Relationship between serum cobalamin concentration and endoscopic ileal appearance and histology in dogs with chronic inflammatory enteropathy

Background It has not been determined whether ileal appearance differs among dogs with chronic inflammatory enteropathy (CIE) and different serum concentrations of cobalamin. Objective To compare endoscopic and histologic ileal findings in dogs with CIE and different serum cobalamin concentrations and then evaluate the correlation of ileal changes to cobalamin serum concentration using updated scoring systems to assess the ileum. Animals Sixty-eight dogs with CIE. Methods Retrospective study. Frequency of ileal features and ileal histologic and endoscopic scores (IHS and IES) were obtained and compared among CIE dogs with severe hypocobalaminemia (SHC; <200 ng/L), hypocobalaminemia (HC; 200-350 ng/L), or normocobalaminemia (NC; >350 ng/L). The correlation of IHS and IES with cobalamin was evaluated. Results Friability, villus atrophy, crypt dilatation, epithelial injury, and intraepithelial lymphocytes were more frequent in SHC than in NC dogs (all P <= .01). Median SHC-IES (2; range, 0-4) was higher than NC-IES (1; range, 0-5; P = .004). Median SHC-IHS (6; range, 3-9) was higher than HC-IHS (4; range, 1-7; P < .001) and NC-IHS (3; range, 1-8; P < .001). Cobalamin concentration correlated negatively with IES (rho = -.34, P = .005) and IHS (rho = -.58, P < .001). Conclusions and Clinical Importance Ileal features and involvement degree markedly differed when cobalamin was 350 ng/L in CIE dogs. With updated scales to assess the mucosa, greater ileal damage was associated with lower serum cobalamin concentration.