Chronic enteropathy in the dog: negative prognostic factors
5-year-old male German Shepherd with small intestinal diarrhoea for 4 months, marked weight loss and an erratic appetite. His clinical activity index (CCECAI) is 13. Endoscopic biopsies show mild lymphoplasmacytic enteritis.
| Parameter | Result | Reference |
|---|---|---|
| Albumin | 1.7 g/dL | 2.6–4.0 |
| Cobalamin | 150 ng/L | 250–900 |
| Folate | 14 µg/L | 7.7–24.4 |
| cPLI | Normal | — |
Which statement about prognosis is correct?
chevron_right Show answer and explanation
A. Low albumin, low cobalamin and a high CCECAI worsen the prognosis
Correct. In dogs with chronic enteropathy, a CCECAI ≥ 12, hypoalbuminaemia (< 2 g/dL) and hypocobalaminaemia have been associated with a negative outcome (poor response or euthanasia). By contrast, histological severity correlates poorly with clinical signs and response.
B. The mild histological grade of the biopsies predicts a good response
Histological severity correlates poorly with clinical severity and outcome: a mild grade does not guarantee a good prognosis in a dog with this picture.
C. Normal folate rules out severe intestinal involvement
Folate is absorbed in the proximal small intestine and a normal value does not exclude severe disease, let alone ileal disease, which is where cobalamin is absorbed.
D. Hypocobalaminaemia no longer matters once corrected with supplements
Cobalamin supplementation is essential and improves response, but the deficiency remains a marker of ileal or severe disease associated with a worse outcome.
lightbulb Key takeaway
In canine chronic enteropathy, clinical severity (CCECAI), albumin and cobalamin guide prognosis better than histology. Always supplement cobalamin when low, and watch for thromboembolic risk in dogs with severe hypoalbuminaemia.
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Updated: November 1, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.