Gastrointestinal Disorders

Dietary Strategies for Dogs and Cats With Chronic Enteropathies

Aarti Kathrani

BVetMed (Hons), PhD, DACVIM (SAIM, Nutrition), FHEA, MRCVS

Royal Veterinary College

North Mymms, United Kingdom

Q. What is the role of nutrition in chronic enteropathies (CE) in dogs and cats?

A. Response to specific dietary therapeutic strategies in dogs and cats with CE is highly variable. Therefore, nutrition should be treated as an individualized therapeutic intervention. Multiple diet trials may be needed to determine the most effective strategy for each animal with CE.

Q. What are the different diet types that can be used for dogs and cats with CE?

A. There are five general categories of diets:

• Highly digestible gastrointestinal diet: Highly digestible therapeutic gastrointestinal diets may help with clinical signs of CE in both dogs and cats. However, it is important to note that one study showed that while a highly digestible therapeutic gastrointestinal diet was able to induce remission in dogs with CE, the dogs were less likely to remain asymptomatic at subsequent rechecks when compared to dogs managed with a hydrolyzed diet.¹
• Hydrolyzed protein diet: Hydrolyzed protein diets may help influence the immune system and have high digestibility. Due to the scientific evidence supporting the use of hydrolyzed protein diets in canine and feline CE and the finding that some dogs that failed an elimination diet trial with a novel protein diet responded to a hydrolyzed protein diet,² these diets should likely be trialed first. If the animal does not consume the diet or the gastrointestinal signs do not improve, then a commercial therapeutic limited-ingredient novel protein diet can be tried.
• Limited-ingredient novel protein diet: Nearly 50% of cats and 60% of dogs with chronic gastrointestinal signs respond positively to a novel protein diet.^3,4 Well-pet novel protein diets should be avoided for the treatment of CE.
• Home-cooked diet: There is a subset of dogs and cats with CE that may respond positively to a home-cooked diet rather than a commercial diet. Consultation with a board-certified veterinary nutritionist should be sought if the dog or cat fails trials with commercial therapeutic diets, so that a complete and balanced home-cooked diet can be formulated.
• Fiber-enriched diets: Fiber-enriched diets may be effective for dogs with chronic large intestinal signs. A handful of published studies have shown a good response rate. These studies also showed that this category of diets was safe and well-tolerated in dogs with chronic disease. Response to these diets was shown to be relatively quick, with one study showing an improvement in a mean of 8.5 days⁵ and another showing an improvement within 1 day.⁶ One study suggested that long-term use of the fiber-enriched diet may be needed to ensure control of the clinical signs long-term.⁷

Q. What are potential reasons for a diet trial not working?

A. Possible reasons for failure to respond to a therapeutic diet include owner non-compliance with feeding, the need for a different dietary strategy, comorbidities, the patient requires medication to help control clinical signs, or misdiagnosis of chronic enteropathy. In many cases, multiple diet trials are needed.

1. Mandigers, P. J., Biourge, V., van den Ingh, T. S., Ankringa, N., & German, A. J. (2010). A randomized, open-label, positively-controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy. Journal of Veterinary Internal Medicine, 24(6), 1350-1357. doi: 10.1111/j.1939-1676.2010.0632.x

2. Marks, S. L., Laflamme, D. P., & McAloose, D. (2002). Dietary trial using a commercial hypoallergenic diet containing hydrolyzed protein for dogs with inflammatory bowel disease. Veterinary Therapeutics, 3(2), 109-118.

3. Guilford, W. G., Jones, B. R., Markwell, P. J., Arthur, D. G., Collett, M. G., & Harte, J. G. (2001). Food sensitivity in cats with chronic idiopathic gastrointestinal problems. Journal of Veterinary Internal Medicine, 15(1), 7-13. doi: 10.1892/0891-6640(2001)015<0007:fsicwc>2.3.co;2

4. Luckschander, N., Allenspach, K., Hall, J., Seibold, F., Grone, A., Doherr, M. G., & Gaschen, F. (2006). Perinuclear antineutrophilic cytoplasmic antibody and response to treatment in diarrheic dogs with food responsive disease or inflammatory bowel disease. Journal of Veterinary Internal Medicine, 20(2), 221-227. doi: 10.1892/0891-6640(2006)20[221:pacaar]2.0.co;2

5. Rossi, G., Cerquetella, M., Gavazza, A., Galosi, L., Berardi, S., Mangiaterra, S. … & Pengo, G. (2020). Rapid resolution of large bowel diarrhea after the administration of a combination of a high-fiber diet and a probiotic mixture in 30 dogs. Veterinary Sciences, 7(1), 21. doi: 10.3390/vetsci7010021

6. Fritsch, D. A., Wernimont, S. M., Jackson, M. I., MacLeay, J. M., & Gross, K. L. (2022). A prospective multicenter study of the efficacy of a fiber-supplemented dietary intervention in dogs with chronic large bowel diarrhea. BMC Veterinary Research, 18(1), 244. doi: 10.1186/s12917-022-03302-8

7. Leib, M. S. (2000). Treatment of chronic idiopathic large-bowel diarrhea in dogs with a highly digestible diet and soluble fiber: a retrospective review of 37 cases. Journal of Veterinary Internal Medicine, 14(1), 27-32. doi: 10.1892/0891-6640(2000)014<0027:tocilb>2.3.co;2