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==Management of Acute Diarrhoea==

==Management of Acute Diarrhoea==

Acute diarrhoea is a common complaint seen in first-opinion small animal veterinary practice. One study reported 14.9% of dogs had experienced an episode of diarrhoea within the previous two-week period<ref name=":1">Hubbard K, Skelly BJ, McKelvie J, Wood JLN. Risk of vomiting and diarrhoea in dogs. Vet Rec 2007; 161: 755–757.</ref>

Acute diarrhoea is a common complaint seen in first-opinion small animal veterinary practice. One study reported 14.9% of dogs had experienced an episode of diarrhoea within the previous two-week period<ref name=":1">Hubbard K, Skelly BJ, McKelvie J, Wood JLN. Risk of vomiting and diarrhoea in dogs. Vet Rec 2007; 161: 755–757.</ref>; another reported 28.6% of dogs visiting the vets had diarrhoea as their presenting complaint or had experienced an episode of diarrhoea within the previous month.<ref name=":2">Stavisky J, Pinchbeck GL, German AJ et al. Prevalence of canine enteric coronavirus in a cross-sectional survey of dogs presenting at veterinary practices. Vet Microbiol 2010; 140: 18–24</ref> Data from pet cats is limited, but one study showed that prevalence of diarrhoea in a rescue cat population was 11.9%.<ref name=":3">German AC, Cunliffe NA, Morgan KL. Faecal consistency and risk factors for diarrhoea and constipation in cats in UK rehoming shelters. J Feline Med Surg 2017; 19(1): 57-65.</ref>

; another reported 28.6% of dogs visiting the vets had diarrhoea as their presenting complaint or had experienced an episode of diarrhoea within the previous month.<ref name=":2">Stavisky J, Pinchbeck GL, German AJ et al. Prevalence of canine enteric coronavirus in a cross-sectional survey of dogs presenting at veterinary practices. Vet Microbiol 2010; 140: 18–24</ref> Data from pet cats is limited, but one study showed that prevalence of diarrhoea in a rescue cat population was 11.9%.<ref name=":3">German AC, Cunliffe NA, Morgan KL. Faecal consistency and risk factors for diarrhoea and constipation in cats in UK rehoming shelters. J Feline Med Surg 2017; 19(1): 57-65.</ref>

Diarrhoea is defined as an increase in frequency, fluidity or volume of faeces and is a common complaint in dogs and cats.<ref name=":4">Battersby I, Harvey A. Differential diagnosis and treatment of acute diarrhoea in the dog and cat. In Practice 2006; 28: 480-488.</ref> Diarrhoea lasting for less than two weeks is generally described as acute<ref name=":5">Chandler ML. The chronically diarrhoeic dog. In Pract 2002; 24: 18–27.</ref> and commonly resolves without the requirement for veterinary intervention.<ref name=":1"/> Therefore, animals are often presented at the vets due to owner concern or difficulty in managing the symptoms. Despite the fact that it is often self-limiting and likely to resolve with symptomatic treatment alone, antibiotics are frequently prescribed as part of the therapeutic management plan.

Diarrhoea is defined as an increase in frequency, fluidity or volume of faeces and is a common complaint in dogs and cats.<ref name=":4">Battersby I, Harvey A. Differential diagnosis and treatment of acute diarrhoea in the dog and cat. In Practice 2006; 28: 480-488.</ref> Diarrhoea lasting for less than two weeks is generally described as acute<ref name=":5">Chandler ML. The chronically diarrhoeic dog. In Pract 2002; 24: 18–27.</ref> and commonly resolves without the requirement for veterinary intervention.<ref name=":1"/> Therefore, animals are often presented at the vets due to owner concern or difficulty in managing the symptoms. Despite the fact that it is often self-limiting and likely to resolve with symptomatic treatment alone, antibiotics are frequently prescribed as part of the therapeutic management plan.

Probiotics are commonly combined with other ingredients that possess properties which can be useful in animals experiencing diarrhoea. Various clays have absorptive and adsorptive properties, meaning they can bind fluid and bacterial or viral toxins.<ref name=":20">Fomina M, Skorochod I. Microbial Interaction with Clay Minerals and Its Environmental and Biotechnological Implications. Minerals. 2020; 10(10):861.</ref> Soluble fibres, such as psyllium, can also be useful due to their gel-forming ability when mixed with water. Other common ingredients are the yeast wall extracts mannan-oligosaccharides (MOS) and beta-glucans which can play a role in preventing pathogenic bacteria binding to the intestinal wall and increasing disease resistance through the activation of intestinal immunity.<ref name=":21">Pignataro G, Di Prinzio R, Crisi PE, Belà B, Fusaro I, Trevisan C, De Acetis L, Gramenzi A. Comparison of the therapeutic effect of treatment with antibiotics or nutraceuticals on clinical activity and the fecal microbiome of dogs with acute diarrhea. Animals. 2021 Jun;11(6):1484.</ref>

