Keynote Message

Chronic enteropathy in a companion animal can be subcategorised retrospectively depending on effective response to treatment. Therefore, the term food-responsive enteropathy describes a group of diseases resulting in chronic gastrointestinal signs that is responsive to dietary management alone; the underlying etiology of these diseases is unknown but likely encompasses immune-mediated and non-immune-mediated causes. Although there is no standard acceptable criterion, the author considers companion animals that fail to respond to at least two appropriate commercial therapeutic diet trials and a limited-ingredient home-cooked diet as likely not having a food-responsive enteropathy. Currently, there are three categories of commercial therapeutic diets that are available for the diagnosis and management of food-responsive enteropathy in dogs and cats: hydrolysed diets, limited-ingredient novel protein diets, and gastrointestinal diets. In humans, exclusive enteral elemental nutritional therapy is the only dietary intervention that has been rigorously tested and shown to induce remission of Crohn's disease. Several studies and a meta-analysis compared elemental diets with corticosteroids in paediatric patients with active Crohn's disease and found no significant difference in remission rates between the two forms of therapy. Similar remission rates have also been reported in adults with newly diagnosed Crohn's disease. In this session, the definition, diagnosis, and dietary treatment of chronic enteropathies in companion animals will be discussed. In addition, insights into the dietary management of human inflammatory bowel disease will be reviewed.

Key References

1.  Mandigers PJ, et al. A randomized, open-label, positively-controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy. J Vet Intern Med. 2010;24(6):1350–7.

2.  Dziechciarz P, et al. Meta-analysis: enteral nutrition in active Crohn's disease in children. Aliment Pharmacol Ther. 2007;26(6):795–806.

3.  Gonzalez-Huix F, et al. Polymeric enteral diets as primary treatment of active Crohn's disease: a prospective steroid controlled trial. Gut. 1993;34(6):778–82.