Long-term evaluation of the initial response to therapy in 60 dogs with chronic inflammatory enteropathy

Background

Dogs with chronic inflammatory enteropathy (CIE) are typically classified into food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunomodulator-responsive enteropathy (IRE), and nonresponsive enteropathy (NRE) based on response to therapy(ies). Reassessment of initial categorization (especially IRE and NRE) is lacking.

Objectives

Investigate validity of categorization scheme when reassessed at least 1 year after diagnosis.

Animals

Sixty client-owned dogs with CIE.

Methods

Retrospective study. Clinical information was gathered from records and owners from time of diagnosis (T_D), time of initial response (T_IR), and at least 1 year after diagnosis (T_≥1y). Category change was defined as a switch between groups.

Results

Median disease activity index (CIBDAI) at T_D was 9 and reduced significantly to 1 at T_≥1y (P < .0001). At T_IR, dogs were categorized as: FRE 27/60 (45%, 95% binomial confidence intervals [CI], 0.32-0.58), IRE 30/60 (50%, CI 0.37-0.63), ARE 0/60 (0%), NRE 3/60 (5%, CI −0.01 to 0.11). Seventeen of 27 (63%) FRE dogs had previously had at least 1 unsuccessful diet trial. At T_≥1y, categorization changed to FRE 44/60 (73%, CI 0.62-0.85), IRE 14/60 (23%, CI 0.13-0.34), ARE 0/60 (0%), NRE 2/60 (3%, CI −0.01 to 0.08). Group changes were found for 24/60 (40%) dogs, largest change was from IRE to FRE (19/24, 79%). Immunosuppressive dosages were administered as sole treatment in 1/30 (3%) IRE dogs at T_IR.

Conclusions and Clinical Importance

Chronic inflammatory enteropathy categorization based on initial response to therapy needs reassessment after 1 year. Frequent change from IRE to FRE suggests that dogs initially categorized as IRE might have been initially categorized as FRE if multiple dietary trials had been performed. In our study, antibiotics were not needed to achieve satisfying clinical responses.