Gastrointestinal Articles Flashcards
Videofluoroscopic swallow study features of lower esophageal sphincter achalasia-like syndrome in dogs - Grobman 2019 (JVIM)
Retrospective (19 LES-AS, 20 controls). 19 LES-AS/130 dogs (14.6%). 14/19 (73.7%) had ME. 68.4% had fluid line. 63.2% had “beak sign.” 8/19 (42%) acontractile esophagus, 42% hypomotile, 16% hypermotile. LES-AS can be IDed on free-feeding VFSS.
Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of LES-AS in dogs - Grobman 2019 (JVIM)
Retrospective (14 client-owned dogs with LES-AS - dogs with + response to botox candidates for surgery). 100% dogs improved w/in 21 days of BTA - BW increased 20.4%, BCS 3 –> 5, regurgitation frequency dec. 80%. Duration of benefit ~ 40 days. Despite clinical improvement, ME/dysmotility persisted in 14/14 dogs. 6 underwent myotomy/fundoplication + maintained improvement. Significant temporary improvement after mechanical dilation + BTA. Myotomy + fundoplication provides lasting benefit despite persistent ME.
Canine perianal fistulas: clinical presentation, pathogenesis, and management - Cain 2019 (VCNASP)
Middle-aged GSD (suspect genetic susceptibility) but other dogs can develop. Suspect immune-mediated. Long-term medical management now preferred to surgery (cyclosporine +/- ketoconazole > other immunosuppressants).
Evaluation of toceranib for treatment of AGASACA in dogs - Heaton 2020 (JVIM)
Retrospective (36 client-owned dogs with AGASACA +/- other chemo or surgery). Progression free survival ~ 313 d; overall survival time ~ 827 d. Benefit in ~ 69% with 20.7% partial responders + 48.3% stable disease (responders had significantly longer PFS + OST). Hypercalcemia negative prognostic indicator. Effective for AGASACA treatment in dogs.
Response and outcome following toceranib phosphate treatment for stage four AGASACA in dogs: 15 cases (2013-2017) - Elliott (JAVMA)
Retrospective (15 client-owned dogs with Palladia as sole agent). 13 dogs (87%) had clinical benefit but no complete or partial response. No SFX/toxicity requiring withdrawal. Median progression-free interval ~ 354 d; medial survival time ~ 356 d. Improved outcomes in stage 4 dogs compared to previously reported dogs not receiving TK inhibitors; not appropriate as sole treatment for dogs w/ significant CS attributable to AGASACA due to potential for euthanasia since CS did not always improve.
Efficacy of intravenous administration of apomorphine for removal of gastric foreign material in dogs: 495 cases (2010-2015) - Kirchofer 2019 (JAVMA)
Retrospective (495 dogs). Emesis in 363/495 after 1 dose (73%) + 11/495 (2%) after 2 doses - 374/495 (75%) total. More success - fabric, leather, bathroom waste, younger dogs, shorter time since ingestion. Less success - opioids, sedatives, antiemetics before administration. Minor SFX in 4 dogs (0.8%).
Aerodigestive disorders in dogs evaluated for cough using respiratory fluoroscopy and VFSS - Grobman 2019 (Vet Journal)
Retrospective (31 client-owned dogs with CXR + VFSS). Normal CXR 11/31 + AP 7/31. 25/31 (81%) had VFSS abnormalities - pharyngeal hypomotility (10/31 - 32%), esophageal hypomotility (10/31 - 32%), reflux (9/31 - 29%), P-A (8/31 - 26%), aerophagia (6/31 - 19%), laryngeal obstruction (3/31 - 10%), ME (3/31 - 10%), HH (2/31 - 6%), LES-AS (1/31 - 3%). Respiratory disorder (17/31 - 55%). Alimentary disorder WITHOUT respiratory disorder (8/31 - 26%).
Detection of silent reflux events by nuclear scintigraphy in healthy dogs - Grobman 2020 (JVIM)
Prospective (12 healthy client-owned dogs). 12/12 dogs (100%) had reflux of variable severity detected via NS. Median frequency - 2 events/5 minutes; median duration - 6 seconds. No dog had detectable aspiration.
