Effects of diet on clinical signs of exocrine pancreatic insufficiency in dogs

Westermarck, Elias; Wiberg, Maria

doi:10.2460/javma.228.2.225

Cited by 14 publications

(7 citation statements)

References 17 publications

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“…Dietary management is recommended as adjunctive therapy in canine EPI, and the most important consideration appears to be in fat content with fat restriction recommended in some [10,11], but not all [12,13], studies. Further, prospective studies have not demonstrated a clear benefit of any specific diet in the treatment of canine EPI [13-15]. In fact, different diet types (i.e.…”

Section: Discussionmentioning

confidence: 99%

A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

et al. 2012

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BackgroundEnzyme treatment is the mainstay for management of exocrine pancreatic insufficiency (EPI) in dogs. ‘Enteric-coated’ preparations have been developed to protect the enzyme from degradation in the stomach, but their efficacy has not been critically evaluated. The hypothesis of the current study was that enteric coating would have no effect on the efficacy of pancreatic enzyme treatment for dogs with EPI.Thirty-eight client-owned dogs with naturally occurring EPI were included in this multicentre, blinded, randomised controlled trial. Dogs received either an enteric-coated enzyme preparation (test treatment) or an identical preparation without the enteric coating (control treatment) over a period of 56 days.ResultsThere were no significant differences in either signalment or cobalamin status (where cobalamin deficient or not) between the dogs on the test and control treatments. Body weight and body condition score increased in both groups during the trial (P<0.001) but the magnitude of increase was greater for the test treatment compared with the control treatment (P<0.001). By day 56, mean body weight increase was 17% (95% confidence interval 11-23%) in the test treatment group and 9% (95% confidence interval 4-15%) in the control treatment group. The dose of enzyme required increased over time (P<0.001) but there was no significant difference between treatments at any time point (P=0.225). Clinical disease severity score decreased over time for both groups (P=0.011) and no difference was noted between groups (P=0.869). No significant adverse effects were reported, for either treatment, for the duration of the trial.ConclusionsEnteric coating a pancreatic enzyme treatment improves response in canine EPI.

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Section: Discussionmentioning

confidence: 99%

A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

et al. 2012

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“…The small intestinal microbiota, even if of normal composition, can contribute to clinical signs when there is an abnormal or increased amount of food or drug substrate in the intestinal lumen. This can be due to feeding diets with poor digestibility, inflammatory diseases that damage the transporters in the epithelial brush border, 28,29 and a lack of digestive enzymes in patients with exocrine pancreatic insufficiency (EPI) 30 . Therefore, abnormal microbial conversion of luminal substrates by normal microbiota can be pathologic, not just changes in bacterial populations.…”

Section: Assessment Of the Intestinal Microbiome—general Considerationsmentioning

confidence: 99%

“…This can be due to feeding diets with poor digestibility, inflammatory diseases that damage the transporters in the epithelial brush border, 28 , 29 and a lack of digestive enzymes in patients with exocrine pancreatic insufficiency (EPI). 30 Therefore, abnormal microbial conversion of luminal substrates by normal microbiota can be pathologic, not just changes in bacterial populations. While some of the microbiome changes that likely originate in the small intestine can be detected in fecal samples, as reported for dogs receiving omeprazole, 23 , 31 dogs with EPI, 32 and dogs with chronic enteropathies (CE), 33 , 34 the above limitations should nevertheless be considered when analyzing fecal samples only.…”

Section: Assessment Of the Intestinal Microbiome—general Considerationsmentioning

confidence: 99%

Analysis of the gut microbiome in dogs and cats

Suchodolski

2021

Veterinary Clinical Pathol

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The gut microbiome is an important immune and metabolic organ. Intestinal bacteria produce various metabolites that influence the health of the intestine and other organ systems, including kidney, brain, and heart. Changes in the microbiome in diseased states are termed dysbiosis. The concept of dysbiosis is constantly evolving and includes changes in microbiome diversity and/or structure and functional changes (eg, altered production of bacterial metabolites). Molecular tools are now the standard for microbiome analysis. Sequencing of microbial genes provides information about the bacteria present and their functional potential but lacks standardization and analytical validation of methods and consistency in the reporting of results. This makes it difficult to compare results across studies or for individual clinical patients. The Dysbiosis Index (DI) is a validated quantitative PCR assay for canine fecal samples that measures the abundance of seven important bacterial taxa and summarizes the results as one single number. Reference intervals are established for dogs, and the DI can be used to assess the microbiome in clinical patients over time and in response to therapy (eg, fecal microbiota transplantation). In situ hybridization or immunohistochemistry allows the identification of mucosa‐adherent and intracellular bacteria in animals with intestinal disease, especially granulomatous colitis. Future directions include the measurement of bacterial metabolites in feces or serum as markers for the appropriate function of the microbiome. This article summarizes different approaches to the analysis of gut microbiota and how they might be applicable to research studies and clinical practice in dogs and cats.

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“…Studies in the human literature, where cross over design using different pancreatic enzyme supplements for cystic fibrosis have employed 1, 2, or 4 weeks duration. Dietary trials in dogs with EPI have also used a 3 week period, hence we decided to use a 3 week period for each treatment arm in our study.…”

Section: Discussionmentioning

confidence: 99%

Randomized placebo controlled clinical trial of an enteric coated micro‐pelleted formulation of a pancreatic enzyme supplement in dogs with exocrine pancreatic insufficiency

Parambeth

Fosgate

Suchodolski

et al. 2018

Veterinary Internal Medicne

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BackgroundPancreatic enzyme supplements for the treatment of exocrine pancreatic insufficiency (EPI) in dogs can be uncoated or enteric coated. Enteric coated supplements might be advantageous.Hypothesis/ObjectivesEnteric coated enzyme supplements are superior to uncoated supplements in dogs with clinical EPI.AnimalsEleven dogs with naturally occurring EPI that were apparently free from other diseases.MethodsRandomized, blinded, controlled cross‐over clinical trial comparing a novel micro‐encapsulated enteric coated enzyme supplement to a commercially available uncoated product in dogs with clinical EPI. Search of serum canine serum trypsin‐like immunoreactivity concentration ≤ 2.5 µg/L in the Gastrointestinal Laboratory database was used to identify dogs with EPI.ResultsThere was no difference −4.46% (95% CI: −7.97%‐–0.96%; P = .15) in the % acid hydrolysis fecal fat (primary outcome) between the enteric coated formulation (median: 11.8%; range 6.4%‐17.0%) and the uncoated pancreatic enzyme replacement product (median: 17.5%; range: 5.2%‐24.9%) in the 11 dogs that completed the study. Other variables did not differ between treatments.Conclusions and Clinical ImportanceThis study, which had low statistical power, did not detect a difference between formulations.

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Effects of diet on clinical signs of exocrine pancreatic insufficiency in dogs

Abstract: Results indicated that responses to different diets varied among individual dogs. Because responses to the feeding regimens were unpredictable, it is suggested that feeding regimens be individually formulated for dogs with EPI.

Cited by 14 publications

References 17 publications

A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

Analysis of the gut microbiome in dogs and cats

Randomized placebo controlled clinical trial of an enteric coated micro‐pelleted formulation of a pancreatic enzyme supplement in dogs with exocrine pancreatic insufficiency

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