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Open Access Highly Accessed Research article

A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

Aran Mas1, Peter-John M Noble1, Peter J Cripps1, Daniel J Batchelor1, Peter Graham2 and Alexander J German1*

Author Affiliations

1 School of Veterinary Science, University of Liverpool, Neston, United Kingdom

2 Nationwide Laboratories Lancefield House, 23 Mains Lane, Poulton-le-Fylde, United Kingdom

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BMC Veterinary Research 2012, 8:127  doi:10.1186/1746-6148-8-127

Published: 28 July 2012

Abstract

Background

Enzyme treatment is the mainstay for management of exocrine pancreatic insufficiency (EPI) in dogs. ‘Enteric-coated’ preparations have been developed to protect the enzyme from degradation in the stomach, but their efficacy has not been critically evaluated. The hypothesis of the current study was that enteric coating would have no effect on the efficacy of pancreatic enzyme treatment for dogs with EPI.

Thirty-eight client-owned dogs with naturally occurring EPI were included in this multicentre, blinded, randomised controlled trial. Dogs received either an enteric-coated enzyme preparation (test treatment) or an identical preparation without the enteric coating (control treatment) over a period of 56 days.

Results

There were no significant differences in either signalment or cobalamin status (where cobalamin deficient or not) between the dogs on the test and control treatments. Body weight and body condition score increased in both groups during the trial (P<0.001) but the magnitude of increase was greater for the test treatment compared with the control treatment (P<0.001). By day 56, mean body weight increase was 17% (95% confidence interval 11-23%) in the test treatment group and 9% (95% confidence interval 4-15%) in the control treatment group. The dose of enzyme required increased over time (P<0.001) but there was no significant difference between treatments at any time point (P=0.225). Clinical disease severity score decreased over time for both groups (P=0.011) and no difference was noted between groups (P=0.869). No significant adverse effects were reported, for either treatment, for the duration of the trial.

Conclusions

Enteric coating a pancreatic enzyme treatment improves response in canine EPI.

Keywords:
Dog; Pancreas; Malabsorption; Diarrhoea; Lipase; Trypsin