 | Rational Dog Training |
| Inflammatory Bowel Disease
By: Shirley Greene
I was lucky enough to be owned and respected by one very special German Shepherd Dog, IKE-MAN. He was my best friend. He was my service dog. He saved my life. His presence gave me the freedom to hike in the woods. His confidence made me comfortable roaming through the washes in the I’m not a vet, but I’m an IBD-dog-mom. The information contained in this article was, however, approved by a veterinarian. Perhaps my experiences may help to make your life with an IBD dog a bit easier. What is inflammatory bowel disease? Inflammatory Bowel Disease in dogs is very similar to Crohn’s Disease in humans. Some scientists believe it is an autoimmune disorder. IBD should not be confused with Irritable Bowel Syndrome (IBS). They are two separate entities and have different treatment protocols. Inflammatory bowel disease (IBD) is a collection of symptoms and finding that occur in people, dogs and even cats. Many physicians and veterinarians refer to it as a specific reaction that the gastrointestinal tract may have to chronic irritation(s). No one is certain of the exact cause in animals, but there has been research and speculation that a variety of factors, solo or in combination, may be the culprits. These factors may include infections, parasites, allergies, nutrition and even genetics. There is even a theory that IBD may not be one disease at all, but rather a catch-all used for a variety of intestinal conditions - - all with similar symptoms. IBD runs in genetic lines and is seen most often in German Shepherd Dogs, Boxers, Golden Retrievers and Basenjis. It is interesting to know that it is fairly common in middle-aged cats, as well. What are the symptoms of IBD in a dog? Symptoms depend upon where in the gastrointestinal tract the irritation is located. What an owner sees in one episode of IBD may be totally different in the next episode. Comparing notes with others owning IBD dogs is often very frustrating. Symptoms depend upon what area of the digestive tract is having problems. My dog may be having uncontrolled vomiting and your dog may have mucous stools - - yet both have been given the diagnosis of IBD. If the stomach is involved, you will have vomiting. If the large intestine or colon is involved, there is diarrhea, often with bloody stools and copious amounts of mucous. IKE’s episodes often started with the stomach and within 72 hours, the bowel would be affected, also. This pattern of predictability helped me map out a solid treatment plan. How is IBD diagnosed? One of the most helpful diagnostic tools is an accurate history. If you suspect your pet may have IBD, start a journal. You will want to include the date, time of day, symptoms and additional pertinent information. This may include activity level, changes in diet or your pet’s routine. I kept a journal on IKE for years and it really helped me understand events that could trigger an episode of IBD. Your vet will do a physical exam and ask questions about diarrhea, vomiting, fever and weight loss. The doctor will be looking for abdominal pain and possible thickening of the intestines. Further diagnosis can be made via non-invasive tests such as blood, urine and stool samples. If your dog is having an intense episode, the liver and pancreas may be inflamed and enzyme levels altered. X-rays and ultra sound exams may be required to rule out a tumor or other pathology. Some veterinarians recommend a tissue biopsy to look for lymphocytes and plasmacytes. The chronic irritation that causes IBD stimulates the body to send cells from the immune system to the affected area. Veterinarians take a tissue sample during an attack to look for elevated levels of these cells. The biopsy is done under general anesthesia either through the mouth and into the stomach or through the rectum and into the colon. This is an invasive procedure. At times the pathology report may show Helicobacter. You may recognize the name as the cause of some stomach ulcers in people. Just because they are found in your dog does not mean that they have caused the symptoms or the IBD. These bacteria are found in normal people and normal dogs, too. It is now considered to be a pathogen only if there is also associated inflammation seen in the mucosa of the stomach. Helicobacter, often treated with antibiotics, may co-exist with IBD. Some veterinarians are against disturbing tissues during the period of “attack” and believe it may lead to an acute infection or worsening of the dog’s condition. A biopsy done when the dog is not having an attack may not be diagnostic. Be certain to discuss both the pros and cons before allowing a diagnostic biopsy to be performed. A second, or even a third, opinion can be valuable. Further diagnostic testing is often required to determine what is causing the tissue reaction to occur in the first place. Your veterinarian will want to rule out certain types of parasites, chronic infections, cancer and even other disease entities – such as EPI (exocrine pancreatic insufficiency). Must I see the vet during every episode? If your dog has been diagnosed with IBD and you have a game plan, you may not need to make a trip to the veterinary clinic for each episode. This is especially true if your dog is in good condition prior to the episode and is not dehydrated from excessive vomiting and/or diarrhea. However, if you do not have a treatment plan in place or if your pet is not in good and stable condition, a visit may be necessary. Call your vet. Remember: PCV (packed cell volume blood test) is the best way to test of dehydration - - don't trust "dry mouth" or drooping skin. It isn't always reliable. I always thought it was a good idea to let my vet know when IKE was having an episode. That way, if he took a turn for the worse, their records reflected when it started and just what I was doing. Is IBD painful? IBD was very painful for IKE. In eight years of speaking with other dog Moms many tell me that the hardest part of dealing with this disease is finding appropriate pain control. Yet, every now and again, I will be contacted