Management of inflammatory bowel disease and lymphangiectasia in a dog with octreotide and tranexamic acid

Abstract

In dogs, inflammatory bowel disease (IBD) is a well-defined form of intestinal disease. Most cases are associated with lymphangiectasia. A 2-year-old, American Staffordshire Terrier male dog, presented with progressive diarrhea for more than 3 months. Clinical findings, laboratory findings, ultrasound images of the dog and also, histopathological evaluation of punch biopsy samples from the intestines were compatible with IBD and lymphangiectasia. The treatment of the dog was started with the treatment protocol containing octreotide (10 µg/dog per day, BID, sc.) and tranexamic acid (10 mg/kg, BID, im.) which was used for the first time in dogs with IBD and lymphangiectasia. Fecal consistency and defecation frequency returned to normal on the 15th day, also at the end of the first month of therapy hypoalbuminemia began to normalize, ascites completely disappeared and the thickness of the mucosal layer began to normalize, and the patient began to gain weight. In the controls performed at the end of the second month, it was determined that the patient's clinical signs and all laboratory results improved. To our knowledge, these results suggest that the combination of octreotide and tranexamic acid can effectively and without any side effects be used for the treatment of IBD in dogs for the first time. This case report, it is aimed to present a successful treatment method using octreotide and tranexamic acid in a dog with intestinal lymphangiectasia related to IBD and to raise awareness among veterinarians in patients with similar clinical findings.

Keywords

• dog
• inflammatory bowel disease
• lymphangiectasia
• octreotide
• tranexamic acid

References

1. Albert EJ (1999): Inflammatory bowel disease: current perspectives. Vet Clin North Am Small Anim Pract, 29, 501-521.
2. Arslan HH (2006): Yangısal Bağırsak Hastalığı ve Probiyotiklerle Güncel Tedavi Yaklaşımı. Uludag Univ J Fac Vet Med, 25, 29-32.
3. Bilgiç B, Bakay Baysal MB, Ulgen Saka S, et al (2020): Kedi ve Köpeklerin Yangısal Bağırsak Hastalığında Terapötik Helmintler. Türkiye Klinikleri Veteriner Bilimleri, 11, 92-98.
4. Craven MD, Washabau RJ (2019): Comparative pathophysiology and management of protein-losing enteropathy. J Vet Intern Med, 33, 383–402.
5. Craven M, Simpson JW, Ridyard AE, et al (2004): Canine inflammatory bowel disease: retrospective analysis of diagnosis and outcome in 80 cases (1995–2002). J Small Anim Pract, 45, 336-342.
6. Cristóbal JI, Duque FJ, Usón-Casaús JM, et al (2021): Effects of Allogeneic Mesenchymal Stem Cell Transplantation in Dogs with Inflammatory Bowel Disease Treated with and without Corticosteroids. Animals (Basel), 11, 2061.
7. Denning A (2011): Ultrasound examination of the gastrointestinal tract Part 1: Location and normal appearance. Compan Animal, 16, 21-28.
8. Díaz-Regañón D, Sainz Á, Rodríguez-Franco F, et al (2023): Assessing the Quality of Life of Dogs with Inflammatory Bowel Disease and Their Owners. Veterinary Sciences, 10, 405.

9. Han ZH, He ZM, Chen WH, et al (2021): Octreotide-induced acute life-threatening gallstones after vicarious contrast medium excretion: A case report. World J Clin Cases, 9, 7484–7489.
10. Harris AG, O'dorisio TM, Woltering EA, et al (1995): Consensus statement: octreotide dose titration in secretory diarrhea. Diarrh Manag Consensus Development Panel Digest Dis Sci, 40, 1464–1473.
11. Jergens AE (2004): Clinical assessment of disease activity for canine inflammatory bowel disease. J Am Anim Hosp Assoc 40, 437–445.
12. Jubb KVF, Kennedy PC, Palmer NC (2016): Veterinary Medicine. Pathology of domestic animals. Alimentary System. 6th ed., Elsevier, Riverport Lane, St. Louis, Missouri, 90-91.
13. Khanna C, Prehn J, Hayden D, et al (2002): A randomized controlled trial of octreotide pamoate long-acting release and carboplatin versus carboplatin alone in dogs with naturally occurring osteosarcoma: evaluation of insulin-like growth factor suppression and chemotherapy. Clin Cancer Res, 8, 2406–2412.
14. Klooker TK, Kuiken SD, Lei A, et al (2007): Effect of long-term treatment with octreotide on rectal sensitivity in patients with non-constipated irritable bowel syndrome. Aliment Pharmacol Ther, 26, 605–615.
15. Kwon Y, Kim ES, Choe YH, et al (2021): Individual approach for treatment of primary intestinal lymphangiectasia in children: single-center experience and review of the literature. BMC Pediatr, 21, 21.
16. Lin CY, Jha AR, Oba PM, et al (2022): Longitudinal fecal microbiome and metabolite data demonstrate rapid shifts and subsequent stabilization after an abrupt dietary change in healthy adult dogs. Anim Microb, 4, 46.
17. Makowska K (2019): Changes in The Expression of Somatostatin (SOM) in Nerve Fibers of Gastrointestinal Mucosa in Dogs with Inflammatory Bowel Disease (IBD). J Med Case Rep, 5, 90.
18. Melzer KJ, Sellon RK (2002): Canine intestinal lymphangiectasia. Compendium On Continuing Education For The Practising Veterinarian-North American Edition, 24, 953-961.
19. Mincher L, Evans J, Jenner MW, et al (2005): The successful treatment of chylous effusions in malignant disease with octreotide. Clin Oncol, 17, 118–121.
20. Moore HB, Moore EE, Chapman MP, et al (2019): Does Tranexamic Acid Improve Clot Strength in Severely Injured Patients Who Have Elevated Fibrin Degradation Products and Low Fibrinolytic Activity, Measured by Thrombelastography? J Am Coll Surg, 229, 92–101.
21. Niina A, Kibe R, Suzuki R, et al (2021): Fecal microbiota transplantation as a new treatment for canine inflammatory bowel disease. Bioscience of microbiota, food and health, 40, 98-104.
22. Plumb DC (2011): Octreotide. In: Plumb DC, ed. Plumb’s Veterinary Drug Handbook. 7th ed. Stockholm, WI: John Wiley & Sons; 2620-2624.
23. Rhimi S, Kriaa A, Mariaule V, et al (2022): The Nexus of Diet, Gut Microbiota and Inflammatory Bowel Diseases in Dogs. Metabolites, 12, 1176.
24. Simpson KW, Stepien RL, Elwood CM, et al (1995): Evaluation of the long-acting somatostatin analogue octreotide in the management of insulinoma in three dogs. J Small Anim Pract, 36, 161–165.
25. Suehiro K, Morikage N, Murakami M, et al (2012): Late-onset primary intestinal lymphangiectasia successfully managed with octreotide: a case report. Ann Vasc Dis, 5, 96–99.
26. Tilley LP, Smith, FWK Jr (2008): The 5-Minute Veterinary Consult Canine and Feline, Blackwell’s, 1332-1333.
27. Trinkley KE, Nahata MC (2011): Treatment of irritable bowel syndrome. J Clin Pharm Ther, 36, 275-282.
28. Zachary JF (2017): Veterinary Medicine. Pathologic basis of veterinary disease. Alimentary system and the peritoneum, omentum, mesentery and peritoneal cavity. 6th ed., Elsevier, Riverport Lane, St. Louis, Missouri, pp. 336-409.