Differentiating IBD from LSA in cats | VETgirl Veterinary Continuing Education Podcasts

VETgirl Veterinary Continuing Education Podcasts

In today's VETgirl online veterinary CE podcast, we discuss diagnostic considerations for gastrointestinal (GI) biopsy samples from those ever-frustrating feline enteropathy cases. I am sure you have all had your fair share of writing inflammatory bowel disease (IBD) versus GI lymphoma (LSA) as the diagnosis in cat medical records and getting biopsy results of lymphocytic plasmocytic something! These two common GI diseases can have similar clinical presentations in cats, and even when owners allow aggressive diagnostics, the conditions can prove challenging to differentiate. Biopsy samples of the GI tract can be obtained surgically or endoscopically. Typically they are simply submitted for routine histopathology, but additional testing such as immunohistochemistry (IHC) or clonality testing can be performed as well. So, Chow et al wanted to evaluate whether the addition of IHC and clonality testing to routine histopathology of intestinal biopsy samples improves our ability to differentiate IBD from LSA in cats in their study entitled Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy. This study also adds another layer to this question, in that they obtained biopsies from both the upper small intestine (USI) and lower small intestine (LSI). The authors note that a previous study looking at both duodenal and ileal endoscopic biopsies showed discrepancies, suggesting that by obtaining both samples we could improve our diagnostic accuracy (Scott). However, that study did not perform IHC or clonality testing in all cases. Therefore, Chow et al not only investigated how adding IHC and clonality testing affects results, but it also assessed the agreement between USI and LSI diagnostic results in light of these additional diagnostics.