The Safety and Efficacy of Oral Low-Volume Sodium Phosphate Bowel Preparation for Colonoscopy in Dogs
Daugherty, Megen Aileen
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Sodium phosphate (NaP) is a low-volume, hyperosmolar laxative that has been shown to be an effective bowel cleansing agent in people. The purposes of this study were to evaluate the safety and efficacy of oral NaP in dogs. Standard (NaP and enemas; NaP1) and control preparations (polyethylene glycol [PEG] and enemas) were compared in a crossover design to determine safety and efficacy of NaP. Serial clinical and serum analytical evaluations were used to determine the safety of NaP. The efficacy of the NaP1 preparation was compared to 3 NaP variations which excluded enema or included bisacodyl, with or without enemas in a crossover design. Eight dogs received each of 6 bowel preparations prior to colonoscopy performed one time per week. An observer blinded to the bowel preparation assigned a score of 1-4 (1 clean colon and ≥3 unacceptable preparation) to each of 5 regions of the colon. Mean total colon cleansing score (TCS), defined as the sum of scores from each region, of the control (9.4) was less than NaP1 (13.6) (p<0.05). There were no significant differences in regional or TCS for the remaining 4 NaP preparations. NaP1 resulted in moderate, but clinically occult, hyperphosphatemia and hypocalcemia, which resolved within 24 hours of initial administration. Despite the safety and ease of administration of the NaP preparations, the NaP bowel cleansing preparations used in this study cannot be recommended for routine clinical use due to the inadequate quality of bowel preparation compared to the PEG containing bowel cleansing protocol evaluated.
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