October 3, 2025Open Access

Retrospective evaluation of short- and medium-term therapeutic response to different immunosuppressive and dietary approaches in 148 dogs diagnosed with immunosuppressant-responsive enteropathy

Key Points

79% of dogs showed positive response at 1 month, indicating effective short-term management of enteropathy.
Treatment failure was linked primarily to hypoalbuminemia and hypocobalaminemia rather than the immunosuppressive protocol used.
Different dietary approaches, including hydrolyzed protein diets, demonstrated varying effects on treatment outcomes.
Mortality was mostly observed within 1 month of diagnosis, highlighting challenges in managing chronic intestinal inflammation.

Abstract

Background: Chronic intestinal inflammation in dogs is common worldwide; however, it can be very difficult to manage and predict clinical response to different treatment protocols. Aim: This retrospective analysis included 148 dogs with chronic intestinal inflammation with the aim to describe different treatment protocols and their impact on clinical response and identify potential predictors of treatment failure. Methods: Of the 148 dogs, 53 were classified as having presumptive inflammatory protein-losing enteropathy (IRE-PLE). The factors associated with treatment failure were also analyzed. Clinical severity (CCECAI), serum albumin concentration, type of immunosuppressive therapy (prednisolone vs prednisolone in combination with cyclosporine or chlorambucil), type of diet (hydrolyzed protein, restricted antigen, highly digestible, restricted fat), and cobalamin supplementation were evaluated at diagnosis (T0) and after 1 (T1) and 6 (T6) months. CCECAI at T1 and T6 were used to evaluate the short- and medium-term response, respectively. Results: A total of 113 dogs (33.6% IRE-PLE) received prednisolone. Twenty-one dogs (28.6% IRE-PLE) received prednisolone and cyclosporine, whereas 14 dogs (64.3% IRE-PLE) received prednisolone and chlorambucil. Ninety-five (41% IRE-PLE) received cobalamin supplementation. Hydrolyzed protein and restricted antigen diets were most commonly prescribed. At T1 and T6, 79% and 59.5% of dogs were responders (24.8% and 15.9% IRE-PLE), and 21% and 27% (79.3% and 72.5% IRE-PLE) were nonresponders, respectively. The median CCECAI scores were 2 (IQR 4) and 0 (IQR 2) at T1 and T6, respectively. Conclusion: Most dogs showed favorable clinical outcomes, although a subset did not respond to treatment at short- and medium-term follow-up. Most deaths or euthanasia occurred within 1 month of diagnosis. The therapeutic response was not influenced by the type of immunosuppressive protocol, but rather by the presence of hypoalbuminemia, hypocobalaminemia, and the need for a home-cooked restricted fat diet.

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