The effect of photobiomodulation therapy on the management of chronic idiopathic large-bowel diarrhea in dogs.

To evaluate photobiomodulation therapy's effectiveness (PBMT) in managing chronic idiopathic large-bowel diarrhea. Thirty dogs were selected and divided into a control (CG) and treatment group (TG). CG received psyllium husk at the dose of 4 tablespoons/day for 30 days. TG received PBMT with a Class IV therapeutic laser, divided into three sessions on week 1, two sessions on week 2, and one session on week 3. A daily log of fecal characteristics was maintained, and on days 0, 8, 15, and 30, a canine inflammatory bowel disease index (CIBDAI) and body condition scores (BCS) were obtained. Results were compared using a Mann-Whitney test. Multiple regression was run to predict CIBDAI, Bristol stool scores, and diarrhea from different parameters. The Kaplan-Meier test was used to compare the occurrence rate of ≥ 1 day of diarrhea and ≥ 2 days of diarrhea by 30 days. Cox regression analysis to investigate interest covariates influences the same outcome. A p < 0.05 was set. The sample included 15 Belgian Malinois Shepherd Dogs, 10 German Shepherd Dogs, and 5 Dutch Shepherd Dog, with a mean age of 3.6 ± 2.3 years and a bodyweight of 24.6 ± 8.0 kg. TG showed an improvement in all scores and clinical signs, increased body weight, and BCS. An increased time of appearance of a second episode of diarrhea was observed in both groups. Activity level contributed to the prediction of defecation frequency and CIBDAI. PBMT significantly improved clinical signs and frequency of diarrhea episodes compared to psyllium husk.

Peptide Receptor Radionuclide Therapy With 177Lu-DOTATATE for Symptomatic Control of Refractory Carcinoid Syndrome.

CONTEXT: Peptide receptor radionuclide therapy (PRRT) with [Lutetium-177-DOTA0-Tyr3]octreotate (177Lu-DOTATATE) results in an increase of progression-free survival and quality of life in patients with progressive, well-differentiated neuroendocrine neoplasms (NENs). OBJECTIVE: To study the effect of 177Lu-DOTATATE in patients with carcinoid syndrome and radiologically stable or newly diagnosed disease treated solely for the purpose of symptom reduction. DESIGN: Retrospective cohort study. SETTING: Tertiary care hospital. PATIENTS: Twenty-two patients with a metastatic midgut NEN, elevated urinary 5-hydroxyindolacetic acid excretion, and flushing and/or diarrhea despite treatment with a somatostatin analog, without documented disease progression. INTERVENTION: PRRT with 177Lu-DOTATATE (intended cumulative dose: 29.6 GBq) with a primary aim to reduce symptoms. RESULTS: After PRRT, mean bowel movement frequency (BMF) decreased from 6.1 ± 3.4 to 4.6 ± 3.6 per day (P = 0.009). Flushes decreased from 4.3 ± 2.9 to 2.4 ± 2.7 flushes per day (P = 0.002). A decrease of BMF of more than 30% occurred in 47% of patients with baseline BMF of 4 or more (n = 17). In patients with ≥2 episodes of flushing a day (n = 15), 67% of patients had more than 50% decrease of daily flushing. A decrease in urinary 5-hydroxyindolacetic acid excretion of more than 30% was seen in 56% of patients. The European Organization for Research and Treatment of Cancer-Core Module diarrhea subscale score showed a trend toward improvement by an average of 16.7 ± 33.3 points (P = 0.11). CONCLUSION: PRRT with 177Lu-DOTATATE effectively reduced diarrhea and flushing in patients with carcinoid syndrome and can be considered for symptomatic treatment of carcinoid syndrome insufficiently controlled with somatostatin analogs.