Peer-reviewed veterinary case report
Cholestyramine helped two dogs with bile acid diarrhea
By Toresson, L. et al.·Published in Canine Medicine and Genetics·2021·View original on Crossref →
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Original publication title: Cholestyramine treatment in two dogs with presumptive bile acid diarrhoea: a case report
- Species:
- dog
Plain-English summary
An 8-year-old Rottweiler and a 4.5-year-old Siberian Husky were both suffering from chronic watery diarrhea that didn't improve with common treatments like special diets or medications. After trying various options without success, the vets suspected bile acid diarrhea, a condition that can affect dogs. They started both dogs on cholestyramine, a medication that helps bind bile acids, and saw significant improvements in their stool consistency, frequency of bathroom trips, and overall activity levels. This case suggests that bile acid diarrhea should be considered in dogs with ongoing diarrhea that doesn't respond to standard treatments.
People also search for: dog chronic diarrhea treatment · cholestyramine for dogs · Rottweiler diarrhea causes · Siberian Husky diarrhea remedy
Abstract
Abstract Background In people, bile acid diarrhoea is a prevalent complication of Crohn’s disease and diarrhoea-associated irritable bowel syndrome. Affected patients typically respond to bile acid sequestrants, such as cholestyramine, but human gastroenterologists often fail to recognize bile acid diarrhoea. Consequently, bile acid diarrhoea is regarded as an underrecognized and undertreated condition in human medicine. Due to lack of diagnostic tools, clinical response to bile acid sequestrants is often used to confirm a diagnosis of bile acid diarrhoea in people. Several recent studies have shown that bile acid dysmetabolism also occurs in dogs with chronic enteropathies. It has further been shown that dogs with chronic enteropathies have significantly decreased expression of a bile acid transport protein in the ileum compared to healthy dogs, which correlates with faecal bile acid dysmetabolism. Consequently, in spite of the lack of reports in the literature, bile acid diarrhoea is likely to exist in dogs as well. Case descriptions Two dogs, an 8-year old Rottweiler and a 4.5-year old Siberian Husky were evaluated for chronic watery diarrhoea. Neither dog responded to dietary trials, probiotics, cyclosporine, faecal microbial transplantations or metronidazole. One of the dogs responded to high daily doses of corticosteroids, which were however associated with unacceptable side effects. The other dog was refractory to all standard treatment protocols, including cyclosporine and corticosteroids. Since none of the dogs responded satisfactorily to standard treatment or modulation of the intestinal microbiome, a suspicion of possible bile acid diarrhoea was raised. Treatment with cholestyramine, a bile acid sequestrant was initiated and resulted in marked improvement of faecal consistency, frequency of defecation and activity level in both dogs. Conclusion This report presents two dogs with presumed bile acid diarrhoea that were successfully treated with cholestyramine. Therefore, bile acid diarrhoea should be considered as a possible diagnosis in dogs with treatment-refractory chronic diarrhoea.
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Search related cases →Original publication on Crossref: https://doi.org/10.1186/s40575-021-00099-x