Download PDF
Tierarztl Prax Ausg K Kleintiere Heimtiere 2021; 49(02): 94-103
DOI: 10.1055/a-1354-0630
Original Article

Chronic enteropathy in dogs – retrospective case analysis and results of an owner survey

Chronische Enteropathie bei Hunden – retrospektive Fallanalyse und Besitzerbefragung
Julia S. Treese
Small Animal Clinic, Veterinary University Hannover, Foundation, Hannover, Germany
,
Ingo Nolte
Small Animal Clinic, Veterinary University Hannover, Foundation, Hannover, Germany
,
Jan-Peter Bach
Small Animal Clinic, Veterinary University Hannover, Foundation, Hannover, Germany
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective Chronic gastrointestinal diseases in dogs are common and often require intensive diagnostic work-up and lifelong therapy. In this study, a survey of owners of affected dogs was conducted in parallel with a retrospective case analysis from the clinic’s documentation system.

Material and methods The records of dogs with gastrointestinal symptomatology and exclusion of an extraintestinal cause, presented from January 2011 to October 2018, were acquired from the clinic’s case system and analysed. Patient owners were interviewed using a questionnaire regarding diagnosis, treatment, course of the disease and improvement in the dog’s quality of life as a result of treatment. To gain a better understanding of influencing factors for the different subtypes of chronic enteropathy, differentiation was made into feed-responsive (FRE), antibiotic-responsive (ARE), immunosuppressant-responsive (IRE), and nonresponsive enteropathy (NRE) according to the success of different therapeutic approaches.

Results Of 125 patient owners contacted, 81 participated in the study. The majority of the 81 dogs had FRE (45; 55.6 %), 11 (13.6 %) dogs had ARE, 23 (28.4 %) had IRE and 2 (2.5 %) had NRE. At the disease onset, dogs in the FRE and ARE groups were significantly younger than those in the IRE group. Interviews with dog owners showed that veterinary recommendations had not been consistently implemented, particularly in dogs in the FRE group. Successful treatment resulted in significant improvement in the quality of life in patients in all 3 groups according to owner assessment, with no differences between the groups.

Conclusion and clinical relevance The majority of the contacted dog owners agreed to participate in the survey. A retrospective case analysis in combination with an owner survey is helpful to elicit the owners’ assessment of their dog’s treatment and disease course and to reveal starting points for improved owner compliance.

Zusammenfassung

Gegenstand und Ziel Chronische gastrointestinale Erkrankungen bei Hunden sind häufig, erfordern oft eine intensive diagnostische Aufarbeitung und eine lebenslange Therapie. In der Studie erfolgte eine Befragung von Besitzern betroffener Hunde parallel zu einer retrospektiven Fallanalyse aus dem Dokumentationssystem der Klinik.

Material und Methoden Die Akten von Hunden mit einer gastrointestinalen Symptomatik und Ausschluss einer extraintestinalen Ursache, vorgestellt zwischen Januar 2011 bis Oktober 2018, wurden aus dem Fallsystem der Klinik extrahiert und ausgewertet. Die Patientenbesitzer wurden anhand eines Fragebogens zu Diagnose, Therapie, Verlauf der Erkrankung und Verbesserung der Lebensqualität des Hundes durch die Behandlung befragt. Um ein besseres Verständnis beeinflussender Faktoren für die verschiedenen Subtypen der chronischen Enteropathie zu erhalten, erfolgte entsprechend dem Erfolg verschiedener Therapieansätze eine Differenzierung in Futtermittel-responsive (FRE), Antibiotika-responsive (ARE), Immunsuppressiva-responsive (IRE) bzw. nicht responsive Enteropathie (NRE).

