A Randomized Double Blinded Placebo-Controlled Clinical Trial of a Probiotic or Metronidazole for Acute Canine Diarrhea

Justin Shmalberg,Giada Morelli,Christina Montalbano,Gareth J Buckley

doi:10.3389/fvets.2019.00163

Justin Shmalberg, Giada Morelli + Show 2 more

Open Access

https://doi.org/10.3389/fvets.2019.00163

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Abstract

Acute diarrhea is a common, often self-limiting, cause of presentation for veterinary care, yet there is a paucity of data on frequently-prescribed treatments. The purpose of this randomized, double blinded placebo-controlled clinical trial was to compare two anecdotally-recommended treatments: a probiotic combination and metronidazole. Sixty dogs without concurrent comorbidities were randomized into three treatment groups. The time to resolution of diarrheal signs was evaluated using owner surveys and fecal scoring charts. Dogs presenting with acute diarrhea achieved acceptable fecal consistency after 3.5 ± 2.2 days when receiving probiotic, 4.6 ± 2.4 days with oral metronidazole, and 4.8 ± 2.9 days with placebo; statistically significant differences were not identified between treatment groups (p = 0.17). These findings failed to provide evidence for the common use of metronidazole in this cohort of dogs with acute canine diarrhea, and a larger study population would be required to identify a statistically significant effect of probiotics.

Highlights

Much of the treatment of acute canine diarrhea remains empiric and confounded by the selflimiting nature of the condition [1,2,3]
Dogs presenting with acute diarrhea achieved acceptable fecal consistency after 3.5 ± 2.2 days when receiving probiotic, 4.6 ± 2.4 days with metronidazole, and 4.8 ± 2.9 days with placebo (p = 0.17)
Neither the probiotic product nor metronidazole achieved a statistically significant improvement in the time to clinical resolution of the patients enrolled in this study

Summary

Introduction

Much of the treatment of acute canine diarrhea remains empiric and confounded by the selflimiting nature of the condition [1,2,3]. The relative risk for diarrhea may be influenced strongly by age, breed, gender, environment, and season [5,6,7]. Acute diarrhea and potentially its resolution may be affected by either primary or secondary changes in the fecal microbiota, an area presently receiving substantial research interest [9,10,11]. Both antimicrobial drugs and probiotics are administered frequently in the treatment of acute diarrhea, with the goal of influencing the gastrointestinal microbiome and shortening the time to clinical resolution [2, 12]

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