Treatment success in cats with chronic enteropathy is associated with a decrease in fecal calprotectin concentrations

Romy M Heilmann; Denise S Riggers; Isla Trewin; Gábor Köller; Aarti Kathrani

doi:10.3389/fvets.2024.1390681

Treatment success in cats with chronic enteropathy is associated with a decrease in fecal calprotectin concentrations

Front Vet Sci. 2024 Apr 3:11:1390681. doi: 10.3389/fvets.2024.1390681. eCollection 2024.

Authors

Romy M Heilmann¹, Denise S Riggers¹, Isla Trewin², Gábor Köller³, Aarti Kathrani²

Affiliations

¹ Department for Small Animals, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
² Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom.
³ Department for Large Animals, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany.

Abstract

Feline chronic enteropathies (FCE) are challenging to diagnose and monitor for progression and response to treatment. Fecal calprotectin might be a useful non-invasive marker to evaluate clinical endpoints of therapeutic monitoring in FCE. We evaluated fecal calprotectin concentrations in cats with FCE before and after initiation of treatment comprised of immunomodulation and/or dietary intervention. Included were 17 cats with FCE and 18 healthy controls. Clinical investigation of FCE cases included clinical severity grading (feline chronic enteropathy activity index, FCEAI) in all cats, abdominal ultrasonography in 15 cats, and gastrointestinal biopsies in 6 cats. Fecal calprotectin was measured in samples from 12 cats with FCE before treatment, all 17 FCE cats ≥6 weeks after treatment initiation, and all healthy controls. Fecal calprotectin concentrations in FCE cases before treatment (median: 61 μg/g) were significantly higher than after treatment initiation (median: 15 μg/g; p = 0.0098) and compared to controls (median: 6 μg/g; p = 0.0235) and correlated with the FCEAI scores (ρ = 0.54, p = 0.0316). Fecal calprotectin concentrations after treatment initiation were higher with more severe duodenal/proximal jejunal pathology (ρ = 0.83, p = 0.0427) and shorter intervals between sampling time points (ρ = -0.54, p = 0.0250). Relevant decreases in initially increased fecal calprotectin concentrations are seen in cats with FCE on varying treatment strategies that significantly improve or have remission of clinical signs. This supports the utility of fecal calprotectin as a surrogate biomarker to assess disease severity in FCE cases. Further studies need to evaluate fecal calprotectin concentrations longitudinally in relation to mucosal healing vs. clinical response.

Keywords: biomarker; diet-responsive; feline; immunomodulation; inflammation; therapeutic trial.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. We acknowledge the generous support of Bühlmann Laboratories (Schönenbuch, BL, Switzerland), providing assay reagents and materials for the study, and financial support by the Winn Feline/EveryCat Health Foundation (grant #W21-030). The authors declare that this study received funding from the American Academy of Veterinary Nutrition and Waltham for the shipment of samples from the U.K. to Germany. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. This publication was funded by the Open Access Publishing Fund of Leipzig University supported by the German Research Foundation within the program Open Access Publication Funding.