Evaluating the effect of metronidazole plus amoxicillin‐clavulanate versus amoxicillin‐clavulanate alone in canine haemorrhagic diarrhoea: a randomised controlled trial in primary care practice

OBJECTIVES:To investigate the benefit of supplementing amoxicillin-clavulanic acidtherapy with metronidazolein dogs presenting to a primary care veterinary practice with severe haemorrhagic diarrhoea. MATERIALS AND METHODS:Prospective randomised blinded trial on dogs presenting with haemorrhagic diarrhoea of less than 3 days duration to a primary care veterinary hospital and also requiring intravenous fluid therapy. Cases were randomised to receive either metronidazoleor saline, in addition to standard supportive therapy consisting of amoxicillin-clavulanic acid, intravenous fluid therapy, buprenorphineand omeprazole. Treatment efficacy was measured by duration of hospitalisation and daily scoring of disease severity. RESULTS:Thirty-four cases successfully completed the trial. There was no significant difference in hospitalisation time between treatment groups (mean for dogs receiving metronidazolewas 29.6 hours and for controls was 26.3 hours) nor in daily clinical scores. CLINICAL SIGNIFICANCE:This study strongly suggests that addition of metronidazoleis not an essential addition to amoxicillin-clavulanic acidtherapy for treatment of severe cases of haemorrhagic diarrhoea in dogs.