Dietary management of chronic enteropathy is important to provide energy and nutrients, to support intestinal function, and to control clinical signs in food-responsive patients. Dietary strategies include high digestibility, novel ingredients, hydrolyzed protein, fat moderation, and fiber enrichment, among others. The best diet choice should be identified after a nutritional assessment and, depending on the clinical presentation, will often require several diet trials before success. Commercial therapeutic diets include gastrointestinal (including low fat), elimination, and fiber-enriched diets. Homemade diets can be a good option when commercial diets do not meet the needs for the patient.
Infectious colitis can cause large intestinal diarrhea and, in severe cases, systemic illness in dogs and cats. Causative agents include bacteria, protozoa, helminths, trematodes, fungi, oomycetes, and algae, with prevalence influenced by signalment, immune status, and environmental exposure. Parasites such as Trichuris vulpis and Tritrichomonas blagburni are common and should be routinely screened for. Management of bacterial colitis should prioritize supportive care and addressing underlying causes rather than routine antimicrobials. Disseminated fungal, oomycete, and algal infections often require prolonged, multiagent therapy. Escherichia coli-associated granulomatous colitis necessitates histopathologic diagnosis and susceptibility-guided antimicrobials. Prognosis varies with infectious agent and presence of dissemination.
Bile acid dysregulation is an emerging yet underrecognized contributor to diarrhea in companion animals. This review explores the pathophysiology of bile acid malabsorption and its clinical manifestation as bile acid diarrhea, emphasizing its relevance in veterinary practice. Mechanisms include defects in bile acid regulation, ileal dysfunction, and dysbiosis-driven alterations in bile acid metabolism. Clinical signs often mimic chronic enteropathy, complicating diagnosis. Current veterinary diagnostics are limited, making therapeutic response to bile acid sequestrants a practical diagnostic and treatment approach. Evidence-based strategies, including dietary management and bile acid sequestrant therapy, are discussed to guide clinicians in managing this challenging condition.
Short bowel syndrome (SBS) is a functional diagnosis referring to clinical manifestations from small intestinal mass loss. SBS primarily results from extensive surgical resection in veterinary patients. Clinical signs often include diarrhea and weight loss. Pathophysiological mechanisms involve alterations in nutrient absorption and gastrointestinal motility. Effective management focuses on nutritional assessment, individualized dietary modifications, and pharmacologic interventions to address malnutrition and motility disorders.
The term "triaditis" represents concurrent inflammatory diseases of the pancreas, hepatobiliary system, and small intestines in cats. This combination of inflammatory disorders appears to be clinically prevalent, and their co-existence may influence diagnostic or therapeutic strategies. The exact origin of the term triaditis in veterinary medicine is undetermined, but some of the earliest references to its potential existence were noted in the 1980s and 1990s. Despite the long-standing recognition of concurrent digestive-associated inflammatory disease in cats ('triaditis'), it is unknown whether this reflects a causative or associative relationship.
The intestinal microbiome plays a crucial role in host health. As intestinal dysbiosis can have different underlying causes, multimodal therapeutic approaches are often necessary. Dietary modulation potentially combined with fibers should be the first-line approaches in all patients with acute or chronic enteropathy and help modulate the microbiome. A subset of animals with chronic intestinal disease have marked dysbiosis that results in abnormal microbial function and reflects underlying mucosal pathology, which often persists in chronic inflammatory enteropathy. Fecal microbiota transplantation can be a useful adjunct treatment of chronic disorders, but in patients with severe dysbiosis, repeated treatments are likely needed.
This article discusses the importance of accurately diagnosing feline gastrointestinal diseases, particularly differentiating inflammatory bowel disease from alimentary lymphoma. It emphasizes that precise diagnosis impacts treatment decisions, prognosis, and research. The review covers diagnostic approaches, including clinical signs, diet trials, imaging, biopsies, histopathology, immunohistochemistry, and molecular testing. It explores the potential progression from chronic inflammation to lymphoma, highlighting similarities with human disease pathways. Ultimately, improved understanding and classification of these diseases will enhance patient management, guide targeted therapies, and advance translational research benefiting both feline and human medicine.
This review emphasizes that most cases of acute diarrhea (AD) in dogs and cats are self-limiting and primarily managed with supportive care, including hydration and nutrition. Diagnostic testing should be tailored to individual cases, focusing on ruling out systemic illness or infectious causes. Recent evidence advocates against routine antibiotic use in uncomplicated AD to prevent antimicrobial resistance and microbiome disruption. Instead, targeted therapy is reserved for systemic or bacterial infections. Additional treatments such as antiemetics and careful hygiene are discussed. Clinicians should prioritize supportive care and judicious diagnostics, adhering to antimicrobial stewardship principles to optimize patient outcomes and combat resistance.
Growing evidence in humans with inflammatory bowel disease reveals a critical subclinical phase during which pathologic changes silently accumulate-sometimes for up to a decade before diagnosis. Dogs with chronic enteropathy appear to follow a similar trajectory, developing subclinical intestinal pathology before manifesting overt clinical signs. This article synthesizes the current understanding of preclinical enteropathy across both species, examining the mechanistic changes that characterize this latent disease state. More importantly, it explores the translational implications of this knowledge: identifying the subclinical phase opens opportunities for early intervention, potentially preventing disease progression rather than merely managing established illness.
