Severe gastrointestinal tract injury influences the system's metabolic and inflammatory response. Translocation of bacteria or their by-products may initiate an inflammatory cascade that could result in systemic inflammatory syndrome (SIRS) or multiorgan dysfunction syndrome. Finding a way to measure intestinal permeability and quantifying the damage to the gastrointestinal tract could potentially predict morbidity and mortality. This study assessed the feasibility of using sugars recovered in urine to determine if intestinal permeability and absorption are altered in dogs with traumatic injury. Twelve client-owned dogs with traumatic injury and six healthy controls were used in the study. After a 6-hour fast, the dogs were given a sugar solution containing lactulose, rhamnose, 3-0-methyl-D-glucose, and xylose via nasogastric tube. These sugars were chosen because of the different ways they are digested or absorbed. Urine was collected at 24, 48, and 72 hours after trauma, and the urine sugar levels measured. Results of the study revealed an increase in the lactulose-rhamnose ratio 48 hours after trauma, indicating increased intestinal permeability. By 72 hours, the ratio was the same as that for controls, suggesting normalization of intestinal permeability. An increased xylose-3-0-methyl-D-glucose ratio found in the dogs with trauma suggested altered absorptive function.
COMMENTARY: This study was small, and medications received by the dogs were not standardized. The dogs also received different nutritional support during the study. However, the results support the hypothesis that intestinal permeability and absorption are altered in dogs with traumatic injury and that measuring urine sugar is a technique worthy of future study in such injuries.
Intestinal permeability and absorption in dogs with traumatic injury. Streeter EM, Zsombor-Murry E, Moore KE, et al. J VET INTERN MED 16:669-673, 2002.
