Inflammatory Bowel Disease: a Review of Diagnosis and Management

DIAGNOSIS & TERMINOLOGY The diagnosis of “Chronic Idiopathic Enteropathy” (CIE), which includes “Inflammatory Bowel Disease” (IBD), is based on the presence of compatible clinical signs (chronic diarrhea, vomiting or weight loss) AND the exclusion of metabolic, infectious, neoplastic, and obstructive disorders of the gut (see Table 1). If biopsy samples also reveal mucosal morphologic abnormalities and inflammation (most commonly lymphoplasmacytic), a diagnosis of IBD is reached. However, a poorly defined number of animals (approximately 25% of dogs) lack substantial mucosal inflammation and continue to be referred to as CIE. A stricter definition of CIE and IBD includes failure to respond to an elimination diet (“Food-Responsive Enteropathy or Diarrhea”) and failure to respond to antimicrobial therapy (“Antibiotic-Responsive Enteropathy or Diarrhea”). At this stage, categorizing animals with IBD vs. CIE is mostly academic, as these cases tend to be treated in a similar manner. However, as our knowledge of chronic enteropathies expands, it will likely become important to separate these syndromes for diagnostic and therapeutic purposes.