Randomized controlled trial of hydrolyzed fish diets in dogs with chronic enteropathy

Abstract

Background: The role of diet in the pathogenesis and treatment of chronic enteropathies (CE) in dogs is unresolved.

Objectives: To compare the ability of diets composed of hydrolyzed fish, rice starch, and fish oil without (HF) or with prebiotics, turmeric, and high cobalamin (HF+) against a limited ingredient diet containing mixed nonhydrolyzed antigens and oils (control) to resolve clinical signs and maintain serum cobalamin and folate concentrations in dogs with nonprotein losing CE (non-PLE). To determine the ability of hydrolyzed fish diets to support recovery and remission in dogs with PLE.

Animals: Thirty-one client-owned dogs with CE: 23 non-PLE, 8 PLE.

Methods: Randomized, blinded, controlled trial. Diets were fed for 2 weeks; responders continued for 12 weeks. Nonresponders were crossed over to another diet for 12 weeks. Response was determined by standardized clinical evaluation with long-term follow-up at 26 weeks. Concurrent medications were allowed in PLE.

Results: Nineteen of 23 (83%; 95% confidence interval [CI], 60%-94%) non-PLE CE responded clinically to their initial diet, with no difference between diets (P > .05). Four nonresponders responded to another diet, with sustained remission of 18/18 (100%; 95%CI, 78%-100%) at 26 weeks. Serum cobalamin concentration was increased (P < .05) and maintained by diet. Serum folate concentration decreased posttreatment (P < .05) but was restored by dietary supplementation. Hydrolyzed fish diets supported weight gain, serum albumin concentration, and recovery (P < .05) in dogs with PLE.

Conclusions and clinical importance: Changing diet, independent of antigen restriction or supplemental ingredients, induced long-term remission in dogs with non-PLE CE. Serum cobalamin and folate concentrations were maintained by diet. Hydrolyzed fish diets supported clinical recovery and remission in PLE.

Keywords: cobalamin; curcumin; folate; inflammatory bowel disease; lymphangiectasia; prebiotics; protein-losing enteropathy.

FIGURE 1

Clinical response to dietary modification. (A) Disease activity (CCECAI score) before and after diet non‐PLE Baseline and 2 weeks = initial diet, 12 weeks = final diet. (B) Fecal scores before and after diet non‐PLE Baseline and 2 weeks = initial diet, 12 weeks = final diet. (C) Clinical outcome in dogs with chronic enteropathy and normal serum albumin concentration. ^cResponse was defined as reduced disease activity and improved fecal consistency. (D) Clinical outcome in dogs with chronic enteropathy and protein‐losing enteropathy (PLE). ^dResponse was defined by increased body weight and serum albumin concentration. Concurrent medications were allowed ^a P < .001 vs baseline; ^b P < .01 vs 2 weeks.