Peer-reviewed veterinary case report
Best diet and medicine combos to ease symptoms in dogs with liver
By Serrano, Goncalo et al.·Published in Journal of veterinary internal medicine·2022·Small Animal Department·View original on PubMed →
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Original publication title: Comparison of diet, lactulose, and metronidazole combinations in the control of pre-surgical clinical signs in dogs with congenital extrahepatic portosystemic shunts.
- Species:
- dog
Plain-English summary
A group of 36 dogs with congenital extrahepatic portosystemic shunts (cEHPSS) showed clinical signs like vomiting and lethargy before surgery. They were treated with a special diet, lactulose, or a combination of both for four weeks. The results showed that dogs receiving the diet plus lactulose had significant improvement in their symptoms, while those on the diet alone or the diet with metronidazole did not see the same benefits. Ultimately, the combination of the special diet and lactulose was effective in stabilizing the dogs before surgery, helping to lower ammonia levels in their blood.
People also search for: dog liver shunt treatment · dog vomiting and lethargy · lactulose for dogs with liver disease
Abstract
BACKGROUND: Hepatic supportive diet (HSD), lactulose, and antimicrobials are medical treatments for dogs with congenital extrahepatic portosystemic shunts (cEHPSS). The relative contribution of these treatment components is currently unknown. OBJECTIVES: To determine which treatment combinations are most efficacious in pre-surgical control of clinical signs of cEHPSS in dogs. ANIMALS: Thirty-six dogs with untreated cEHPSS. METHODS: Three-arm randomized clinical trial. At inclusion (T0), dogs were divided into 3 groups: HSD (n = 12), HSD + lactulose (n = 12), or HSD + metronidazole (n = 12) and received the randomized treatment for 4 weeks (T1) followed by combined treatment of HSD + lactulose + metronidazole for 2 weeks or until cEHPSS attenuation (T2). Clinical score as well as fasting ammonia (FA) and C-reactive protein (CRP) concentrations were compared among groups and time points. RESULTS: Thirty-four dogs were evaluated. Thirty-four dogs reached T1 and 29 dogs T2. At T1, clinical scores decreased in the HSD + lactulose (n = 11; P = .001), but not in the HSD (n = 8; P = .96) and HSD + metronidazole (n = 10; P = .06) groups. Adding metronidazole to HSD + lactulose (n = 11) did not result in further clinical score improvement (T2; P = 1.000). Moderate and weak correlation between clinical score and FA and clinical score and CRP was present (ρ = .35, P < .001; ρ = .27, P = .01, respectively) with FA decreasing over time on medical treatment (P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Combined HSD + lactulose seems sufficient for pre-surgical cEHPSS stabilization unlike sole HSD or HSD + metronidazole. Medical treatment of cEHPSS clinical signs decreases FA.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35633289/