Update on the non-invasive monitoring of intestinal disease in dogs and cats

Diagnosis and management of intestinal disease in the dog and cat can prese nt a considerable challenge to the clinician because of the many potential causes and The relative inaccessibility of the small intestine. Intestinal disease is typically characterised on the basis of histopathologic criteria . However, this approach provides little information on the underlying caus e of damage and many cases may be overlooked by reliance on these morpholog ic criteria alone. In addition, it is impractical to take serial samples of the intestine for the objective assessment of response to treatment. Asses sment of intestinal disorders in dogs and cats by non-invasive procedures h as clear advantages, particularly for monitoring of progress during treatme nt. Current tests available to practitioners include assays of serum folate and cobalamin which provide indirect evidence of intestinal disease but ha ve limited sensitivity and specificity. Measurement of intestinal permeabil ity using dual sugar absorption tests has recently been validated as a sens itive test in dogs, not only for the detection of mucosal damage but also t o monitor response to treatment. This test has been combined with the hydro gen breath test to allow the simultaneous detection of small intestinal bac terial overgrowth in dogs. New tests that are currently being developed are designed to defect protein-losing enteropathies (faecal alpha-1-protease i nhibitor) and small intestinal bacterial overgrowth (serum deconjugated bil e acids).