Chronic inflammatory enteropathy without moderate to severe hypoalbuminemia: long-term outcome in 60 dogs

BACKGROUND: Limited information is available on the long-term prognostic outcome of chronic inflammatory enteropathy (CIE) in dogs with serum albumin concentrations ≥20 g/L. HYPOTHESIS/OBJECTIVES: Assess prognostic factors for dogs with CIE without moderate to severe hypoalbuminemia. ANIMALS: Seventy-eight client-owned dogs with CIE. METHODS: Retrospective study of CIE cases with concurrent duodenal and colonic endoscopic biopsy specimens reviewed by a board-certified veterinary pathologist. Outcome data was collected via an electronic questionnaire distributed to referring veterinary practices. Univariable binary logistic regression assessed associations between clinicopathologic variables and gastrointestinal (GI)-related death. RESULTS: Food-responsive enteropathy (FRE, 48.3%) was the most common CIE treatment subtype, followed by immunosuppressive-responsive enteropathy (IRE, 30%) and non-responsive enteropathy (NRE, 21.7%). Food-responsive enteropathy carried the best outcome (0 GI-related deaths; IRE, 4 GI-related deaths; NRE, 9 GI-related deaths), highest remission rate (89.7%; IRE, 44.4%) and longest median follow-up time (1258 days; IRE, 572 days; NRE, 260 days). Age (odds ratio [OR], 1.015; 95% confidence interval [CI], 1-1.030), weight loss (OR, 5.37; 95% CI, 1.301-22.172), hypocobalaminemia (OR, 6.286; 95% CI, 1.45-27.250), alanine aminotransferase activity (OR, 4.317; 95% CI, 1.182-15.760), duodenal histopathological composite score (OR, 1.27; 95% CI, 1.043-1.545), duodenal lacteal dilatation (OR, 6.647; 95% CI, 2.052-20.389), duodenal crypt dilatation (OR, 3.036; 95% CI, 1.185-7.77), and intraepithelial lymphocytes (OR, 2.602; 95% CI, 1.023-6.26) were significantly positively associated with GI-related death, with vomiting being protective (OR, 0.189; 95% CI, 0.05-0.715). CONCLUSIONS AND CLINICAL IMPORTANCE: Histopathologic variables were associated with outcome in non- to mildly hypoalbuminemic dogs with CIE, indicating their potential as prognostic markers, as well as possible roles in guiding treatment and monitoring disease.