Histopathologic characteristics of intestinal biopsy samples from dogs with chronic inflammatory enteropathy with and without hypoalbuminemia (vol 31, pg 371, 2017)

Background: Previous studies have identified hypoalbuminemia as a risk factor for negative outcome in dogs with chronic enteropathy (CE), but it has not been determined whether histopathology differs between CE dogs with and without hypoalbuminemia. Objective: To compare histopathologic findings in dogs with biopsy-diagnosed inflammatory CE with and without hypoalbuminemia. Animals: 83 dogs that had intestinal biopsy performed between January 2010-July 2015. Dogs had signs compatible with CE of at least 3-weeks' duration and no evidence of clinically relevant extra-gastrointestinal (GI) disease or potential non-GI causes of hypoalbuminemia. Dogs had primary diagnosis of inflammatory enteritis based on histopathology. Methods: Dogs were grouped into CE with normoalbuminemia (CEN; serum albumin concentration >= 3.0 g/dL, N = 46) or chronic enteropathy with hypoalbuminemia (CEH; serum albumin concentration <3.0 g/dL, N = 37). A pathologist (SLP) blinded to the groups reviewed biopsy samples and applied the World Small Animal Veterinary Association scoring system to all samples. Results: Intestinal biopsy samples from dogs in the CEH group were significantly more likely to display villous stunting, epithelial injury, crypt distension, and lacteal dilatation, and were more likely to have intraepithelial lymphocytes and lamina propria neutrophils than biopsy samples from dogs in the CEN group. Additionally, higher scores for each of the above listed histopathologic criteria were associated with a lower serum albumin concentration. Conclusions and Clinical Importance: Histopathologic features of chronic inflammatory enteropathy differ between dogs that are hypo-versus normoalbuminemic. Additional work is needed to elucidate the clinical relevance of these differences.