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Use of antibiotics in dogs with aseptic haemorrhagic gastroenteritis

Clinical Scenario

Bruno, a 2.5 year old black and tan rottweiler cross, is presented to you with acute haemorrhagic gastroenteritis that began 12 hours ago. He is bright and alert, has a normal body temperature and other than gas filled small intestines on abdominal palpation, no abnormalities are detected. He is mildly dehydrated and his capillary refill time is normal. He has never had a problem like this before and is up to date with vaccinations and worming. You admit Bruno for observation and intravenous fluid therapy and the head nurse asks you if you want to give him some antibiotics, and you wonder if it will make any difference to his clinical signs....

3-Part Question (PICO)

In [clinically well dogs with haemorrhagic gastroenteritis] does [systemic antibiotics compared to no antibiotics] [decrease the time to resolution of clinical signs]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp Dogs/)

AND

(haemorrhagic gastroenteritis.mp. OR haemorrhagic enteritis.mp. OR hemorrhagic gastroenteritis.mp. OR hemorrhagic gastroenteritis.mp.)

AND

(antibacterial.mp. OR antibacterials.mp. OR antibiotic.mp. OR antibiotics.mp. OR antimicrobial.mp. OR antimicrobials.mp. OR exp Anti-Bacterial Agents/ OR exp Anti-Infective Agents/)

CAB Abstracts 1910 to Present using the OVID interface

(dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR OR exp dogs/)

AND

(haemorrhagic gastroenteritis.mp. OR haemorrhagic enteritis.mp. OR hemorrhagic gastroenteritis.mp. OR hemorrhagic gastroenteritis.mp. OR exp haemorrhagic enteritis/)

AND

(antibacterial.mp. OR antibacterials.mp. OR antibiotic.mp. OR antibiotics.mp. OR antimicrobial.mp. OR antimicrobials.mp. OR exp antibacterial agents/ OR exp antibiotics/ OR exp antiinfective agents/)

Search Outcome

MEDLINE

  • 4 papers found in MEDLINE search
  • 3 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 27 papers found in CAB search
  • 25 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 1 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Unterer et al., 2011 Germany

Title:

Treatment of Aseptic Dogs with Hemorrhagic Gastroenteritis with Amoxicillin/Clavulanic Acid: A Prospective Blinded Study

Patient group:

60 dogs with aseptic haemorrhagic gastroenteritis (HGE).

30 dogs received 7 days of amoxicilin/clavulanic acid (injection in hospital and tablets at home) and 30 dogs received no treatment (nothing in hospital and placebo tablets at home)

Study Type:

Randomised Controlled Trial

Outcomes:
  • Haemorrhagic gastroenteritis (HGE) activity index
  • Duration of hospitalisation
  • Drop out rates
  • Mortality rates
Key Results:
  • There was no significant difference between treatment and placebo groups in terms of the canine HGE index on any day of the study (p = 0.487).
  • There was no difference in faecal consistency between groups.
  • A rapid improvement in clinical signs was seen in both groups.
  • The duration of hospitalisation was not significantly different between groups (p = 0.740).
  • Median duration of hospitalisation in treatment group was 3 days (range 3-4), median duration of hospitalization in placebo groups was 3 days (range 3-7)
  • The number of drop-outs between groups was not statistically significant. The power to detect a difference was calculated as 58%.
Study Weaknesses:
  • No sample size calculation was carried out.
  • A relatively small trial with 30 dogs in each arm
  • The person administering the treatments was not blinded but those making the assesments were
  • The 'Haemorrhagic gastroenteritis (HGE) activity' index is subjective and unvalidated
Attachment:
Evidence appraisalEvidence appraisal

Comments

This is a small but well conducted and reported randomised controlled trial. The authors acknowledge the limitations well. The patient group is well described enabling application of this evidence to practice where appropriate.

Only one study was found that answered this question in which only one antibiotic was used. It is not possible to comment on the efficacy of antibiotics in general in the treatment of aseptic HGE in dogs.

This BET was first suggested and initially developed at a BSAVA regional workshop about Evidence-based Veterinary Medicine which was run by the CEVM in collaboration with RCVS Knowledge.

Bottom line

Treatment of dogs with aseptic haemorrhagic gastroenteritis with amoxicillin/clavulanic acid does not reduce the time to resolution of clinical signs.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Unterer S, Strohmeyer K, Kruse BD, Sauter-Louis C, Hartmann K, (2011). Treatment of aseptic dogs with hemorrhagic gastroenteritis with amoxicillin/clavulanic acid: a prospective blinded study. Journal of Veterinary Internal Medicine. 25:973-79.

About this BET

First author:
Rachel Dean
Second author:
Rachel Perry
Institution:

Rachel Dean: Centre for Evidence-based Veterinary Medicine, University of Nottingham

Rachel Perry: Perrydental Vet Ltd. www.perrydentalvet.co.uk 

 

Search last performed:
2017-03-02 17:38:11
Original publication date:
2017-03-30 17:38:11
Last updated:
2017-03-30 17:38:11
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