Ergebnisse Von 125 kontaktierten Patientenbesitzern nahmen 81 an der Studie teil. Bei der Mehrzahl der 81 Hunde lag eine FRE vor (45; 55,6 %), 11 (13,6 %) Hunde litten an einer ARE, 23 (28,4 %) an einer IRE und 2 (2,5 %) an einer NRE. Zu Erkrankungsbeginn waren Hunde der Gruppen FRE und ARE signifikant jünger als in die Gruppe IRE. Die Befragung der Hundebesitzer zeigte insbesondere bei Hunden der Gruppe FRE, dass die tierärztlichen Empfehlungen nicht konsequent umgesetzt wurden. Die erfolgreiche Behandlung führte bei Patienten aller 3 Gruppen nach Besitzereinschätzung zu einer signifikanten Verbesserung der Lebensqualität ohne Unterschiede zwischen den Gruppen.

Schlussfolgerung Die überwiegende Zahl der kontaktierten Hundebesitzer erklärten sich zur Teilnahme an der Umfrage bereit. Eine retrospektive Fallanalyse in Kombination mit einer Besitzerbefragung ist hilfreich, um die Einschätzung der Besitzer bezüglich Behandlung und Krankheitsverlauf ihres Hundes zu eruieren und Ansatzpunkte für eine bessere Besitzercompliance aufzudecken.

Key words

Chronic gastrointestinal diseases - retrospective work-up - data acquisition

Schlüsselwörter

Chronisch entzündliche Darmerkrankung - retrospektive Fallaufarbeitung - Datenerhebung


