Clinical Response to Dietary Management in Dogs with Food-Responsive Chronic Enteropathy: A Review

Abstract

Canine chronic enteropathy (CE) encompasses a group of digestive disorders characterized by persistent gastrointestinal signs and the absence of identifiable underlying causes. Within this category, food-responsive enteropathy (FRE) is the most common subtype, particularly in young animals. In contrast to other CE types, such as immunosuppressant-responsive enteropathy (IRE) or antibiotic-responsive enteropathy (ARE), FRE cases have a notably more favorable prognosis and, in many instances, can be treated solely through dietary modifications. The aim of this study is to evaluate the clinical efficacy of diet as a primary therapeutic tool in dogs with FRE, through the analysis of seven studies published between 2010 and 2025. Both controlled trials and retrospective or prospective studies were included, assessing clinical remission rates, the type of diet used (hydrolyzed, novel protein, or homemade), and the impact on parameters such as the CCECAI score or fecal consistency. The results consistently show that dietary intervention, particularly when formulated with low antigenicity and high digestibility, can induce sustained clinical remission in most dogs diagnosed with FRE, with success rates above 60–80%. In some studies, even dogs previously categorized as non-responders achieved significant improvement following a second dietary trial with an alternative formulation. Additionally, several cases showed concurrent improvements in gut microbiota, suggesting a secondary modulatory effect of diet. In conclusion, dietary trials should be considered the first-line treatment in clinically stable dogs with chronic enteropathy. Nutritional management holds not only diagnostic value but also high therapeutic potential. This approach can help avoid unnecessary pharmacological treatments, support faster clinical recovery, improve the animal’s quality of life, and offer a more accessible option for pet owners.