Diagnostic features, treatment, and outcome of dogs with inflammatory protein‐losing enteropathy

AbstractBackground: Protein-losing enteropathy (PLE) due to chronic inflammatory enteropathy (CIE) in dogs is often treated with a combination of glucocorticoids and second-line immunosuppressant (SLI). This combined approach might not be necessary in all dogs. Hypothesis/objectives: To describe diagnostic features and outcomes of dogs with PLE responding to glucocorticoids alone (group P) versus dogs receiving SLI (group S). Routine diagnostic parameters were assessed as indicators for treatment response, prognosis or outcome.Material and methods: Data from signalment, blood work, abdominal ultrasound, endoscopy, and histopathological scores were collected retrospectively from dogs with CIE/PLE (2015 -2017). Multivariate and univariate comparisons between groups P and S, cobalamin status and outcome as well as Pearson's correlation of data and Kaplan-Maier survival analysis were performed.Results: 31 dogs were included (n=17 group P; n=14 group S). WSAVA histology score of the duodenum was significantly different between treatment groups (p = 0.049). There were no differences in outcome measures. Serum folate and cobalamin showed an inverse correlation (r = -0.391, p = 0.036). Median time until serum albumin reached > 20 g/l was 13 days. Median follow-up was 99 days, with 8 dogs deceased by the end of the study. Median survival was 99 days in group P and 273 days in group S.Conclusion and clinical importance: 55% of dogs with CIE/PLE did not require an SLI. No routine diagnostic test was predictive of this response, or outcome. Treatment with glucocorticoids alone should be considered in dogs with PLE.