Issue Description Inflammatory bowel disease is a condition in
which the stomach and/or intestine is chronically infiltrated by
inflammatory cells. It is characterized by certain cells invading the
wall of the intestine. Other Names Inflammatory Bowel Disease
Causes The causes of inflammatory bowel disease are
not well understood. Usually, a cause is not found. The basic theory
is that "something" is leading to a chronic stimulus of inflammation.
This could be an allergy against a food protein, the continuing
presence of a parasite, inflammatory products produced by the normal
bacteria living in the intestine or there may be an underlying problem
with the immune system in affected individuals. Obviously, there may
be different causes in different individuals or a combination of the
possibilities listed working together. Most of the time an extensive
search for the underlying cause is not made.
Symptoms Many owners notice that their pets seem to have
vomiting or diarrhea a bit more often than it seems they should. It
might be subtle where one notices that one is cleaning up a hairball
or vomit pile rather more frequently than with previous pets or it
could be the realization that one hasn't seen the pet have a normal
stool in weeks or months. Typically, the animal doesn't seem obviously
sick. Maybe there has been weight loss over time but nothing acute.
There is simply a chronic problem with vomiting, diarrhea or both.
Inflammatory bowel disease is probably the most common cause of
chronic intestinal clinical signs and would be the likely condition to
Diagnosis If your dog has a history of frequent diarrhea
and/or vomiting and you suspect that he may have IBD, your
veterinarian should start by performing a thorough physical exam on
your pet. In most cases, dogs with IBD will not present with any
obvious problems upon examination besides potentially being thin. If
the disease is very severe, your vet may actually be able to
physically feel the thickened intestines via palpation. The next step
would be to perform blood work on your dog. Your veterinarian will
check to see if there is an increase in any of the enzymes from the
organs which surround the intestines, and also to see if there is an
increase certain cells of the immune system.
may also choose to x-ray your dog to rule out the possibility of a
tumour or other obstruction in the intestinal tract. It may also be
possible to visualize a thickened intestine on the x-ray. Each of
these tests is fairly non-invasive, and it is possible that your
veterinarian may feel confident in making a diagnosis of IBD based on
these findings alone. However, the only way your veterinarian can
diagnose this disease with absolute certainty is to perform a biopsy
on your dog. This will involve taking a small tissue sample from the
gut which is analyzed in the lab. While this procedure is considered
to be invasive, it can help to put minds at ease by providing you with
a definitive diagnosis.
Treatment Most dogs with true IBD require medication in
addition to dietary management to have complete resolution of
symptoms. If dietary management alone results in complete improvement
a diagnosis of IBD caused by an adverse reaction to food is made.
Diet Highly digestible diets are usually recommended
for dogs with IBD because nutrients from these diets are more
completely absorbed and the amount of diarrhea will be minimized.
Diets that contain a single protein source never previously eaten and
a carbohydrate source that is unlikely to be antigenic (such as
potato) may also be recommended. Commercial products are available or
your veterinarian can advise you on a homemade dog food recipe. An
appropriate diet must be fed for eight to twelve weeks before a
positive affect may be seen.
Fiber supplementation is recommended for IBD that affects the colon.
Dietary fiber improves stool consistency and produces fatty acids that
nourish the colon and discourage the growth of harmful bacteria.
Corticosteroids (aka steroids, cortisone,
prednisone) are the mainstay of therapy for IBD. Corticosteroids
inhibit the inflammatory process and reduce the inflammation within
the intestine. As steroids have potentially severe side effects, the
goal of therapy is to gradually adjust the dose to the lowest possible
amount that controls symptoms. Over time, many dogs can be weaned off
steroids completely and be maintained on diet alone.
There are several other anti-inflammatory medications available
and you should ask your veterinarian if any of them are right for your
dog. Metronidazole is an antibiotic that helps restore the normal
balance of intestinal bacteria and also has anti-inflammatory
properties. The beneficial effects of metronidazole can sometimes
reduce the dosage of steroids that are needed. Dogs with severe cases
of IBD often need more aggressive anti-inflammatory therapy.
Azathioprine, chlorambucil and cyclosporine are examples of drugs that
reduce inflammation by suppressing the immune system.
Some dogs benefit from antacid, anti-nausea or anti-diarrheal
therapy. Your veterinarian can advise if any of these are right for
Prognosis IBD can be controlled, but not cured. All
patients with IBD will require a strict diet and possibly
anti-inflammatory medication to manage their disease. Most dogs with
IBD do well for many years while others require alterations in therapy
every few months to treat flare-ups and recurrent symptoms.
Unfortunately, a few dogs will fail to respond to treatment and some
severe forms of IBD can progress to intestinal cancer.