References
Selecting appropriate diets for management of chronic enteropathies
Abstract
Gastrointestinal signs including inappetence, vomiting, diarrhoea and weight loss that persist for more than 3 weeks are described as chronic enteropathy. Chronic enteropathies are further classified as food-responsive enteropathy, antimicrobial-responsive enteropathy, immunosuppressant-responsive enteropathy and non-responsive enteropathy. Diagnosis of each type of enteropathy relies on the exclusion of other causes, along with the response to various therapeutic interventions including diet trials, use of therapies directed towards the microbiome and/or immunosuppressant medications. Chronic inflammatory enteropathy is a diagnosis based on the chronicity of clinical signs while inflammatory bowel disease can only be confirmed by obtaining tissue biopsy demonstrating histopathological evidence of intestinal mucosal inflammation. Diet may play a role in the pathogenesis of chronic enteropathies, but it is critical to the management of these patients. Since between 50% and 66% of cases are food responsive, diet trials are essential in the management of these patients. The selection of appropriate therapeutic diets relies on thorough patient nutritional assessment, detailed dietary history (including both historical diets and current diet) and inventory of feeding management practices and the patient's environment.
The prevalence of chronic enteropathy in veterinary patients is not known, but is estimated to be 1–2% (Dandrieux, 2016) of referral cases with 20–30% of companion animal veterinary visits related to vomiting and/or diarrhoea (O'Neill et al, 2014). Diet modification can be an important aspect of patient management with the potential to improve clinical signs in ≥50–65% of cases (Jergens and Heilmann, 2022). Choosing diets for patients with chronic enteropathy must be based on a thorough nutritional assessment. Clinical signs and physical examination findings are used to localise the extent of the gastrointestinal tract involved. Diet selection will then consider changing the macronutrient content (level of protein, fat or fibre) or ingredient list (utilisation of hydrolysed or novel proteins). Multiple diet trials are often required to find the best diet, and it is important to note that many patients will show improvement with diet change even if the first diet trial is not successful (Jergens and Heilmann, 2022).
Register now to continue reading
Thank you for visiting UK-VET Companion Animal and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.