Oral, gastrointestinal and pancreas

Campylobacter

Infection rarely causes clinical disease and the bacteria is frequently isolated from healthy animals. Attempts to induce enteritis in puppies with C. jejuni have been equivocal³¹. C. upsaliensis may be more pathogenic in dogs but is not zoonotic^32,33. Clinical signs still tend to be relatively mild³⁴. Concurrent infection with another pathogen is likely in animals with clinical signs. C. jejuni inoculum for human infection is very low³⁵ so both asymptomatic carriers and diarrhoetic dogs pose a zoonotic risk. Diagnosis can be made by examining stained faecal smears, however other Campylobacter-like organisms may be present leading to false-positives. Faecal PCR or culture can be performed however results need to be interpreted with caution.

Salmonella

Clinical salmonellosis is rare and asymptomatic carriers are common with international studies suggesting up to 44% of healthy dogs^36,37 and 14% of healthy cats³⁸ may carry Salmonella. Infection can result in severe gastroenteritis with or without septicaemia. Isolation of the organism in faeces, in conjunction with clinical signs of disease, is generally used to make a diagnosis, however the organism can be isolated from healthy animals so caution should be used in interpreting results.

Clostridium difficile & C. perfringens

Clinical signs are variable, from mild and self-limiting to potentially fatal acute haemorrhagic diarrhoea, and the clinical significance is unknown. C. perfringens can be found in ~15%, and C. difficile in up to 40%, of non-diarrhoetic dogs^39,40. Detection of a enterotoxigenic isolate, in combination with positive ELISA for the clostridial toxin, is required for a diagnosis of C. perfringens. C. difficile is more difficult to diagnose as culture is not useful, the toxin tests are not validated for use in dogs and have given high numbers of toxin-positive, culture-negative results³⁹. Faecal lactoferrin has been used in humans, as a marker of intestinal inflammation, in combination with toxin testing. This has not yet been evaluated for the diagnosis of C. difficile infection in dogs.

E. coli

The significance of enteropathogenic (EPEC) or enterotoxin-producing (ETEC) E. coli in diarrhoea in dogs and cats is unknown. ETEC has been incriminated in diarrhoea in young dogs^41,42. Enteroinvasive E. coli has a role in the development of histiocytic colitis in young boxers⁴³. PCR is the most common method for detecting and differentiating pathogenic strains of E. coli.

This syndrome incorporates a group of chronic inflammatory conditions of the GI tract. Several types have been identified:

• Lymphoplasmocytic enteritis / colitis
• Eosinophilic enteritis / colitis
• Lymphangectasia
• Histiocytic (granulomatous) colitis

Diagnostics

Based on GI biopsies. Histiocytic ulcerative colitis in Boxers can be diagnosed by histopathology (FISH test) of colonic biopsies.

Treatment

Prednisolone alone is as effective as prednisolone in combination with metronidazole⁵⁰ so solo therapy with prednisolone is recommended as first line. The first choice antimicrobial for non-responsive cases is tylosin⁵¹. If tylosin is not available, alternatives are oxytetracycline or lastly metronidazole. Histiocytic ulcerative colitis in Boxers can respond to long-term antimicrobial therapy⁴³. Resistance development is widespread so therapy should be based on susceptibility testing rather than empirically.

Duration of therapy

2-8 weeks have been described.

Diagnostics

Diagnosis is generally made from serum biochemistry results.

Treatment

Antimicrobial therapy is not indicated.

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