Practice Scenario

Get to know Annie, a young adult, small-breed dog with pruritus and chronic diarrhea.

Meet ANNIE

A 1-year-old, spayed female Scottish Terrier

  • Annie presents for itching, diarrhea, and moderate brown discharge in her right ear. The owner reports her signs started 3 months ago.
  • Annie was eating a store brand, dry puppy food until approximately a month ago when the owner changed her to the same brand of dry adult food. Annie lives indoors with a 3-year-old Schnauzer, Bebe, who is healthy with no skin or gastrointestinal signs. They are taken for 3 walks daily on leash.
  • On exam, Annie exhibits generalized erythema, saliva-stained paws, and otitis externa (right ear). There is no evidence of fleas or other ectoparasites. Annie has no coughing, sneezing, or ocular discharge, and has normal heart and lung sounds.
  • Annie has a lean body condition and normal muscle mass.
  • The rest of her exam is within normal limits.

Gastrointestinal Disorders

Food-Responsive Enteropathy (Diarrhea) in Dogs

Food-responsive enteropathy is one of the most common forms of chronic enteropathy in dogs and includes those with adverse food reactions (i.e., food allergy and food intolerance) and those with intestinal inflammation that benefits from properties of a different diet.1 Food-responsive enteropathy is characterized by persistent or intermittent gastrointestinal (GI) clinical signs lasting 3 weeks or longer in the absence of other causes (e.g., dietary indiscretion, parasitism, identified enteropathogens, or neoplasia) and non-GI diseases.2,3 

canine stomach intestine icon


Dogs with food-responsive enteropathy are more likely to be younger, have less severe clinical signs, and exhibit more large-bowel diarrhea compared to dogs with immunosuppressant-responsive enteropathy.4─6 

Since many dogs with chronic idiopathic GI signs respond well to dietary changes, an elimination diet trial is often recommended before endoscopy for those dogs with mild or moderate signs unless negative prognostic factors (e.g., hypoalbuminemia, hypocobalaminemia, high clinical activity index score) are present.1,2,4,7,8 

The goals of nutritional intervention are to provide a complete and balanced diet that avoids known allergens or ingredients that cause adverse food reactions and resolves or minimizes clinical signs.

Key Messages

did you know

An elimination diet has been proven to be the most effective method for diagnosis and treatment of food-responsive enteropathy.6

Related Tools and Content:

Diet Elimination Trials

Diet elimination trials are the gold standard for the diagnosis of food allergies and food intolerances.

View Brief 1 min to 5 min

Taking a Good Diet History

The only way to know what each patient really eats is to ask ꟷ and document the information in the medical record.

View Brief 1 min to 5 min

Nutritional Assessment Is an Iterative Process: Extended Evaluation

An extended nutritional evaluation is important for pets at risk for nutrition-related problems.

View Brief 1 min to 5 min

Purina Fecal Scoring Chart

The Purina Fecal Scoring Chart is a practical, easy-to-use tool that can help clients describe their pets’ stools.

View Tool 1 min to 5 min

Why Distinguish Between Small and Large Bowel Diarrhea

Identifying which part of the gastrointestinal (GI) tract is involved is a first step in diagnosing GI problems.

View Brief 1 min to 5 min

Distinguishing Characteristics of Small and Large Bowel Diarrhea Chart

A practical, easy-to-use chart that helps localize diarrhea to the small or large intestine.

View Tool 1 min to 5 min

Intestinal Dysbiosis in Dogs and Cats

Diet modification is a key component of therapeutic plans for managing dogs and cats with intestinal dysbiosis.

View Brief 1 min to 5 min

To Share With Pet Owner:

Screening Diet History Form

This short, screening diet history form is a practical, easy-to-use document that can help clients provide important information about their pets’ diets.

View Tool 1 min to 5 min

How to Encourage Finicky Pets to Eat

Pets who are finicky, fussy or not interested in food can be a challenge.

View Brief 1 min to 5 min

Canine Body Condition System Sheet

A visual aid to the Purina Body Condition Score System for dogs.​

View Tool 1 min to 5 min

Food Allergies & Food Intolerances in Pets

The terms “food allergy” and “food intolerance” are often used interchangeably, but they are not the same. How do they compare, and how are they diagnosed and managed?