Publication History

Received: 27 January 2020

Accepted: 09 December 2020

Article published online:
26 April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Willard MD. Diarrhea. In: Ettinger SJ, Feldman EC, Cote E. eds. Textbook of Veterinary Internal Medicine. eBook. Elsevier Health Sciences; 2017: 619-624
    Google Scholar
  • 2 Dandrieux JRS. Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?. J Small Anim Pract 2016; 57: 589-599 DOI: 10.1111/jsap.12588.
    CrossrefPubMedGoogle Scholar
  • 3 Simpson. Die Behandlung der Inflammatory Bowel Disease beim Hund. Veterinary Focus 2013; 23
    PubMedGoogle Scholar
  • 4 De Souza HS, Fiocchi C. Immunopathogenesis of IBD: current state of the art. Nat Rev Gastroenterol Hepatol 2016; 13: 13-27
    Google Scholar
  • 5 Craven M, Simpson J, Ridyard A. et al. Canine inflammatory bowel disease: retrospective analysis of diagnosis and outcome in 80 cases (1995–2002). J Small Anim Pract 2004; 45: 336-342
    CrossrefPubMedGoogle Scholar
  • 6 Allenspach. Culverwell C, Chan D. Long-term outcome in dogs with chronic enteropathies: 203 cases. Vet Rec 2016; 178: 368 DOI: 10.1136/vr.103557.
    CrossrefPubMedGoogle Scholar
  • 7 Kilpinen S, Spillmann T, Syrjä P. et al. Effect of tylosin on dogs with suspected tylosin-responsive diarrhea: a placebo-controlled, randomized, double-blinded, prospective clinical trial. Acta Vet Scand 2011; 53: 26
    CrossrefPubMedGoogle Scholar
  • 8 Westermarck E, Skrzypczak T, Harmoinen J. et al. Tylosin-Responsive Chronic Diarrhea in Dogs. J Vet Intern Med 2005; 19: 177-186
    CrossrefPubMedGoogle Scholar
  • 9 Dandrieux JR, Noble P-JM, Scase TJ. et al. Comparison of a chlorambucil-prednisolone combination with an azathioprine-prednisolone combination for treatment of chronic enteropathy with concurrent protein-losing enteropathy in dogs: 27 cases (2007–2010). J Am Vet Med Assoc 2013; 242: 1705-1714
    CrossrefPubMedGoogle Scholar
  • 10 Bortz J, Döring N. Forschungsmethoden und Evaluation für Human-und Sozialwissenschaftler: Limitierte Sonderausgabe. Berlin: Springer; 2007
    Google Scholar
  • 11 Golper T. Patient education: can it maximize the success of therapy?. Nephrol Dial Transplant 2001; 16: 20-24 DOI: 10.1093/ndt/16.suppl_7.20.
    CrossrefPubMedGoogle Scholar
  • 12 Hartigan K. Patient education: the cornerstone of successful oral chemotherapy treatment. Clin J Oncol Nurs 2003; 7 (6 Suppl): 21-24 DOI: 10.1188/03.CJON.S6.21-24.
    CrossrefPubMedGoogle Scholar
  • 13 Case DJL. The Path to High-Quality Care: Practical Tips for Improving Compliance. CO: American Animal Hospital Association; 2003
    Google Scholar
  • 14 Wayner CJ, Heinke ML. Compliance: crafting quality care. Vet Clin Small Anim Pract 2006; 36: 419-436
    CrossrefPubMedGoogle Scholar
  • 15 Volkmann M, Steiner J, Fosgate G. et al. Chronic Diarrhea in Dogs – Retrospective Study in 136 Cases. J Vet Intern Med 2017; 31: 1043-1055
    CrossrefPubMedGoogle Scholar
  • 16 Jergens. Schreiner CA, Frank DE. et al. A scoring index for disease activity in canine inflammatory bowel disease. J Vet Intern Med 2003; 17: 291-297
    CrossrefPubMedGoogle Scholar
  • 17 Allenspach. Wieland B, Grone A. et al. Chronic enteropathies in dogs: evaluation of risk factors for negative outcome. J Vet Intern Med 2007; 21: 700-708
    CrossrefPubMedGoogle Scholar
  • 18 Zhang Y-Z, Li Y-Y. Inflammatory bowel disease: pathogenesis. World J Gastroenterology 2014; 20: 91-99
    CrossrefPubMedGoogle Scholar
  • 19 Kathrani A, Werling D, Allenspach K. Canine breeds at high risk of developing inflammatory bowel disease in the south-eastern UK. Vet Rec 2011; 169: 635
    CrossrefPubMedGoogle Scholar
  • 20 Marks SL, Laflamme DP, McAloose D. Dietary trial using a commercial hypoallergenic diet containing hydrolyzed protein for dogs with inflammatory bowel disease. Vet Ther 2002; 3: 109-118
    PubMedGoogle Scholar
  • 21 Strombeck. Donald R, Guilford WG. et al. Idiopathic inflammatory bowel diseases. In: Strombeck’s Small Animal Gastroenterology. 3 rd ed.. Philadelphia: Saunders; 1996: 451-486
    Google Scholar
  • 22 Jacobs G, Collins-Kelly L, Lappin M. et al. Lymphocytic-plasmacytic enteritis in 24 dogs. J Vet Intern Med 1990; 4: 45-53
    CrossrefPubMedGoogle Scholar
