Monoclonal Antibodies For GI Disease?

Hello Summarians!

Can radiographs help in determining a course of action for bladder stones? Classically, the answer has been no. Maybe we need to rethink that ? I’ll let you decide …

In other news, monoclonal antibodies may start to help with a variety of disorders. We’ll have to monitor the potential for side effects…

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Radiographic Bladder Stone Types In Dogs

Urolithiasis is a common, often recurrent condition in dogs, with calcium oxalate and struvite uroliths being the most frequent types, followed by urate, silica, and cystine. Accurate identification of urolith mineral composition (UMC) is crucial for determining appropriate treatment and prevention strategies. Struvite, urate, and cystine uroliths can often be managed medically and through dietary therapy, while calcium oxalate and silica stones usually require surgical or minimally invasive removal. Radiography remains a cost-effective, non-invasive diagnostic method capable of detecting radiopaque uroliths and providing insight into their number, size, shape, opacity, and surface characteristics, which can aid in predicting UMC. However, radiographic overlap between mineral types and limitations in previous ex vivo research underscore the need for in vivo evaluation. 

This retrospective cross-sectional study analyzed in vivo radiographic characteristics of canine lower urinary tract uroliths to identify distinguishing features and establish thresholds for non-invasive prediction of mineral composition. The authors found significant radiographic differences among calcium oxalate, struvite, and cystine uroliths, particularly regarding opacity, size, and shape. Calcium oxalate uroliths were most common and exhibited unique radiographic traits, including bosselated or spiculated surfaces and associations with concurrent nephroliths, suggesting a link to Randall’s plaques, as described in humans and cats. Cylindrical calcium oxalate uroliths were linked to prior cystotomies, indicating suture-associated nidus formation. Struvite uroliths were frequently faceted or pyramidal, with the latter shape being distinctive for struvite and associated with larger size and multiplicity. The study established an 11 mm size threshold for predicting struvite composition with high specificity, reflecting the influence of urease-positive bacterial infections that promote rapid growth. 

Cystine uroliths were more radiopaque than historically reported, visible in 97% of cases, although typically less opaque than calcium oxalate and struvite. Their shapes were non-distinctive, but a ratio of urolith-to-L5 vertebral mean pixel value (UOR) ≤ 0.83 helped identify cystine uroliths with moderate specificity and high sensitivity. Despite good measurement reliability, UOR was influenced by individual factors like body condition and bone density. Limitations of the study included its retrospective design, variable imaging conditions, lack of standardized radiographic protocols, potential effects of prior treatments or diets, and possible selection bias toward cases requiring surgical removal. Nevertheless, the study provides novel, clinically relevant data on in vivo radiographic differentiation of canine uroliths, confirming and extending prior ex vivo findings, and supporting the integration of radiographic criteria with epidemiological and laboratory data for improved, non-invasive diagnosis and management of urolithiasis in dogs. 

D. Pulido Vega, M. Motteau-Lévêque, C. Maurey, and J. Mortier, “ In Vivo Radiographic Characteristics Associated With the Mineral Composition of Calcium Oxalate, Struvite, and Cystine Lower Urinary Tract Uroliths in Dogs,” Journal of Veterinary Internal Medicine 39, no. 6 (2025): e70252, https://doi.org/10.1111/jvim.70252. 

Bottom line — May be useful to help facilitate correct treatment.

Reliability Of Ulcer Signs in Horses

Equine gastric ulcer syndrome (EGUS), encompassing equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), is common in sports horses and can significantly affect welfare and performance. The two forms differ in location and pathophysiology, with ESGD often linked to feed deprivation and exercise, while EGGD appears to have a distinct etiology. Prevalence varies by discipline and intensity of training, with ESGD reported in up to 93% of endurance horses and EGGD in around half of sports horses. In competition dressage horses, the prevalence has been poorly characterized. 