Ultrasonographic features and prevalence of presumed gastric wall edema in dogs with hypoalbuminemia - Murakami 2020 (JVIM)
Retrospective - 42 dogs with Alb < 2.3. >5 mm considered thickened. Prevalence of thickening 21.4% with mean thickness ~ 10 mm. All 9 with thickening had submucosal thickening but preserved mucosa. All 9 also had peritoneal effusion. No correlation b/t Alb and thickness. Gastric wall thickening common in dogs with hypoalb. but levels did not correlate with thickness.
Ultrasonographic features of presumed gastric wall edema in 14 dogs with pancreatitis - Murakami 2019 (JVIM)
Retrospective - 14 dogs with acute panc. + gastric wall thickness > 5 mm. Mean thickness ~ 9.9 mm. Complete loss of layering in 2 dogs, thickened submucosa in 12 dogs, concurrent thickened muscularis in 5 dogs. Focal and adjacent to panc. in 12 dogs. Resolution observed in 3 dogs. Gastric wall thickening (suspect edema) could be complication of acute pancreatitis.
The effect of combined carprofen and omeprazole administration on gastrointestinal permeability and inflammation in dogs - Jones 2020 (JVIM)
6 healthy research beagles. LPS + plasma iohexol conc. did not differ b/t treatments. DI varied over time based on treatment received. Omeprazole + carprofen sig. inc. fecal calprotectin + DI compared to baseline and carprofen alone. Prophylactic omeprazole induces dysbiosis + inc. inflammatory markers when co-administered with carprofen.
Ultrasonographic assessment of the effect of metoclopramide, erythromycin, and exenatide on solid-phase gastric emptying in healthy cats - Husnik 2020 (JVIM)
Prospective randomized double-blind crossover - 8 healthy DSH. Metoclopramide + erythromycin sig. sped up gastric emptying. Exenatide sig. slowed down emptying in first half of curve. Metoclopramide + erythromycin shorten gastric emptying times and inc. motiliy index of antral contractions; exenatide causes initial delay in gastric emptying.
The pattern of mortality in dogs with gastric dilatation and volvulus - Sharp 2020 (JVECC)
Retrospective - 498 dogs. 319 (64.1%) survived to discharge; 179 (35.9%) nonsurvivors - 149 nonsurvivors (31.3%) were euthanized [116/149 euthanized at presentation with no intent to treat] while 30 (6%) died. Excluding those euthanized at presentation, 83.5% survived to discharge. Euth. dogs older than survivors. Most mortality was pre-op. euthanasia w/o intent to treat - prevention will result in greater improvement in mortality than treatment.
Comparison of body condition score and other minimally invasive biomarkers between dogs with gastric carcinoma and dogs with chronic gastritis - Seim-Wikse 2019 (JAVMA)
Prospective - 15 carcinoma, 29 gastritis, 7 controls. Carcinoma - sig. older, lower BCS, lower folate, higher CRP. Age > 8 YO, BCS < 4, CRP > 25, hypofolatemia may be useful and should prompt biopsy.
Diagnostic evaluation of urea nitrogen/creatinine ratio in dogs with gastrointestinal bleeding - Stiller 2021 (JVIM)
Retrospective/prospective - 89 GIB (65 overt, 24 occult; 37 upper, 13 lower, 8 both) + 65 controls. UCR sig. higher in overt compared to occult and healthy; no diff. b/t upper and lower. Higher Hb/HCT lowered odds of occult GIB. Not clinically useful marker for occult + poorly discriminatory b/t upper + lower. Inc. UCR in dog w/o overt signs [esp. with normal HCT] does not warrant gastroprotectants.
Clinical characteristics of dogs with food-responsive protein-losing enteropathy - Nagata 2020 (JVIM)
Retrospective - 33 PLE. 23 dogs (70%) responded to ULFD. FRE had sig. lower CCECAI than IR/NRE (AUC of cutoff 8 - 0.935). MST sig. longer in FR (not reached) than IR/NR (432 days). FRE have favorable prognosis - CCECAI could help differentiate FR from IR/NRE.
Diagnostic value of fecal cultures in dogs with chronic diarrhea - Werner 2021 (JVIM)
Prospective case-control - 18 chronic diarrhea (CDG) + 18 controls. DI sig. inc. in CDG (0.9 vs -3.0) but culture failed to detect differences. Hemolytic E. coli only cultured enteropathogen, but no diff. b/t groups. No agreement b/t culture + DI, with high variability between culture laboratories. Fecal cultures failed to distinguish disease vs control and had high inter-laboratory variation.
