Feline Chronic Enteropathy

Micah A. Bishop, DVM, PhD, DACVIM (SAIM), WAVE Veterinary Internal Medicine, Naples, Florida

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Feline Chronic Enteropathy


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

Test Result Reference Range Finding
Leukocytes 15 400 cells/L (15.4 x 109/L) 4500-14 000 cells/L (4.5-14.0 x 109/L)_ Leukocytosis
Neutrophils 11 000 cells/L (11.0 x 109/L) 2000-9000 cells/L(2.0-9.0 x 109/L) Mild neutrophilia
Lymphocytes 700 cells/L(0.7 x 109/L) 1500-7000 cells/L(1.5-7.0 x 109/L) Lymphopenia
Hematocrit 27% 30%-50% Mild nonregenerative anemia
Reticulocyte count 14 000 cells/L (14 x 109/L) 7000-60 000 cells/L(7-60 x 109/L) Normal
Albumin 2.1 g/dL(21 g/L) 2.3-3.9 g/dL (23-39 g/L) Mild hypoalbuminemia
Total protein 5.1 g/dL(51 g/L) 5.4-7.8 g/dL(54-48 g/L) Mild hypoproteinemia
Serum cobalamin 150 ng/L

(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.



To prescribe a series of food and therapeutic trials for presumptive IBD and assess patient response.

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To pursue endoscopy to obtain a diagnosis for prognosis and targeted therapy.

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IBD = inflammatory bowel disease

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