View Hot Topic 6 min to 10 min

Switching Pet Foods - Dogs

Gradually transitioning onto a new diet minimizes the risk of stomach upset.​

View Brief 1 min to 5 min

References

  1. Gaschen, F. P., & Merchant, S. R. (2011). Adverse food reactions in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 41(2), 361─379. doi: 10.1016/j.cvsm.2011.02.005
  2. Dandrieux, J. R. S., & Mansfield, C. S. (2019). Chronic enteropathy in canines: Prevalence, impact and management strategies. Veterinary Medicine: Research and Reports, 10, 203─214. doi: 10.2147/VMRR.S162774
  3. Jergens, A. E., & Simpson, K. W. (2012). Inflammatory bowel disease in veterinary medicine. Frontiers in Bioscience-Elite, 4(4), 1404─1419. doi: 10.2741/470
  4. Allenspach, K., Wieland, B., Gröne, A., & Gaschen, F. (2007). Chronic enteropathies in dogs: Evaluation of risk factors for negative outcome. Journal of Veterinary Internal Medicine, 21(4), 700─708. doi: 10.1111/j.1939-1676.2007.tb03011.x
  5. Allenspach, K., Culverwell, C., & Chan, D. (2016). Long-term outcome in dogs with chronic enteropathies: 203 cases. Veterinary Record, 178(15), 368. doi: 10.1136/vr.103557
  6. Volkmann, M., Steiner, J. M., Fosgate, G. T., Zentek, J., Hartmann, S., & Kohn, B. (2017). Chronic diarrhea in dogsꟷRetrospective study in 136 cases. Journal of Veterinary Internal Medicine, 31(4), 1043─1055. doi: 10.1111/jvim.2017.31.issue-4
  7. Dandrieux, J. R. S. (2016). Inflammatory bowel disease versus chronic enteropathy in dogs: Are they one and the same? Journal of Small Animal Practice, 57(11), 589─599. doi: 10.1111/jsap.12588
  8. 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
  9. Makielski, K., Cullen, J., O’Connor, A., & Jergens, A. E. (2019). Narrative review of therapies for chronic enteropathies in dogs and cats. Journal of Veterinary Internal Medicine, 33(1), 11─22. doi: 10.1111/jvim.15345
  10. Lenox, C. E. (2021). Nutritional management of dogs and cats with gastrointestinal diseases. Veterinary Clinics of North America: Small Animal Practice, 51(3), 669─684. doi: 10.1016/j.cvsm.2021.01.006
  11. Marks, S., Laflamme, D. P., & McAloose, D. (2002). Dietary trial using a commercial hypoallergenic diet containing hydrolyzed protein for dogs with inflammatory bowel disease. Veterinary Therapeutics: Research in Applied Veterinary Medicine, 3(2), 109─118.
  12. Procoli, F. (2020). Inflammatory bowel disease, food-responsive, antibiotic-responsive diarrhoea, protein losing enteropathy: Acronyms, clinical staging, and treatment of chronic inflammatory enteropathy in dogs. Advances in Small Animal Care, 1, 127─141. doi: 10.1016/j.yasa.2020.07.010
  13. Simpson, K. W., & Jergens, A. E. (2011). Pitfalls and progress in the diagnosis and management of canine inflammatory bowel disease. Veterinary Clinics of North America: Small Animal Practice, 41(2), 381─398. doi: 10.1016/j.cvsm.2011.02.003
  14. Rudinsky, A. J., Rowe, J. C., & Parker, V. J. (2018). Nutritional management of chronic enteropathies in dogs and cats. Journal of the American Veterinary Medical Association, 253(5), 570─578. doi: 10.2460/javma.253.5.570
  15. Zoran, D. L. (2017). Nutritional management of gastrointestinal disease. In S. J. Ettinger, E. C. Feldman & E. Côté (Eds.), Textbook of veterinary internal medicine: Diseases of the dog and the cat (8th ed., pp. 1892─1899). Elsevier.
  16. Mueller, R. S., Olivry, T., & Prélaud, P. (2016). Critically appraised topic on adverse food reactions of companion animals (2): Common food allergen sources in dogs and cats. BMC Veterinary Research, 12, Article 9. doi: 10.1186/s12917-016-0633-8
  17. Verlinden, A., Hesta, M., Millet, S., & Janssens, G. P. (2006). Food allergy in dogs and cats: A review. Critical Reviews in Food Science and Nutrition, 46(3), 259─273. doi: 10.1080/10408390591001117
  18. Craig, J. M. (2019). Food intolerance in dogs and cats. Journal of Small Animal Practice, 60(2), 77─85. doi: 10.1111/jsap.12959
  19. Leib, M. (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: 10.1111/j.1939-1676.2000.tb01495.x
  20. Cave, N. (2012). Nutritional management of gastrointestinal diseases. In A. J. Fascetti & S. J. Delaney (Eds.), Applied veterinary clinical nutrition (pp. 175─220). John Wiley & Sons.