Use of video capsule endoscopy to identify gastrointestinal lesions in dogs with microcytosis or gastrointestinal hemorrhage - Mabry 2019 (JVIM)
Retrospective case-conrol - 16 client-owned dogs with microcytosis, low-normal MCV, or clinical GIB with VCE. AUS (16), AXR (4), and CT (1) did not identify cause of GIB. 15/16 dogs had gastric mucosal lesions; 12/14 had SI mucosal lesions (2 capsules retained in stomach). 2 dogs scoped before VCE - 1 had additional SI lesions IDed. VCE is min. invasive + can help ID GI lesions in dogs w/ microcytosis or GIB when imaging inconclusive, however majority of lesions would have been apparent with endoscopy.
Association of chronic enteropathy activity index, blood urea concentration, and risk of death in dogs with protein-losing enteropathy - Kathrani 2019 (JVIM)
Retrospective - 71 client-owned PLE dogs. CCEAI + BUN sig. associated with death. For CCEAI, each unit increase inc. hazard by 22.9%. CCEAI < 8 survived 256 d longer; BUN < 7 survived 279 d longer. Inc. CCEAI + BUN at diagnosis might predict death in PLE (CE + lymphangiectasia).
Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25-hydroxycholecalciferol concentrations - Wennogle 2019 (JVIM)
Prospective cohort - 15 CIE w/ low VD and 15 CIE w/ normal VD. Low-VD had higher CCECAI and CRP, and lower serum a-tocopherol, cholesterol, and Alb. VD-binding protein not diff. VD conc. neg. correlated w/ histopathologic changes. Path. likely multifactorial - consider fat malabsorption, but does not appear to be VDBP.
Ability of ultrasonography to predict the presence and location of histologic lesions in the small intestine of cats - Guttin 2019 (JVIM)
Retrospective - 169 cats. US changes had high PPV for histologic lesions (duo - 82%, jej - 91%, il - 88.1%). High PPV for mucosal lesions (72.7 - 100%) but low for submucosa or muscularis (18.9 - 57.1%). In pop. with high prevalence, SI mucosal US lesions will have histological lesions. Submucosal + muscularis US lesions not predictive of lesions in those layers so full-thickness biopsy may not be needed.
Differentiation of lymphocytic-plasmacytic enteropathy and small cell lymphoma in cats using histology-guided mass spectrometry - Marsilio 2020 (JVIM)
Retrospective - 41 LPE + 52 SCL. HGMS - Se 86.7%, Sp 91.7%, accuracy 88.9%. Clonality testing - Se 85.7%, Sp 33.3%, accuracy 61.5%. Diagnostic tests were compared to panel of pathologists. HGMS was reliable for diff. duodenal LPE + SCL and may have advantages over current tests.
Evaluation of novel serological markers and autoantibodies in dogs with inflammatory bowel disease - Estruch 2020 (JVIM)
Prospective control - 70 IBD, 23 non-IBD (acute) GI dx, 58 controls. IBD dogs 39 - 76% seropositivity against serologic markers; 0 - 13% in non-IBD and controls (ROC sig. different). OmpC highest single performance marker. OmpC - Se 76 - 97%, Sp 93 - 99%; APMNA - Se 66 - 86%, Sp 79 - 98%. IgA seropos. against markers appears promising to diff. IBD from other GI dx - E. coli OmpC + AAb against PMN had highest performance.
Association of fecal sample collection technique and treatment history with Tritrichomonas foetus polymerase chain reaction test results in 1717 cats - Hedgespeth 2020 (JVIM)
Retrospective (1808 fecal samples). 274 positives (16%). 2.04x OR of positivity for fecal loop via colonic flush. No correlation b/t results and treatment history or type (inc. prior ronidazole). 4/19 ronidazole-treated cats (21%) had second positive test. Fecal loop > colonic flush. Limitations to ronidazole - lack of association with PCR result + 21% failure rate.
Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo-controlled, double-blinded clinical study - Nixon 2019 (JVIM)
Double-blind, placebo-controlled, randomized (148 client-owned dogs with acute diarrhea). Pro-Kolin contains E. faecium 4b1707. ADPP had sig. shorter duration of diarrhea (32 vs 47 hours) and diarrhea resolved 1.6x faster. Fewer ADPP req. additional med. intervention for failure to improve or worsening (3.5% vs 14.8%, relative risk 0.88). ADPP may accelerate resolution of diarrhea and decrease req. for AMI.
Metronidazole treatment of acute diarrhea in dogs: A randomized double blinded placebo-controlled clinical trial - Langlois 2020 (JVIM)
Randomized controlled (14 test, 17 control). Time to resolution shorter for test (2.1 days) vs controls (3.6 days). Test had less C. perfringens carriage at day 7 (23.1% vs 78.6%). Metronidazole can shorten duration of diarrhea and dec. fecal culture detection of C. perfringens.
Effects of metronidazole on the fecal microbiome and metabolome in healthy dogs - Pilla 2020 (JVIM)
Prospective, nonrandomized (24 healthy pet dogs). G1 - control, G2 - hydrolyzed diet + metronidazole, G3 - metronidazole. Metronidazole sig. changed microbiome in G2 + G3 (dec. richness and important bacteria ex. Fusobacteria) that did not resolve ~ 4 weeks after discontinuation. Metronidazole sig. inc. DI and fecal lactate, and dec. secondary bile acids. Min. 4-week effect of metronidazole on fecal microbiome and metabolome - use with caution.
Long-term impact of tylosin on fecal microbiota and fecal bile acids of healthy dogs - Manchester 2019 (JVIM)
Prospective randomized controlled (16 healthy adult dogs). Fecal scores unchanged. Day 7 samples from tylosin dogs had dec. bacterial diversity (esp. Fusobacterium and Veillonellaceae). Primary UBA inc. at day 21 (7.42) and 63 (3.49) compared to 0 (0.14) in tylosin dogs. At day 63, taxa were not sig. different but degree of recovery was individualized. Tylosin causes dysbiosis in healthy dogs w/ corresponding shifts in UBAs. Changes did not uniformly dissolve after discontinuation.
Dysautonomia in 53 cats and dogs: retrospective review of clinical data and outcome - Clarke 2020 (Vet Record)
34 cats + 19 dogs. CS - esophageal and GI dysmotility/distention, urinary retention, dec. tear production, third eyelid prolapse, inappropriate mydriasis. TX - supportive (prokinetics, feeding tubes, urinary retention meds). Survival to discharge - 29% cats, 47% dogs. Overall survival - 21% cats, 32% dogs. Survival > 2 years - 6 cats (18%), 3 dogs (16%). Some patients can have long-term survival with good prognosis.
Retrospective evaluation of risk factors and treatment outcome predictors in cats presenting to the emergency room for constipation - Benjamin 2020 (JFMS)
189 cats + 99 controls. Inc. risk - older, overweight, CKD, previous episodes of constipation. iCa sig. higher in constipated cats but varied significantly. Cats with ab. pain less likely to defecate after enema. Adjunctive tx (IVF, laxatives) inc. likelihood of successful enema but not statistically sig. Older, obese cats with history of constipation or CKD more likely to present for constipation.
Successful management of 3 dogs with colonic pythiosis using itraconzaole, terbinafine, and prednisone - Reagan 2019 (JVIM)
3 dogs with colonic pythiosis with complete resolution of CS, regression of non-resectable colonic masses, and progressive dec. in serological titers after treatment with itraconazole, terbinafine, and steroids. Promising treatment protocol for dogs with GI pythiosis where surgery is not feasible.
Evaluation of prognostic factors for return of urinary and defecatory function in cats with sacrocaudal luxation - Couper 2020 (JFMS)
70 cats. 55/61 (90%) regained urinary function. Higher neuro grade associated with dec. likelihood and longer time to regaining function. Cats that regained defecatory function had longer survival times. Neurological grade most important prognostic indicator for cats with SC luxation, and can help inform anticipated timeline. Fecal incontinence may be more important prog. factor than previously suspected.
