Journal Scan: Can budesonide help dogs with IBD?

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Budesonide is a nonhalogenated glucocorticoid. Clinical interest in it stems from its immune-modulating effects directly at the level of the intestinal tract with few of the systemic effects typically associated with corticosteroids.

What they did

Eleven dogs with histopathologically confirmed moderate to severe inflammatory bowel disease (IBD) were treated with oral controlled-release budesonide (3 mg/m2 once daily) for 30 days. Plasma and urine samples were tested for budesonide and 16-alpha-hydroxyprenisolone (a budesonide metabolite) concentrations on days 1 and 8. On those days, plasma samples were obtained before budesonide administration and 30 minutes and one, two, four, and seven hours after administration. Urine samples were collected after the last blood sample was drawn.

Patients were clinically evaluated at enrollment and on days 20 and 30 of the study period. A canine IBD activity index (CIBDAI) score was calculated for all dogs at baseline and on day 20. This CIBDAI score has been validated previously and is based on attitude, appetite, vomiting, stool consistency, stool frequency, and weight loss.1

What they found

Plasma concentrations of budesonide and 16-alpha-hydroxyprenisolone were highest one hour and two hours, respectively, after drug administration. Evaluation on day 20 indicated improvement based on a decrease in the CIBDAI score (mean CIBDAI at enrollment: 7.4 ± 3.1; mean CIBDAI score on day 20: 2.3 ± 2.1; P < 0.001). Overall, clinical improvement was noted in eight of the 11 dogs.

Researchers found that budesonide was rapidly absorbed and resulted in clinical improvement in the signs of IBD with no episodes of polyuria, polydipsia, polyphagia, panting, or hair loss reported.

Take-home message

Budesonide may be useful in the treatment of IBD in dogs and may decrease the occurrence of undesirable side effects of treatment with glucocorticoids. It is important to note, however, that the sample size was small and the study duration was brief, so the results should be interpreted with caution.

Reference

1. Jergens AE Schreiner CA, Frank DE, et al. A scoring index for disease activity in canine inflammatory bowel disease. J Vet Intern Med 2003;17(3):291-297.

Pietra M, Fracassi F, Diana A, et al. Plasma concentrations and therapeutic effects of budesonide in dogs with inflammatory bowel disease. Am J Vet Res 2013;74(1):78-83.

Link to abstract: http://avmajournals.avma.org/doi/abs/10.2460/ajvr.74.1.78