Fat-Soluble Vitamin Deficiency in Intestinal Malabsorptive and Maldigestive Diseases: Do We Need to Worry?

摘要

Malabsorptive and maldigestive diseases are common presentations in veterinary internal medicine. These diseases can result in nutrient and vitamin malabsorption, which can negatively impact health and interfere with control of the underlying diseaseprocess. For example, cobalamin deficiency is the most well-recognized vitamin deficiency that occurs in dogs and cats with exocrine pancreatic insufficiency and chronic enteropathy.13 Patients with these conditions may not fully respond to other therapies until cobalamin is supplemented.4 Therefore, routine practice is to measure serum cobalamin in all patients diagnosed with EPI and chronic enteropathy, and provide supplementation as necessary. Similarly, a high prevalence of vitamin D deficiency exists in dogs and cats with IBD, but no guidelines for routine measurement and supplementation currently exist. Additionally, a high prevalence of vitamin K deficiency in cats with inflammatory bowel disease (IBD) has been suggested by a single study.5 Vitamins A, D, and K are important in the regulation of inflammation, and vitamin D deficiency can predispose animals to experimental intestinal inflammation. Therefore, should we also be routinely measuring and supplementing vitamin D and other fat-solublevitamins in patients with gastrointestinal diseases?