Nonpharmacological Treatment Strategies for the Management of Canine Chronic Inflammatory Enteropathy—A Narrative Review

Abstract

Chronic inflammatory enteropathy (CIE) refers to a heterogeneous group of idiopathic diseases of the dog characterised by persistent gastrointestinal (GI) clinical signs. If conventional dietary treatment alone would be unsuccessful, management of CIE is traditionally attained by the use of pharmaceuticals, such as antibiotics and immunosuppressive drugs. While being rather effective, however, these drugs are endowed with side effects, which may impact negatively on the animal’s quality of life. Therefore, novel, safe and effective therapies for CIE are highly sought after. As gut microbiota imbalances are often associated with GI disorders, a compelling rationale exists for the use of nonpharmacological methods of microbial manipulation in CIE, such as faecal microbiota transplantation and administration of pre-, pro-, syn- and postbiotics. In addition to providing direct health benefits to the host via a gentle modulation of the intestinal microbiota composition and function, these treatments may also possess immunomodulatory and epithelial barrier-enhancing actions. Likewise, intestinal barrier integrity, along with mucosal inflammation, are deemed to be two chief therapeutic targets of mesenchymal stem cells and selected vegetable-derived bioactive compounds. Although pioneering studies have revealed encouraging findings regarding the use of novel treatment agents in CIE, a larger body of research is needed to address fully their mode of action, efficacy and safety.

Serum/Faecal S100A12, CRP and lactoferrin can be used to distinguish ınfectious and non‐ınfectious canine diarrhoea

“…The presence of IBD was excluded due to the fact that the gastrointestinal findings lasted less than 3 weeks and the enteropathogens causing the clinical findings had already been identified. The presence of diarrhoea without any sign and symptom such loss of appetite due to sudden diet change, which was learned from the anamnestic data, was accepted as the cause of nutritional diarrhoea (Isidori et al., 2022).…”

Oxidative stress in dogs with chronic inflammatory enteropathy treated with allogeneic mesenchymal stem cells

“…Patients that do not respond to any of the treatments are included in the non-responsive enteropathies group (Dandrieux 2016 ; Isidori et al 2022 ).…”

Complete Blood Count-Derived Inflammatory Markers Changes in Dogs with Chronic Inflammatory Enteropathy Treated with Adipose-Derived Mesenchymal Stem Cells

“…Based on the patient’s response to treatment, the enteropathy can be considered food-responsive (FRE), antibiotic-responsive (ARE), immunosuppressant-responsive (IRE), or nonresponsive (NRE) [ 2 ]. The terms IBD and IRE are considered synonymous for dogs in which the histology has confirmed the presence of intestinal inflammation.…”

“…Corticosteroids and other immunosuppressants are commonly used to treat CIE; however, nonresponsiveness and adverse reactions limit their usage [ 3 , 4 , 5 ]. Adipose-derived mesenchymal stem cells (Ad-MSCs) are a promising alternative therapy to treat chronic enteropathies in dogs and cats, which has been shown to be safe and effective [ 2 , 6 , 7 , 8 ]. After administration, Ad-MSCs not only migrate directly to the site of inflammation but also exert indirect anti-inflammatory effects through secretory factors [ 9 , 10 , 11 , 12 ].…”