Chronic Enteropathy in Dogs—Epidemiologic Aspects and Clinical Characteristics of Dogs Presenting at Two Swedish Animal Hospitals

Abstract

Information about prevalence and breed predisposition of canine chronic enteropathy (CE) is limited. The aim of this retrospective study was to investigate period prevalence, breed disposition, clinical features, diagnostic results, and treatment response of CE in dogs presenting at two Swedish animal hospitals during 2013–2018. A medical record search was performed to identify CE dogs including those with ≥3 visits because of gastrointestinal disease and/or that had undergone gastroduodenoscopy/colonoscopy during 2013–2018. Dog characteristics, case history, physical examination, laboratory variables, therapeutic protocol, and treatment response were recorded. Inclusion criteria for CE were met by 814 dogs. Period prevalence of CE was 1.1% of total number of dogs. Breeds with the highest relative risk included Norwegian Lundehund, West Highland White Terrier, and Miniature Poodle. Median age at presentation was 3.8 (IQR 1.8–6.8) years. French Bulldogs and Miniature Schnauzers presented at a younger age (<2.5 years) compared to other breeds (p < 0.05). In a subset of dogs, serum hypoalbuminemia (116/662, 17.5%), hypocobalaminemia (98/647, 15.1%), and increased C-reactive protein (CRP) concentrations (145/267, 54.3%) were diagnosed. Treatment outcome was classified in 72.9% of dogs and characterized as immunosuppressant-responsive (55.2%), food-responsive (11.4%), non-responsive (5.2%), and antibiotic-responsive (1.1%). Non-responsive dogs were more likely to present with anemia hypoproteinemia/albuminemia, increased CRP, and ascites (p < 0.05). In conclusion, the prevalence of dogs with CE at Swedish hospitals agreed with earlier reports, but risk breeds differed slightly and, compared to other breeds, a younger age of CE onset was found in two breeds. The largest proportion of dogs was immunosuppressant-responsive and the smallest antibiotic-responsive.

Efficacy of an elemental diet in achieving clinical remission in dogs with chronic enteropathy

“…useful in predicting response to EL. The Rs had a median CCECAI of 6.5(3)(4)(5)(6)(7)(8) and age of 2.75 (0.9-11) years, which are consistent with publications reporting a wide range of ages and disease severity in diet-responsive CE dogs 12,48,49. Our results conflict with previous reports finding diet-responsive CE dogs to be younger, with lower clinical activity indices, as compared to dogs not responding to diet 1,6.…”

“…Dietary therapy is a mainstay of CE management in dogs, with resolution of clinical signs reported in up to 69% of dogs after dietary intervention. [1][2][3][4] Treatment success has been documented with hydrolyzed protein, limited ingredient, and fat-restricted diets. 3,5 The mechanisms underlying clinical improvement after diet change are incompletely understood, but likely involve host, microbiome, and dietary factors.…”

“…Chronic enteropathy (CE) is a common condition in dogs characterized by persistent clinical signs referrable to gastrointestinal (GI) dysfunction such as diarrhea, vomiting, and poor appetite. Dietary therapy is a mainstay of CE management in dogs, with resolution of clinical signs reported in up to 69% of dogs after dietary intervention 1‐4 . Treatment success has been documented with hydrolyzed protein, limited ingredient, and fat‐restricted diets 3,5 .…”

Randomized controlled trial of hydrolyzed fish diets in dogs with chronic enteropathy

“…From a practical perspective, our findings support the strategy of conducting multiple dietary trials in dogs with CE, with or without PLE, before escalating to use of antimicrobial or immunosuppressive agents 5,7,16 . We speculate that the high proportions of dogs with immunosuppression‐responsive versus food‐responsive enteropathy reported in some studies may reflect therapeutic escalation based on a single dietary trial 40,41 …”

“…5,7,16 We speculate that the high proportions of dogs with immunosuppression-responsive versus foodresponsive enteropathy reported in some studies may reflect therapeutic escalation based on a single dietary trial. 40,41 In dogs with PLE, the role of diet as monotherapy is less clear because the prognosis is poor and such dogs often receive concurrent medications or refuse to eat therapeutic diets. [3][4][5]7,10,12,16,18 We showed that diets containing hydrolyzed proteins and moderate amounts of fat (3.97 g fat /100 kcal) support an increase in body weight, serum albumin concentration, and sustained remission.…”