Shelter Medicine Journal Club - July 2024

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Six articles will be presented each year with an accompanying quiz consisting of 5-10 questions. You must correctly answer 80% of questions to receive credit, and Diplomates may take each quiz up to three (3) times.
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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. Which of the following is cited as a reason that the use of metronidazole in the treatment of acute diarrhea is considered controversial?

Risks for neurologic side effects

Demonstrated reduction in Clostridium hiranonis bacteria

Interaction of generated drug metabolites with host DNA

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* 5. Which clinical parameter was significantly different between the group treated with metronidazole and the group treated with the synbiotic in the first 10 days following initial presentation (day 0) for treatment?

Fecal consistency scores

Defecation frequency

There was no significant difference in fecal consistency scores or defecation frequency between the two groups.

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* 6. On days 6 and 30, which of the treatment groups showed a significant increase in E. coli bacteria concentration?

Metronidazole

Synbiotic

Both groups

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* 7. Only one dog in the study was noted to show an increased dysbiosis index (DI) and severely decreased abundance of C. hiranonis on the day of presentation. What is the clinical significance of these findings?

These findings are suggestive of chronic enteropathy.

These findings indicate significant overgrowth of Clostridium difficile.

These findings suggest that use of metronidazole was contraindicated.

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* 8. The concentration of Clostridium perfringens (C. perfringens, a potential enteropathogen) was increased in 35% of the study dogs on day 0 and returned to within the reference interval in all dogs on day 6. Considering this, which of the following statements is most consistent with the conclusions of this study?

A synbiotic is a better empiric choice for treatment of acute diarrhea as the increases in C. perfringens were self-limiting and normalize simultaneously with clinical improvement and without antibiotic treatment.

A synbiotic is a better empiric choice for treatment of acute diarrhea as the increases in the concentration C. hiranonis in this treatment group improved the intestinal microbiome.

Since there was no difference between the two treatment groups either metronidazole or a synbiotic would be a reasonable empiric treatment choice for dogs with acute diarrhea.