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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

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Inflammatory Bowel Diseases, or IBD, is the most common cause of chronic vomiting and diarrhea in cats and dogs. In addition to the discomfort caused by the symptoms, pets with IBD also suffer significant nutrient deficiencies. Although this condition is without a cure, nutritional strategies may help control the symptoms and potentially decrease the dosage of drugs needed for this condition.

What is IBD?

IBD is an idiopathic condition. In med-speak that means we have no real clue to its cause, so we are left with speculations. The condition is characterized by an abnormal immune response in the innermost layer of the stomach and intestines, called the mucosal lining. The mucosal lining is responsible for regulating the digestion and absorption of food. The abnormal "invasion" of infection fighting white blood cells interferes with those functions, resulting in the symptoms of vomiting and/or diarrhea, depending on the location of the condition in the gut. Pets with lesions in the stomach or upper intestines typically vomit, while those with lower bowel involvement exhibit chronic diarrhea.

It is speculated that the disease is an over-reaction of the immune system to the normal intestinal bacteria. This is supported by the fact that the administration of antibiotics directed at gut bacteria is often helpful. Abnormal immune response to food proteins is also speculated. Improvement with limited protein diets or elimination diets supports this theory.

As the condition progresses, antibiotics and dietary changes become less effective and these pets are treated with corticosteroids, prednisone, or prednisolone, and in retractable cases chemotherapeutic drugs like azathioprine.

Nutritional Strategies for IBD in Pets

Disruption of the digestive and absorption processes by the exaggerated immune response causes multiple nutritional deficiencies.

Many of these pets experience significant weight loss due to the inability to absorb adequate calories and protein. The lack of adequate absorption of magnesium and iron can result in decreased muscle and nerve function and anemia. Zinc deficiency exacerbates diarrhea. Generally the gut bacteria produce adequate amounts of vitamins B12 and K. For pets with IBD this is not the case. B12 deficiency can enhance the level of anemia and K deficiency can prolong blood clotting function and promote bleeding and blood loss in IBD patients.

Increasing the protein levels in diets and supplementing with multiple vitamin and mineral supplements may help these patients. The protein source should be novel (venison, duck, salmon, etc.) or hydrolyzed. Injectable vitamin and mineral supplements may also be necessary for pets with advanced disease.

IBD patients also exhibit antioxidant deficiencies. Free radical production increases with inflammation, and deficiencies of the vitamins A, E, and C, and antioxidant defensive minerals zinc, manganese, and copper accelerate oxidative damage. Supplementation with antioxidants has shown to be effective in reducing intestinal damage.

The use of pre- and probiotics to treat IBD has received much attention. Results are conflicting but consensus is that quality pre-biotics increase the population of beneficial gut bacteria that may aid IBD patients. The amount of beneficial bacteria found in probiotics has yet to be defined for IBD patients. Veterinary products are thought to be low quality, so human products may be a better supplement choice.

Increased levels of omega-3 fatty acids in the diet can decrease destructive inflammatory responses and have shown to be effective in humans. The benefit has yet to be proven in the IBD of pets and there is presently no established dosage of fish oil for these patients. I, however, continue to treat these patients with fish oil.

Despite mostly anecdotal evidence for dietary manipulation to treat IBD, I expect greater nutritional interventions strategies as more research is conducted.

Dr. Ken Tudor

Image: Creativa / via Shutterstock

Comments  7

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  • IBD
    11/01/2012 07:04am

    It makes sense that if food doesn't stay in the body long enough, the nutrition won't have time to be absorbed.

    Have you ever had an IBD patient cured of IBD or is it a chronic condition that will always progress?

  • TheOldBroad
    11/01/2012 10:29am

    Cured-No; Various levels of stable management-Yes. My experience is early in the disease dietary management works adequately, but eventually immuno-suppressive therapy is necessary. Part of the reason is that the disease viewed at the tissue level can look like food sensitivity at one point to looking like lymphosarcoma cancer at another and range between the two extremes at other times. Where the individual animal will spend most of it's time on this scale is not predictable, nor is the level of medical intervention.
    Dr. T

  • 11/01/2012 11:11pm

    Thanks for this post. I'm always seeking more information on IBD and allergies. My dog is atopic, has mild IBD, and probably has food allergies too. (He is an otherwise very healthy 10 year old.) A hydrolyzed protein diet (along with Atopica and fluconazole) is working well to control his symptoms. Methyl pred is needed occasionally to help with flare ups. He gets fish oil too, but I honestly haven't seen that it makes any difference. Friends say I should try a raw diet, but it's been so hard to get these issues under control that I am scared to rock the boat.

    What does "retractable cases" mean?

  • 11/02/2012 01:40am

    Jasmine was diagnosed with IBD at the age of 5.5 when she was in for x-rays of her joints. The new vet we turned to then, decided to do further examination while she was under and discovered a mass in her abdomen. It felt like a mass and it showed up as one on additional x-rays also. It was very scary.

    Eventually, after bunch of testing, exploratory surgery and biopsy it turned out be eosinophilic gastroenteritis. Her digestive tract was in a very poor shape. This was not diagnosed this late due to our lack of trying. She's had problems since she came to us and we were at the vet's at least once a month. Yet, no diagnosis was made and was only treated with repeated courses of antibiotics and put on i/d which didn't do anything for her.

    Now, on a home-cooked diet, with lots of supplementation, she is doing quite well. Even likes eating now, which she did not before.

  • KLD
    11/02/2012 10:13am

    Retractable is med-speak for problem cases that don't respond predictably and have frequent relapses of symptoms often with increasing severity.
    Dr. T

  • IBD or no IBD?
    03/06/2013 10:08am

    My 7 mo. old GSD (imported from Germany) is presenting with dull,progressively thinning coat, no weight gain in 2 weeks, seemingly poor food absorbtion....but NO chronic vomiting and/or diarrhea! Blood test showed high eosinophil levels (1.55). He has been wormed and is now on Heart Gard. My vet also prescribed prednisone (20mg) 35 tabs, decreasing doseage over 30 days.
    Something is definitely going on in his gut BUT he is not vomiting and his stools are formed...so is it possible that his immune system (via eosinophils) is just over-reacting to the rich, high protein content of his Orijens puppy food? (Ingredients: Boneless chicken, chicken meal, chicken liver, whole herring, boneless turkey, turkey meal, turkey liver, whole eggs, boneless walleye, whole salmon, chicken heart, chicken cartilage, herring meal, salmon meal....)
    Would the intestinal bacteria in a dog from Germany be different? Should I go for a food lower in protein?

  • Tom Payne
    03/08/2013 10:19pm

    These questions are more appropriate for your veterinarian that has benefit of a physical exam, blood work and and hopefully other diagnostic information as well as a working diagnosis or presumptive diagnosis.
    Dr. T

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