Probiotics are commonly combined with other ingredients that possess properties which can be useful in animals experiencing diarrhoea. Various clays have absorptive and adsorptive properties, meaning they can bind fluid and bacterial or viral toxins.<ref name=":20">Fomina M, Skorochod I. Microbial Interaction with Clay Minerals and Its Environmental and Biotechnological Implications. Minerals. 2020; 10(10):861.</ref> Soluble fibres, such as psyllium, can also be useful due to their gel-forming ability when mixed with water. Other common ingredients are the yeast wall extracts mannan-oligosaccharides (MOS) and beta-glucans which can play a role in preventing pathogenic bacteria binding to the intestinal wall and increasing disease resistance through the activation of intestinal immunity.<ref name=":21">Pignataro G, Di Prinzio R, Crisi PE, Belà B, Fusaro I, Trevisan C, De Acetis L, Gramenzi A. Comparison of the therapeutic effect of treatment with antibiotics or nutraceuticals on clinical activity and the fecal microbiome of dogs with acute diarrhea. Animals. 2021 Jun;11(6):1484.</ref>

Assessing the clinical outcomes of probiotic supplementation in dogs with acute diarrhoea has been the subject of numerous placebo-controlled studies.<ref name=":15"/>-<ref name=":19">Li Y, Xia S, Jiang X, Feng C, Gong S, Ma J, Fang Z, Yin J and Yin Y (2021) Gut Microbiota and Diarrhea: An Updated Review. Front. Cell. Infect. Microbiol. 11:625210. doi: 10.3389/fcimb.2021.625210</ref>,<ref name=":22">Gómez-Gallego C, Junnila J, Männikkö S, et al. A canine-specific probiotic product in treating acute or intermittent diarrhea in dogs: A double-blind placebo-controlled efficacy study. Vet Microbiol. 2016;197:122-128. </ref> Amongst these studies, findings in the probiotic treated groups included: shorter times to diarrhoea resolution, <ref name=":15"/> -<ref name=":17"/>  greater improvement in stool consistency score,18 faster improvement in Canine Haemorrhagic Diarrhoea Severity Index (CHDSI),18 greater decrease of faecal C. perfringens,<ref name=":17"/> and a lower requirement for additional medical interventions. <ref name=":15"/>,<ref name=":17"/>

Assessing the clinical outcomes of probiotic supplementation in dogs with acute diarrhoea has been the subject of numerous placebo-controlled studies.<ref name=":15"/>-<ref name=":19">Li Y, Xia S, Jiang X, Feng C, Gong S, Ma J, Fang Z, Yin J and Yin Y (2021) Gut Microbiota and Diarrhea: An Updated Review. Front. Cell. Infect. Microbiol. 11:625210. doi: 10.3389/fcimb.2021.625210</ref>,<ref name=":22">Gómez-Gallego C, Junnila J, Männikkö S, et al. A canine-specific probiotic product in treating acute or intermittent diarrhea in dogs: A double-blind placebo-controlled efficacy study. Vet Microbiol. 2016;197:122-128. </ref> Amongst these studies, findings in the probiotic treated groups included: shorter times to diarrhoea resolution, <ref name=":15"/><ref name=":16"/><ref name=":17"/>  greater improvement in stool consistency score,18 faster improvement in Canine Haemorrhagic Diarrhoea Severity Index (CHDSI),18 greater decrease of faecal C. perfringens,<ref name=":17"/> and a lower requirement for additional medical interventions. <ref name=":15"/>,<ref name=":17"/>

==Summary==

==Summary==

Acute diarrhoea is often self-limiting and likely to resolve without veterinary intervention. Diagnostic investigations are infrequently performed in these cases and even when faecal analysis is carried out, the results can be difficult to interpret given that many potentially pathogenic bacteria are also found in healthy individuals. Antibiotics are still frequently prescribed to dogs or cats that present with acute diarrhoea, however this can contribute to the development of antibacterial resistance, as well as causing disruptions to the normal gastrointestinal microbiota and can result in adverse effects for the patient. Therefore, antibiotics should be reserved for specific cases where bacterial infection is confirmed or highly suspected, and/or there is concern of bacterial translocation or sepsis.

Acute diarrhoea is often self-limiting and likely to resolve without veterinary intervention. Diagnostic investigations are infrequently performed in these cases and even when faecal analysis is carried out, the results can be difficult to interpret given that many potentially pathogenic bacteria are also found in healthy individuals. Antibiotics are still frequently prescribed to dogs or cats that present with acute diarrhoea, however this can contribute to the development of antibacterial resistance, as well as causing disruptions to the normal gastrointestinal microbiota and can result in adverse effects for the patient. Therefore, antibiotics should be reserved for specific cases where bacterial infection is confirmed or highly suspected, and/or there is concern of bacterial translocation or sepsis.

==References==

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

==References ==

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[[Category:Alimentary_System_-_Microbiota|10]]

[[Category:Alimentary_System_-_Microbiota]]