Diagnosis of Inflammatory Bowel Disease

Zwingenberger AL, Marks SL, Baker TW et al: Ultrasonographic evaluation of the muscularis propria in cats with diffuse small intestinal lymphoma or inflammatory bowel disease, J Vet Intern Med, 2010.

The objective of this study was to investigate the association of imaging biomarkers with inflammatory bowel disease (IBD) and lymphoma in cats. Thickening of the muscularis propria layer of the small intestine and lymphadenopathy have been ultrasound pattern findings associated with these conditions in cats. The study included 142 cats with a histological diagnosis of normal small intestine (SI), lymphoma, or IBD determined by full-thickness biopsy. All the cases had an ultrasonographic examination within 28 days before biopsy. Of all the samples, 56 were classified as normal SI, 62 as lymphoma, and 24 as IBD. Previously, 10 samples classified as IBD were reclassified as lymphoma after immunohistochemistry and clonality assays. Cats with lymphoma were found to be significantly older than those with IBD or normal SI. Cats with thickening of the muscularis propria detected by ultrasound were more likely to have lymphoma than normal SI cats and those with IBD. Cats with ultrasound evidence of lymphadenopathy were more likely to have a diagnosis of lymphoma or IBD than normal SI. 56 of the 62 cats were diagnosed with lymphoma of the diffuse T-cell type. The results indicate that lymphoma or IBD could be misclassified if immunohistochemical and clonality assays were not performed on biopsy samples. Also, older cats with muscularis layer thickening are more likely to have T-cell lymphoma than IBD. Lymphadenopathy is associated with lymphoma or IBD. [VT]

Related articles:
Kleinschmidt S, Harder J, Nolte I et al: Chronic inflammatory and non-inflammatory diseases of the gastrointestinal tract in cats: diagnostic advantages of full-thickness intestinal and extraintestinal biopsies, J Feline Med Surg 12:97, 2010.

Evans SE, Bonczynski JJ, Broussard JD et al: Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats, J Am Vet Med Assoc 229:1447, 2006.

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Zwingenberger AL, Marks SL, Baker TW et al: Ultrasonographic evaluation of the muscularis propria in cats with diffuse small intestinal lymphoma or inflammatory bowel disease, J Vet Intern Med, 2010.

The objective of this study was to investigate the association of imaging biomarkers with inflammatory bowel disease (IBD) and lymphoma in cats. Thickening of the muscularis propria layer of the small intestine and lymphadenopathy have been ultrasound pattern findings associated with these conditions in cats. The study included 142 cats with a histological diagnosis of normal small intestine (SI), lymphoma, or IBD determined by full-thickness biopsy. All the cases had an ultrasonographic examination within 28 days before biopsy. Of all the samples, 56 were classified as normal SI, 62 as lymphoma, and 24 as IBD. Previously, 10 samples classified as IBD were reclassified as lymphoma after immunohistochemistry and clonality assays. Cats with lymphoma were found to be significantly older than those with IBD or normal SI. Cats with thickening of the muscularis propria detected by ultrasound were more likely to have lymphoma than normal SI cats and those with IBD. Cats with ultrasound evidence of lymphadenopathy were more likely to have a diagnosis of lymphoma or IBD than normal SI. 56 of the 62 cats were diagnosed with lymphoma of the diffuse T-cell type. The results indicate that lymphoma or IBD could be misclassified if immunohistochemical and clonality assays were not performed on biopsy samples. Also, older cats with muscularis layer thickening are more likely to have T-cell lymphoma than IBD. Lymphadenopathy is associated with lymphoma or IBD. [VT]

Related articles:
Kleinschmidt S, Harder J, Nolte I et al: Chronic inflammatory and non-inflammatory diseases of the gastrointestinal tract in cats: diagnostic advantages of full-thickness intestinal and extraintestinal biopsies, J Feline Med Surg 12:97, 2010.

Evans SE, Bonczynski JJ, Broussard JD et al: Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats, J Am Vet Med Assoc 229:1447, 2006.

