Feline Chronic Enteropathy
Micah A. Bishop, DVM, PhD, DACVIM (SAIM), WAVE Veterinary Internal Medicine, Naples, Florida
THE CASE
Plato, an 8-year-old spayed domestic longhair cat from east Texas, is presented for an approximate 4-week history of weight loss, small-bowel diarrhea, mild polyphagia, and occasional vomiting. Her owners feel her energy level is slightly decreased, and she has lost approximately 1 lb (0.45 kg).
On physical examination, Plato is responsive and alert. Temperature, pulse, and respiration rate are normal. BCS is approximately 4 of 9, and Platos haircoat is slightly unkempt. Mucous membranes are light pink, and capillary refill time is less than 2 seconds. Heart and lung auscultation is normal, but slightly thickened bowel loops with no distinct masses are noted during abdominal palpation.
CBC reveals a stress leukogram characterized by leukocytosis, mild neutrophilia, and lymphopenia. Mild non-regenerative anemia is present. Serum chemistry profile reveals mild hypoalbuminemia and decreased total protein. Urinalysis and abdominal radiography findings are unremarkable. A GI panel (ie, trypsin-like immunoreactivity, feline pancreatic lipase immunoreactivity, cobalamin, folate) is normal except for hypocobalaminemia. Abdominal ultrasonography reveals thickened intestinal walls with a prominent and hypoechoic musculoskeletal layer.1No enlarged lymph nodes or other abnormalities are noted. Total T4, FeLV, FIV, and fecal tests are negative. See Table.
Test Results
(111 pmol/L)
| 209-1500 ng/L(154-1107 pmol/L) | Hypocobalaminemia | | Intestinal wall thickness | 3.4 mm | 2.6-2.8 mm | Increased |
You suspect inflammatory bowel disease (IBD)/chronic enteropathy (ie, disease responsive to food, antibiotics, and/or anti-inflammatory therapy) or alimentary lymphoma; however, you cannot rule out uncommon bacterial, fungal, or parasitic infection.
IBD = inflammatory bowel disease