Malabsorption due to selected oral antibiotics

This article represents an overview of recent research conducted on antibiotic-induced malabsorption in calves. The authors feel strongly that this work identifies a serious and ill-defined problem in the management of neonatal calves. Too often the solution utilized by veterinarian and stockmen for controlling neonatal diarrhea has been to administer oral antibiotics. In many cases, this has been done on the basis of antibiotic sensitivity testing, an approach that seems appropriate. Unfortunately, little consideration has been given to the relative sensitivity of the neonatal intestinal mucosa, with its very rapid turnover, to the potentially detrimental effects of oral antimicrobial therapy. The data that we have collected over the past 3 years conclusively demonstrate that high levels of four commonly used oral antibiotics, especially neomycin and chloramphenicol but also tetracycline and ampicillin, can cause a malabsorption diarrhea in normal calves. This action is not due to viral agents or overgrowth of resistant microbes but is the result of direct modification of the intestinal mucosa. Extrapolation of these data to different dose levels may not be accurate. Oral antibiotics may be of value in treating neonatal enteritis. Conversely, there can be too much of a good thing, and many cases of chronic diarrhea following use of oral antibiotics may be the result of an overenthusiastic and prolonged dosage regimen. Be cautious!     

Malabsorption in the horse associated with alimentary lymphosarcoma.

Three horses suffering from malabsorption were shown to have alimentary lymphosarcoma predominantly affecting the small intestine and the associated lymph nodes. The diffuse cellular infiltration in two of the case produced marked changes in the villous architecture reducing the available mucosal surface area, and, with lowered or barely detectable disaccharidase activities, contributed to the impairment of digestive-absorptive processes. One of the horses maintained a voracious appetite and was not diarrhoeic, but failed to gain weight, indicating differences in the production and utilisation of energy sources absorbed from the small and the large intestines. A large proportion of plasma cells in the infiltrate, and the resulting morphological changes in two of the cases bore a striking resemblance to features of alpha chain disease, an immunodeficiency disease of man, although immunological studies were not conducted on these horses.     

Malabsorption syndrome in the dog: a study of thirty-eight cases

The clinical findings and results of an investigational procedure on thirty-eight confirmed cases of canine malabsorption are described in detail. Exocrine pancreatic insufficiency was frequently responsible for the syndrome, but on occasions small intestinal disorders, liver disease and alactasia were diagnosed. Possible methods of treatment are suggested and their value in the present series of cases discussed briefly. Résumé. Les résultats cliniques et les résultats d'un procédé d'investigation concernant trente-huit cas confirmés de malabsorption canine, sont décrits en détail. L'insuffisance sécrétoire du pancréas en exocrine était fréquemment la cause responsable du syndrome, mais en certaines occasions, on a diagnostiqué de légers troubles intestinaux, une maladie de foie et une alactasie. On suggère des méthodes possibles de traitement et leur valeur dans la présente série des cas est brièvement discutée. Zusammenfassung. Die Abhandlung gibt eine eingehende Beschreibung der klinischen Befunde und die Ergebnisse einer Forschungsmethode an 38 nachgewiesenen Fällen von Malabsorption bei Hunden. Exokrine Pankreasinsuffizienz war dabei häufig für die Entstehung des Syndroms verantwortlich; jedoch wurden in einigen Fällen auch kleine Darmstörungen, Lebererkrankungen und Alaktasie diagnostiziert. Auf einige mögliche Behandlungsmethoden wird hingewiesen und deren Wirksamkeit im Rahmen der vorliegenden Serie wird kurz besprochen.     

Some Preliminary Clinical Observations on the Malabsorption Syndrome in the Cat

Abstract— —The clinical syndrome associated with malabsorption in the cat is described. Three cases illustrating different possible aetiologies of the syndrome are described. Methods of diagnosis and treatment are discussed.
Résumé— —L'auteur examine le syndrome clinique qu'entraînent chez le chat les troubles de l'absorption. I. déctir trois cas correspondant à diverses étiologies possibles et expose les métiodes propres au diagnostic et au traitement.
Zusammenfassung— —Das mit mangelhafter Absorption im Verdauungskanal verbundene klinische Syndrom bei der Katze wird beschrieben. Drei Falle, die verschiedene mögliche Ätiologien des Syndroms illustrieren, werden beschrieben. Methoden der Diagnose und Behandlung werden besprochen.     