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Intestinal Biopsies in Cats

Kleinschmidt S, Harder J, Nolte I et al: Chronic inflammatory and non-inflammatory diseases of the gastrointestinal tract in cats: diagnostic advantages of full-thickness intestinal and extraintestinal biopsies, J Feline Med Surg 12:97, 2010.

Forty-three cats with chronic gastrointestinal disease signs had histologic evaluation of full-thickness biopsies from the gastrointestinal tract (GIT) and extraintestinal samples. The GIT samples were one biopsy taken from the fundus of the stomach, duodenum, mid-jejunum, ileum, and descending colon. Extraintestinal samples were collected from the liver, pancreas, mesenteric lymph node, and mesentery. In all the cats, chronic gastrointestinal signs (vomiting, diarrhea, and anorexia) had been present for at least 3 weeks up to 1 year. In 42 of 43 cats, findings revealed different histopathological gastrointestinal alterations on full thickness biopsy, with inflammatory lesions being the most frequent alteration (46.5%). Ten of the 43 cases (23.3%) had diffuse lymphoma diagnosed. In many cases, the demonstration of transmural spread of the neoplastic lymphoid cells is a very helpful method of diagnosing a neoplastic infiltration of the intestinal wall. The mesenteric lymph nodes and liver are frequently involved in cases of diffuse intestinal lymphoma and should be sampled during the laparotomy procedure. Extraintestinal samples are helpful in diagnosing intestinal tumors such as lymphoma and ones of mast cell origin. [VT]

Related articles:
Lingard AE, Briscoe K, Beatty JA et al: Low-grade alimentary lymphoma: clinicopathological findings and response to treatment in 17 cases, Journal of Feline Medicine & Surgery 11:692, 2009.

More on cat health: Winn Feline Foundation Library
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Kleinschmidt S, Harder J, Nolte I et al: Chronic inflammatory and non-inflammatory diseases of the gastrointestinal tract in cats: diagnostic advantages of full-thickness intestinal and extraintestinal biopsies, J Feline Med Surg 12:97, 2010.

Forty-three cats with chronic gastrointestinal disease signs had histologic evaluation of full-thickness biopsies from the gastrointestinal tract (GIT) and extraintestinal samples. The GIT samples were one biopsy taken from the fundus of the stomach, duodenum, mid-jejunum, ileum, and descending colon. Extraintestinal samples were collected from the liver, pancreas, mesenteric lymph node, and mesentery. In all the cats, chronic gastrointestinal signs (vomiting, diarrhea, and anorexia) had been present for at least 3 weeks up to 1 year. In 42 of 43 cats, findings revealed different histopathological gastrointestinal alterations on full thickness biopsy, with inflammatory lesions being the most frequent alteration (46.5%). Ten of the 43 cases (23.3%) had diffuse lymphoma diagnosed. In many cases, the demonstration of transmural spread of the neoplastic lymphoid cells is a very helpful method of diagnosing a neoplastic infiltration of the intestinal wall. The mesenteric lymph nodes and liver are frequently involved in cases of diffuse intestinal lymphoma and should be sampled during the laparotomy procedure. Extraintestinal samples are helpful in diagnosing intestinal tumors such as lymphoma and ones of mast cell origin. [VT]

Related articles:
Lingard AE, Briscoe K, Beatty JA et al: Low-grade alimentary lymphoma: clinicopathological findings and response to treatment in 17 cases, Journal of Feline Medicine & Surgery 11:692, 2009.

More on cat health: Winn Feline Foundation Library
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Probiotics for Cats

Wynn, S. G. (2009). "Probiotics in veterinary practice." Journal of the American Veterinary Medical Association 234(5): 606-613.

