Feline Chronic Enteropathy

Question 1

FCE signalment

Answer 1

generally older cats

Question 2

pathogenesis of FCE

Answer 2

combination of factors from the environment, microbiome, and immune system within a genetically susceptible host

Question 3

types of feline chronic enteropathies

Answer 3

1. food responsive enteropathy
2. idiopathic inflammatory bowel disease
3. low grade intestinal T cell lymphoma (SCL)

Question 4

clinical signs of FCE

Answer 4

1. weight loss
2. vomiting
3. hyporexia or polyphagia
4. diarrhea (FRE)

Question 5

FRE signalment, signs, and treatment

Answer 5

• young to young adult
• large bowel diarrhea
• +/- cutaneous signs
• static clinical signs
• normal PE

TX: diet trial - elimination

Question 6

IBD signalment, signs, treatment

Answer 6

• middle aged
• weight loss, hyporexia, vomiting, diarrhea
• progressive or cyclical clinical signs
• normal or abnormal PE

TX:
1. diet trial
2. probiotics, prebiotics, antibiotics
3. +/- immunomodulators

Question 7

small cell GI lymphoma signalment, signs, treatment

Answer 7

• middle aged to older
• weight loss, hyporexia, vomiting, diarrhea
• slowly progressive clinical signs
• normal or abnormal clinical signs

TX: chlorambucil

Question 8

lab abnormalities with FCE

Answer 8

• hypoalbuminemia
• +/- hypoglobulinemia
• reactive hepatopathy
• low B12/folate
• iron deficiency anemia
• hypophosphatemia
• hypovitaminosis D

spec fPL: evelated only if concurrent pancreatitis
fTLI: can be low if concurrent EPI (rare)

MAY NOT HAVE LAB CHANGES

Question 9

diagnostics for FCE

Answer 9

abdominal ultrasound

diffuse thickening of the muscularis and mucosa

if LNs enlarged –> more likely lymphoma > IBD

if intestinal wall thickening without clinical signs - NOT diagnostic of IBD

Question 10

feline triaditis

Answer 10

concurrent comorbitities:
1. pancreatitis
2. hepatopathy
3. chronic enteropathy

occurs due to pancreatic duct in cats joining the common bile duct BEFORE entering the duodenum - allows the inflammatory process to extend locally

Question 11

how to differentiate IBD vs GI lymphoma

Answer 11

intestinal biopsy w/ histopathology, IHC staining, and clonality testing

Question 12

IBD biopsy results

Answer 12

histo: small, mature lymphocytes + plasma cells infiltrating villi and crypts –> villus blunting

IHC: mixed infiltrate (T, B, NK cells)

PARR: polyclonal

Question 13

low grade intestinal T cell lymphoma biopsy results

Answer 13

histo: small, mature lymphocytes causing destruction of the mucosal architecture and present in epithelium

IHC: uniform infiltrate (T cells only)

PARR: monoclonal

Question 14

what general diagnostics should be performed on cats with GI disease

Answer 14

1. monitor BW trends
2. minimum database
3. total T4
4. +/- fecal
5. serum B12/folate
6. +/- fPLI, fTLI
7. abdominal US +/- LN aspirate
8. biopsies + histopathology