Clinical characteristics and long-term outcome of E. coli-associated granulomatous ileocolitis in dogs: five cases (2010-2014).

OBJECTIVES: To describe the clinical characteristics and long-term outcome of Escherichia coli-associated granulomatous ileocolitis in dogs. METHODS: Retrospective review of medical records from dogs with periodic acid-Schiff positive (PAS+) granulomatous ileocolitis and mucosally invasive E. coli in the ileum and colon. Initial bacterial colonisation was evaluated using fluorescence in situ hybridization (FISH) in all dogs and corroborated with colonic and/or ileal culture, when performed. RESULTS: Four boxer dogs and 1 French Bulldog with PAS+ granulomatous ileocolitis (GIC) were evaluated. All dogs had chronic diarrhoea refractory to empirical therapy. Ileocolonoscopy revealed mucosal haemorrhage and ulceration in the ileum (3/4) and colon (5/5). E. coli were visualised as clusters within the ileal and colonic mucosa. Complete (CR, 4/5) or partial (PR, 1/5) clinical response to fluoroquinolones was noted in all dogs within 30 days. CR was sustained in three of four dogs (median disease-free interval 40 months, range 16 to 60). Two dogs relapsed while receiving fluoroquinolones. Repeat biopsy isolated multidrug-resistant, mucosally invasive E. coli in the ileum (1/2) and colon (2/2). Targeted antimicrobial therapy was associated with long-term PR (78 months) in both dogs. CLINICAL SIGNIFICANCE: Concurrent E. coli-associated granulomatous inflammation in the ileum and colon did not impart a poor clinical outcome or lack of response to the conventional standard of care for granulomatous colitis in dogs that were aggressively diagnosed and treated. Clinical outcome was influenced by antimicrobial resistance, with response dependent upon antimicrobial therapy informed by susceptibility testing.

Clinicopathologic and prognostic factors in short- and long-term surviving dogs with protein-losing enteropathy.

INTRODUCTION: The aim of the present study was to investigate the differences in the characteristics of short- and long-term surviving dogs with protein-losing enteropathy (PLE) and to identify factors that predict its outcome. We retrospectively reviewed the medical records of 59 client- owned dogs with PLE diagnosed at three different hospitals between January 2009 and November 2013. The dogs were classified as either short-term (= 6 months; STs) or long-term (> 6 months; LTs) survivors. Clinical and clinicopathological variables were investigated between the groups and receiver operating characteristic (ROC) curve analysis was performed. Nineteen dogs were classified as STs and 40 as LTs. Body weight and blood urea nitrogen concentrations were significantly higher in the STs at diagnosis (P < 0.05). At 1 month after initiation of immunosuppressive therapy (data- driven cut-off, T1), chronic canine enteropathy clinical activity index (CCECAI) scores were higher (P < 0.01) and albumin, serum total protein and total cholesterol concentrations were lower (P < 0.01) in the STs. ROC curve analysis showed that CCECAI > 5 evaluated at T1 was the best predictor of poor outcome. Although the severity of clinical signs and the majority of clinicopathological findings at diagnosis did not influence the outcome, survival time was shorter in the dogs with high CCECAI scores at T1 and which did not respond to therapy.

INTRODUCTION: Le présent travail avait pour buts d'étudier quels sont les différences de symptômes chez les chiens survivant à court et à long terme à une d'entéropathie exsudative (PLE) et d'identifier les facteurs ayant une valeur pronostique. On a étudié pour cela les dossiers médicaux de 59 chiens sur lesquels une entéropathie exsudative avait été diagnostiquée dans trois cliniques différentes entre janvier 2009 et novembre 2013. Les chiens ont été classés comme survivants à court terme (= 6 mois; STs) respectivement à long terme (= 6 mois; LTs). Les variations cliniques et clinico-pathologiques entre les groupes ont été relevées et une courbe ROC a été établie. Dixneuf chiens ont été classés comme STs et 40 comme LTs. Le poids corporel et la concentration sanguine d'urée était significativement plus élevée (P < 0.05) chez les STs que chez les LTs. Un mois après le début d'une immunosuppression (cut-off établi sur la base des données disponibles, T1), le score clinique d'activité pour une entéropathie chronique chez le chien (CCEAI) était plus élevé chez les STs que chez les LTs(P < 0.01), les valeur sanguines d'albumine, de protéines totales et de cholestérine totale par contre plus basses (P < 0.01). Dans l'analyse par la courbe ROC, un CCEAI > 5 à T1 s'est avéré être un indice fiable quant à une évolution de courte ou de longue durée. Bien que l'étendue des symptômes cliniques et la quantité des découvertes clinico-pathologiques n'aient pas influencé le pronostic, le taux de survie des chiens avec un CCEAI élevé à T1 et de ceux qui n'avaient pas répondu au traitement a été plus faible.