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==Introduction==

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==Description==

'''Inflammatory bowel disease (IBD)''' is an idiopathic group of disorders characterised by intestinal inflammatory changes, associated with persistent or recurrent gastrointestinal signs.  IBD can affect any part of the intestines and is classified according to the predominant cellular inflammatory infiltration.  Several histological types have been recognised, including [[Enteritis, Lymphocytic - Plasmacytic |Lymphocytic - Plasmacytic Enteritis]] (LPE) and [[Enteritis, Eosinophilic |Eosinophilic Enteritis]] (EE).

'''Inflammatory bowel disease (IBD)''' is an idiopathic group of disorders characterised by intestinal inflammatory changes, associated with persistent or recurrent gastrointestinal signs.  IBD can affect any part of the intestines and is classified according to the predominant cellular inflammatory infiltration.  Several histological types have been recognised, including [[Enteritis, Lymphocytic - Plasmacytic |Lymphocytic - Plasmacytic Enteritis]] (LPE) and [[Enteritis, Eosinophilic |Eosinophilic Enteritis]] (EE).

===Laboratory Tests===

===Laboratory Tests===

====Haematology====

<u>'''Haematology''':</u>

 

A [[Neutrophilia|Neutrophilia]] ± a mild left shift will be present in [[Enteritis, Lymphocytic - Plasmacytic |LPE]].  

A [[Neutrophilia|Neutrophilia]] ± a mild left shift will be present in [[Enteritis, Lymphocytic - Plasmacytic |LPE]].  

An [[Eosinophilia|Eosinophilia]] is not always present in [[Enteritis, Eosinophilic|EE]].

An [[Eosinophilia|Eosinophilia]] is not always present in [[Enteritis, Eosinophilic|EE]].

====Biochemistry====

<u>'''Biochemistry''':</u>

 

On biochemistry there is often a Panhypoproteinaemia, Hypocholesterolaemia and mildly elevated liver enzymes, secondary to intestinal inflammation.

On biochemistry there is often a Panhypoproteinaemia, Hypocholesterolaemia and mildly elevated liver enzymes, secondary to intestinal inflammation.

====Other Tests====

<u>'''Other Tests''':</u>

Faecal analysis should be carried out to rule out parasitic causes such as [[Trichuris vulpis|whipworms]], [[Uncinaria stenocephala|hookworms]] and [[Giardia|''Giardia'']].

 

Serum folate level decreases with proximal small intestinal inflammation and serum cobalamin level decreases with distal small intestinal inflammation.

'''Faecal analysis''' should be carried out to rule out parasitic causes such as [[Trichuris vulpis|whipworms]], [[Uncinaria stenocephala|hookworms]] and [[Giardia|''Giardia'']].

 

'''Serum folate''' level decreases with proximal small intestinal inflammation and serum cobalamin level decreases with distal small intestinal inflammation.

===Diagnostic Imaging===

===Diagnostic Imaging===

====Radiography====

<u>'''Radiography''':</u>

Plain radiography is used to evaluate for anatomic abnormalities.  Contrast study is only valuable if there is a severe mucosal disease.

Plain radiography is used to evaluate for anatomic abnormalities.  Contrast study is only valuable if there is a severe mucosal disease.

====Ultrasonography====

<u>'''Ultrasonography''':</u>

Ultrasonography may reveal mesenteric lymphadenopathy and thickening of the intestinal wall.

Ultrasonography may reveal mesenteric lymphadenopathy and thickening of the intestinal wall.

===Histopathology===

===Histopathology===

A biopsy of the intestine is required for a definitive diagnosis of IBD.  A non-invasive biopsy may be taken via endoscopy.  However, this limits where the samples can be taken from as the [[Jejunum - Anatomy & Physiology|jejunum]] and [[Ileum - Anatomy & Physiology|ileum]] are not easily accessible.  Exploratory laparotomy and full thickness biopsy may be preferred at times.

A biopsy of the intestine is required for a definitive diagnosis of IBD.  A non-invasive biopsy may be taken via endoscopy.  However, this limits where the samples can be taken from as the [[Jejunum - Anatomy & Physiology|jejunum]] and [[Ileum - Anatomy & Physiology|ileum]] are not easily accessible.  Exploratory laparotomy and full thickness biopsy may be preferred at times.

   

   

==Pathology==

==Pathology==

==Treatment==

==Treatment==

===Dietary modification===

===Dietary modification===

An elimination diet should be instigated.  The patient should be fed strictly on a novel protein source which they have not previously been exposed to.  Clinical signs should resolve within 1-2 weeks.  The patient should ideally be rechallenged to demonstrate a true dietary [[Hypersensitivity - WikiBlood|hypersensitivity]].

An elimination diet should be instigated.  The patient should be fed strictly on a novel protein source which they have not previously been exposed to.  Clinical signs should resolve within 1-2 weeks.  The patient should ideally be rechallenged to demonstrate a true dietary [[Hypersensitivity - Introduction|hypersensitivity]].

Folate and cobalamin supplementation may be required if the levels are subnormal.

Folate and cobalamin supplementation may be required if the levels are subnormal.

==Prognosis==

==Prognosis==

Variable

Variable

==References==

==References==

Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

[[Category:Intestine_-_Inflammatory_Pathology]][[Category:Dog]]

 

[[Category:Cat]]

 

[[Category:To_Do_-_Caz]]

[[Category:Alimentary_Disorders_-_Horse]]

 

[[Category:To_Do_-_Review]]

 

[[Category:Intestine_-_Inflammatory_Pathology]][[Category:Intestinal Diseases - Dog]][[Category:Immunological Diseases - Dog]]

[[Category:Intestinal Diseases - Cat]][[Category:Immunological Diseases - Cat]]

 

[[Category:Alimentary Diseases - Horse]]

[[Category:Expert_Review]]

[[Category:Allergic Alimentary Diseases]]