Prevalence of Clostridium perfringens alpha toxin and enterotoxin in the faeces of dogs with acute haemorrhagic diarrhoea syndrome

Abstract

Objectives To investigate the prevalence of Clostridium perfringens alpha toxin encoding gene and C. perfringens enterotoxin encoding gene in dogs with acute haemorrhagic diarrhoea syndrome. Materials and Methods Retrospective study looking at the prevalence of C. perfringens alpha toxin and C. perfringens enterotoxin in the faeces of three groups of dogs – those with acute haemorrhagic diarrhoea syndrome (n = 16), those with haemorrhagic diarrhoea from another cause (n = 17) and those without haemorrhagic diarrhoea (n = 10). Correlation between the presence of C. perfringens alpha toxin and/or C. perfringens enterotoxin and Acute Patient Physiological and Laboratory Evaluationfast scores, acute haemorrhagic diarrhoea index scores and length of hospitalisation in dogs with acute haemorrhagic diarrhoea syndrome was assessed. Results Prevalence of C. perfringens alpha toxin was not higher in dogs with acute haemorrhagic diarrhoea syndrome (43.75%) than dogs with haemorrhagic diarrhoea from another cause (58.82%) (difference in prevalence 15.07%; 95% CI −37% to 32%) or in dogs without haemorrhagic diarrhoea (60%) (difference in prevalence 16.25%; 95% CI −4% to 36%). Dogs with acute haemorrhagic diarrhoea syndrome did not have a significantly higher prevalence of C. perfringens enterotoxin (18.75%) compared to dogs without haemorrhagic diarrhoea (11.76%) (difference in prevalence 6.99%; 95% CI −18% to 32%). Prevalence of C. perfringens enterotoxin was similar in dogs with acute haemorrhagic diarrhoea syndrome and dogs without haemorrhagic diarrhoea (20%) (difference in prevalence 1.25% 95% CI −33% to 30%). The presence of C. perfringens alpha toxin did not correlate with increased Acute Patient Physiological and Laboratory Evaluationfast scores, acute haemorrhagic diarrhoea index scores or length of hospitalisation in dogs with acute haemorrhagic diarrhoea syndrome. Clinical Significance This study does not demonstrate increased prevalence of C. perfringens alpha toxin or C. perfringens enterotoxin in dogs with acute haemorrhagic diarrhoea syndrome compared to dogs with haemorrhagic diarrhoea from another cause or dogs without haemorrhagic diarrhoea.

Clinical response in dogs with acute hemorrhagic diarrhea syndrome following randomized probiotic treatment or fecal microbiota transplant

“…In the two dogs that did not respond to therapy, abdominal ultrasound and necropsy did not find other disease etiologies. While a lack of imaging could be considered a limitation, this is consistent with previous veterinary literature ( 5 , 8 , 9 ). These study variabilities highlight the substantial differences in veterinary literature among AHDS studies, making comparisons among studies challenging, and highlighting the need for standardized veterinary studies to accurately compare treatment efficacy.…”

“…As dogs were randomized to the treatment group based on sequential presentation, this is likely due to random chance. The median age of 2.67 years in FMT dogs is more similar to other canine AHDS studies ( 2 , 7 , 9 ) than the median of 8.5 years in probiotic dogs; however, dogs up to 16 years of age are affected ( 7 , 25 , 36 ). To the authors' knowledge, the effect of age on response to supportive AHDS treatment has not been reported.…”

“…The study inclusion time-frame of 48 h was also shorter than, though falls within, the <3 days used by many studies. (8,10,19,36) However, disease duration is not defined in all previous studies (5,9), and only three dogs in the current study presented at the 48-h duration of clinical signs allowed, suggesting that dogs often present to veterinarians well within 72 h due to the severity of clinical signs. Several dogs in this study also had known dietary indiscretions or recent introduction of novel commercial dog foods or treats.…”

“…However, there is no accepted Hct cut-off for the diagnosis of AHDS. Most published veterinary studies do not state Hct as an inclusion criterion, ( 2 , 4 , 6 , 7 , 9 , 10 , 36 ) and a range from 33 to 76% has been reported, ( 36 ) suggesting that the degree of hemoconcentration is less important than clinical disease presentation. The study inclusion time-frame of 48 h was also shorter than, though falls within, the < 3 days used by many studies.…”

“…Acute hemorrhagic diarrhea syndrome (AHDS) is a common cause of severe, hemorrhagic diarrhea and vomiting in dogs associated with gastrointestinal (GI) bacterial dysbiosis (1)(2)(3)(4) and hyperpermeability (2,4). Previous studies have inferred associations with shifts in normal bacterial communities, increases in potentially pathogenic bacteria targeted for analysis (e.g., Clostridium perfringens) (2-5), endotoxin production (6)(7)(8), and dietary factors (1), but the presence of these predisposing factors is inconsistent in AHDS dogs (6)(7)(8)(9)(10)(11) and in some cases, can be found in healthy dogs (e.g., fecal Clostridium perfringens) (8,10). Therefore, AHDS is considered an idiopathic condition, with standard therapy consisting of intensive intravenous fluids and supportive care.…”