A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), showed that cats with chronic vomiting and/or diarrhoea of unknown cause, may benefit from a hydrolysed diet in the first instance, before resorting to antibiotic and/or glucocorticoid therapy1.
The study titled “The use of hydrolysed diets for vomiting and/or diarrhoea in cats in primary veterinary practice” described the responses of cats prescribed a hydrolysed diet with or without concurrent antibiotic and/or glucocorticoid for chronic vomiting and/or diarrhoea of undetermined aetiology. A secondary aim of the study was to determine if antibiotic or glucocorticoid use for vomiting and/or diarrhoea before or concurrently with the hydrolysed diet was associated with the response.
The study population included all cats under primary veterinary care at clinics participating in the VetCompass Programme in 2016. The medical records of 5,000 cats with evidence of receiving a hydrolysed diet were reviewed for gastrointestinal indication, prior and concurrent medication and response after hydrolysed dietary intervention. A poor response was defined as evidence of receiving antibiotic or glucocorticoid treatment for vomiting and/or diarrhoea at visits after the onset of the diet, or death from gastrointestinal signs for a follow-up period of at least six months.
Dr Aarti Kathrani, Senior Lecturer in Small Animal Internal Medicine at the Royal Veterinary College and corresponding author for the paper said: “Overall in our study, 42% of cats that were first prescribed a hydrolysed diet with or without concurrent antibiotic and/or glucocorticoid had a poor response.
“Antibiotic and/or glucocorticoid administration before and concurrent with the diet were associated with higher odds of a poor response. Although our study was unable to determine the causality behind this association, possible explanations may include the association of antibiotic and glucocorticoid treatment with severity of GI signs, prescribing habits of veterinary surgeons, or the effects of antibiotic and glucocorticoids on the intestinal microbiota and mucosal immune system, respectively reducing the effectiveness of a hydrolysed diet.”
Nicola Di Girolamo, Editor of JSAP concluded: “The results of this study are particularly prudent with the increased awareness and understanding of the role that companion animal veterinary surgeons can play in preventing the development of antimicrobial resistance. Although the information available did not allow the authors to correct for the severity of the condition of the individual cats, and this fact could have biased the results if cats that had a more severe condition -and therefore more likely to have a poorer outcome- were immediately prescribed additional medications other than the hydrolysed diet. These results are a base for further randomised controlled trials and provide useful guidance for veterinary surgeons facing similar situations.”
The full article can be found in the December issue of the Journal of Small Animal Practice and can be read online here. It is open access and can be freely accessed by anyone.
The Journal of Small Animal Practice is published monthly and access to articles is free for BSAVA members. For information on how to become a BSAVA member visit the website here.
1A. Kathrani, D. B. Church, D. C Brodbelt, C. Pegram and D.G. O’Neill (2020) The use of hydrolysed diets for vomiting and/or diarrhoea in cats in primary veterinary practice. Journal of Small Animal Practice, 61 (12). Available at: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13214