The gastrointestinal tract is a highly complex and delicate system that allows your pet to function properly and is responsible for a lot of functions, such as the proper mixing of digestive enzymes and nutrients. Because the GI tract is highly delicate and complex, it also often comes under attack, due to various afflictions, such as inflammatory bowel disease.
What is Inflammatory Bowel Disease?
As we established, one of the primary purposes of the GI tract is the absorption and proper transportation of dietary nutrients. Inflammatory bowel disease is when inflammation cells get called into the GI tract, disrupting the movement and absorption of nutrients. Typically, these cells are involved in immune responses, and shouldn’t be inside the dog’s delicate GI tract. Their presence here, through IBD, leads to weight loss, diarrhea, vomiting, and other similar symptoms.
The symptoms exhibited by your dog will depend on where exactly the foreign cells came in. For instance, if the infiltration occurred in the stomach or higher areas of the small intestine, it’s likely your dog will experience chronic vomiting. Watery diarrhea, coupled with weight loss, indicated infiltration in the lower small intestine, and mucous diarrhea suggests infiltration in the large intestine.
Caution: don’t confuse inflammatory bowel disease (IBD) with irritable bowel syndrome (IBS). Although the two sound similar, IBS is stress-related, while IBD, as we’ve seen, is not.
Causes of IBD
Inflammatory bowel disease occurs when inflammatory stimulants penetrate the intestinal tract. Most commonly, these include toxic materials produced by bacteria living inside the bowel, parasites, the bacteria themselves, or some digestive proteins.
Inflammatory bowel disease can be tricky to diagnose, especially since symptoms are very similar for several gastro-intestinal diseases. This is why IBD is often diagnosed by a rule of exclusion (diagnosis of exclusion). This means that all other potential diseases have first been excluded, which logically suggests IBD is the culprit.
Usually, pet owners end up in the vet’s office after seeing more frequent vomiting and/or diarrhea in their pet. While both these behaviors are normal for most pets, try to gauge how often they occur. If you find yourself constantly cleaning up after your pet, and/or haven’t seen them have normal stools recently, this may be a good sign you need to visit a vet at your nearest convenience.
The thing is, many animals with IBD won’t exhibit any other symptoms than the one outlined above, so it can be tricky to catch on that something is wrong. There may be weight loss, but usually, it won’t be pronounced, or acute, so keep an eye on your pet’s habits.
Your vet will begin exploring causes before they pass a definite IBD diagnosis.
Step-by-Step IBD Diagnosis
The first thing your vet will do will be to establish a metabolic database. To do this, they will need to run a basic blood panel and urinalysis, which rules out biochemically widespread problems (e.g. liver disease, pancreatitis, kidney disease, etc.). For cats, hyperthyroidism may also be the cause of similar symptoms to IBD. This will establish the level of blood proteins, which in turn can indicate the location of the issue. The metabolic database will also tell your vet more about different areas of concern in your pet’s body, which may determine the treatment course later.
The vet will also perform fecal testing and deworming, to rule out parasites. They will also perform a trypsin-like immunoreactivity test, to rule out pancreatic exocrine insufficiency. This, alongside Addison’s disease, requires its own specific test to be ruled out. The vet may also order an upper-body ultrasound, so prepare yourself for excessive testing.
How is IBD treated?
This depends on your pet. If the patient is deemed stable (has a normal B12 level, isn’t losing weight rapidly, has a normal appetite, blood levels, etc.), the vet can try multiple treatments, to see which works best.
There are three types of IBD:
- Antibiotic responsive;
- Food responsive;
- The steroid is responsive.
Antibiotic-responsive IBD is usually treated through a 2-week trial of metronidazole/tylosin, followed by an additional 4-week treatment window, if the patient responds well. Some patients may require indefinite antibiotic treatment if symptoms reappear after the initial treatment period.
Food-responsive IBD is the easiest treatment option, as it brings about positive results through diet alone. For this, we use hydrolyzed protein diets, in which the “predigested” proteins are too small to irritate the GI tract. We also focus on helpful omega 3 and omega 6 acid levels.
Dietary treatments may also expose the patient to novel protein sources (foods the patient has never experienced, such as duck, venison, rabbit, etc.), in the hope that he can’t have an adverse reaction to this new source. Dietary treatments usually take up to 12 weeks to complete.
Steroid-responsive IBD is the most aggressive treatment form, only to be used when the patient hasn’t responded to either dietary or antibiotic treatments. A trial course of corticosteroids (prednisolone or dexamethasone) is used for about a month, followed by more intense immunosuppression steroids, in case of poor results. Of course, long-term immune-suppression treatment is not recommended without the appropriate tests.
These are the options for a stable patient. The unstable patient, on the other hand, will require more aggressive intervention. The unstable patient is a pet who is losing weight rapidly, lacks appetite, suffers from B12 deficiency, and has low blood protein levels. In this case, the vet will do a biopsy to confirm the IBD diagnosis, which will either be done by surgery or endoscopy.
While this will diagnose the animal more quickly, it is an expensive and invasive procedure. While it may be costly to have all these tests done to determine a secure IBD diagnosis, going ahead with treatment without a proper diagnosis may do more harm than good. For instance, if you try going back later with tests, you may find the results altered by the treatments already used. So in the end, the testing is worth it, if your vet thinks you may be dealing with IBD.