2001-Wed Aug 15 09:35:12 EDT 2018
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Does your cat vomit every week? Can’t remember the last time your dog had a firm stool? Does your pet seem to be losing weight for no apparent reason? Though these signs could indicate any number of conditions, they are also commonly seen in pets with an inflammatory bowel disease (IBD).
If your pet is showing gastrointestinal (GI) signs, it’s important to schedule an exam with your veterinarian as soon as possible.
Inflammatory bowel diseases are the most common cause of chronic vomiting and diarrhea in dogs and cats. The term IBD is used to describe a group of conditions characterized by inflammation of the gastrointestinal tract and persistent or recurrent GI signs.
Because IBD can affect any or all parts of the GI tract, the signs can vary in frequency and severity. Common signs include vomiting, diarrhea, flatulence, gurgling or rumbling intestinal sounds, decreased appetite, and weight loss.
Although the exact cause of IBD is not known, it is believed to involve a number of factors including genetics, the pet’s environment, the intestinal immune system and intestinal bacteria.
First, your veterinarian will want to rule out other possible causes, including metabolic diseases, such as liver or kidney disease, infectious diseases, GI obstructions, parasites and cancer. After a thorough history and physical exam, your veterinarian may recommend blood tests, a urinalysis, a fecal exam and possibly diagnostic imaging, such as X-rays or an abdominal ultrasound.
If no other causes for your pet’s GI signs are found, your veterinarian may suggest an intestinal biopsy, which is the only way to confirm a diagnosis of IBD. However, if your pet is stable, it may be possible to reach the diagnosis by excluding other potential GI causes.
A food trial may be initiated to help determine if the pet has an allergy to the protein in the diet or intolerances to other dietary substances, such as food colorings or preservatives.
Typically, pets are fed a novel protein diet or a hydrolyzed diet. A novel protein diet is comprised of a single protein source the pet has never been exposed to before, such as venison, rabbit, kangaroo or white fish. A hydrolyzed diet is one in which the protein is broken into very small pieces which are unable to be recognized by the body’s immune system.
During a diet trial, it is important that your pet is not given any other types of protein, including treats and flavored supplements. It can take up to four to six weeks to see a dramatic improvement, however, some improvement should be noted within two to three weeks of initiating the new diet.
If a pet fails to improve on a diet trail, then a diagnosis of IBD is more likely. Some patients with IBD will have a food allergy/intolerance component, so their signs may improve but will not completely resolve.
In some pets, GI signs may be associated with an imbalance of the normal bacteria in the digestive tract. In other words, there are fewer beneficial bacteria and more harmful bacteria. An antibiotic trial may be initiated to try to bring the bacterial population back into a normal balance.
Patients who fail to improve on either diet or antibiotic trials are typically diagnosed with IBD by exclusion.
Ideally, GI biopsies are obtained to confirm an IBD diagnosis and to rule out cancer that cannot be identified on ultrasound. While samples can be obtained with an abdominal surgery, a less invasive method is via endoscopy while your pet is under anesthesia. During this procedure, a thin tube with a small camera is inserted down the throat into the stomach and small intestine, or through the rectum into the intestine, where small tissue samples can be removed for analysis.
IBD treatment typically entails immunosuppressive therapy, such as steroids, to decrease and eliminate GI inflammation. If an animal’s GI signs improve but do not resolve on steroids alone, additional immunosuppressive therapy may be considered.
Depending on your pet’s condition, your veterinarian may also recommend additional treatments, such as therapeutic diets, antibiotics, vitamin B12 injections or probiotics. If there’s still no improvement, a consultation with a veterinary internal medicine specialist may be helpful.
In most cases, IBD is not cured, but the condition can usually be managed. With treatment, many pets will show fewer GI signs, although the signs may wax and wane. By working closely with your veterinarian, you can monitor your pet’s signs and manage the disease to help your pet have the best quality of life possible.
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