Chronic gastrointestinal diseases are common problems in small animals and can present a considerable challenge to the clinician. This part of the site introduces new procedures as part of a practical approach to the diagnosis and successful management of chronic gastrointestinal disease in dogs and cats.

Presenting signs that warrant further investigation can include chronic vomiting, chronic intermittent or persistent diarrhoea, weight loss or failure to gain weight, polyphagia or anorexia. It is important to appreciate that vomiting and diarrhoea may be due to systemic disease and not primary disease of the gastrointestinal tract. It is also important to remember that the absence of vomiting and diarrhoea does not exclude the possibility of severe gastrointestinal disease.

The main differential diagnoses determine the overall approach to investigation and can be grouped as follows:

• systemic and metabolic disease
• intestinal parasites and bacterial pathogens
• partial obstruction and gastrointestinal neoplasia
• pancreatic disease
• gastric disease
• intestinal disease – small bowel / large bowel

A stepwise approach to diagnosis may include:

Baseline investigations

• history and physical examination
• haematology and serum biochemistry profile – systemic / metabolic disease – plus T4, FeLV and FIV in cats
• faecal examination – intestinal parasites and bacterial pathogens
• abdominal imaging – partial obstruction / neoplasia

Specialised investigations

• serum TLI – pancreatic disease
• serum folate and cobalamin (vitamin B12) - small intestinal disease
• intestinal permeability test - small intestinal disease
• visualisation and biopsy - endoscopy or laparotomy