Inflammatory Bowel Disease or IBD in Dogs

Inflammatory Bowel Disease – also called IBD- is a disease that targets the gastrointestinal tract of dogs. When a dog has IBD the gastrointestinal tract will become so inflamed that it is unable to function properly to digest and absorb nutrients. IBD is the most common gastrointestinal disease seen in dogs and makes up nearly half of all cases of chronic vomiting and loose stools. IBD can come in many different forms and can affect both the small or the large intestine – making both treatment and response treatment variable. At this time there are three known causes of Inflammatory Bowel Disease in Dogs – Genetics, Environmental, and the Immune System.

CLINICAL SIGNS OF IBD IN DOGS:

• Chronic intermittent vomiting
• Diarrhea
• Picky eater
• Nausea
• Lip licking
• Drooling
• Burping
• Flatulence
• Rumbly Tummy
• Heartburn
• Bloating

Causes of IBD in Dogs

There are three main factors that veterinary researchers have associated with gastrointestinal inflammation and may cause IBD in dogs: genetics, environmental, and immune response.

GENETICS

Certain breeds have been associated with specific types of inflammatory bowel disease more than others. These include: softcoated wheaten terriers, basenji, french bulldogs, german shepherd, norwegian lundenhund, and yorkshire terriers.

Though the exact genetic mutation has not been identified in dogs, research has identified a correlation between TLR mRNA expression and the severity of IBD in dogs.

ENVIRONMENTAL

The main possible environmental triggers for IBD in dogs are: stress, diet and pharmaceuticals (mainly antibiotics). All three of these factors influence the microbiome of the dog in a negative way, and research has shown that a certain composition of microbiome is seen in dogs with IBD.

Dogs with inflammatory bowel disease typically have a microbiome with decreased firmicutes bacteria (clostridia and bacilli), decreased bacteroides, decreased clostridium, and increased enterobacteriaceae (e coli and pseudomonas).

IMMUNE SYSTEM

Some dogs with IBD will have issues with their immune system – basically, the IgA receptors – which are supposed to function to defend the body against harmful bacteria within the gastrointestinal tract no longer do their job well. This creates little gaps between the cells that line the intestines that allow things like e. coli to go where it shouldn’t.

Once e. coli (or another particle) passes through the cells that line the intestine the T helper cells (which respond to remove foreign invaders) respond and secrete proinflammatory cytokines – causing the entire gastrointestinal tract to become inflamed.

Diagnosis of IBD in Dogs

Probably one of the hardest parts of inflammatory bowel disease in dogs is the diagnosis. There are many different diseases and conditions that affect the gastrointestinal tract and can cause the clinicals signs of IBD in dogs.

Ruling out other Disease or Conditions

The first thing most veterinarians will do when a dog presents with gastrointestinal problems where they suspect a dog may have IBD is rule out other diseases or conditions. These will be things like parasites, pathogenic bacteria, fungi/algae, cancer, anatomical abnormalities, organ disfunction, foreign body (things like rocks, bark, even pieces of toys or chews), food allergies, or dietary indiscretion.

Typically this will involve a series of diagnostic testing, and depending on clinical signs and severity of those clinical signs veterinarians may start to aggressively perform these tests, or they may perform them slowly over several days/weeks.

Diagnostic Tests:

• Stool Sample – Fecal Test with Antigen Testing for Giardia and Cryptospordium
• Blood Sample – Complete Blood Cell Count, and Blood Chemistry
• X-Rays
• Ultrasound with possible Fine Needle Aspirate
• Endoscopy with Mucosal Biopsy
• Histopathology

Due to financial reasons many dogs are actually never diagnosed with IBD – most dogs do not undergo the final Endoscope with Biopsy and Histopath. Instead, a dog may be diagnosed with IBS after having clinical signs for about 3-4 weeks and started on treatment prior to diagnosis.

Nutritional Management of IBD in dogs

The hardest part of dietary management of IBD in dogs is that there are no “general” recommendations for ALL dogs. Depending on the area of the gastrointestinal tract which is affected, and the individual dog’s response – one dog may do extremely well on one food or composition – where another dog will do poorly.

The general idea of nutritional management is to calm down inflammation, provide highly digestible sources of nutrients, and balance the microbiome.

Dietary Management of IBD in Dogs

NOVEL PROTEIN OR HYDROLYZED PROTEIN DIET

Many dogs that have IBD struggle with an over-active immune system due to inflammation within their gastrointestinal tract. There are two ways to help mitigate this issue – first is by using a novel protein diet (or a diet containing ingredients that the dog’s immune system has never seen before), and the second is a hydrolyzed protein diet (where the proteins within the diet have been split into smaller pieces, making them less recognized by the immune system and easier for the body to digest). Both of these options often can help calm the immune system and decrease inflammation within the GI tract.

