BSAVA Congress 2024 – Day Two Round-up

23 March 2024

It is a vital part of the veterinary practitioner’s job to enter the Belly of the Beast and examine the different ways that a healthy gut can influence the wellbeing of their patients.

So, sessions on the second day of the BSAVA’s annual Congress in Manchester included a series of presentations on disorders of the alimentary tract in canine and feline patients. But conditions affecting the digestive system can also have implications for their owners, as was clear from a debate involving Oxfordshire vet Martin Whitehead and Ian Wright, a practitioner from Lancashire with a particular interest in parasitic disease in cats and dogs.

Dr Whitehead maintained that the evidence for the benefits of regular worming of adult animals is unconvincing and colleagues should discontinue the policy of giving regular quarterly doses. This is often seen as a key element in the practice health plans intended to underpin better healthcare for the country’s pets.

The main reason for worming companion animal patients is to prevent pets shedding eggs in their faeces from the gut parasite Toxocara, an organism that can cause blindness and other serious conditions in humans, and particularly in children. But as Dr Whitehead argued, there is little evidence to show that routine worming either reduces the number of eggs being released in the faeces of infected pets or the risk of humans then coming into contact with the parasite.

The evidence from the limited number of published studies on Toxocara infections around the globe showed no connection between the frequency of worming treatment in adult animals and either the levels of environmental contamination or human disease. He acknowledged that treatment of kittens and puppies was different matter and veterinarians should encourage owners of young pets to seek treatment that will prevent them developing serious parasitic infections.

He suspected that the main cause of environmental contamination with Toxocara eggs will be found to be wild carnivores like foxes and stray cats. He suggested that treatment in domestic dogs should take account of the disease risk and wormers should only be used in adult dogs at higher risk of exposure to the eggs, such as dogs kennelled outside, those allowed to scavenge and individual dogs that eat the faeces of other animals, he said.

Dr Wright, who is scientific advisor to ESCCAP, the European Scientific Counsel on Companion Animal Parasites, responded that controlling Toxocara was not the only reason why the organisation recommended worming every quarter. Other significant parasites that are destroyed by veterinary treatment included the lungworm Angiostrongylus vasorum and the tapeworm Echinococcus multilocularis, another cause of significant disease in humans.

Session chair Dawn Howard, chief executive of the National Office of Animal Health noted that while the debate highlighted different perspective on veterinary care, both sides had bemoaned the lack of evidence on the threats of parasitic disease and of appropriate strategies for tackling them. She urged veterinary organisations, industry and the research funding bodies to give a higher priority to conducting studies on the human, animal and environmental impacts of parasitic diseases.

Another session at the event addressed a complex and distressing condition affecting the intestinal tract, chronic enteropathy. This was an area where the search for safe and effective treatments for dogs has been long and difficult, speakers said.

Consequently, veterinarians will often have to rely on treatments that have only limited success rates and animal owners may try to deal with a condition that causes chronic diarrhoea by seeking out unapproved treatment, when few other realistic options are available.

Dr Julien Dandrieux, from the University of Edinburgh veterinary school, noted that corticosteroids were much less commonly used in dogs with chronic enteropathy as our understanding of the underlying causes of the condition has improved. Similarly, far fewer practitioners will use antimicrobial treatments like metronidazole now that the evidence shows such treatment has limited value and can cause long term disturbance to the normal function of the gut.

Meanwhile, Dr Andrew Wales, a veterinary pathologist at the University of Surrey reviewed the published research on the value of the raw food diets often favoured by dog owners for managing this condition in their pets. He suggested that unprocessed foods not only encourage the spread of pathogenic bacterial strains, many published analyses of their contents have also shown deficiencies in important micronutrients and even in main components such as protein levels.

Less conventional options for treating gut disorders in veterinary patients are also emerging and were discussed in the same session. Silke Salavati from the University of Edinburgh is one of the leading authorities in the UK on the use of faecal matter transplants from healthy donor animals to treat digestive disorders in veterinary patients.

Professor Salavati described her methods for the collection, processing and storage of faecal matter before being used against conditions like chronic enteropathy, acute colitis and parvovirus infection. She insisted that the technique was fairly straightforward and requires very little specialist equipment. Understandably, given the nature of the materials she is using, her colleagues are happy to allow her to keep her own dedicated equipment, such as a food processor and freezer, when conducting her experiments on what she calls Poo Smoothies and one quick-witted audience member dubbed her ‘Crappucchino’.

Developments of these methods are still in the early stages and she belongs to a group of international researchers that are working on producing agreed protocols for their use in veterinary patients. While these procedures have been shown to produce good results in the majority of patients, around 20 per cent of patients do not respond to treatment and experience in human patients has shown that significant adverse effects can also occur, she said.

More conventional biochemical therapies for conditions like chronic enteropathy may also be emerging soon, according to Aarti Kathrani, a senior lecturer in small animal medicine at the Royal Veterinary College, London. Her team is investigating the effects of supplementing levels of the amino acid tryptophan in the blood of canine patients with chronic enteropathy. This project, named the AminoGut study has recruited more than 70 of its required target of about 90 dogs and it is hoped that the results will be presented at a future BSAVA meeting.