Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?

Abstract

The aim of this review is to discuss why "chronic enteropathy" might be a better term than "inflammatory bowel disease" in dogs, because the treatment and outcome of the disease is very different from that of inflammatory bowel disease in humans. The effect of food, antibiotics and immunosuppressant drugs on chronic enteropathy will be reviewed. New treatments under investigation will also be introduced. Although there are several studies evaluating treatment of chronic enteropathy in dogs, the quality and quantity of evidence supporting individual therapies remains scarce and more work is needed to improve management of this disease. Finally, new findings about dogs with chronic enteropathy complicated by protein-losing enteropathy will be discussed. Although prognosis for these dogs is poor, recent data might help improve their treatment.

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

“…Routine clinicopathologic variables usually are not specific for a diagnosis of CIE but are important to rule out other diseases causing similar clinical signs and to assess the overall status of the patient 1, 3, 6…”

“…Chronic inflammatory enteropathies (CIE) in dogs comprise a group of disorders that are characterized by chronic persistent or recurrent gastrointestinal signs, histologic evidence of mucosal inflammation, and the exclusion of other underlying gastrointestinal or extra‐gastrointestinal diseases 1, 2, 3, 4. Clinicopathologic variables, fecal parasite examination, and diagnostic imaging are important means to rule out other etiologies with a similar clinical presentation.…”

“…The CIEs are retrospectively classified based on the response to empirical treatment as food‐responsive (FRE), antibiotic‐responsive (ARE), or immunosuppressant‐responsive enteropathy (IRE). Patients that do not respond to immunomodulatory treatment are categorized as having nonresponsive enteropathy (NRE) 3, 4, 5, 6. The term protein‐losing enteropathy (PLE) is used for a subgroup of affected CIE dogs with intestinal protein loss, overall carrying a worse prognosis 3, 6, 7.…”

“…Histopathologic and routine clinicopathologic findings usually are not able to distinguish different subgroups of CIE,5, 10 but younger dogs with less severe clinical signs are more likely to be diagnosed with FRE 5, 9. Treatment trials often are lengthy and further diagnostic tests, after appropriately designed dietary and antibiotic trials have failed, are usually invasive 3, 4, 5, 6. Biomarkers that can aid in diagnostic evaluation or patient monitoring or that can assess the response to various forms of treatment thus would be clinically useful in dogs with CIE. Several functional, biochemical, microbiomic, metabolomic, genetic, and cellular biomarkers have been evaluated in dogs with CIE during the last decade.…”

Improving IBD in dogs through exercise

“…One could therefore question the value of extensive investigations when the results of the tests do not invariably provide a definitive diagnosis. In dogs with severe protein-losing enteropathies, perhaps the rationale for such investigations may be much greater (Dandrieux 2016). However, problems arise in dogs that have a less severe disease where the results of diagnostic investigations may be more equivocal.…”