HIGHLY DIGESTIBLE CARBOHYDRATE or LOW CARBOHYDRATE

Another issue that many dogs have with IBD is that their gastrointestinal tract is so inflamed that it cannot digest carbohydrates as well as it used to. There are two known ways to combat this issue – one is to provide highly digestible carbohydrates (this may be simple carbohydrates such as white rice rather than complex carbohydrates like brown rice). The second way is to remove carbohydrates from the diet completely – providing a diet that is higher in protein and fat instead.

LOW FAT

Since there is so much inflammation within the gastrointestinal tract dogs with IBD can also have issues digesting fat. If a dog has sensitivities to fat, diets may need to contain more carbohydrates or protein in order to allow for the decreased fat within the diet. Unlike the case of pancreatitis where fat sensitivity is related to inflammation within the Pancreas which causes issues with the release of digestive enzymes, in IBD this fat sensitivity is related to inflammation within the gastrointestinal tract itself. Digestive enzyme production is normal, the food is just not able to be absorbed by the body.

SOLUBLE and FERMENTABLE FIBER

The addition of soluble or fermentable fibers is often recommended for dogs that have IBD because it is an excellent source of prebiotics for dogs. It is important to note that when it comes to fiber there is such thing as “too much of a good thing” – and if you give too much soluble fiber to a dog it can actually cause loose stools.

But why soluble and fermentable fiber? Soluble, fermentable fiber actually produces butyrate which is a source of energy for the cells within the colon and short-chain fatty acids. Thus it indirectly helps with the repair of the colon, and the SCFA actually helps reduce inflammation within the GI tract!

VITAMINS AND MINERALS

Due to digestibility issues associated with IBD many dogs with the condition will suffer from vitamin and mineral loss associated with the condition. For these dogs, additional supplementation may be needed during flares. The most common supplemental vitamins that are needed are B Vitamins – such as Vitamin B12, and minerals such as Magnesium

PROBIOTICS

Several studies have been done looking at the benefits of probiotics for dogs with IBD. However results have been variable, and in both studies, probiotics were given as an adjunctive therapy, not a stand-alone treatment. The most promising results were seen with a multi-strain highly concentrated probiotic capsule (containing 8 different bacterial strains and a concentration of over 100 CFU), rather than a single strain probiotic.

OMEGA 3 FATTY ACIDS

Though there has been some research in humans suggesting the use of omega 3 fatty acids (fish oil) for help with IBD, at this time there is no good supportive research of this in dogs. Due to possible issues with fat sensitivity for some dogs – it is not generally recommended to help with disease management.

Antibiotics:

Typically dogs with antibiotic responsive enteritis will resolve once treated once with a long course of antibiotics (usually tylosin or metronidazole). However, a select few (16%) will relapse after treatment is discontinued. These dogs are can be kept on a dose of tylosin long-term in order to help manage symptoms of the disease, however, more severe interventions may be needed.

Steroids:

Of that 16% of dogs that do not respond to antibiotic treatment, 50% of them will respond to the use of steroids in order to help with inflammation within the body. Steroids are usually the last effort used in order to control the symptoms of the disease, however, even with steroid use, 4% of dogs will be unresponsive to treatment altogether.

Alternative Therapties:

Acupuncture: There is some research to support the use of acupuncture to help with inflammation within the body by using a “neuroanatomically directed needling protocol” which basically stimulates the parasympathetic nervous system to reduce inflammation with the body. (1,2) 

Herbal Therapies: Though there is limited research that has been performed on dogs there is some research that has shown that the following herbs can assist in decreasing inflammation associated with IBD or Crohn’s Disease in people.

• Plaintain leaf (Plantago spp.)
• Licorice root (Glycyrhizza glabra)
• Boswellia serrata
• L-Glutamine

A majority of dogs with IBD will respond favorably to nutritional management alone (about 60-70%), however, a small portion of dogs with IBD will require more serious and aggressive management strategies long-term OR may require chronic treatment with more intensive methods during “flares” of the disease. These options include antibiotics and steroids – neither of these strategies are usually employed for long-term management unless other avenues do not work to manage the disease.

If you have a dog that is suffering from chronic gastrointestinal issues one of the best things you can do is have them see a specialist. For most gastrointestinal diseases this would fall under the category of Internal Medicine Specialists – if you live in a large city these specialists are often employed at larger veterinary specialty hospitals or 24/hr emergency hospitals and will have “DACVIM” initials after their name along with their DVM. If you do not have nearby you can search for a veterinary specialist here.

I hope you found this blog post helpful – and always feel free to reach out if you have any questions, you can always send me an email or a DM and I’ll be more than happy to help. Until next time my Canine Health Nuts!

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