Prognosis for surgical intestinal resection in inflammatory bowel disease refractory to medical treatment in a dog.

Abstract

A 14-year-old spayed female Maltese dog had been diagnosed with inflammatory bowel disease (IBD)surgical biopsy and histopathologic findings. The dog had shown stable clinical control with prednisolone for 2 y but subsequently developed diarrhea, and serum albumin levels could not be adequately controlled. Despite titrating up the prednisolone dosage (1 mg/kg, PO, q12h), serum albumin concentration remained low and diarrhea persisted. Diagnostic imaging identified the underlying cause of the gastrointestinal signs as segmental eccentric small intestine wall thickening with homogenous hypoenhancement. A surgical resection of the affected segment was undertaken, primarily for histopathologic examination to identify the underlying cause rather than for therapeutic purposes. Postoperatively, medical management was continued, and the therapeutic response to medical therapy improved as the prednisolone was gradually tapered. Stable management was ultimately achieved at a prednisolone dosage of 0.25 mg/kg, PO, q24h, once. Key clinical message: In veterinary medicine, IBD is generally managed with medical therapy, and poor prognosis may occur if the clinical signs are not controlled. In certain cases, however, a surgical approach may offer benefits in the management of IBD. In the case reported herein, surgical resection was conducted on the segments of intestine with severe inflammation in a 14-year-old spayed female Maltese dog diagnosed with IBD that was not controlled by medical therapy. After surgery, the IBD was managed successfully with prednisolone.