Update on Acute Hemorrhagic Diarrhea Syndrome in Dogs

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Topic: Update on Acute Hemorrhagic Diarrhea Syndrome in Dogs
Culture-based assessment of feces is a diagnostic tool that should be used to identify specific or opportunistic enteropathogenic bacteria (eg, Salmonella spp., Campylobacter jejuni, specific enteropathogenic Escherichia coli strains, Yersinia spp., Clostridium perfringens, Clostridium difficile) and fungi in animals showing clinical signs associated with infectious acute or chronic diarrhea.1-3 Several commercial veterinary diagnostic laboratories offer fecal culture as a tool to assess microbial composition (ie, growth of gram-negative and gram-positive flora) and, furthermore, to provide treatment recommendations based on their own interpretation of normobiosis and dysbiosis. Doing so is problematic, because aerobic culture-based methods do not adequately represent the mostly anaerobic intestinal microbiota. Several limitations are associated using fecal culture to diagnose the cause of diarrhea, such as lack of standardization with regard to sampling technique (eg, amount of feces), shipping (eg, chilled vs. room temperature), and methodology (eg, culture media, subsampling, dilution error, method used to count colonies) among different laboratories.
  • Should assessing microbiota composition based on culture be the diagnostic method of choice to assess dysbiosis?
  • Did the culture results of laboratories detect any difference between chronic diarrhea patients and healthy control dogs?
  • Was there an agreement between dysbiosis index and fecal culture results?
  • Is interpretation of culture results and routinely provided sensitivity testing for antibiotics misleading, resulting in unnecessary antibiotic treatment?
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Stefan Unterer

Prof., Dr. med. vet., Dr. habil., Dipl ECVIM-CA

Stefan Unterer is Professor of Small Animal Internal Medicine and Director of the Small Animal Internal Medicine Clinic at the Vetsuisse Faculty Zurich, Switzerland. He completed his internship and residency in small animal internal medicine at the University of Zürich, Switzerland and the University of Georgia, USA. Stefan Unterer became board-certified by the European College of Veterinary Internal Medicine in 2003. After one year in private practice, he returned to academia and became a faculty member at the University of Munich, Germany.
He finished his habilitation thesis in 2016. Stefan Unterer is a member of the Comparative Gastroenterology Society (CGS), the European Society of Comparative Gastroenterology (ESCG), and the Society of Comparative Hepatology. In addition, he supports the Examination Committee of the European College of Veterinary Internal Medicine.
His clinical research projects include the intestinal microbiome, acute hemorrhagic diarrhea in dogs, intestinal barrier function and long-term consequences of acute enteritis.

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