Gluten-sensitive enteropathy, also known as celiac disease in humans, GSE, gluten allergy, and wheat-sensitive enteropathy, is a disease caused by an allergy or sensitivity to gluten that causes small intestinal disease that can occur in dogs and cats. Glutens are proteins found in grains such as wheat but also related to proteins in barley and rye.
In normal dogs and cats, ingested food is chewed, swallowed and broken down by digestive enzymes in the stomach. This ingesta then moves to the intestine where microscopic hair-like villa in the intestinal lining function to absorb nutrients. Thousands of hairline villa increase the absorptive surface allowing for a large surface area for absorption.
In dogs and cats with gluten-sensitive enteropathy, ingestion of gluten triggers an immune response that assaults the intestinal villa and causes them to atrophy (erode and flatten). This results in lack of absorption of vitamins and minerals leading to signs of failure to thrive, and weight loss or failure to gain weight. Lack of absorption also causes diarrhea.
The cause of gluten-sensitive enteropathy is due to a genetic defect. Gluten-sensitive enteropathy is an uncommon disorder in dogs and is believed to occur in cats but is not well documented. When it occurs, it can affect any sex, age, or breed of dogs however the Irish setter, soft-coated wheaten terrier, and the Samoyed are more commonly affected. By far the most common breed affected is the Irish setter and most commonly diagnosed when puppies or young to middle-aged.
What to Watch For
Dogs and cats with gluten sensitivity or intolerance may have the following clinical signs:
- Failure to thrive
- Poor weight gain or weight loss
- Diarrhea which can be intermittent or persistent
- Underweight thin body condition
- Dull haircoat
Diagnosis of Gluten-Sensitive Enteropathy in Dogs and Cats
The diagnosis of gluten-sensitive enteropathy is based on the following:
- A physical examination generally reveals an underweight patient with a dull hair coat, history of diarrhea, and general failure to thrive.
- Blood work and urinalysis is recommended to rule out other possible diagnoses and concurrent disease. A complete blood count, biochemical profile, and urinalysis are generally unremarkable.
- Fecal examination is recommended to rule out concurrent parasitic infections.
- Trypsin-like immunoreactivity (TLI) testing is recommended to determine if exocrine pancreatic insufficiency (EPI) is a cause for the gastrointestinal symptoms.
- Abdominal radiographs are recommended to evaluate for evidence for other causes of the clinical signs. Results are generally unremarkable.
- Abdominal ultrasound is recommended to evaluate for evidence for other causes of the clinical signs. Results are generally unremarkable.
- Serum folate and cobalamin levels may be normal or decreased. This can reflect malabsorption of nutrients.
- The most accurate diagnostic test is a biopsy of the intestine that reveals abnormalities in the intestinal villi.
- The final diagnosis of gluten-sensitive enteropathy is based on a dietary trial of a gluten free diet that leads to resolution of clinical signs.
Treatment of Gluten-Sensitive Enteropathy in Dogs and Cats
Treatment options focus on dietary modification and elimination of all glutens from the diet. All grains that contain gluten are eliminated from the diet that includes wheat, barley, rye, oats and buckwheat.
Folate may be supplemented depending on blood values.
Prognosis for Gluten-Sensitive Enteropathy in Dogs and Cats
The prognosis for dogs and cats with GSE is good with proper dietary modifications. Most symptomatic patients will respond medical therapy within one to two months.
It is important that pets with GSE not be given any grains in their core diets as well as treats or table scraps.
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