Gastroenterology in dogs and cats in practice: Key takeaways from the VET KU Texas A&M Conference in Pattaya
- Ecommercy
- 2026-09-22
- 16:01
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The latest findings from the international gastroenterology conference in Pattaya provide new insights into the practical diagnosis and treatment of gastrointestinal diseases in dogs and cats. Lectures by Prof. Janis M. Tolbert, Dr Emily Gould and other specialists from Texas A&M focused on food-responsive enteropathies, differences between species, management when a dietary trial fails, and the treatment of canine chronic hepatitis.
Below are the key takeaways that can have a meaningful impact on everyday clinical practice.
- Nutritional assessment as the foundation of managing gastrointestinal patients
Prof. Tolbert emphasised that as many as 67–75% of enteropathies in dogs respond to dietary modification, making a detailed nutritional history an essential part of both diagnosis and treatment.
Key information to collect includes:
• a complete list of diets previously and currently fed, including analysis of their composition,
• the duration of each diet and the timing of clinical signs,
• body weight and appetite history,
• the presence of intolerances, food aversions and preferences regarding food texture or temperature,
• total calorie intake, including not only the main diet but also treats, supplements and other additions.
According to studies cited by Prof. Tolbert, owners may underestimate their pets’ daily calorie intake by as much as 47% or overfeed them by more than 150%, clearly demonstrating that subjective assessment alone is insufficient.
In clinical practice, this means that energy requirements should be calculated and actual food portions established for every patient.
How should food composition be interpreted? The future is “grams per 100 kcal”
The current method of presenting nutrient composition in g/100 g is convenient but provides limited precision when comparing diets. In the United States, expressing nutrients as grams per 100 kcal of metabolisable energy is increasingly becoming standard practice. This approach makes it possible to:
• compare diets with different energy densities,
• assess the actual amount of a nutrient consumed by the patient,
• tailor the diet more accurately to the needs of an animal with enteropathy.
Prof. Tolbert noted that veterinary pet food labelling regulations in the United States are expected to be modernised in the coming years. Following approaches used in human nutrition, labels may include information such as calories per serving and the percentage of energy derived from protein, fat and carbohydrates.
Why are high-fibre diets unsuitable for young animals?
In growing patients, high dietary fibre levels may reduce mineral bioavailability and interfere with normal development. In adults, increasing fibre intake may be appropriate depending on the type of enteropathy, but this should always be done cautiously and with an understanding of how it affects overall diet digestibility.
According to data presented by Texas A&M, a high-fibre diet provides approximately:
• dogs: 3.5 g fibre/100 kcal,
• cats: 2.5 g fibre/100 kcal.
These values are considerably higher than those found in standard maintenance diets.
Essential supplies for owners of patients with enteropathy
Because periodic relapses can occur in patients with enteropathies even when the diet is well selected, owners are advised to keep several useful products readily available:
• probiotics and synbiotics,
• products that help improve stool consistency, for example those containing clay, pectins or cellulose,
• soluble and insoluble fibre,
• well-tolerated palatability enhancers,
• antiemetics and appetite stimulants prescribed by the vet.
Being prepared can help minimise stress, which itself may adversely affect gastrointestinal motility and the patient’s clinical condition.
2. When an elimination diet fails: Prof. Tolbert’s recommendations
Failure of the first dietary trial is common in clinical practice. Prof. Tolbert highlighted the importance of:
• ensuring that the diet was followed for a sufficient period – at least 6–8 weeks,
• checking whether the patient is receiving any unintended dietary additions,
• considering fat intolerance or poor digestibility,
• considering changes not only to the protein source but also to the carbohydrate source, type of fibre and moisture content of the diet,
• reassessing the patient’s history – the timing of clinical signs may indicate a contact reaction to food, fat intolerance or a reaction to technological additives.
According to Prof. Tolbert, one of the most underestimated tools when reassessing a case is a detailed analysis of when a flare-up occurred in relation to the introduction of individual dietary components.
3. Cats are not small dogs: the specific nature of feline enteropathies
Chronic enteropathies in cats present particular challenges for several reasons:
• clinical diagnosis is more difficult – cats may mask clinical signs for a long time, and weight loss may be the only indication of disease,
• food aversions are common, and cats tend to be more selective and more sensitive to changes in food texture,
• concurrent diseases are more common, including IBD, lymphoplasmacytic enteritis and disorders involving the pancreas and hepatobiliary system,
• cats are more sensitive to stress and environmental changes.
