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- Author or Editor: Elias Westermarck x
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Objective—To study progression of autoimmunemediated atrophic lymphocytic pancreatitis from the subclinical to the clinical phase (exocrine pancreatic insufficiency [EPI]) and determine whether progression of the disease could be halted by treatment with immunosuppressive drugs.
Design—Randomized controlled trial.
Animals—20 dogs with subclinical EPI.
Procedure—Diagnosis of subclinical EPI was determined on the basis of repeatedly low serum trypsin like-immunoreactivity (TLI) in dogs with no signs of EPI. Laparotomy was performed on 12 dogs with partial acinar atrophy and atrophic lymphocytic pancreatitis. A treatment group (7 dogs) received an immunosuppressive drug (azathioprine) for 9 to 18 months, and a nontreatment group (13) received no medication.
Results—During the subclinical phase, serum TLI was repeatedly low (< 5.0 µg/L). Although a few dogs had nonspecific gastrointestinal tract signs, they did not need diet supplementation with enzymes. While receiving immunosuppressive medication, treated dogs had no clinical signs of EPI, but within 2 to 6 months after treatment was stopped, 2 dogs had signs of EPI, and diet supplementation with enzymes was started. Five of the 13 untreated dogs needed diet supplementation with enzymes within 6 to 46 months. During follow-up of 1 to 6 years, 3 of the 7 treated dogs and 8 of the 13 untreated dogs did not need continuous diet supplementation with enzymes.
Conclusions and Clinical Relevance—Progression of atrophic lymphocytic pancreatitis varied widely. The subclinical phase may last for years and sometimes for life. The value of early treatment with an immunosuppressive drug was questionable and, because of the slow natural progression of the disease, cannot be recommended. (J Am Vet Med Assoc 2002;220:1183–1187)
Objective—To assess the effects of dietary modification on clinical signs of exocrine pancreatic insufficiency (EPI) in dogs.
Design—Blinded randomized crossover study.
Animals—21 dogs with EPI.
Procedure—Dogs were fed the diet they received at home for 2 weeks. Thereafter, they received 3 special diets (a high-fat diet, a high-fiber diet, and a highly digestible low-residue diet) for 3 weeks each. Owners scored dogs daily for the last 2 weeks of each 3-week period for severity of 6 clinical signs including appetite, defecation frequency, consistency of feces, borborygmus, flatulence, and coprophagia. An EPI index was calculated for each dog by adding the daily scores for each clinical sign.
Results—Significant differences in daily EPI indices among diets were observed in 20 dogs. The original diet appeared to be the most suitable in 8 dogs, whereas the high-fat diet was most suitable in 5 dogs, the high-fiber diet was most suitable in 4 dogs, and the low-residue diet was most suitable in 2 dogs. In 1 dog, the lowest EPI index score was the same during the original diet and the high-fat diet feeding periods. One dog did not complete the feeding period for the high-fiber diet. Differences in mean EPI indices among diets were not significant.
Conclusions and Clinical Relevance—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.
Objective—To provide values for gastrointestinal permeability and absorptive function tests (GIPFTs) with chromium 51 (51Cr)-labeled EDTA, lactulose, rhamnose, d-xylose, 3-O-methyl-d-glucose, and sucrose in Beagles and to evaluate potential correlations between markers.
Animals—19 healthy adult male Beagles.
Procedures—A test solution containing 3.7 MBq of 51Cr-labeled EDTA, 2 g of lactulose, 2 g of rhamnose, 2 g of d-xylose, 1 g of 3-O-methyl-d-glucose, and 8 g of sucrose was administered intragastrically to each dog. Urinary recovery of each probe was determined 6 hours after administration.
Results—Mean ± SD (range) percentage urinary recovery was 6.3 ± 1.6% (4.3% to 9.7%) for 51Cr-labeled EDTA, 3.3 ± 1.1% (1.7% to 5.3%) for lactulose, 25.5 ± 5.0% (16.7% to 36.9%) for rhamnose, and 58.8% ± 11.0% (40.1% to 87.8%) for 3-O-methyl-d-glucose. Mean (range) recovery ratio was 0.25 ± 0.06 (0.17 to 0.37) for 51Cr-labeled EDTA to rhamnose, 0.13 ± 0.04 (0.08 to 0.23) for lactulose to rhamnose, and 0.73 ± 0.09 (0.60 to 0.90) for d-xylose to 3-O-methyl-d-glucose. Median (range) percentage urinary recovery was 40.3% (31.6% to 62.7%) for d-xylose and 0% (0% to 0.8%) for sucrose.
Conclusions and Clinical Relevance—Reference values in healthy adult male Beagles for 6 of the most commonly used GIPFT markers were determined. The correlation between results for 51Cr-labeled EDTA and lactulose was not as prominent as that reported for humans and cats; thus, investigators should be cautious in the use and interpretation of GIPFTs performed with sugar probes in dogs with suspected intestinal dysbiosis.
Objective—To assess the safety of endoscopic retrograde pancreatography (ERP) in dogs by performing repeated clinical examinations and laboratory analyses of serum amylase, lipase, canine trypsin-like immunoreactivity (cTLI), and canine pancreatic elastase 1 (cE1) after the procedure.
Animals—7 healthy Beagles.
Procedure—Clinical examinations were performed and blood samples obtained for serum enzyme determinations before and at intervals (10 minutes; 2, 4, and 6 hours; and 1, 2, and 3 days) after ERP.
Results—Repeated clinical examinations revealed no signs of ERP-induced complications in the 7 dogs. Results of repeated laboratory tests indicated a transient increase in serum values of amylase, lipase, and cTLI but not cE1. Mean ± SD lipase activity increased from 120.7 ± 116.4 U/L to 423.4 ± 243.1 U/L at 4 hours after ERP. Median serum cTLI concentration increased from 16.2 µg/L (range, 7.7 to 26.5 µg/L) to 34.9 µg/L (range, 16.6 to 68.3 µg/L) 10 minutes after ERP. Enzyme values returned to baseline levels at the latest on day 2 in 6 of 7 dogs. Highest values for serum amylase, lipase, and cTLI and their delayed return to baseline values were detected in 1 dog with contrast filling of the pancreatic parenchyma.
Conclusions and Clinical Relevance—Results indicated that ERP appears to be a safe imaging technique of pancreatic ducts in healthy dogs, although it induced a transient increase in serum values of pancreatic enzymes. In dogs, repeated clinical examinations and serum enzyme determinations can be used to monitor ERP-induced complications such as acute pancreatitis. ( Am J Vet Res 2004;65:616–619)