Administration of a Synbiotic Containing Enterococcus faecium Does Not Significantly Alter Fecal Microbiota Richness or Diversity in Dogs With and Without Food-Responsive Chronic Enteropathy - Pilla 2019 (Front Vet Sci)
12 dogs with FRD on HP diet received synbiotic or placebo + 8 controls. Fecal samples at baseline + 6 weeks –> 16S rRNA gene sequencing. Small inc. in diversity in synbiotic-tx FRD dogs, but no sig. differences in microbiome composition in either group, and large individual variations observed. No changes in microbial composition in diseased or healthy dogs with diet alone, but synbiotic inc. bacterial richness in both groups.
Treatment With Hydrolyzed Diet Supplemented With Prebiotics and Glycosaminoglycans Alters Lipid Metabolism in Canine Inflammatory Bowel Disease - Ambrosini 2020 (Front Vet Sci)
TX with diet + PRB-GAG impacted serum metabolome - most altered metabolites involved in lipid metabolism (cell membranes ex. glycerophospholipids, sphingolipids, di- and triglycerides). Sig. increase in metabolites that protect gut cell membrane integrity in respnse to diet alone and diet + PRB-GAG. TX for 70 days improved serum markers of IBD, poss. indicating improved intestinal membrane integrity.
Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea - Cerquetella 2020 (JSAP)
Advocate use of antibacterials only after histopathologic evaluation of GI biopsies, or after other therapeutic trials (diet/pre-probiotics or anti-inflammatories) have been unsuccessful (in cases where biopsy not possible). Reserve (after appropriate diet trials) for chronic diarrhea patients with signs of true primary infection (SIRS or adherent-invasive bacteria).
Fecal Microbial and Metabolic Profiles in Dogs With Acute Diarrhea Receiving Either Fecal Microbiota Transplantation or Oral Metronidazole - Chaitman 2020 (Front Vet Sci)
Fecal consistency improved sig. in dogs treated with FMT + MET by days 7 + 28, but on day 28 consistency better in FMT than MET. Dogs had dysbiosis on day 0 - improved in FMT group but sig. worsened in MET on days 7 + 28. FMT dec. percentage of primary BAs. Dogs with AD had sig. diff. in microbiome and metabolome - MET still had altered profiles at day 28 compared to FMT or HC.
One dog’s waste is another dog’s wealth: A pilot study of fecal microbiota transplantation in dogs with acute hemorrhagic diarrhea syndrome - Gal 2021 (PLOS One)
No sig. diff. in median AHDS scores b/t FMT + controls at admission or discharge. SDI lower in AHDS than donors at admission - did not change in control dogs but inc. in FMT to levels comparable to donors. No diff. b/t all 3 groups at 30 days. Inc. SCFA-producing in FMT + donor dogs. FMT did not have any clinical benefit - single FMT can inc. SCFA-producing genera for up to 30 days post-FMT.
Pilot study of the effect of gastrointestinal diets on fecal occult blood testing in cats - Spies 2020 (JFMS)
10 mcL of whole blood could reliably be detected in stool at all time points. No association b/t dry hydrolyzed and GI diet and positive FOB. Cats fed canned GI diet had sig. higher probability of positive FOB than normal diet. Canned hydrolyzed did not have inc. prob. compared to normal diet. Small amounts of blood can be reliably detected as soon as 5 min. Cats fed canned GI diet had greater likelihood of false-positive FOB.
Retrospective evaluation of anemia and erythrocyte morphological anomalies in dogs with lymphoma or inflammatory bowel disease - Parachini-Winter 2019 (JAVMA)
Retrospective cross-sectional (82 client-owned dogs). Anemia more prevalent in lymphoma dogs (53% vs 22%). RBC anomalies sig. higher in lymphoma vs IBD and controls - cutoff of 3 RBC anomalies IDed lymphoma with Se 71% and Sp 70% - eccentrocytes specifically more common in lymphoma (29% vs 4%). Anemia and > 3 RBC abnormalities (esp. eccentrocytes) should increase suspicion for lymphoma > IBD.
Platelet indices as biomarkers for characterization and determination of severity in canine chronic enteropathy - Mehain 2019 (Vet Journal)
22 enteropathy dogs + 22 matched controls. PLT component distribution width sig. different b/t groups. PLT count (elevating) + PLT dry mass (decreasing) sig. different for predicting CCECAI severity of disease.
