A retrospective analysis of 59 cats diagnosed with idiopathic inflammatory bowel disease (IBD) was conducted to evaluate the potential association with histopathologic lesions of intestinal inflammation.
Cats were included in the retrospective study if they met the clinical criteria for idiopathic IBD, including persistent gastrointestinal signs, failed response to dietary or empiric therapies alone, thorough diagnostic evaluation with exclusion of other causes for gastroenteritis, and histologic diagnosis of intestinal inflammation. All cats were fed an elimination diet for a minimum of 14 days to rule out adverse food reactions. Metronidazole or amoxicillin with clavulanic acid was administered to most cats for 2 to 3 weeks if they failed to respond to dietary intervention alone. Multivariate logistic regression was used to determine which independent variables (from the retrospective study) best predicted the histopathologic severity of IBD. The combination of gastrointestinal signs, endoscopic abnormalities, serum total protein, serum alanine transaminase/alkaline phosphatase activity, and serum phosphorous concentration had the best correlation with histopathologic inflammation and comprised the feline chronic enteropathy activity index (FCEAI). Validation of the potential utility of the FCEAI was assessed in a prospective clinical trial of 23 cats with a history of chronic gastrointestinal disease. Seventeen cats diagnosed with IBD were fed an elimination diet and prescribed prednisolone, whereas food-responsive enteropathy (FRE) cats were fed an elimination diet alone. Data indicated that the FCEAI was a useful method for assessing clinical disease activity in cats with IBD or FRE at diagnosis in this study. Positive treatment responses were accompanied by changes in the FCEAI, suggesting that this clinical scoring system is suitable for monitoring the effect of induction therapy in cats with CE.
Commentary: This report demonstrates the utility of a clinical disease activity index for cats with chronic enteropathies, similar to the index reported previously for dogs. This system applies a numerical scoring system that incorporates multiple objective parameters to determine a measure of inflammatory intestinal disease activity in individual patients. Use of a clinical disease index allows for more standardized assessment of the initial severity of disease and improvement with treatment.—Shawn Kearns, DVM, Diplomate ACVIM
A clinical index for disease activity in cats with chronic enteropathy. Jergens AE, Crandell JM, Evans R, et al.
J VET INTERN MED 24:1027-1033, 2010.