Dandrieux Jrs, Martinez Lopez L M, Prakash N, Mansfield C S
Translational Research and Animal Clinical Trial Study (TRACTS) group, The University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, 250 Princes Hwy, Werribee, 3030, Victoria, Australia.
Mount Pleasant Veterinary Group, Mount Pleasant @ Gelenggang, 2 Jalan Gelenggang, Singapore, 578187, Singapore.
Aust Vet J. 2019 Sep;97(9):301-307. doi: 10.1111/avj.12846. Epub 2019 Jul 22.
Chronic enteropathy (CE) in dogs is common worldwide, but little data is available from Australia. The aim of this study was to describe treatment response and long-term outcome in a cohort of dogs with CE. Dogs were prospectively enrolled at Murdoch University and the University of Melbourne. After diagnostic investigation to rule out diseases other than CE, dogs underwent sequential therapeutic trials until achieving a clinical response (diet then antibiotics, and finally immunosuppressants). Success was defined as 75% reduction of clinical severity for a minimum of five weeks. A total of 21 dogs were enrolled, and 19 completed the study. One dog was euthanised for lack of response to treatment and one excluded for lack of owner compliance. Most dogs responded to diet (n = 10), followed by antibiotics (n = 7) and immunosuppressants (n = 2). Long-term remission (median 21.1 months, [3.0-44.7]) was achieved in eight out of ten dietary responders without additional treatment. In contrast, only two dogs with antibiotic response remained in long-term remission, of which one needed on-going antibiotic treatment. Longer term remission was achieved in the two dogs treated with immunosuppressants with on-going low dose therapy. This study concludes that most dogs referred for CE in Australia respond to dietary treatment (even after previous dietary interventions), and remission is long-term compared to dogs treated with an antibiotic. Furthermore, the need for long-term antibiotics in some dogs to maintain response may lead to antibiotic resistance. This study supports adequate dietary trials for CE in dogs, and a need for alternative second-line treatments.
犬慢性肠病（CE）在全球范围内都很常见，但澳大利亚的相关数据较少。本研究的目的是描述一组患有CE的犬的治疗反应和长期预后。犬在默多克大学和墨尔本大学进行前瞻性登记。在进行诊断性检查以排除CE以外的疾病后，犬接受序贯治疗试验，直到获得临床反应（先饮食调整，然后使用抗生素，最后使用免疫抑制剂）。成功定义为临床严重程度降低75%，且至少持续五周。共登记了21只犬，19只完成了研究。一只犬因对治疗无反应而实施安乐死，一只因主人未遵守规定而被排除。大多数犬对饮食调整有反应（n = 10），其次是抗生素（n = 7）和免疫抑制剂（n = 2）。十只饮食调整有反应的犬中有八只在未进行额外治疗的情况下实现了长期缓解（中位时间21.1个月，[3.0 - 44.7]）。相比之下，只有两只对抗生素有反应的犬保持了长期缓解，其中一只需要持续使用抗生素治疗。接受免疫抑制剂治疗的两只犬在持续低剂量治疗的情况下实现了更长期的缓解。本研究得出结论，在澳大利亚，大多数转诊来治疗CE的犬对饮食治疗有反应（即使之前已经进行过饮食干预），并且与使用抗生素治疗的犬相比，缓解期更长。此外，一些犬需要长期使用抗生素来维持反应可能会导致抗生素耐药性。本研究支持对犬CE进行充分的饮食试验，以及需要替代的二线治疗方法。