Protein-losing enteropathy in dogs is a complex syndrome characterized by excessive intestinal protein loss, most commonly resulting from intestinal lymphangiectasia and chronic intestinal inflammation. While glucocorticoid therapy is beneficial in many dogs, evidence increasingly shows that diet optimization, rather than aggressive immunosuppression, offers the best outcomes. The condition requires individualized management based on breed predisposition, diagnostic information, and patient response, with many steroid and immunosuppressive refractory cases responding to tailored dietary interventions.
The microbiome-gut-brain axis (MGBA) is a complex network of gastrointestinal (GI) microbiota and host enteric, immune, neural, endocrine, and metabolic pathways. Disruptions to homeostasis promote dysbiosis, immune dysregulation, inflammation, and vagal signal disruption. Many disease states and behavioral disorders are associated with a change in GI microbial composition and diversity. Psychoactive treatments may specifically target the MGBA to reduce systemic and neuroinflammation linked to the pathogenesis of many GI and neuropsychiatric conditions.
Large intestinal diseases in dogs and cats predominantly present as large bowel diarrhea, with constipation occurring less frequently. Etiologies are diverse and include infectious agents, parasites, inflammatory disease, neoplasia, vascular malformations, and motility disorders. Diagnostic evaluation incorporates a thorough history, physical examination, fecal testing, diagnostic imaging, and, when indicated, colonoscopy with mucosal biopsy. Therapeutic strategies are directed toward the underlying cause, complemented by dietary modification and supportive care. Prognosis is contingent upon the specific etiology, disease severity, and timeliness of intervention.
Gastrointestinal disorders are some of the most common diseases in dogs and cats, and treatment can be challenging. Practicing clinicians who understand the physiochemical properties of dietary fiber, the clinical scenarios in which fiber may be effective, and how to appropriately utilize dietary fiber in dogs and cats can see significant improvement in patients' clinical signs. Specifically, core gastrointestinal concerns including acute diarrhea, chronic diarrhea, hairball vomiting, and constipation may be effectively managed via alterations in dietary fiber intake.
Aerodigestive disorders (AeroD) encompass a wide range of clinical syndromes, reflecting disruption of the interactions between the respiratory and alimentary tracts. The aerodigestive tract includes the pharynx (nasopharynx, oropharynx, and laryngopharynx), larynx, trachea, bronchi, and bronchioles, esophagus, and esophageal gastric junction. Airway protection (AirPro) remains a key but underrecognized function of the alimentary tract. The esophagus plays an important role in AirPro such that most forms of esophageal disease are considered "AeroD."
Increasingly, many pets have become family. Sometimes, they are the family's favorite members, and they have no trouble admitting it. Technically, in many places, pets are legally considered property; however now many are considered family, sleeping in bed, eating better than their families, the reason a couple gets together, their first "child," as some have phrased it. While we take care of the patient, we must consider the quality of life of the pet and that of its family. At the end of the patient's life, it is our honor to help them pass peacefully.
This article explores species-specific approaches to end-of-life care, emphasizing the importance of understanding each animal's unique biology, behavior, and environment. The Five Domains model guides holistic welfare assessments, integrating physical, mental, and social health. Visual tools like Rainbow Mapping facilitate family involvement in quality of life evaluations and care planning. The article provides detailed protocols for sedation, euthanasia, and aftercare across various species, highlighting the importance of compassionate communication and tailored care strategies to ensure humane, dignified passings while supporting the emotional needs of families.
Veterinary geriatrics is evolving from an age-based label to a dynamic, functional assessment of how pets experience aging. This article explores key concepts including frailty, caregiver perception, functional versus medical aging, quality of life, and prediction of decline. Drawing from emerging veterinary literature and adapted human geriatric models, it offers practical tools and frameworks to support proactive, compassionate care for aging pets.
Veterinary hospice provides a compassionate, patient-centered approach to end-of-life care that emphasizes comfort, dignity, and quality of life over curative intent. This article outlines the principles of hospice care, including patient selection, multimodal pain and symptom management, environmental adaptations, and integration with geriatric care. It highlights the importance of proactive communication, quality-of-life assessment tools, and euthanasia planning to guide families through difficult decisions. By supporting both patients and caregivers, veterinary hospice strengthens the human-animal bond and ensures that a pet's final stage of life is managed with empathy, evidence-based strategies, and respect for individual values.
Sensory decline, particularly vision and hearing loss, is nearly universal in aging dogs and cats yet remains underrecognized in general practice. These changes are often mistaken for cognitive dysfunction or normal aging, but they significantly affect quality of life, behavior, and the human-animal bond. This review provides busy clinicians with practical, evidence-based strategies for identifying and managing sensory decline, including screening approaches, diagnostic tools, and real-world management tactics. Emphasis is placed on proactive care, client education, and the interplay between sensory loss and cognitive dysfunction to improve outcomes for senior patients.
