References
The role of hydrolysed diets in diagnosing and treating canine enteropathy
Abstract
Canine enteropathy is often a difficult condition to treat. The cause is usually idiopathic and the treatment process can be stressful for both patients and their owners. Procedures such as endoscopy are unable to assist in diagnosing the root of the problem, but merely confirm inflammation and damage to the digestive tract is present. The condition can be confused with adverse food reactions due to similar clinical signs, however when challenged with their original diets, patients with canine enteropathy do not relapse. Studies have shown that hydrolysed diets are successful in treating the gastrointestinal signs associated with adverse food reactions. These diets prevent immune recognition of an intact protein by removing the allergenic epitopes in a chemical reaction called enzymatic hydrolysis. There are minimal studies available proving the efficacy of hydrolysed protein diets in treating enteropathy when an adverse food reaction is not the cause, however they all concur that patients remain in remission post treatment. This review aims to explore the studies available which test the efficacy of hydrolysed diets in treating enteropathies and discuss their use in the veterinary practice.
Canine enteropathy is often used to describe chronic gastrointestinal signs in dogs (Dandrieux, 2016); the clinical signs characterising canine enteropathy are vomiting, diarrhoea, borborygmus, hyporexia and weight loss (Dandrieux, 2016). There is no single test available to diagnose canine enteropathy. Multiple diseases such as adverse food reactions, idiopathic inflammatory bowel disease (IBD) and antibiotic-responsive diarrhoea present with clinical signs affecting the intestinal tract. History taking and a thorough clinical examination using the Canine Chronic Enteropathy Disease Activity Index (Mandigers and German, 2010) is essential when treating any patient. Patients with gastrointestinal signs could undergo endoscopy; it would not diagnose the cause of the enteropathy, merely confirm its presence. In both adverse food reactions and IBD, biopsies taken using endoscopy show villous atrophy, infiltration of lymph, plasma and eosinophils, and an abnormal intraepithelial lymphocyte infiltration (Mandigers and German, 2010). Therefore, once extra-intestinal, parasitic disease (Dandrieux, 2016) or bacteriosis is ruled out, these disorders are commonly diagnosed retrospectively by their response to treatment (Allenspach et al, 2007); the use of hydrolysed diets as a primary treatment can aid in the diagnosis by distinguishing between idiopathic enteropathies and adverse food reactions.
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