GASTROENTEROLOGY
Diagnosing Inflammatory
Bowel Disease
In The Dog And Cat
Dr Martin de Scally BVSc , Hons MMedVet ( Med ) Small Animals ( Pret ) Hilton Veterinary Hospital e-mail : martin @ hiltonvethospital . co . za Tel : 0333434602 | Fax : 0333431021
Canine and feline inflammatory bowel disease ( IBD ) is a chronic (> 3 weeks ), idiopathic , inflammatory enteropathy . These idiopathic inflammatory changes may respond to immunosuppression but it is vital to rule out all known causes before calling the disease idiopathic .
Introduction and description IBD is currently under intensive investigation . With evolving theories of pathogenesis , aetiologies and treatment , IBD will probably continue to be redefined . As an example , histopathological findings together with new technologies such as 16sRNA pyrosequencing and fluorescent in situ hybridisation ( FISH ) and candidate gene sequencing have helped clarify certain previously idiopathic diseases that were incorporated under the IBD umbrella . Granulomatous colitis ( GC ) and Histiocytic ulcerative colitis ( HUC ) seen in Boxers and French Bulldogs is now known to be highly associated with attached invasive Escherichia coli ( AIEC ); these cases have a long term response to fluoroquinolone antimicrobials and do not respond well to immunosuppressive therapy .
Classification Traditionally IBD has been classified histologically according to the type of inflammatory cell infiltration and the site of inflammation , for example lymphoplasmacytic enteritis or granulomatous colitis . Secondary changes in the intestinal mucosa including , villous atrophy , fusion of villi , fibrosis , lacteal dilation and crypt changes are considered important in characterising the significance of these infiltrates . IBD can be clinically classified into food responsive enteropathies ( FRE ), antibiotic responsive enteropathies ( ARE ) and idiopathic IBD .
A GAME CHANGER
Granulomatous colitis ( GC ) and Histiocytic ulcerative colitis ( HUC ) seen in Boxers and French Bulldogs is now known to be highly associated with attached invasive Escherichia coli ( AIEC ); these cases have a long term response to fluoroquinolone antimicrobials and do not respond well to immunosuppressive therapy .
Clinical Signs The clinical signs of ( IBD ) are similar to other chronic enteropathies ( CE ) and are determined by the site , extent , chronicity and severity of disease . Vomiting , for example , may reflect upper gastro-intestinal involvement ; large volume diarrhoea , depression , melena , anorexia and ascites and other severe systemic signs may indicate small intestinal involvement ; and small volume frequent stools with tenesmus and mucus or haematochezia may indicate colonic disease . Patients may also have a diffuse disease distribution .
The clinical signs may fluctuate in severity over time and overlap with many other organ diseases such as Addison ’ s disease , hepatic and pancreatic diseases . Clinical signs are therefore broad spectrum and nonpathognomonic but usually strongly indicative of intestinal involvement . vet360
Issue 04 | AUGUST 2016 | 20