Benefits of Canine EN Gastrointestinal and FortiFlora® in the

This case report demonstrates the successful use of PURINA® PRO PLAN® VETERINARY DIETS Canine EN Gastrointestinal

together with the probiotic supplement FortiFlora® in the dietary management of canine chronic colitis

Benets of Canine EN Gastrointestinal and

FortiFlora

in the successful management of

canine chronic colitis

Chronic colitis is frequently diagnosed in veterinary practice and is one

of the most common causes of chronic diarrhoea in dogs. Even though

it is not life threatening, it is nevertheless very uncomfortable for the

patient and inconvenient for the dog’s owners. The term chronic colitis

encompasses several conditions all of which have inammation of the

colon as their predominant pathology. Causes of chronic colitis include

parasitic, infectious, immune-mediated or primary in ammatory

conditions. Regardless of aetiology, the clinical signs of chronic colitis

are similar and easy to recognise - an increased frequency of defaecation

(which is often associated with tenesmus) and poorly formed stools,

often containing mucus and fresh blood. Treatment options for patients

with colitis include standard supportive treatments to restore uid

balance, antibiotics, anti-diarrhoeal or antispasmodic medications during

acute episodes, non-steroidal antiinammatories such as Salazopyrin®,

(sulphasalazine) and corticosteroids

. Dietary change is also highly

recommended to provide adequate dietary bre and high digestibility

to limit the passage of ingesta into the colon. Probiotics are also often

recommended on account of their immunomodulatory effect and positive

inuence on intestinal micro oral balance and stability.

Case history

Brygton, a 4-year-old entire male Husky was referred for a nutrition

consultation at the Nantes National Veterinary College. Brygton had

been having episodes of chronic diarrhoea since he was acquired (3,5

years ago). He was otherwise well. The owners reported that the dog’s

stools varied on a daily basis from liquid to soft to barely formed, (faecal

score of 4 to 7 on a 7-point scale- where 7 is very liquid diarrhoea).

Brygton was fed on a mixed diet formulated by his owner including

easily digestible dry food, rice or pasta, accompanied by ham or red

meat to encourage him to eat following many refusals. He was up-to-

date with routine worming and vaccinations. Brygton had received

many previous treatments for his colitis including intestinal mucosal

protectants, corticosteroids, antibiotics (metronidazole) and sulphasalazine

(Salazopyrin

- the locally acting colonic anti-inammatory drug) without

much improvement.

Clinical examination

Clinical examination revealed no signi cant abnormalities with the

patient appearing to be in a good general state of health. Brygton

weighed 21 kg and was in ideal body condition (body condition score

5/9).Circulating trypsin-likeimmunoreactivity (TLI), folate, vitamin B12,

albumin and bile acid levels were measured and a faecal examination

was performed. An abdominal ultrasound was also carried out. The only

signicant nding was elevated serum folate (18.6 mg/l, while normal

values should be < 12 μg/L), consistent with small intestinal bacterial

proliferation

2,3

Treatment

A dietary treatment protocol based on probiotics and highly digestible

food was recommended. Canine EN Gastrointestinal dry food and a daily

sachet of Canine FortiFlora® were prescribed. It was also recommended

that the food be split into 3 meals per day. After starting this dietary regime,

Brygton’s stools became well-formed with a consistent faecal score of 3/7.

He has now remained on this treatment protocol for four months.

Clinical Case: Canine FortiFlora®/EN Gastrointestinal

Dr Caroline Daumas

DVM, Former nutrition resident at ONIRIS

(Nantes National Veterinary College, France)

Follow-up

After only one month on Canine EN Gastrointestinal and FortiFlora

Brygton did not suffer any more bouts of diarrhoea and had gained

weight (+1 kg). Four months later, the owners conrmed no recurrence

of diarrhoea, a good stool quality and maintenance of weight.

About the diet

Nutritional recommendations for the management of canine colitis

include provision of a highly digestible diet to reduce colonic irritation

as a result of poorly digested residues entering the large intestine and

the provision of adequate dietary bre to inuence colonic motility as

well as enhancing luminal SCFA (short chain fatty acid) production.

Canine EN Gastrointestinal is a highly digestible, low residue clinical

diet containing a balance of soluble and insoluble bres and medium

chain fatty acids which are easily absorbed by the small intestine, even

during inammatory processes. It also contains a source of prebiotics

(puried inulin) which helps promote good intestinal health.

Given together with dietary live probiotics, such as FortiFlora

(containing

a specic strain of microencapsulated SF68), the two dietary treatments

combined helped ensure a quick return to good colonic health in this

case.

Probiotics are able to both modify the intestinal microora and

enhance the innate immune responses. They are able to:

•

inuence the composition of the intestinal ora when they are present

in sufcient quantities (more than 1x 10

CFU/g) and to promote the

growth of ‘good’ bacteria.

•

modify the mucus layer in the intestines strengthening the integrity

of the intestinal barrier.

•

stimulate the synthesis of bactericidal substances (such as defensins)

by the mucosal cells, contributing to the ght against pathogens.

The main indications for probiotics include

•

Acute or chronic diarrhoea - because they inhibit the growth of

pathogenic bacteria such as coliforms or salmonellae

•

Chronic inammatory conditions of the intestines - on account of

their immunomodulatory action

•

Food allergies or vaccination - due to their ability to help strengthen

the immune barrier

In chronic colitis, probiotics help optimise the balance of the intestinal

bacterial ora and also have a local immunomodulatory and anti-

inammatory action. It is important to choose probiotics which are

appropriate to the species concerned, ensuring a large quantity of living

microorganisms reach the area to be treated

. In the case presented

here, the probiotic supplement (FortiFlora®) sprinkled on the food was

well accepted because it is highly palatable. In chronic conditions, long-

term treatment is recommended to sustain benecial adaptations of

the intestinal microora. FortiFlora® probiotics are both safe and locally

efcacious.

The prognosis for chronic colitis is generally good as long as systemic

health is unaffected. However, elimination of bouts of diarrhoea should

be sought in order to restore the dog’s digestive well-being and improve

quality of life for both dog and owner. In the long term, chronic colonic

diarrhoea can lead to electrolyte imbalance and prevent absorption of

vitamins synthesised by resident bacteria. In cases of proven bacterial

proliferation or recurrent chronic colitis despite conventional treatment,

the use of probiotics is strongly recommended. Whilst the mainstay of

therapy for chronic colitis remains the use of a highly digestible diet

rich in bre, probiotics should now also become an important part of

a practitioner’s therapeutic arsenal to manage this common condition.