What is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is a catch-all term. It is used to describe many conditions with similar signs but different causes. It can be quite confusing because IBD is also called, Chronic Colitis, Colitis, Irritable Bowel Syndrome, Lymphocytic-plasmacytic Inflammatory Bowel Disease, Regional Enteritis, Granulomatous Enteritis or Spastic Bowel Syndrome depending on what symptoms predominate.

Irritable Bowel Syndrome (IBS) is not the same as Inflammatory Bowel disease (IBD). IBS has many of the same symptoms. But in IBS, the intestines are hyperactive, not from irritation, but from excessive nerve stimulation. The stimulation is usually psychological and due to stress, fear or nervousness. It occurs in dogs and is similar to what occurs in humans.

Occasional intestinal and stomach disorders are very common in dogs . Most cases are caused by eating things your pet shouldn’t which usually cause a big mess and then correct themselves in a matter of days. But dogs with IBD have loose stools and diarrhea day after day.

In all forms of IBD, defense cells, accumulate in the walls of your pet’s digestive system. Sometimes this occurs because the pet is consuming things that do not agree with it or shouldn’t have been eaten. But just as frequently or more so, it is just that the pet’s body defenses have gotten out of synch and are mistakenly attacking compounds in the intestine that are really not a threat to the dog.

What causes IBD?

Some types of IBD are genetic and are associated with certain breeds. The lymphocytic/plasmacytic (LPIBD) form is one of these and the most common. It is most proliferant in German Shepherd and Shar Pei dogs. LPIBD describes the type of cells that pathologists see when they examine biopsies from the pet’s intestine. Some of these cells are always there, but it is abnormal when they are found in large numbers.

The second most common form of IBD is Eosinophilic IBD. It tends to be more severe than the lymphocytic form, but it often gets better when diet changes are made. Eosinophils are blood cells involved in allergies – so food allergies are a suspected cause. These are the cases where changing the protein sources in your pet’s diet helps most. Some dogs are not really allergic to food ingredients that bother them. It is their inability to digest or absorb certain nutrients (maldigestion-malabsorption) that leads to intestinal upset every time they are exposed to the ingredient(s). This is sometimes called mal-assimilation syndrome as well.

What happens in IBD?

When things irritate the lining of your pet’s intestine, they cause food to move through it faster. With time, this irritation causes the lining to thicken and become inflamed. Blood and tissue cells that normally fight bacteria and other invaders, accumulate within the lining of the inflamed intestines causing cramping, pain, colic, diarrhea and distress. These fragile intestines are more likely to bleed and they allow unhealthy intestinal organisms to proliferate and displace the healthy ones. These changes also make it harder for your pet to absorb nutrients from its food. When the beginning portions of the intestine are involved, the pet may also vomit or loose its appetite. When the final portions of the intestine are involved, the stool is loose, frequent, watery and sticky with mucus. Bright blood is often present when the lower intestine is involved (colitis).

These problems can be occasional or continuous. When they are continuous, pets often loose weight. It is also common for dogs with this condition to eat or chew on unusual items (pica) and it can be difficult to decide if pica is the cause or result of the problem.

What are the signs of IBD?

The most common complaint is persistent loose stools, straining and diarrhea. This occurs because the intestine is moving too fast and not given time to remove enough water from the things your dog ate. Irritation of the colon and anus causes the straining.

Dogs with this problem can also vomit. Some vets include conditions that cause stomach irritation and vomiting in the IBD complex whilst otherscall those conditions gastritis . When vomiting occurs with IBD, it is due to inflammation in the upper small intestine just below the stomach. It is possible for a pet to have both conditions simultaneously.

Certain things hint as to what portion of the digestive tract is most inflamed. When vomiting and infrequent, bulky loose stools and weight loss predominate, we tend to think of a problem high in the intestine. When frequent smaller stools, straining, blood or mucus-flecked stools occur, we tend to think of a problem lower down in the intestines. Most often, a bit of both is occurring but one predominates.

Flatulence is also a common problem and so is a dull hair coat and heavy shed. When the lower intestine or colon is inflamed, the pet may strain and defecate more frequent, mucous-covered, stools.

Dogs with the high form may run low fevers. The may also have secondary bacterial intestinal infections. In general, pets with the high form of IBD look more ill.

What tests will my vet run?

Generally, the vet will start with a fecal sample examination to rule out parasites and some blood work to rule out pancreatic, liver or other systemic disease as the cause.

In most cases of IBD, the blood work results are normal. If the problem is long standing and severe, your pets total blood protein level may be low due to its inability to absorb nutrients and leakage out through the intestinal wall. Occasionally it’s globulin level will be elevated. If the pet has been vomiting persistently, its blood potassium level may be low. A few pets will have an increase in their WBC eosinophil numbers – a possible hint at a food sensitivity or parasitic problem.

When the results of those tests come back negative, most vets will try modifying your pet’s diet and perhaps putting the pet on a medication.

If diet modification and temporary medications do not solve the problem other tests must be run often including an x-ray and abdominal ultrasound to rule out other potential causes. The only test that gives a clear yes-no answer to an IBD diagnosis is an intestinal biopsy.

What treatments will help my dog?

All the treatments for IBD try to decrease inflammation in the intestines. Some are aimed directly at the immune system itself, some at slowing down intestinal motility, some at coating and protecting the lining of the intestine and some at limiting specific diet ingredients that are irritating your pet’s digestive system. None of these techniques will permanently cure your pet but they often help manage the problem.

What about diet changes and special diets?

You should always try diet changes before resorting to medications to manage IBD. It is rare that diet changes alone will be enough. But limiting your pets food to the things that are easiest for it to handle will allow you to use less medication.

Many highly digestible, hypoallergenic and bland diets are commercially available or can be prepared at home .These diets should be free of preservatives, additives and coloring agents. They should either contain an unusual protein source such as cheese, rabbit, venison, cottage cheese or duck or contain proteins that are hydrolyzed into small non-antigenic component molecules (HA, z/d, etc.). It can take up to several months to see improvement.

Sometimes high fiber diets are helpful. Again, they are available commercially (OM, r/d etc). You can also add fiber to your current diet. Increased fiber does not help all pets with IBD. Some do better when the fiber content of their diet is actually reduced.

Some dogs with IBD have less diarrhea when the fat content (or source) in their diet is reduced. High fiber diets, designed for pet to loose weight are also lower in fat.

Can my dog be cured?

Dealing with IBD in a pet requires a great deal of patience and dedication.

Occasionally, owners see the problem go away with, or without treatment. In these cases, the problems was probably not true IBD in the first place. In true IBD, we can control the problem, but we can not cure it. This is because the underlying biochemical defects that make your pet prone to the problem are not understood. But once you have worked out a special nutrition and life-style plan for your dog, it is a problem you both can live with. There will probably be flare ups when medications will be needed. In some pets, we see the best results when you give medications continuously.

Because there is often an underlying genetic element in this disease, you should never breed from a dog with IBD.

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