Aarti Kathrani

Dogs with protein-losing enteropathy (PLE) caused by inflammatory enteritis, intestinal lymphangiectasia, or both, have a guarded prognosis, with death occurring as a result of the disease in approximately 50% of cases. Although dietary therapy alone is significantly associated with a positive outcome, there is limited ability to differentiate between food-responsive (FR) PLE and immunosuppressant-responsive (IR) PLE at diagnosis in dogs. Our objective was to determine if a transfer learning computational approach to image classification on duodenal biopsy specimens collected at diagnosis was able to differentiate FR-PLE from IR-PLE. This was a retrospective study using paraffin-embedded formalin-fixed duodenal biopsy specimens collected during upper gastrointestinal tract endoscopy as part of the diagnostic investigations from 17 client-owned dogs with PLE due to inflammatory enteritis at a referral teaching hospital that were subsequently classified based on treatment response into FR-PLE (n = 7) or IR-PLE (n = 10) after 4 months of follow-up. A machine-based algorithm was used on lower magnification and higher resolution images of endoscopic duodenal biopsy specimens. Using the pre-trained Convolutional Neural Network model with a 70/30 training/test ratio for images, the model was able to differentiate endoscopic duodenal biopsy images from dogs with FR-PLE and IR-PLE with an accuracy of 83.78%. Our study represents an important first step toward the use of machine learning in improving the decision-making process for clinicians with regard to the initial treatment of canine PLE.

Background Dietary factors have been extensively studied as potential triggers of inflammatory bowel disease in humans. Scant literature exists regarding diet as a pre‐illness risk factor in dogs with chronic enteropathy (CE). Hypothesis To evaluate possible pre‐illness dietary risk factors in dogs with CE. Animals Ninety‐five client‐owned dogs; 48 with CE (25 presumptive and 23 confirmed) and 47 without a history of signs of gastrointestinal disease. Methods Retrospective case‐control questionnaire‐based study at a veterinary referral teaching hospital in the United Kingdom. Diet history was obtained relating to the onset of initial presenting signs for all dogs. The main diet consumed underwent ingredient analysis and caloric distribution calculation using a guaranteed analysis convertor software. Length of time the main diet was fed and adherence to the World Small Animal Veterinary Association Global Nutrition Committee guidelines was also recorded. Results The frequency of the main diet containing no carbohydrate was greater for controls (5/47 dogs, 11%) vs the combined presumptive and confirmed CE dogs (0/48 dogs, 0%; P = .05). Fewer dogs with confirmed CE were fed a main diet containing red meat as the primary protein source (2/23 dogs, 9%) vs controls (15/47 dogs, 32%; P = .03). A main diet moisture percentage of ≤14% as fed was significantly associated with confirmed CE in logistic regression analysis (OR 5.71 [95% CI: 1.18‐27.69]; P = .03). Conclusions and Clinical Importance The presence of dietary carbohydrate, protein source, and dietary moisture content, or factors related to moisture content such as preservatives, might play a role as potential pre‐illness dietary risk factors in dogs with CE.

Objectives To culture Malassezia and other fungi from the duodenum of dogs with gastrointestinal signs undergoing routine endoscopic examination. Materials and Methods Quantitative microbial culture was performed on duodenal juice aspirated from dogs with suspected enteropathy during routine upper gastrointestinal endoscopy; samples were cultured on Sabouraud's dextrose agar (30, 32 and 37°C) and modified Dixon agar (32°C) for 14 days. Isolates were identified phenotypically and by matrix‐assisted laser desorption ionisation‐time of flight, and internal transcribed spacer sequencing. Yeast presence was also evaluated by cytological and histopathological examination of smears and biopsy specimens. Results Forty‐five dogs were recruited with chronic inflammatory enteropathy (n=38), granulomatous colitis (n=2), gastric adenocarcinoma (n=2), duodenal small cell lymphoma (n=1) and idiopathic severe gastrointestinal haemorrhage (n=2). Fungi were cultured from 14 dogs: Malassezia pachydermatis was isolated from eight [chronic inflammatory enteropathy (n=7) (along with Candida albicans n=1); granulomatous colitis (n=1)] and Malassezia sympodialis from another (gastric adenocarcinoma). Five dogs with chronic inflammatory enteropathy yielded other yeasts ( C. albicans , Candida glabrata , Kazachstania slooffiae , Kazachstania telluris , Pichia kudriavzevii [syn. C. krusei ]). Yeasts were never observed in histopathological specimens. Fluorescent microscopical examination of cytological specimens showed yeast in only one case, from which K. slooffiae was subsequently isolated. Clinical Significance Based on a literature search, this is the first report of isolation of M. pachydermatis , M. sympodialis , K. slooffiae and K. telluris from the canine duodenum. Further studies are needed to determine whether these are resident or transient fungi in the canine duodenum and whether their presence has a pathogenic effect on the host.