Chronic intestinal inflammation (IBD) in the dog

What is chronic enteropathy?

'Chronic enteropathy' (CE) is the broader and more correct term for what many people call 'IBD' [1][2]. True IBD is strictly speaking a histopathological diagnosis that requires an endoscopic biopsy; CE encompasses all forms of chronic intestinal inflammation in the dog [2]. CE is classified based on treatment response: food-responsive (38–89% of cases), steroid-responsive (immune-mediated) and non-responsive [1]. Many dogs initially considered non-responsive turn out to be food-responsive upon further dietary adjustment [2].

What does the evidence say?

Diet as the first step

The ACVIM consensus guideline (2026) recommends dietary adjustment as the first step, before invasive investigation [1]. A trial with at least three therapeutic diets — each maintained for at least two weeks — is recommended. Hydrolysed protein diets achieve remission in 64–89% of food-responsive cases; novel protein diets are an equivalent alternative [1][4]. This is a structured medical protocol and not a reason to bypass the veterinary surgeon, but an argument for a stepwise approach.

Probiotics

Of the over-the-counter probiotics, only Visbiome Vet currently has clinical substantiation via a randomised controlled study in dogs with CE [3]. That study showed a positive effect on microbiome composition. Evidence for other probiotic products in dogs is insufficient or absent. Probiotics are therefore not a universally proven remedy; for this specifically investigated product, cautiously positive evidence is available [3].

Antibiotics: no longer first choice

Empirical antibiotic use as first-line treatment is no longer recommended by the ACVIM (2026) [1]. Long-term use has negative effects on the intestinal microbiome, which plays a central role in CE precisely. Microbiome-targeted therapies — including probiotics and faecal microbiota transplantation — are gaining ground as alternatives [1][2].

Medication in immune-mediated CE

When diet has insufficient effect, corticosteroids (prednisolone) form the standard treatment in immune-mediated CE [1]. Cyclosporine is an alternative in case of adverse effects or when concurrent diabetes mellitus makes prednisolone unsuitable [1]. In the steroid-responsive form, veterinary medication is necessary and cannot be replaced by supplementary agents.

Supplementary ≠ replacement

Therapeutic diet and — to a lesser extent — specific probiotics can be valuable additions, but do not replace veterinary diagnostics and treatment. CE has multiple causes and subtypes; without a correct diagnosis there is a risk that a treatable underlying cause is missed [1][2]. Especially in cases of persistent or worsening complaints, a veterinary surgeon is indispensable.