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

ABSTRACT: BACKGROUND:Metronidazole is commonly administered to dogs with acute diarrhea, but there is limited evidence to support this practice. OBJECTIVE:To investigate the effects of metronidazole administration on dogs with acute nonspecific diarrhea. ANIMALS:Thirty-one dogs, including 14 test population dogs and 17 controls. METHODS:Randomized controlled clinical trial. Dogs with acute diarrhea in which causation was not determined by routine fecal diagnostic testing were randomly assigned to metronidazole treatment (10-15?mg/kg PO q12h for 7?days) or placebo. Fecal cultures and characterization of Clostridium perfringens isolates also were performed. Owners maintained medication and fecal scoring logs, and fecal diagnostic tests were repeated on day 7. RESULTS:The mean?± SD time to resolution of diarrhea for test population dogs (2.1?±?1.6?days) was less than that for controls (3.6?±?2.1?days, P =?.04). Potential relationships of C. perfringens with acute diarrhea pathogenesis were not investigated, but only 3 of 13 (23.1%) test population dogs had persistent C. perfringens carriage at day 7, which was less than the 11 of 14 (78.6%) controls with persistent growth (P =?.007). CONCLUSIONS AND CLINICAL IMPORTANCE:Our results suggest that metronidazole treatment can shorten duration of diarrhea and decrease fecal culture detection of C. perfringens in some dogs with acute nonspecific diarrhea. Additional studies are needed to assess the benefits and risks of routine use of metronidazole for this purpose because most dogs achieve resolution of diarrhea within several days regardless of treatment.

SUBMITTER: Langlois DK

PROVIDER: S-EPMC6979100 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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

Langlois Daniel K DK Koenigshof Amy M AM Mani Rinosh R

Journal of veterinary internal medicine 20191119 1

<h4>Background</h4>Metronidazole is commonly administered to dogs with acute diarrhea, but there is limited evidence to support this practice.<h4>Objective</h4>To investigate the effects of metronidazole administration on dogs with acute nonspecific diarrhea.<h4>Animals</h4>Thirty-one dogs, including 14 test population dogs and 17 controls.<h4>Methods</h4>Randomized controlled clinical trial. Dogs with acute diarrhea in which causation was not determined by routine fecal diagnostic testing were ...[more]

PMID: 31742807

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Project description:ImportanceStudies suggest gut worms induce immune responses that can protect against multiple sclerosis (MS). To our knowledge, there are no controlled treatment trials with helminth in MS.ObjectiveTo determine whether hookworm treatment has effects on magnetic resonance imaging (MRI) activity and T regulatory cells in relapsing MS.Design, setting, and participantsThis 9-month double-blind, randomized, placebo-controlled trial was conducted between September 2012 and March 2016 in a modified intention-to-treat population (the data were analyzed June 2018) at the University of Nottingham, Queen's Medical Centre, a single tertiary referral center. Patients aged 18 to 61 years with relapsing MS without disease-modifying treatment were recruited from the MS clinic. Seventy-three patients were screened; of these, 71 were recruited (2 ineligible/declined).InterventionsPatients were randomized (1:1) to receive either 25 Necator americanus larvae transcutaneously or placebo. The MRI scans were performed monthly during months 3 to 9 and 3 months posttreatment.Main outcomes and measuresThe primary end point was the cumulative number of new/enlarging T2/new enhancing T1 lesions at month 9. The secondary end point was the percentage of cluster of differentiation (CD) 4+CD25highCD127negT regulatory cells in peripheral blood.ResultsPatients (mean [SD] age, 45 [9.5] years; 50 women [71%]) were randomized to receive hookworm (35 [49.3%]) or placebo (36 [50.7%]). Sixty-six patients (93.0%) completed the trial. The median cumulative numbers of new/enlarging/enhancing lesions were not significantly different between the groups by preplanned Mann-Whitney U tests, which lose power with tied data (high number of zeroactivity MRIs in the hookworm group, 18/35 [51.4%] vs 10/36 [27.8%] in the placebo group). The percentage of CD4+CD25highCD127negT cells increased at month 9 in the hookworm group (hookworm, 32 [4.4%]; placebo, 34 [3.9%]; P = .01). No patients withdrew because of adverse effects. There were no differences in adverse events between groups except more application-site skin discomfort in the hookworm group (82% vs 28%). There were 5 relapses (14.3%) in the hookworm group vs 11 (30.6%) receiving placebo.Conclusions and relevanceTreatment with hookworm was safe and well tolerated. The primary outcome did not reach significance, likely because of a low level of disease activity. Hookworm infection increased T regulatory cells, suggesting an immunobiological effect of hookworm. It appears that a living organism can precipitate immunoregulatory changes that may affect MS disease activity.Trial registrationClinicalTrials.gov Identifier: NCT01470521.

Dataset Information

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

Publications

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

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