Effect of amoxicillin-clavulanic acid on clinical scores, intestinal microbiome, and amoxicillin-resistant Escherichia coli in dogs with uncomplicated acute diarrhea - Werner 2020 (JVIM)
Prospective, placebo-controlled, double-blinded - 16 dogs with AD. No difference in recovery time for AG (2 days) or controls (1.6 days). No difference in DI for AG (-2.6) or controls (-0.8). Inc. proportion of resistant E. coli in AG (100% vs 0.2%) during treatment and 3 weeks later (10% vs 0.0%). ABX confers no clinical benefit but predisposes development of AMR - do not treat with ABX unless signs of sepsis.
Fecal short-chain fatty acid concentrations and dysbiosis in dogs with chronic enteropathy - Minamoto 2019 (JVIM)
Prospective cohort - 49 healthy controls + 73 CE dogs. Acetate (185.5 vs 224.0), propionate (46.4 vs 105.9), and total SCFA (268.1 vs 377.2) in CE vs healthy controls. CE had dec. bacterial diversity / richness, distinct clustering, and higher DI. CE dogs had altered SCFA conc. and sig. changes to fecal microbiota.
Prevalence and characterization of hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease: A multicenter study - Hauck 2020 (JVIM)
Prospective - 151 dogs with chronic GI signs. BC < 3 in 80/151 (53%), <2 in 42/151 (28%), and <1 in 9/151 (6%). HA in 6/151 (4%). No diff. in HX, PE, BW but 4/6 HA dogs had melena or hematochezia. No hyperkalemia/hyponatremia in any dog. Adrenal testing should be standard screening test in dogs with chronic GI signs.
Enteroplication in cats with intussusception: a retrospective study (2001-2016) - Haider 2019 (JFMS)
21 cats. Males and Maine Coons overrepresented. 10/21 (48%) had enteroplication and were sig. younger. No diff. in surgery duration, hospitalization time, complication rate, or outcome. 2 short-term + 1 long-term complication poss. associated with enteroplication. 2/17 had recurrence ~ 12 months later (both prev. enteroplicated). Enteroplication should be cautiously performed in cats with intussusception as it may be associated with ST + LT complications, and efficacy remains unclear. Need for enteroplication following correction could be questioned.
Prevalence of Clostridium perfringens netE and netF toxin genes in the feces of dogs with acute hemorrhagic diarrhea syndrome - Sindern 2019 (JVIM)
174 dogs. Sig. diff. in gene prevalence - AHDS (26/54 - 48.1%), parvo (0/54 - 0%), healthy (8/66 - 12.1%). No diff. in variables b/t AHDS dog w/ and w/o NetE or NetF genes. Prevalence of C. perfrigens with NetE/NetF sig. higher in AHDS vs controls.
Escherichia coli-associated granulomatous colitis in dogs treated according to antimicrobial susceptibility profiling - Manchester 2021 (JVIM)
20 Boxers + 4 FB with GC. FQS 9/24 (37.5%), FQR 15/24 (62.5%). MDR prevalent (14/15) and 13/15 only susceptible to carbapenems. 8/9 FQS (89%) had CR; 9/13 (69%) FQS had CR/PR. 5/5 FQS had sustained CR; 6/12 (50%) FQR had sustained CR, 4/12 (33%) PR, 2/12 (17%) NR. ABX guided by C+S had positive long-term outcome in >80%. FQR common and not clonal.
Frequency of signs of chronic gastrointestinal disease in dogs after an episode of acute hemorrhagic diarrhea - Skotnitzki 2022 (JVIM)
Retrospective longitudinal (151 dogs - 80 AHDS, 71 matched controls). Higher prevalence of chronic GI dx in previous AHDS dogs (28% vs 13%, OR 2.57). Severe mucosal damage and barrier dysfunction might trigger GI DX later in life.
Efficacy and safety of the nucleoside analog GS-441524 for treatment of cats with naturally occurring feline infectious peritonitis - Pedersen 2019 (JFMS)
31 cats (26 effusive, 5 dry - no ocular or neuro). 5/31 euth. w/in 5 days. Of remaining 26, 18/26 (69%) healthy with 1 TX course; 8/26 (31%) relapsed. 5/8 relapsed cats received higher 4 mg/kg dosage - all healthy; 3/3 relapsed cats that received lower dosage relapsed again (1 euthanized, 2 healthy after higher dosage). Safe and effective treatmet for FIP. Optimum dosage 4 mg/kg SQ q24h x 12 weeks).
