Fecal ELISA for C. perfringens enterotoxin
For these tests we will require up
to 1 gram of fresh feces. Samples should be refrigerated shortly
after collection and shipped overnight cooled withice packs (please
concerning our shipping program).
perfringens, a gram-positive, anaerobic, spore-forming rod,
has been associated with bacterial diarrhea in both dogs and cats.
One of the main virulence factors believed to be associated with
C. perfringens-associated diarrhea is the C.
perfringens enterotoxin (CPE), which is encoded by the cpe
gene. CPE, produced during sporulation and released after cell
lysis, has been shown to induce mucosal damage, increase intestinal
permeability, and reduce water absorption, thus leading to
In general, any dog or cat with
small and/or large bowel diarrhea may have C.
perfringens-associated diarrhea. The diarrhea may or may not
be accompanied by the presence of mucus, blood, and/or tenesmus,
and it can be acute or chronic. The disease might range from mild
and self-limiting to severe. Systemic signs are uncommon. C.
perfringens is considered to be a major cause of nosocomial
diarrhea, which often occurs a few days after admission of a
patient to a veterinary hospital. Due to the non-specific clinical
signs associated with C. perfringens-diarrhea, any dog
or cat with diarrhea could be tested for this disease.
Bacterial culture for the isolation
of C. perfringens has little diagnostic value, as
C. perfringens is a commensal organism that can be
detected in up to 100% of the feces from dogs and cats. Microscopic
examination of fecal smears and enumeration of fecal endospores
also is not useful for the diagnosis of C.
perfringens-associated diarrhea, because sporulation of
these organisms occurs in both healthy and diarrheic animals. The
development of C. perfringens-associated diarrhea has
primarily been related to the presence of various toxins,
especially C. perfringens enterotoxin (CPE). Only a
subset of C. perfringens organisms carries the gene
coding for CPE. When sporulation occurs, which is induced by
conditions that are not well understood (suspected triggers include
dietary changes or antibiotic use), the enterotoxin is released in
high quantities and may potentially cause changes in intestinal
permeability, leading to diarrhea.
perfringens can be detected using PCR assays that target the
CPE gene. However, recent studies have shown that approximately 20%
of healthy cats, 37% of healthy dogs, and 37% of diarrheic dogs and
cats harbor the CPE gene. Similar results with no significant
differences in prevalence rates of enterotoxigenic C.
perfringens between healthy and diarrheic dogs have been
observed in other studies. Furthermore, in only a small percentage
of animals that harbor enterotoxigenic C. perfringens,
the expressed enterotoxin can be detected in the feces. Therefore,
the use of PCR for the detection of the cpe gene of enterotoxigenic
C. perfringens appears to have limited utility for the
diagnosis of C. perfringens-associated diarrhea.
We therefore recommend to evaluate
fecal samples for C. perfringens enterotoxin by
ELISA in patients that are suspected of having C.
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