A Preliminary Study of Modulen IBD Liquid Diet in Hospitalized Dogs with Protein-Losing Enteropathy

SIMPLE SUMMARY: Modulen IBD is an oral liquid food that results in remission rates similar to immunosuppressive drugs in children with inflammatory bowel disease. This diet has not been previously investigated in dogs. We aimed to describe the use of Modulen IBD in hospitalized dogs with inflammatory protein-losing enteropathy (PLE) when combined with whey powder and a multivitamin/mineral blend to ensure this was complete and balanced for dogs. Five dogs hospitalized for PLE that had an esophagostomy feeding tube placed were eligible and prospectively enrolled. All dogs received Modulen IBD without concurrent immunosuppressive drugs and tolerated tube feedings. All dogs had resolution of anorexia, three had stable or improved serum albumin concentrations, four had improved or normalized serum globulin concentrations, and four dogs had improved or normalized serum cholesterol concentrations 2–3 days after initiating the diet. In conclusion, the Modulen IBD liquid diet was well-tolerated in-hospital and resolved anorexia in all dogs and helped to improve selected biochemical parameters in some dogs. Further studies are needed to assess the long-term effects of feeding this diet to dogs with inflammatory PLE. ABSTRACT: Modulen IBD is an enteral liquid diet that can induce remission rates similar to glucocorticoids in children with inflammatory bowel disease. The Modulen IBD liquid diet has not been previously investigated in dogs. Our study aimed to describe the use of the Modulen IBD liquid diet in hospitalized dogs with inflammatory protein-losing enteropathy (PLE), including its tolerance and effects on appetite and gastrointestinal signs, and laboratory parameters during hospitalization. Of the 14 dogs hospitalized for PLE that had an esophagostomy feeding tube placed at the time of endoscopy, 5 were eligible and prospectively enrolled. The Modulen IBD liquid diet was supplemented with whey powder isolate and a multivitamin/mineral blend to ensure the diet was complete and balanced for canine adult maintenance and had a macronutrient profile desirable for PLE. All five dogs tolerated tube feedings with the Modulen IBD liquid diet, allowing an increase of 75 to 100% of the resting energy requirement (RER) by day 3 to 4. The diet was administered without glucocorticoid in all five dogs. All five of these dogs had a resolution of anorexia allowing the voluntary intake of a commercial hydrolyzed protein diet prior to the use of glucocorticoids. Of these five dogs, three (60%) had stable or improved serum albumin concentrations (median % increase: 10.3, range: 0–31.1), four (80%) had improved or normalized serum globulin concentrations (median % increase: 12.9, range: 5.1–66.2) and four (80%) had improved or normalized serum cholesterol concentrations (median % increase: 31.5, range: 4.8–63) 2–3 days after initiating the diet. However, there were no significant differences in these selected biochemical parameters pre- and post-feeding with the diet (p > 0.080). In conclusion, the Modulen IBD liquid diet, fed via an esophagostomy feeding tube was well-tolerated in-hospital and resolved anorexia in all dogs and helped to improve selected biochemical parameters in some dogs. Further studies are needed to assess the long-term effects of feeding this diet on the rate of serum albumin increase and remission in dogs with inflammatory PLE.