Abstract
BackgroundEnzyme treatment is the mainstay for management of exocrine pancreatic insufficiency (EPI) in dogs. ‘Enteric-coated’ preparations have been developed to protect the enzyme from degradation in the stomach, but their efficacy has not been critically evaluated. The hypothesis of the current study was that enteric coating would have no effect on the efficacy of pancreatic enzyme treatment for dogs with EPI.Thirty-eight client-owned dogs with naturally occurring EPI were included in this multicentre, blinded, randomised controlled trial. Dogs received either an enteric-coated enzyme preparation (test treatment) or an identical preparation without the enteric coating (control treatment) over a period of 56 days.ResultsThere were no significant differences in either signalment or cobalamin status (where cobalamin deficient or not) between the dogs on the test and control treatments. Body weight and body condition score increased in both groups during the trial (P<0.001) but the magnitude of increase was greater for the test treatment compared with the control treatment (P<0.001). By day 56, mean body weight increase was 17% (95% confidence interval 11-23%) in the test treatment group and 9% (95% confidence interval 4-15%) in the control treatment group. The dose of enzyme required increased over time (P<0.001) but there was no significant difference between treatments at any time point (P=0.225). Clinical disease severity score decreased over time for both groups (P=0.011) and no difference was noted between groups (P=0.869). No significant adverse effects were reported, for either treatment, for the duration of the trial.ConclusionsEnteric coating a pancreatic enzyme treatment improves response in canine EPI.
Highlights
Enzyme treatment is the mainstay for management of exocrine pancreatic insufficiency (EPI) in dogs
Study centres and dogs A total of 5 dogs were enrolled at the Small Animal Teaching Hospital (SATH), one practice enrolled 2 dogs, and the remaining 31 practices enrolled 1 dog each
Twenty dogs were initially enrolled to the control treatment
Summary
Enzyme treatment is the mainstay for management of exocrine pancreatic insufficiency (EPI) in dogs. ‘Enteric-coated’ preparations have been developed to protect the enzyme from degradation in the stomach, but their efficacy has not been critically evaluated. The hypothesis of the current study was that enteric coating would have no effect on the efficacy of pancreatic enzyme treatment for dogs with EPI. Most dried pancreatic extracts are given as a powdered formulation, ‘enteric-coated’ preparations have been developed in which granules of enzyme powder are coated in a lacquer that protects the enzymes from degradation in the stomach. Given the conflicting information from previous studies, our chosen hypothesis was that enteric coating of a pancreatic enzyme extract would have no effect on the efficacy of treatment for canine EPI. Our aim was to conduct the first blinded randomised controlled trial (RCT) assessing therapeutic efficacy in this condition
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