Inflammatory Bowel Disease (IBD)
What is IBD?
IBD is a chronic condition in which the gastrointestinal system is inflamed and irritated. Many dogs and cats with IBD have a history of chronic vomiting and diarrhoea. IBD can also disrupt the absorption of nutrients and energy from food, leading to weight loss over time. Many of the IBD cases remain undiagnosed as many would attribute chronic gastrointestinal signs to their furbaby having a sensitive gut. This is usually not the case. IBD can be painful and a full work-up is highly recommended if your furbaby is often affected by recurrent bouts of gastrointestinal signs.
IBD is an interesting disease. Your body essentially sends white blood cells to infiltrate the gut lining. White blood cells aren’t usually a bad thing, but when they hang around for too long, they cause inflammation of the gut, resulting in vomiting and/or diarrhoea.
The severity of disease depends on how many white blood cells are hanging around. The clinical signs you see also depend on where they’re hanging out, that is, you are more likely to get vomiting if the white blood cells are in the stomach lining.
What are the signs of IBD?
IBD signs may include some or all of the following:
- Intermittent vomiting
- Loss of appetite
In more severe case, signs may include the following:
- Blood in stools
- Weight loss
What causes IBD?
The exact cause of IBD is unknown, however there are some factors believed to be associated with IBD:
- Breed genetics
- Immune system
- Environmental factors: stress and diet
- Microbial factors
What breeds are predisposed to IBD?
- French Bulldog
- English Bulldog
- German Shepherd
- Soft-coated Wheaten Terrier
- Norwegian Lundehound
- Yorkshire terrier
- Oriental breeds
- Domestic short/ longhair
How do we diagnose IBD?
Your vet may discuss IBD with you if your furbaby vomits or has diarrhoea on-and-off. It’s easy to dismiss your furbaby as “just really sensitive” but, if we can control IBD and minimise the number of times your furbaby gets sick, we’re more likely to manage your furbaby’s gut health better in the long-term.
IBD is a diagnosis of exclusion, so it’s important to rule out everything else that can cause vomiting and diarrhoea. That means keeping your furbaby up-to-date with prevention (to make sure it’s not worms causing all this trouble!). Intestinal lymphoma is a very common gut cancer in cats and can be especially difficult to tell apart from IBD in cats.
Some diagnostic tests that your vet may recommend are:
- A full blood test
- This helps us pick up any non-gut related issues like kidney/ liver diseases or hormonal diseases which can present similarly as IBD.
- A blood test for vitamin B12 levels
- Animals with IBD often have low Vitamin B-12 due to reduced absorption in the intestinal tract. Supplementation is usually required as Vitamin B-12 is very important to overall health.
- An abdominal ultrasound
- This helps us to assess for any abnormalities along the entire gastrointestinal tract or other organs which may have contributed to your furbaby’s clinical signs. It also helps confirm any abnormalities detected on blood tests or pick up an abnormality that the blood test may have missed.
- Dietary modification
- A moderately fat restricted, lactose-free and high fibre diet may benefit some cases of IBD. Proteins are often incriminated as the trigger of an immune response in many IBD cases. Many furbabies with IBD will therefore, improve on a hypoallergenic diet (a diet that is usually free of additives and preservatives, and contains an easily digestible novel protein), a hydrolysed diet (proteins that have been broken down so small that the immune system does not react to it) or a novel protein diet (a protein source that your furbaby has not had before). This usually involves putting your furbaby strictly on a special diet for 6-8 weeks (this means no treats/ other food). This is then followed by a re-challenging phase, where you introduce a protein source one at a time, each for a week, to identify what exacerbates your furbaby’s clinical signs. Some furbabies may also react to carbohydrates so a diet with a novel carbohydrate source may also deem helpful.
- A biopsy of the gut
- This is the gold-standard of diagnosis. It involves taking a sample directly from the affected gut. This is often done via an endoscopy (a procedure in which a camera is introduced into the body) because it is the least invasive procedure compared to a laparoscopy (a keyhole surgery) or an exploratory- laparotomy (an abdominal surgery). If this comes back positive, we can more confidently proceed with treatment.
How do we treat IBD?
It depends on the results from all the aforementioned tests. If we catch it early enough, we can manage IBD easily enough with a special diet, which minimises the amount of different food proteins that can set the gut off. Some furbabies do not respond to diet changes alone and may need immunosuppressive drugs to calm the gut down. Other furbabies may need antibiotics and/or probiotics.
If Vitamin B12 levels are low, we will often supplement them. The addition of probiotics and/or soluble fibre like psyllium can also promote a healthier gut microbiome and reduce the clinical signs of IBD.
The accurate treatment(s) of IBD heavily relied on all the prior testing that was carried out. Hence, the work up of IBD is often crucial and ever so important. We never want to treat a disease with pure guesswork because it can compromise the health of your furbaby. These tests also allow us to personalise your furbaby’s care, so your furbaby gets what is most important!
Will they get better?
IBD in dogs and cats may sound scary but it is a very manageable disease in most cases. Early diagnosis and long term management can yield excellent prognosis to ensure that your furbaby has a good quality of life. Therefore, if you suspect that your furbaby is prone to getting recurrent gastrointestinal signs like vomiting and/ or diarrhoea, please do not hesitate to contact your local veterinarian to get a full work-up for IBD.