For many cats, preferences regarding food temperature or even the type of bowl may determine whether they eat at all. These factors should therefore be taken just as seriously as the analytical composition of the diet.
4. Immune-mediated chronic hepatitis – a disease with a prolonged subclinical phase
In immune-mediated hepatitis, the dog’s immune system targets hepatocytes, leading to slow, progressive destruction of liver tissue. The speaker emphasised that the disease develops insidiously and may remain subclinical for a long time, even in predisposed breeds such as:
• Dobermanns,
• Labrador Retrievers,
• English Spaniels and Cocker Spaniels.
Animals in this phase may show no clinical signs, and routine blood test results may remain within reference ranges. By the time the first signs appear – loss of appetite, loss of muscle mass, polydipsia or polyuria – the disease process may already have been present for many months.
In advanced disease, typical signs of liver dysfunction may develop, including jaundice, ascites and hepatic encephalopathy.
Diagnosis: biopsy remains the gold standard
According to the lecture, biopsy is the only method that allows a definitive diagnosis of immune-mediated hepatitis.
Recommendations include:
• collecting several biopsy samples from different liver lobes,
• having the samples assessed by a pathologist experienced in hepatopathology,
• simultaneously assessing hepatic copper accumulation to confirm or rule out copper-associated hepatopathy.
Early diagnosis is essential – the sooner the disease is identified, the better the prognosis, including the possibility of complete recovery.
Management: immunosuppression and nutritional support
Immunosuppression remains the first-line treatment. From a nutritional perspective, particular emphasis was placed on:
• maintaining an adequate energy balance and supporting muscle mass,
• using hepatoprotective supplements,
• responding to complications such as portal hypertension or hepatic encephalopathy by modifying dietary sodium or protein levels.
Among supplements with documented benefits, S-adenosylmethionine (SAMe) was highlighted for its role in supporting glutathione synthesis. It should be administered on an empty stomach to optimise absorption.
During acute deterioration – such as a sudden loss of appetite, worsening clinical signs or encephalopathy – appetite stimulants may be used, and in selected cases enteral feeding via a feeding tube may be required.
5. Copper-associated hepatopathy: a hidden threat
The second liver disease discussed was chronic hepatitis associated with copper accumulation in hepatocytes. This condition is particularly difficult to diagnose because clinical signs may be absent in its early stages and even blood tests may show no abnormalities.
The speaker described this condition as “silent hepatitis”, which may remain undiagnosed for years.
In one case presented during the lecture, a puppy remained clinically healthy for three years, with the first clinical signs appearing only after liver cirrhosis had already developed. In another study involving 191 clinically healthy Labrador Retrievers, as many as 64% showed histopathological evidence of hepatitis, despite having no clinical signs.
The role of copper and the consequences of its accumulation
Although copper is essential for processes including ATP production, iron metabolism and antioxidant function, excessive accumulation can cause irreversible hepatocyte damage.
These abnormalities may occur both in animals with genetic mutations that predispose them to copper accumulation and in patients with a normal genotype when diet or other factors promote excessive copper storage.
Genotyping is particularly recommended in Labrador Retrievers because it can help predict how an individual patient may respond to dietary management or copper chelation.
Diagnosis and dietary management of copper accumulation
Key elements of management include:
• liver biopsy with quantitative measurement of hepatic copper concentration,
• avoiding copper-rich dietary ingredients, such as organ meats and certain fish,
• using diets with reduced copper content,
• introducing pharmacological copper chelation when required,
• considering individually formulated diets – in some cases based on cottage cheese, as mentioned towards the end of the lecture.
Copper deficiency is also harmful, so the aim is to regulate copper intake rather than eliminate it excessively.
Differential diagnosis and patient monitoring
In both types of liver disease, comprehensive monitoring is essential and should include:
• regular biochemical testing,
• assessment of muscle condition score (MCS),
• monitoring for neurological signs,
• analysis of the diet in terms of energy balance and micronutrient intake.
In patients with portal hypertension or ascites, additional dietary modifications may be required, including sodium restriction.
Summary
Gastroenterology in dogs and cats now requires a holistic approach in which diagnostics and nutrition are closely interconnected. Enteropathies and liver diseases are not static conditions – their course is influenced by nutrition, environment, stress and the individual predispositions of the animal.
Key takeaways:
• diet is a fundamental therapeutic tool,
• liver biopsy remains essential in the diagnosis of hepatological diseases,
• monitoring and individualisation of treatment are crucial,
• cats require a distinctly different approach from dogs,
• when there is no improvement, the search for an appropriate dietary strategy should continue.