The definition of a probiotic is one of several “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Probiotics have luminal and mucosal effects in the gastrointestinal tract. The gastrointestinal tract is the largest immune organ of the body. Mucosal effects would include interactions with immune cells and enterocytes. Luminal effects include chemical changes in ingesta and mucus as a result of the probiotic activity. Cats and dogs have high numbers of bacteria in the proximal portion of the gastrointestinal tract, more so than seen in humans. Cat feces contain high number of anaerobic bacteria, so the effect of Lactobacillus acidophilus has been evaluated in the cat. The use of probiotics clearly seems to enhance immune function in cats and seems to have a role in the treatment of certain gastrointestinal conditions (e.g., inflammatory bowel disease and diarrhea). Other clinical effects are still being considered. However, probiotic products have a large variation in quality control and the safety factor is still being evaluated. [VT]
>> PubMed Abstract

Related articles:
Weese, J. S. (2002). "Microbiologic evaluation of commercial probiotics." J Am Vet Med Assoc 220(6): 794-7.
>> PubMed Abstract

Weese, J. S. (2003). "Evaluation of deficiencies in labeling of commercial probiotics." Can Vet J 44(12): 982-3.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Wynn, S. G. (2009). "Probiotics in veterinary practice." Journal of the American Veterinary Medical Association 234(5): 606-613.

The definition of a probiotic is one of several “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Probiotics have luminal and mucosal effects in the gastrointestinal tract. The gastrointestinal tract is the largest immune organ of the body. Mucosal effects would include interactions with immune cells and enterocytes. Luminal effects include chemical changes in ingesta and mucus as a result of the probiotic activity. Cats and dogs have high numbers of bacteria in the proximal portion of the gastrointestinal tract, more so than seen in humans. Cat feces contain high number of anaerobic bacteria, so the effect of Lactobacillus acidophilus has been evaluated in the cat. The use of probiotics clearly seems to enhance immune function in cats and seems to have a role in the treatment of certain gastrointestinal conditions (e.g., inflammatory bowel disease and diarrhea). Other clinical effects are still being considered. However, probiotic products have a large variation in quality control and the safety factor is still being evaluated. [VT]
>> PubMed Abstract

Related articles:
Weese, J. S. (2002). "Microbiologic evaluation of commercial probiotics." J Am Vet Med Assoc 220(6): 794-7.
>> PubMed Abstract

Weese, J. S. (2003). "Evaluation of deficiencies in labeling of commercial probiotics." Can Vet J 44(12): 982-3.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

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Endoscopy for Diagnosis of Gastrointestinal Disease in Cats

Willard, M. D., J. Mansell, et al. (2008). "Effect of sample quality on the sensitivity of endoscopic biopsy for detecting gastric and duodenal lesions in dogs and cats." Journal of Veterinary Internal Medicine 22(5): 1084-1089.

A common diagnostic procedure for assessment of chronic gastrointestinal disease in cats is endoscopy with biopsies of gastrointestinal mucosa. Previous studies have highlighted the difficulty in obtaining quality biopsy samples via endoscopy. In this study, the researchers attempted to address two issues: whether the ability to demonstrate a histologic lesion in the stomach or duodenum is affected by sample quality, and whether more samples are needed to find a lesion when tissue specimens are of poor quality. The researchers evaluated tissues obtained via endoscopy from 51 cats (and 99 dogs) that were examined as clinical cases at 8 veterinary institutions or practices in 5 different countries. The results showed that the quality of endoscopically obtained tissue samples has a profound effect on their sensitivity for identifying certain lesions, and there are differences between biopsies of canine and feline tissues. Multiple samples need to be taken to ensure that a sufficient number of adequate tissue samples are obtained during endoscopic procedures. The old assumption that a single adequate biopsy sample is sufficient for diagnosis was shown to be incorrect. The study suggests that a goal of obtaining 6 marginal or adequate feline duodenal or gastric samples will be sufficient to give 99% confidence of finding any lesions present.
>> PubMed Abstract

Related articles:
Day, M. J., T. Bilzer, et al. (2008). "Histopathological standards for the diagnosis of gastrointestinal inflammation in endoscopic biopsy samples from the dog and cat: a report from the World Small Animal Veterinary Association Gastrointestinal Standardization Group." J Comp Pathol 138 Suppl 1: S1-43.
>> PubMed Abstract

Evans, S. E., J. J. Bonczynski, et al. (2006). "Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats." J Am Vet Med Assoc 229(9): 1447-50.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Willard, M. D., J. Mansell, et al. (2008). "Effect of sample quality on the sensitivity of endoscopic biopsy for detecting gastric and duodenal lesions in dogs and cats." Journal of Veterinary Internal Medicine 22(5): 1084-1089.