Poult malabsorption syndrome. I. Malabsorption in poult enteritis.

One-day-old poults were placed on littler on which poults had previously developed diarrhea, increased mortality, and stunting. Small intestines, pancreas, and liver were evaluated histologically. Morphometric evaluations were conducted to determine villous length and crypt depth. Poults were evaluated for malabsorption utilizing D-xylose and lipid absorption tests. Compared with controls, the gastrointestinal tract of affected birds was grossly distended, was fluid-filled, and had thin, flaccid walls on days 5 and 8. Ceca were distended with brown watery fluid and gas on days 5, 8, and 12. No histologic lesions were present in the liver, pancreas, or pancreatic ducts, and only mild inflammatory changes were present in the small intestine. Villous atrophy and crypt hypertrophy were present in the small intestine on days 5, 8, 12, 16, and 21. Morphometry revealed significant decreases in villous lengths and increases in crypt depth throughout the trial. D-Xylose and lipid absorption were significantly decreased on days 8 and 11. Intestinal epithelial damage by infectious agents with subsequent villous atrophy is postulated to have produced malabsorptive diarrhea.     

Malabsorption of vitamin A in preruminating calves infected with Cryptosporidium parvum.

Serum retinol, retinyl palmitate, and total vitamin A concentrations, and jejunoileal morphology were examined in neonatal calves infected with Cryptosporidium parvum. Group-1 calves served as noninfected controls and, after an adjustment period, were given 50 ml of saline solution i.v. every 12 hours for 6 days. Group-2 calves were inoculated with 10(7) C parvum oocysts and, after the onset of diarrhea, were given 50 ml of saline solution i.v. every 12 hours for 6 days. Group-3 calves were inoculated with 10(7) C parvum oocysts and, after the onset of diarrhea, were treated with difluoromethylornithine (DFMO, 200 mg/kg of body weight i.v., q 12 h) for 6 days. Group-4 calves were naturally infected with C parvum. Jejunoileal biopsy specimens were excised from calves of groups 1-3 at 3 and again at 15 to 16 days of age. During the course of diarrhea and 3 days after saline or DFMO administration, water-miscible retinyl palmitate was administered orally (2,750 micrograms/kg) to each calf in each group. Cryptosporidium parvum infection was associated with significant (P < or = 0.05) reduction in postadministration serum retinol, retinyl palmitate, and total vitamin A concentrations in calves of groups 2, 3, and 4. Cryptosporidium parvum infection caused significant (P < or = 0.05) reduction in villus height. Decreased villus height, villus blunting and fusion, and attenuation of the intestinal mucosa were associated with reduced absorption of vitamin A, as indicated by lower peak postadministration retinyl palmitate concentration in C parvum-infected calves. Intravenous administration of DFMO to group-3 calves did not improve retinol absorption.(ABSTRACT TRUNCATED AT 250 WORDS)     

Probable Vitamin K-Deficient Bleeding in Two Cats With Malabsorption Syndrome Secondary to Lymphocytic Plasmacytic Enteritis

Two cats with intestinal malabsorption developed a hemorrhagic diathesis. Although unsubstantiated, the probable cause of bleeding was a chronic malabsorption of fat and the fat-soluble vitamin K. When treated with vitamin K1 per os, one cat's clotting times were only partially corrected. Since vitamin K1 is actively absorbed in the proximal small intestine, the incomplete response of this case to orally administered vitamin K1 was predictable. The infrequent occurrence of bleeding in animals with malabsorption is, in part, attributable to the ileal and colonic absorption of bacterially derived vitamin K2. For this reason, nonspecific use of antibiotics in these animals is contraindicated. Since long-chain, polyunsaturated fats impair vitamin K absorption, dietary fat given to animals with malabsorption should be restricted to medium- and short-chain, saturated fats. Vitamin K should be administered subcutaneously to these animals if prolonged clotting times or active bleeding is present, and routinely prior to surgery. Oral supplementation with vitamin K3, which is absorbed in the colon and less lipid soluble than vitamin K1, should be given to animals with malabsorption that are maintained as outpatients. Adequate dosage levels of vitamin K3, however, are yet to be established for the cat, and dose-dependent hemolytic anemia is a probable toxic manifestation.