Relationship between serum cobalamin concentration and endoscopic ileal appearance and histology in dogs with chronic inflammatory enteropathy

Pérez-Merino, Eva M.; Cristóbal-Verdejo, Ignacio; Duque, Javier; Espadas-González, Lorena; Pastor-Sirvent, Nieves; Usón-Casaús, Jesús M

doi:10.1111/jvim.16436

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…The prevalence of hypocobalaminaemia in dogs with chronic gastrointestinal disease is reported to be between 6% and 64% (Allenspach et al ., 2007; Berghoff et al ., 2013; Craven et al ., 2004; Heilmann et al ., 2018; Volkmann et al ., 2017). Dogs with hypocobalaminaemia might not respond to treatment of the primary disease process, in fact, cobalamin deficiency can contribute to mucosal inflammatory infiltration and villous atrophy (Pérez‐Merino et al ., 2022). For this reason, early recognition of hypocobalaminaemia may be important for therapeutic outcome.…”

Section: Introductionmentioning

confidence: 99%

Hypocobalaminaemia in dogs with acute gastrointestinal diseases

Mattavelli,

Willems,

Gomez Soto

et al. 2024

J of Small Animal Practice

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ObjectivesThe objectives of this study were to investigate the prevalence of hypocobalaminaemia in dogs with acute gastrointestinal diseases and to evaluate its relationship with disease severity and outcome.Materials and MethodsMedical records of dogs presented for acute gastrointestinal signs that a serum cobalamin concentration measured between September 2019 and 2021 were included in this study. Hypocobalaminaemia was defined as serum cobalamin concentration <200 pmol/L, and low‐normal cobalamin was defined as serum cobalamin concentration of 200 to 295 pmol/L. Duration of clinical signs prior to presentation, Acute Patient Physiologic and Laboratory Evaluation (APPLE) fast score, length of hospitalisation and outcome were recorded.ResultsThirty‐three dogs were included. Seventeen dogs were diagnosed with acute gastrointestinal disease of unknown aetiology, seven dogs with parvoviral enteritis, three dogs with acute haemorrhagic diarrhoea syndrome and six dogs with miscellaneous diseases. The prevalence of hypocobalaminaemia in this population was 30.3% and low‐normal cobalamin concentration was detected in 18.2% of dogs. There was no statistically significant relationship between the detection of hypocobalaminaemia or low‐normal cobalamin and the duration of clinical signs before presentation, length of hospitalisation or Acute Patient Physiologic and Laboratory Evaluation fast score on admission. Mortality rate was 3%.Clinical SignificanceHypocobalaminaemia and low‐normal cobalamin are common findings in dogs with acute gastrointestinal diseases. The therapeutic significance and potential implications for prognosis of hypocobalaminaemia in these patients requires further investigation.

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Section: Introductionmentioning

confidence: 99%

Hypocobalaminaemia in dogs with acute gastrointestinal diseases

Mattavelli,

Willems,

Gomez Soto

et al. 2024

J of Small Animal Practice

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Relationship between serum cobalamin concentration and endoscopic ileal appearance and histology in dogs with chronic inflammatory enteropathy

Pérez-Merino

Cristóbal-Verdejo

Duque

et al. 2022

Veterinary Internal Medicne

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Background It has not been determined whether ileal appearance differs among dogs with chronic inflammatory enteropathy (CIE) and different serum concentrations of cobalamin. Objective To compare endoscopic and histologic ileal findings in dogs with CIE and different serum cobalamin concentrations and then evaluate the correlation of ileal changes to cobalamin serum concentration using updated scoring systems to assess the ileum. Animals Sixty‐eight dogs with CIE. Methods Retrospective study. Frequency of ileal features and ileal histologic and endoscopic scores (IHS and IES) were obtained and compared among CIE dogs with severe hypocobalaminemia (SHC; <200 ng/L), hypocobalaminemia (HC; 200‐350 ng/L), or normocobalaminemia (NC; >350 ng/L). The correlation of IHS and IES with cobalamin was evaluated. Results Friability, villus atrophy, crypt dilatation, epithelial injury, and intraepithelial lymphocytes were more frequent in SHC than in NC dogs (all P ≤ .01). Median SHC‐IES (2; range, 0‐4) was higher than NC‐IES (1; range, 0‐5; P = .004). Median SHC‐IHS (6; range, 3‐9) was higher than HC‐IHS (4; range, 1‐7; P < .001) and NC‐IHS (3; range, 1‐8; P < .001). Cobalamin concentration correlated negatively with IES (ρ = −.34, P = .005) and IHS (ρ = −.58, P < .001). Conclusions and Clinical Importance Ileal features and involvement degree markedly differed when cobalamin was <200 or >350 ng/L in CIE dogs. With updated scales to assess the mucosa, greater ileal damage was associated with lower serum cobalamin concentration.

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Expression of the cobalamin transporters cubam and MRP1 in the canine ileum–Upregulation in chronic inflammatory enteropathy

Kather,

Kacza,

Pfannkuche

et al. 2024

PLoS ONE

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Chronic inflammatory enteropathy (CIE) in dogs, a spontaneous model of human inflammatory bowel disease (IBD), is associated with a high rate of cobalamin deficiency. The etiology of hypocobalaminemia in human IBD and canine CIE remains unknown, and compromised intestinal uptake of cobalamin resulting from ileal cobalamin receptor deficiency has been proposed as a possible cause. Here, we evaluated the intestinal expression of the cobalamin receptor subunits, amnionless (AMN) and cubilin (CUBN), and the basolateral efflux transporter multi-drug resistance protein 1 (MRP1) in 22 dogs with CIE in comparison to healthy dogs. Epithelial CUBN and AMN levels were quantified by confocal laser scanning microscopy using immunohistochemistry in endoscopic ileal biopsies from dogs with (i) CIE and normocobalaminemia, (ii) CIE and suboptimal serum cobalamin status, (iii) CIE and severe hypocobalaminemia, and (iv) healthy controls. CUBN and MRP1 expression was quantified by RT-qPCR. Receptor expression was evaluated for correlation with clinical patient data. Ileal mucosal protein levels of AMN and CUBN as well as mRNA levels of CUBN and MRP1 were significantly increased in dogs with CIE compared to healthy controls. Ileal cobalamin receptor expression was positively correlated with age, clinical disease activity index (CCECAI) score, and lacteal dilation in the ileum, inversely correlated with serum folate concentrations, but was not associated with serum cobalamin concentrations. Cobalamin receptor downregulation does not appear to be the primary cause of hypocobalaminemia in canine CIE. In dogs of older age with severe clinical signs and/or microscopic intestinal lesions, intestinal cobalamin receptor upregulation is proposed as a mechanism to compensate for CIE-associated hypocobalaminemia. These results support oral supplementation strategies in hypocobalaminemic CIE patients.

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Relationship between serum cobalamin concentration and endoscopic ileal appearance and histology in dogs with chronic inflammatory enteropathy

Cited by 4 publications

References 40 publications

Hypocobalaminaemia in dogs with acute gastrointestinal diseases

Hypocobalaminaemia in dogs with acute gastrointestinal diseases

Relationship between serum cobalamin concentration and endoscopic ileal appearance and histology in dogs with chronic inflammatory enteropathy

Expression of the cobalamin transporters cubam and MRP1 in the canine ileum–Upregulation in chronic inflammatory enteropathy

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