A common diagnostic procedure for assessment of chronic gastrointestinal disease in cats is endoscopy with biopsies of gastrointestinal mucosa. Previous studies have highlighted the difficulty in obtaining quality biopsy samples via endoscopy. In this study, the researchers attempted to address two issues: whether the ability to demonstrate a histologic lesion in the stomach or duodenum is affected by sample quality, and whether more samples are needed to find a lesion when tissue specimens are of poor quality. The researchers evaluated tissues obtained via endoscopy from 51 cats (and 99 dogs) that were examined as clinical cases at 8 veterinary institutions or practices in 5 different countries. The results showed that the quality of endoscopically obtained tissue samples has a profound effect on their sensitivity for identifying certain lesions, and there are differences between biopsies of canine and feline tissues. Multiple samples need to be taken to ensure that a sufficient number of adequate tissue samples are obtained during endoscopic procedures. The old assumption that a single adequate biopsy sample is sufficient for diagnosis was shown to be incorrect. The study suggests that a goal of obtaining 6 marginal or adequate feline duodenal or gastric samples will be sufficient to give 99% confidence of finding any lesions present.
>> PubMed Abstract

Related articles:
Day, M. J., T. Bilzer, et al. (2008). "Histopathological standards for the diagnosis of gastrointestinal inflammation in endoscopic biopsy samples from the dog and cat: a report from the World Small Animal Veterinary Association Gastrointestinal Standardization Group." J Comp Pathol 138 Suppl 1: S1-43.
>> PubMed Abstract

Evans, S. E., J. J. Bonczynski, et al. (2006). "Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats." J Am Vet Med Assoc 229(9): 1447-50.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

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Understanding Inflammatory Bowel Disease in Cats

Winn funded research

Janeczko, S., D. Atwater, et al. (2008). "The relationship of mucosal bacteria to duodenal histopathology, cytokine mRNA, and clinical disease activity in cats with inflammatory bowel disease." Vet Microbiol 128(1-2): 178-93.

Inflammatory bowel disease (IBD) is a term for a group of poorly understood gastrointestinal (GI) diseases of cats. Cats with IBD have uncontrolled intestinal inflammation but the inciting causes are poorly understood. This study was designed to evaluate the relationship of intestinal mucosal bacteria to inflammation and clinical signs in cats with IBD. Biopsies of the duodenum were obtained from 27 cats: 17 cats sampled as part of diagnostic investigation for GI disease, and 10 control cats. The number of Enterobacteriaceae was higher in cats with clinical signs of GI disease than healthy cats. Total numbers of mucosal bacteria were associated with changes in mucosal architecture and the degree of inflammation. The results of this study suggest that mucosal bacteria such as Enterobacteriaceae, E. coli and Clostridium are involved in the pathogenesis of IBD in cats.

>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Winn funded research

Janeczko, S., D. Atwater, et al. (2008). "The relationship of mucosal bacteria to duodenal histopathology, cytokine mRNA, and clinical disease activity in cats with inflammatory bowel disease." Vet Microbiol 128(1-2): 178-93.

Inflammatory bowel disease (IBD) is a term for a group of poorly understood gastrointestinal (GI) diseases of cats. Cats with IBD have uncontrolled intestinal inflammation but the inciting causes are poorly understood. This study was designed to evaluate the relationship of intestinal mucosal bacteria to inflammation and clinical signs in cats with IBD. Biopsies of the duodenum were obtained from 27 cats: 17 cats sampled as part of diagnostic investigation for GI disease, and 10 control cats. The number of Enterobacteriaceae was higher in cats with clinical signs of GI disease than healthy cats. Total numbers of mucosal bacteria were associated with changes in mucosal architecture and the degree of inflammation. The results of this study suggest that mucosal bacteria such as Enterobacteriaceae, E. coli and Clostridium are involved in the pathogenesis of IBD in cats.

>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

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