  • 23 Makielski K, Cullen J, O’Connor A. et al. Narrative review of therapies for chronic enteropathies in dogs and cats. J Vet Intern Med 2019; 33: 11-22
    CrossrefPubMedGoogle Scholar
  • 24 Simpson. Jergens A. Pitfalls and progress in the diagnosis and management of canine inflammatory bowel disease. Vet Clin Small Anim Pract 2011; 41: 381-398
    CrossrefPubMedGoogle Scholar
  • 25 Rudorf H, van Schaik G, O’Brien RT. et al. Ultrasonographic evaluation of the thickness of the small intestinal wall in dogs with inflammatory bowel disease. J Small Anim Pract 2005; 46: 322-326
    CrossrefPubMedGoogle Scholar
  • 26 Maeda S, Tsuboi M, Sakai K. et al. Endoscopic cytology for the diagnosis of chronic enteritis and intestinal lymphoma in dogs. Vet Pathol 2017; 54: 595-604
    CrossrefPubMedGoogle Scholar
  • 27 Slovak J, Wang C, Sun Y. et al. Development and validation of an endoscopic activity score for canine inflammatory bowel disease. Vet J 2015; 203: 290-295
    CrossrefPubMedGoogle Scholar
  • 28 Oberhuber G, Hirsch M, Stolte M. High incidence of upper gastrointestinal tract involvement in Crohn’s disease. J Virchows Archiv 1998; 432: 49-52
    CrossrefPubMedGoogle Scholar
  • 29 Hoffmann JC, Pawlowski NN, Kühl AA. et al. Animal models of inflammatory bowel disease: an overview. Pathobiology 2002; 70: 121-130
    CrossrefPubMedGoogle Scholar
  • 30 Dandrieux JR. Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?. J Small Anim Pract 2016; 57: 589-599 DOI: 10.1111/jsap.12588.
    CrossrefPubMedGoogle Scholar
  • 31 Allenspach K, Aflalo S, Procoli F. Long-term Relapse Rate, Compliance And Clinical Severity In Dogs Diagnosed With Chronic Enteropathies (29 Cases). J Vet Intern Med 2015; 29: 434
    PubMedGoogle Scholar
  • 32 Kawano K, Shimakura H, Nagata N. et al. Prevalence of food-responsive enteropathy among dogs with chronic enteropathy in Japan. J Vet Med Sci 2016; 78: 1377-1380
    CrossrefPubMedGoogle Scholar
  • 33 Allenspach. Diagnosis of small intestinal disorders in dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43: 1227-1240 DOI: 10.1016/j.cvsm.2013.07.001.
    CrossrefPubMedGoogle Scholar
  • 34 Allenspach K, Culverwell C, Chan D. Long-term outcome in dogs with chronic enteropathies: 203 cases. Vet Rec 2016; 178: 368 DOI: 10.1136/vr.103557.
    CrossrefPubMedGoogle Scholar
  • 35 Allenspach. Rufenacht S, Sauter S. et al. Pharmacokinetics and clinical efficacy of cyclosporine treatment of dogs with steroid-refractory inflammatory bowel disease. J Vet Intern Med 2006; 20: 239-244
    CrossrefPubMedGoogle Scholar
  • 36 Rychlik A, Nieradka R, Kander M. et al. Macroscopic and histopathological examination of the gastric mucosa in dogs with inflammatory bowel disease (IBD) treated with mesalazine. Pol J Vet Sci 2009; 12: 217-223
    PubMedGoogle Scholar
  • 37 Rychlik. Nieradka R, Depta A. et al. Efficacy of different treatment methods in dogs’ inflammatory bowel disease. Medycyna Weterynaryjna 2008; 64: 796-799
    PubMedGoogle Scholar
  • 38 Cohen RD, Woseth DM, Thisted RA. et al. A meta-analysis and overview of the literature on treatment options for left-sided ulcerative colitis and ulcerative proctitis. Am J Gastroenterol 2000; 95: 1263
    CrossrefPubMedGoogle Scholar
  • 39 Marshall JK, Irvine EJ. Putting rectal 5-aminosalicylic acid in its place: the role in distal ulcerative colitis. Am J Gastroenterol 2000; 95: 1628-1636
    CrossrefPubMedGoogle Scholar
  • 40 Allenspach K, Wieland B, Grone A. et al. Chronic enteropathies in dogs: evaluation of risk factors for negative outcome. J Vet Intern Med 2007; 21: 700-708
    CrossrefPubMedGoogle Scholar
  • 41 Berghoff N, Steiner JM. Laboratory tests for the diagnosis and management of chronic canine and feline enteropathies. Vet Clin Small Anim Pract 2011; 41: 311-328
    CrossrefPubMedGoogle Scholar
  • 42 Braun B, Marstedt G. Non-compliance bei der Arzneimitteltherapie: Umfang, Hintergründe, Veränderungswege. Gesundheitsmonitor 2011; 56-76
    PubMedGoogle Scholar
  • 43 Fontaine F. Untersuchungen zur „Compliance” und Adhärenz von Vogelbesitzern in der tiermedizinischen Therapie mit Entwicklung einer „Veterinary Medication Adherence Scale”(VMAS) [Dissertation]. München: Ludwig-Maximilians-Universität; 2020
    Google Scholar