Efficacy of an orally administered anti‐diarrheal probiotic paste (Pro‐Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo‐controlled, double‐blinded clinical study

Abstract

Background Acute diarrhea is a common clinical presentation of dogs. The effect of specific anti‐diarrheal probiotic pastes (ADPPs) in the management of acute, uncomplicated diarrhea in dogs is unknown. Hypothesis Administration of an ADPP containing Enterococcus faecium 4b1707 will improve the clinical outcome of acute, uncomplicated diarrhea in dogs compared to placebo. Animals One hundred forty‐eight client‐owned dogs with acute diarrhea as the main clinical sign. Methods Double‐blinded, placebo‐controlled, randomized, blocked, multicenter clinical field study conducted at 14 primary care veterinary practices in the United Kingdom and Ireland. Results The ADPP was associated with better clinical outcome compared to placebo in dogs with acute, uncomplicated diarrhea. Dogs in the ADPP group had a significantly shorter duration of diarrhea (ADPP: median, 32 hours; 95% confidence interval [CI], 2‐118; n = 51; Placebo: median, 47 hours; 95% CI, 4‐167; n = 58; P = .008) and the rate of resolution of diarrhea was 1.60 times faster in the ADPP group than in the Placebo group (ratio, 1.60; 95% CI, 1.08‐2.44; P = .02). Fewer dogs required additional medical intervention (AMI) for non‐improvement or worsening in the ADPP group compared to the Placebo group (3.5% of dogs and 14.8% of dogs, respectively), with a relative risk of 0.88 ( P = .04; AMI, ADPP, 3.5%, 2/57 dogs; Placebo, 14.8%, 9/61 dogs; relative risk, 0.88; 95% CI, 0.77‐0.99). Conclusion and Clinical Importance The ADPP may accelerate resolution of acute diarrhea in dogs and decrease the requirement for AMI.

Metronidazole treatment of acute diarrhea in dogs: A randomized double blinded placebo‐controlled clinical trial

“…Additionally, evidence suggests that metronidazole treatment dramatically alters the intestinal microbiome of normal dogs, and some of these changes persist for an indefinite time period . Dietary modifications or probiotic treatment might yield clinically advantageous effects comparable to those of metronidazole and preclude the need for antimicrobial treatment . These and other important issues require further consideration, but they were beyond the scope of our study.…”

“…Management strategies for acute diarrhea in dogs have garnered considerable attention in recent years . Probiotics have been studied extensively, but with inconsistent results.…”

“…Probiotics have been studied extensively, but with inconsistent results. Various formulations have been documented to decrease the duration of acute diarrhea by 0.6, 0.9, 1, and 2.7 days as compared to placebo‐treated dogs. Other studies have shown no treatment effects, and a recent systematic review suggested that the overall clinical benefit of probiotic therapy is potentially unimportant .…”

“…Owners also maintained fecal scoring logs (Supplementary File S2) using the Bristol scoring system (Supplementary File S3), and a laminated copy of the Bristol fecal chart was provided to owners to aid in fecal scoring. This scoring system has not been validated in dogs, but it has been validated and utilized extensively in humans and it shares many similarities with other non‐validated scoring scales that have been used in studies of diarrheic dogs . Briefly, fecal scores could range from 1 to 7, with scores of ≤4 considered to be non‐diarrheic .…”

“…Acute diarrhea, which is defined as a short‐term increase in the liquidity of feces, is a common reason for non‐wellness–related veterinary evaluations in dogs . Most cases are mild and self‐limiting, but owners frequently seek veterinary care because of concern for their pet's well‐being in conjunction with the difficulties associated with managing a dog with diarrhea . The causes of acute diarrhea are varied.…”