A Scoring Index for Disease Activity in Canine Inflammatory Bowel Disease

Abstract

The clinical course of inflammatory bowel disease (IBD) in dogs is characterized by spontaneous exacerbations and remissions, which makes assessment of disease burden difficult. The objectives of this study were to develop a scoring system for evaluation of canine IBD activity and to validate this scoring method by correlating it to objective laboratory and histologic indices of intestinal inflammation. Fifty-eight dogs with IBD were evaluated prospectively and compared to 9 disease-free control dogs. Clinical disease activity was quantified by a simple scoring system, the canine IBD activity index (CIBDAI), and compared to serum concentrations of C-reactive protein (CRP), haptoglobin (HAP), ␣-acid glycoprotein (AGP), and serum amyloid A (SAA), as well as histology scores derived from endoscopic biopsy specimens. Forty-six dogs were available for a reevaluation of the CIBDAI, CRP, HAP, and AGP, and 34 dogs had repeat analysis of SAA performed after medical therapy. Serum concentrations of CRP were significantly (P Ͻ .02) increased in dogs with CIBDAI scores Ն5 (mild disease activity or greater) compared to controls. Among IBD dogs, the CIBDAI showed good correlation (r ϭ 0.82, P Ͻ .0001) to both histology and HAP scores, but CRP also was a strong co-correlate of disease activity. The IBD dogs showed significantly (P Ͻ .0001) decreased CIBDAI and CRP values but significantly (P Ͻ .0001) increased HAP concentrations after medical therapy compared to pretreatment values. We conclude that the CIBDAI is a reliable measure of inflammatory activity in canine IBD and that CRP is suitable for laboratory evaluation of the effect of therapy in these patients.

C-Reactive Protein Concentration in Canine Idiopathic Polyarthritis

“…We observed increased CRP concentrations in all the IPA dogs included in this study. This finding was expected based on previous studies that reported elevated CRP concentrations in dogs with other inflammatory diseases [10,12,13,18]. However, all the IPA dogs showed remarkable increase in the CRP levels; these levels in 11 dogs (29%) were greater than the measurement limit.…”

“…CRP has also been used as a predictor of survival in some neoplastic conditions [17] and of risk for myocardial infarction and stroke [6,20]. Recently, the CRP concentration was measured in dogs and it was shown to be elevated in several conditions such as surgical trauma [13], inflammatory bowel diseases (IBD) [12], pancreatitis [10], and autoimmune hemolytic anemia (AIHA) [18]. In Japan, a nepherometric immunoassay that is specific for canine CRP was developed in 1998, and the data of canine plasma CRP concentrations were accumulated for more than 10 years [13].…”

Cytokine mRNA abundance in intestinal biopsies from dogs with chronic diarrhea

“…Details on recruitment procedure have been described elsewhere (Allenspach et al, 2004;Sauter et al, 2005Sauter et al, , 2006Spichiger et al, 2005). Animals were clinically examined and scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) (Jergens et al, 2003b) to define the severity of disease. A scoring from 0 to 3 indicates clinically insignificant disease, from 4 to 5 a mild degree of clinical symptoms, from 6-8 a moderate degree of clinical symptoms, and above 9 the scoring indicates a severe degree of clinical symptoms.…”

Measurement of Intestinal Mucosal Permeability in Dogs with Lymphocytic-Plasmacytic Enteritis

“…In some instances, additional tests, such as trypsinlike immunoreactivity and serum assays for folate and cobalamin, were performed. Clinical disease activity was assessed by CIBDAI [6]. Briefly, 6 variables-attitude/activity, appetite, vomiting, stool consistency, stool frequency, and weight loss-were scored using a 4 point scale (0 to 3 points).…”

“…In dogs, the activity of IBD is normally assessed by pathological examination of biopsy specimens or calculation of the canine IBD activity index (CIBDAI) described by Jergens et al [6]. However, CIBDAI and pathological grading do not correlate with each other, and both indexes contain several subjective factors [1,12].…”