title: Comparison of oral prednisone and prednisone combined with metronidazole for induction therapy of canine inflammatory bowel disease: a randomized-controlled trial.
abstract: BACKGROUND
  Although prednisone and metronidazole are commonly used to treat canine inflammatory bowel disease (IBD), no randomized-controlled trials have been performed.
  
  
  OBJECTIVE
  Combination drug therapy with prednisone and metronidazole will be more effective than prednisone alone for treatment of canine IBD. Reduction in disease severity will be accompanied by decreased canine IBD activity index (CIBDAI) scores and serum C-reactive protein (CRP) concentrations.
  
  
  METHODS
  Fifty-four pet dogs diagnosed with IBD of varying severity.
  
  
  METHODS
  Dogs were randomized to receive oral prednisone (1 mg/kg; n = 25) or prednisone and metronidazole (10 mg/kg; n = 29) twice daily for 21 days. Clinical (CIBDAI) scores and serum CRP were determined at diagnosis and after 21 days of drug therapy. The primary efficacy measure was remission at 21 days, defined as a 75% or greater reduction in baseline CIBDAI score.
  
  
  RESULTS
  Differences between treatments in the rate of remission (both exceeding 80%) or the magnitude of its change over time were not observed. CRP concentrations in prednisone-treated dogs were increased because of many dogs having active disease. Both treatments reduced CRP in comparison with pretreatment concentrations. An interaction between CIBDAI and CRP was identified in 42 of 54 dogs (78%), whereas 8 of 54 dogs (15%) showed disagreement between these indices.
  
  
  CONCLUSIONS
  Prednisone is as effective as combined treatment with prednisone and metronidazole for induction therapy of canine IBD. CRP may be normal or increased in dogs with IBD and may be useful in assessing the response of individual dogs to treatment along with changes in the CIBDAI.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50010, USA. ajergens@iastate.edu
authors.forename: A E
authors.initials: AE
authors.lastname: Jergens
authors.forename: J
authors.initials: J
authors.lastname: Crandell
authors.forename: J A
authors.initials: JA
authors.lastname: Morrison
authors.forename: K
authors.initials: K
authors.lastname: Deitz
authors.forename: M
authors.initials: M
authors.lastname: Pressel
authors.forename: M
authors.initials: M
authors.lastname: Ackermann
authors.forename: J S
authors.initials: JS
authors.lastname: Suchodolski
authors.forename: J M
authors.initials: JM
authors.lastname: Steiner
authors.forename: R
authors.initials: R
authors.lastname: Evans
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004359:Drug Therapy, Combination; D005260:Female; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage* / Q000627:therapeutic use*; D011241:Prednisone / Q000008:administration & dosage* / Q000627:therapeutic use*
chemical_list: D008795:Metronidazole; D011241:Prednisone