Clinical signs associated with EGUS include behavioral changes, poor performance, and gastrointestinal symptoms, but their diagnostic value is limited. Girth aversion and poor performance are often interpreted as signs of gastric discomfort but are also seen in unaffected horses, reducing their reliability as diagnostic markers. Studies have shown inconsistent associations between clinical signs, lesion severity, and type, suggesting that these manifestations may stem from multifactorial causes, including musculoskeletal or saddle-related pain. 

Gastroscopy remains the diagnostic gold standard for EGUS. However, many owners avoid it due to cost, the need for fasting, and sedation requirements. Empirical treatment without gastroscopy is discouraged, as lesion type dictates appropriate therapy. Alternative diagnostic tools, such as fecal occult blood testing (FOBT), salivary or serum biomarkers, and behavioral scoring systems, have shown poor diagnostic accuracy. The present study confirmed that both owner-reported signs and FOBT lacked sensitivity and specificity for detecting EGUS in a referral cohort of competition dressage horses, with 31% of horses showing no ulcers on endoscopy despite exhibiting suspected signs. 

Treatment using omeprazole, with or without sucralfate depending on lesion type, achieved higher healing rates for ESGD than EGGD, consistent with previous research. Nonetheless, clinical improvement did not always correspond with mucosal healing—some horses with persistent ulcers appeared clinically normal, while others with healed ulcers remained symptomatic. This discrepancy underscores the limitations of relying on clinical response to assess recovery. 

The study’s limitations include potential owner-reporting bias, absence of lameness or performance evaluations, and incomplete follow-up gastroscopies, which may have introduced selection bias. Despite these constraints, the findings reinforce that subjective clinical signs and stall-side diagnostic tests like FOBT are unreliable for diagnosing or monitoring EGUS. Gastroscopy remains essential for accurate diagnosis, lesion differentiation, and treatment assessment. The results highlight the need for continued research into EGUS pathogenesis, its true contribution to equine performance issues, and more accurate non-invasive diagnostic tools. 

T. Frippiat, M. Bonhomme, S. Dyson, and D.-M. Votion, “ Evaluation of Owner-Reported Clinical Signs and Fecal Occult Blood Tests as Predictors of Equine Gastric Ulcer Syndrome in Competition Dressage Horses,” Journal of Veterinary Internal Medicine 39, no. 6 (2025): e70248, https://doi.org/10.1111/jvim.70248. 

Bottom line — Scoping is the gold standard.

Monoclonal Antibodies For GI Disease

This study evaluated the safety, tolerability, and pharmacokinetics of VMB-C001a, a novel canine-specific monoclonal antibody (mAb) developed for treating chronic inflammatory enteropathy (CIE). Twenty healthy beagles were randomized into five treatment groups receiving either placebo or VMB-C001a intravenously (IV) or subcutaneously (SC) at different doses and schedules. Dogs received three monthly SC doses at 3, 6, or 18 mg/kg, or a single IV dose of 6 mg/kg, while controls received phosphate-buffered saline (PBS). Physical exams, clinical pathology, and pharmacokinetic (PK) sampling were performed throughout the 84-day study period. 

VMB-C001a was well tolerated across all treatment groups, with no clinically significant adverse events or abnormalities detected in hematology or serum chemistry results. Serum concentration profiles showed predictable dose-dependent exposure following SC administration and consistent PK after IV dosing. The mean elimination half-life was approximately 9.25 days for IV and 11.93 days for SC administration at 6 mg/kg, indicating a prolonged systemic presence. The accumulation ratios for the 3, 6, and 18 mg/kg SC regimens were 1.20, 1.30, and 1.50, respectively, suggesting moderate accumulation with repeated dosing. The absolute bioavailability of the SC route at 6 mg/kg was high at 89%. 

Overall, three monthly SC doses of VMB-C001a were safe, well tolerated, and achieved pharmacokinetic parameters supportive of monthly dosing. These findings provide the foundational safety and PK data for further evaluation of VMB-C001a as a potential therapeutic option for dogs with chronic inflammatory enteropathy.

2025 ACVIM Forum Research Abstract Program. J Vet Intern Med, 39: e70258. https://doi.org/10.1111/jvim.70258 

Bottom line — May develop into a treatment regimen in the future.

Just putting things in perspective …