Updated: 1/8/23

Understanding Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic digestive condition in dogs and cats that occurs when the body's immune system attacks the intestinal lining, causing inflammation, irritation, and damage to the intestinal tissue. This can lead to symptoms such as vomiting, diarrhea, weight loss, abdominal pain, and poor appetite. The exact cause of IBD in animals is unknown, but it is believed to be related to a combination of genetics, environmental factors, and diet. Treatment for IBD typically involves a combination of dietary management, medication to reduce inflammation and suppress the immune system, and close monitoring by a veterinarian. 

Symptoms

In addition to vomiting, diarrhea, weight loss, abdominal pain, and poor appetite, other symptoms of IBD in pets can include:

• Flatulence (excessive gas)

• Dehydration

• Lethargy (low energy)

• Poor coat condition

• Anemia (low red blood cell count)

• Loss of muscle mass

• Rectal bleeding

It is important to note that the symptoms of IBD can vary greatly between patients and can be similar to those of other digestive disorders, so a thorough veterinary examination is necessary to make a proper diagnosis.

Diagnosis

The diagnosis of IBD in dogs and cats typically involves a combination of the following methods:

1. Physical examination: A thorough physical examination by a veterinarian can help identify any signs of abdominal discomfort or pain. In addition, because the clinical signs of IBD are vague, the goal of the physical exam is to look for other potential causes of your animal's clinical signs, such as cancer, liver failure, etc.

2. Blood tests: General bloodwork can help check for evidence of other possible causes of a patient's clinical signs, such as liver or kidney failure. Bloodwork may also show signs of inflammation, anemia, and infection, although these findings are not specific to IBD. Specialized bloodwork can be performed to evaluate for vitamin absorption or to look at pancreatic inflammation or function.

3. Fecal testing: Evaluation for intestinal parasites or empiric treatment is important as these parasites can cause similar clinical signs to IBD.

4. Imaging studies: Imaging studies such as X-rays and ultrasound can provide images of the digestive tract and help identify any structural abnormalities that may be contributing to symptoms. The majority of pets will have normal imaging studies but in cases where another cause of the clinical signs is found, these tests are invaluable in avoiding extensive diagnostics for the wrong disease. For example, an intestinal mass may cause all the same signs as severe IBD, but the treatment and prognosis would be completely different.

5. Endoscopy: Endoscopy is a diagnostic procedure that involves inserting a flexible, lighted tube with a camera into the digestive tract. This allows the veterinarian to visualize the interior of the gut and obtain biopsy samples for further analysis. Unfortunately only a small portion of the entire intestinal tract can be visualized, and we also cannot obtain samples on the outside of the intestines. Therefore ultrasound is a valuable tool to guide us towards endoscopy vs. surgical biopsies.

6. Biopsy: A biopsy is the removal of a small piece of tissue for laboratory examination. Biopsy samples of the intestinal lining are often necessary to diagnose IBD definitively.

It is important to note that IBD can be a difficult condition to diagnose and that a comprehensive diagnostic approach is often necessary to arrive at a definitive diagnosis.

Treatments

Treatment for IBD in dogs and cats typically involves a combination of the following:

1. Dietary management: Changing to a highly digestible, low-fat diet can help reduce inflammation and improve symptoms in some pets with IBD. Other animals may have developed a food allergy throughout their lifetime, leading to the body reacting to certain proteins as if they were invading agents and causing the inflammation seen in IBD. 

Diet trial

A diet trial is a common diagnostic tool used in the evaluation of patients with suspected IBD. The goal of a diet trial is to determine if dietary changes can improve the dog's symptoms. About 50% of dogs will respond to a diet trial, and therefore their disease would be considered a "food responsive enteropathy". Other dogs or cats with IBD may improve with a change in their diet but their signs may not resolve completely.

Here is how a diet trial typically works:

1. 1. Change to a novel protein source: Your veterinarian may recommend switching to a diet that contains a protein source that your pet has not previously been exposed to, such as duck or fish. This helps eliminate any potential food sensitivities or allergies that may be contributing to symptoms. There are also hydrolyzed diets which take the protein source and process them into smaller sections so that the body can no longer recognize them as the original protein. A dismantled engine cannot be identified from a single screw.

   2. Avoid treats and table scraps: During the diet trial, it is important to strictly avoid giving any treats or table scraps. Any deviations from the prescribed diet can compromise the results of the trial. Even a small lick of another housemate's food, or a scrap of food from the street can cause inflammation within the intestinal tract and negate the results of the diet trial.

   3. Monitor for improvement: Over the course of the trial, which typically lasts 3-4 weeks, your veterinarian will closely monitor for improvement in symptoms. If there is significant improvement, this may support a diagnosis of IBD.

2. Medications: Anti-inflammatory drugs, immunosuppressive drugs, and antibiotics can be prescribed to reduce inflammation, suppress the immune system, and treat any secondary infections.

3. Probiotics: Supplementing the diet with probiotics, which are beneficial bacteria, may help improve gut health and reduce symptoms in some dogs with IBD.

It is important to note that IBD is a chronic condition, and long-term management and monitoring by a veterinarian is necessary to keep symptoms under control. The specific treatment plan for your pet will depend on the severity and type of IBD, as well as your animal's individual needs and response to treatment. Some clinical signs will resolve completely but many patients will continue to have flare-ups of their disease throughout their lifetime. The goal of therapy is to reduce the severity and frequency of clinical signs and improve quality of life. IBD is a disease that is managed but not necessarily cured, and it is important to go into treatment with realistic expectations. Just like IBS or Crohn's disease in humans, it can take a lot of work to help improve clinical signs but with the right tools and a good amount of effort many animals can live fairly normal lives with their disease. For a more in-depth discussion of IBD treatments, visit this link: https://www.askavetspecialist.com/articles/cat-and-dog-ibd-treatments