatory Bowel Disease

Introduction: The apical junction complex (AJC) plays a significant role in regulating epithelial paracellular permeability. Materials and Methods: We have studied by immunohistochemistry the distribution of tight junction components (claudin-2, occludin) and adherens junction (E-cadherin) proteins in the normal intestinal tract from three control dogs (CD) and from 10 dogs with IBD, before and after a probiotic treatment (VSL#3, VSL Pharmaceuticals, Inc; 450 billion lyophilized bacteria daily for 60 days). Results: In the CD group, occludin-specific labelling was most intense at the epithelial cell AJC and appeared uniformly expressed throughout the epithelium of the small and large intestine, but in the IBD group a weak to absent expression was observed in luminal epithelium and in some intestinal glands of the small intestine. No differences in the distribution or labelling intensity of E-cadherin were observed between normal and affected dogs. In the CD group, claudin-2 was detected in the duodenal epithelium and glands and in the colonic crypt epithelium, decreasing in intensity from the distal to the proximal crypt and becoming barely detectable at the luminal surface of the colon. However, claudin-2 expression was increased in the proximal crypt and luminal epithelium of all dogs with IBD. Conclusions: The observation that the expression and distribution of occludin and claudin-2 were restored after VSL#3 treatment may provide insight into the effects of probiotics on intestinal barrier function

Serum cobalamin concentrations in dogs with leishmaniosis before and during treatment

Hypocobalaminemia in dogs is most commonly associated with gastrointestinal disorders leading to impaired absorption and utilization of cobalamin. The objectives of this study were to compare serum cobalamin concentrations between dogs with leishmaniosis and clinically healthy dogs, and to assess possible alterations of serum cobalamin concentrations in dogs with leishmaniosis at different timepoints during treatment. Fifty-five dogs with leishmaniosis and 129 clinically healthy dogs were prospectively enrolled. Diagnosis of leishmaniosis was based on clinical presentation, positive serology and microscopic detection of Leishmania amastigotes in lymph node aspiration smears. Twenty of the dogs with leishmaniosis were treated with a combination of meglumine antimonate and allopurinol for 28 days and serum cobalamin concentrations were measured in blood samples that were collected before initiation of treatment (timepoint 0) and on days 14 and 28. In order to estimate alterations of serum cobalamin concentrations during treatment, cobalamin concentrations were measured in blood samples from 20 out of 55 dogs with leishmaniosis at all timepoints. Serum cobalamin concentrations were significantly lower in dogs with leishmaniosis before treatment (median: 362 ng/L; IQR: 277−477 ng/L) compared to clinically healthy dogs (median: 470 ng/L; IQR: 367−632 ng/L; P = 0.0035). Serum cobalamin concentrations increased significantly in dogs with leishmaniosis on day 14 of treatment compared to timepoint 0 (P = 0.02). In the present study, serum cobalamin concentrations were significantly lower in dogs with leishmaniosis compared to clinically healthy dogs. In addition, there was an increase in serum cobalamin concentrations during treatment. The clinical significance of hypocobalaminemia in dogs with leishmaniosis remains to be determined. © 2021 Elsevier Lt

The 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6’-methylresorufin) ester (DGGR) lipase assay in cats and dogs is not specific for pancreatic lipase

Background: The measurement of pancreatic lipase is important for the diagnosis of feline and canine pancreatitis. Recent studies have claimed that lipase assays using the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6’-methylresorufin) ester (DGGR) as a substrate are more specific for measuring pancreatic lipase than traditional lipase assays. However, the analytical specificity of this assay for pancreatic lipase has not been demonstrated. Objectives: We aimed to determine whether hepatic and/or lipoprotein lipases can interfere with the DGGR-based assay results in cats and dogs. We, therefore, compared plasma lipase activities measured using DGGR-based and pancreatic lipase immunoreactivity (PLI) assays before and after administering heparin, known to cause the release of hepatic and lipoprotein lipases, in cats and dogs. Methods: Heparin was administered in six cats and six dogs. Blood was collected at baseline and 10, 20, 30, 60, and 120 minutes after heparin administration. Lipase activity was measured using a DGGR-based assay, and PLI concentrations were measured using the Spec fPL and cPL assays for cats and dogs, respectively. Results: Plasma lipase activities, as measured using the DGGR-based assay, increased significantly 10 minutes after heparin administration in both cats (P =.003) and dogs (P =.006) and returned to baseline by 120 minutes. In contrast, PLI concentrations showed no significant changes after heparin administration. Conclusions: DGGR is not only hydrolyzed by pancreatic lipase but also by hepatic lipase, lipoprotein lipase, or both, in cats and dogs. Since these extrapancreatic lipases are also naturally present in cats and dogs, they could contribute to the lack of analytical specificity for the DGGR-based assays. © 2020 American Society for Veterinary Clinical Patholog