Dietary modulation of methotrexate-induced enteritis in cats

To determine effects of purified and dry expanded (complex) diets on intestinal structure and function in healthy cats and in a feline model of methotrexate-induced enteritis.

19 adult specific-pathogen-free cats.

Cats were randomized in groups to receive a purified diet intragastrically or a complex diet orally to meet their daily metabolizable energy requirements. After 21 days, cats received either methotrexate (MTX; 10 mg/kg of body weight, i.v., n = 12) or saline solution i.v. (n = 7), and were anesthetized 72 hours later. Celiotomy was performed for aseptic removal of mesenteric lymph nodes, full-thickness biopsy of the gastrointestinal tract, and collection of aortic and portal venous blood samples for determination of arteriovenous amino acid concentrations across the intestine.

MTX was associated with severe enterotoxicosis in cats receiving the purified diet, as manifested by diarrhea (4 of 6 cats) and vomiting (2 of 6 cats). One cat receiving the complex diet developed mild diarrhea, and none of these cats vomited. The purified diet was associated with marked villus blunting in the proximal and distal portions of the duodenum and increased bacterial translocation (3 of 6 cats), whereas none of the cats in the complex diet group developed bacterial translocation after MTX administration. For the cats given saline solution, bacterial translocation occurred in 1 of 4 cats receiving the complex diet versus 2 of 3 cats receiving the purified diet.

Feeding of a complex diet containing intact protein as the nitrogen source abrogated the proximal small intestinal atrophy and bacterial translocation associated with feeding an amino acid-based purified diet.

Use of purified diets containing free amino acids as the only nitrogen source cannot be endorsed in human and animal cancer patients receiving systemic chemotherapy.