The RVC has published a new VetCompass study which has concluded that prescribing antibiotics or nutraceuticals at first presentation of uncomplicated diarrhoea in dogs causes no difference in clinical resolution of these cases.

The study1 suggests that dogs with uncomplicated diarrhoea do not need antibiotics as part of their veterinary care plans. 

The study included a random sample of 894 dogs aged between three months and 10 years old diagnosed with uncomplicated diarrhoea in 2019.

Of these, 355 (39.7%) dogs were prescribed antibiotics, and 539 (60.3%) dogs were not prescribed antibiotics (with or without additional supportive treatment) at first presentation for diarrhoea.

For the analysis, the dogs were balanced for a range of other differences between the groups including age, breed, bodyweight, insurance status, the presence of two or more medical conditions, vomiting, reduced appetite, blood in faeces, raised temperature, duration of diarrhoea, additional treatment prescription and veterinary group.

The researchers say this effectively meant that the only difference between the two groups was that one group received antibiotic treatment while the other did not.

The likelihood of clinical resolution of diarrhoea in the dogs prescribed antibiotics was 88.3%, compared with 87.9% in dogs not prescribed antibiotics.

This tiny difference of 0.4% between the groups was not statistically significant, leading to the conclusion that antibiotic treatment did not cause any beneficial effects in the treatment of uncomplicated diarrhoea in dogs.

Almost nine in 10 dogs with uncomplicated diarrhoea recovered after a single veterinary visit regardless of antibiotic treatment.

As an additional analysis, the study also explored gastrointestinal nutraceuticals (products derived from food sources that aim to restore digestive health such as probiotics and prebiotics) for treatment of uncomplicated diarrhoea in dogs.

Gastrointestinal nutraceutical prescription (with or without other supportive treatment) at first presentation of uncomplicated diarrhoea caused no statistically significant difference in clinical resolution compared to dogs not prescribed gastrointestinal nutraceuticals.

Camilla Pegram, VetCompass PhD student at the RVC and lead author of the paper, said: “This study used an exciting new approach that allowed us to determine ‘cause’ rather than being limited to ‘association’.

"Diarrhoea is a common condition in dogs and is often treated with antibiotics.

"However, this study highlighted that antibiotic prescription at first presentation of diarrhoea caused no difference in clinical resolution.

"Therefore, this arms veterinarians with the evidence-base for restricting antibiotics for uncomplicated diarrhoea in dogs, and owners should be prepared to only have an antibiotic prescription if absolutely necessary.”

Fergus Allerton, project lead for the PROTECT ME guidelines and co-author of the paper said: “Rational antimicrobial use is critical to defend ourselves and our pets against the growing threat from antimicrobial resistance.

"This study provides vital evidence to strengthen recommendations to withhold antibiotics when treating dogs with acute diarrhoea. Knowing that the outcome will be the same without antibiotics should reassure veterinarians to adopt this approach consistently.”

Reference

  1. PEGRAM, C., DIAZ-ORDAZ, K., BRODBELT, D. C., CHANG, Y., TAYLER, S., ALLERTON, F., PRISK, L., CHURCH, D. B. & O’NEILL D.G. 2023. Do antimicrobials or gastrointestinal nutraceuticals prescribed at first presentation for acute diarrhoea cause a better clinical outcome in dogs under primary veterinary care in the UK? PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0291057 

PS: Whilst you're here, take a moment to see our latest job opportunities for vet nurses.