Enteritis, Eosinophilic

Signalment

Seen in any breed or age
However, more common in younger animal
More common in
- Boxers
- Dobermans
- German Shepherd Dogs

Description

Eosinophilic enteritis (EE) is the second most common form of IBD, characterised by a mixed, but predominantly eosiphilic, mucosal inflammatory infiltration. EGE may be limited to the small intestine or it may affect other areas of the gastrointestinal tract such as stomach or colon.

An eosinophilic infiltrate may indicate a diet-induced, type 1 hypersensitivity. However, most dogs do not respond to a purely exclusion diet. Endoparasitism should also be excluded prior to immunosuppressive therapy for EE.

Diagnosis

Clinical Signs

Vomiting
Diarrhoea; small intestinal is more common
- Haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
Protein-losing enteropathy in severe cases
Hypoproteinaemia in severe casese

Laboratory Tests

Haematology

Anaemia if gastrointestinal haemorrhage is severe.

Biochemistry

Eosinophilia
- This is not always present. Even when present, alone, it cannot prove the presence of EE.
- It is also a marker for parasitism, hypoadrenocorticism, allergic dermatological disease, allergic respiratory disease and mast cell tumour.
Panhypoproteinaemia
- Secoondary to concurrent protein-losing enteropathy

Other Tests

Diagnostic Imaging

Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.

Histopathology

Biopsy is required for a definitive diagnosis.

Treatment

Anti-parasiticide
- Fenbendazole may be given due to the possible endoparasitism or dietary sensitivity
Dietary modification
- A hypoallergenic diet should be used
Immunosuppressive therapy

Refer to IBD for further information

Prognosis

Guarded if the initial response to treatment is poor. Good if the underlying cause is detected and successfully treated.

References

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA
Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.