ACVIM endorses updated guidance on canine chronic inflammatory enteropathy

The American College of Veterinary Internal Medicine (ACVIM) announced it has endorsed a new consensus statement on diagnosing and treating chronic inflammatory enteropathy (CIE) in canine patients, published in the Journal of Veterinary Internal Medicine. The endorsement comes after recent research advanced the industry’s understanding of chronic gastrointestinal (GI) inflammation in canine patients.

Published on January 21, 2026, the consensus statement outlines a stepwise diagnostic approach for veterinary professionals, including clinical signs, patient history, physical examination findings, sequential diagnostic testing, and imaging. The consensus statement also covers practical treatment and management strategies for CIE, tailored to the patient’s underlying disease subtype and response to therapy.¹ The guidelines also emphasize a diet-first stepwise approach and identify the De Simone Formulation, which is a multistrain probiotic used in Visbiome Vet, as the only probiotic supported by a randomized clinical trial. The evidence from that trial was strong enough to justify evidence-based recommendations for consideration after diet trials.²

"The new ACVIM guidance highlights not only the central role of diet in managing chronic enteropathy but also the potential value of microbiome-directed interventions," Albert Jergens, DVM, PhD, DACVIM (SAIM), of Iowa State University College of Veterinary Medicine, said in an ACVIM release.²

"With Visbiome Vet, clinicians have access to a probiotic supported by randomized clinical trial data, allowing them to offer an evidence-based adjunctive option when dogs do not respond adequately to elimination diets. The panel's conditional recommendation sets a high bar that most probiotic products do not meet."

According to the authors, 38% to 89% of dogs with CIE are food responsive, and many dogs maintain long-term clinical remission on dietary treatment alone for at least 3 months,³ making dietary modification as a test of treatment an adequate therapeutic starting point.

The guidance recommends for canine patients suspected of having CIE the following, among other things^1,3:

• Considering fecal culture exclusively in canines with specific risk factors, such as a raw meat-based diet. The researchers noted that a fecal microbiome analysis can offer veterinary professionals a way to create an individualized approach for their patients.
• Carrying out a thorough diagnostic evaluation to assess for signs of malnutrition or hypoalbuminemia. Canines with CIE, especially protein-losing enteropathy, are susceptible to malnutrition.
• Grading clinical disease severity according to disease activity scores on the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or Canine Chronic Enteropathy Clinical Activity Index (CCECAI), both of which are effective ways to distinguish canines suspected of CIE from healthy dogs.

“Complete dietary treatment trials should entail exclusive feeding of a therapeutic diet [ie, highly digestible, limited-ingredient novel protein, hydrolyzed protein, elemental protein, fiber enriched, low to ultralow fat, home prepared] exclusively for at least 2 weeks. The choice of therapeutic diet should be selected based on diet history, GI signs, and pertinent physical examination and diagnostic findings,” the researchers stated.³

“At least 3 trials with different diets should be considered, if possible. Owner guidance should be provided for adequate implementation of a diet trial, and clinical response monitored [using CIBDAI or CCECAI] at least weekly,” they continued.

References

1. Won C. Updated guidance on canine chronic inflammatory enteropathy discourages antibiotic use, encourages dietary trials. News release. February 23, 2026. Accessed February 25, 2026. https://www.avma.org/news/updated-guidance-canine-chronic-inflammatory-enteropathy-discourages-antibiotic-use-encourages
2. New ACVIM consensus statement highlights Visbiome Vet's De Simone Formulation in diet-first approach. News release. ExeGi Pharma. February 23, 2026. Accessed February 25, 2026. https://www.prnewswire.com/news-releases/new-acvim-consensus-statement-highlights-visbiome-vets-de-simone-formulation-in-diet-first-approach-302694840.html
3. Heilmann RM, Jergens AE, Kathrani A, et al. ACVIM–endorsed statement: consensus statement and systematic review on guidelines for the diagnosis and treatment of chronic inflammatory enteropathy in dogs. J Vet Intern Med. 2026;40(1):aalaf017. doi:10.1093/jvimsj/aalaf017