by a person who believes her dog cannot have IBD, as it never appears to be in pain. Pain is very evident in some dogs; other pets may be stoic. Signs of pain may be panting, pacing and a roaching of the back. The abdomen may become very tender and the animal “guards” when you lightly place pressure on the belly area. Some dogs may whine and whimper while passing stool or pacing. Pain control is an important part of an IBD protocol for helping your pet. Be certain it is discussed as part of your overall treatment approach to living with an IBD dog. How is IBD treated? For me, treatment was best achieved through a combination of tactics that included: q Attitude – IBD is not cured, it is controlled. By having a support system consisting of traditional and holistic veterinarians and a nutritionist, IKE was able to continue working for many, many years after diagnosis. q Supplements – In my experience, herbs and natural supplements greatly reduced the number and severity of attacks. q Charting – keeping a daily diary of activities, food, bowel movements, etc. helped me to understand what could trigger IBD attacks in my dog and plan appropriately. My veterinarian also found that my daily diaries during an episode helped him in selecting therapies. q Pharmaceuticals – during flair ups and for severe attacks episodes, I found pharmaceutical drugs to be appropriate. However, my goal was always to use them sparingly and save them as my “heavy hitters.” q Routine – IBD dogs thrive on routine. Once you find what works for your dog, try to feed your dog at the same times each day and schedule plenty of time for potty breaks. Sudden increases in exercise may trigger an attack in some dogs, as well being more sedentary. q Food – it has been suggested that one component of IBD may be food allergies. When you find a diet that words for your pet - - stick with it until it doesn’t. If you must change foods, do so very, very slowly and with the help and advice of your dog’s health care provider and nutritionist. q Fiber Vs Low Residue – this has been debated for a number of years. IKE did well on high fiber kibble and I even added more fiber in the form of oat bran. Other dogs may not tolerate fiber and will require a low residue diet plan. Many IBD dogs do well on Metamucil. Be certain to discuss its proper use with your vet. q Patience – IBD episodes will vary in intensity and length. What helps one time may not help the next. As long as your dog is not dehydrated and is able to maintain its body mass in good condition, you have options for treatment. If one thing isn’t working well discuss making appropriate dietary, pharmaceutical and lifestyle changes with your veterinarian. q Consultations – When IKE’s protocol stopped working, I got on the computer and on the telephone and began calling veterinary medical centers. Through these wonderful people, I was networked to two consultants in my area. Both agreed to speak with me - - and only one charged a small fee. I used them as a sounding board. Their ideas were polar opposites, but my outcome was positive. I tried one set of ideas and when IKE became worse, I tried the other. Happily, it worked like a charm for over four years. Tell Us What You Used for IBD I am not a veterinarian. I am not a scientist. I am not a researcher. However, I was an IBD dog Mom. Based only on that experience, here are some of the prescription drugs and some of the herbs and supplements that were successful for my dog.
ü I kept an IBD log, daily, that included activity level, food content and a brief description of the number of stools, presence or absence of blood or mucous, color and consistency. ü IKE did very well on a high fiber diet; some IBD dogs need a low residue food. Many owners prepare their pet’s diet from fresh, natural ingredients. IKE did not tolerate a raw diet, but it may work very well for your pet. ü IKE did well with 3 feedings throughout the day, rather than just one large meal. Most IBD dogs need smaller feedings - more often. ü Supplements I used included: oat bran, vitamin C, vitamin B, cayenne pepper in capsules, acidophilus, aloe vera juice, decaf green tea, bottled water, Nature’s Sunshine bowel builder and an over-the-counter acid reducer. ü IKE exercised by walking. If he was going to run, it could only be in small spurts. Even a 2-mile hike that involved lots of bunny chasing could bring on an attack. However, each dog is different. If I knew IKE was going to “over” exercise, I’d start medications before our outing. ü IKE tolerated several antibiotics. Initially, we used metronidazole. However, it has been linked to problems with long-term use, including cancer. If you and your veterinary health team agree that a long-term antibiotic is necessary for your IBD dog, consider using something else. Tylan powder also worked for us and we were able to use it continually for 3-months and then gradually reduce it. Baytril, stared as an injection and followed as a pill, also had good results for us. ü Steroid drugs, like prednisolone, have their place in the treatment of severe episodes of IBD. IKE did not react well to steroids and became destructive and very moody. It is normal for dogs to react this way and to also experience an increase in thirst and appetite. Remember: a dog on steroids will need to go outside more often. ü If you find yourself needing to rely on steroid drugs too often, there are alternative methods of helping your dog. These methods include using chemotherapeutic agents to help turn off the immune response. One such drug is cyclosporin. Another new drug, budesonide, is a form of cortisone used in humans with inflammatory bowel disease conditions. Be certain to discuss the pros and cons of each medication with your vet. Every protocol has side effects and your job is to have as much information as possible in order to make an informed decision for your pet. ü The best medication we used for vomiting was phenobarbital. Reglan did not help IKE,. Anecdotal evidence has turned up a number of IBD dogs that have controlled vomiting very well using Phenobarbital, which has the added benefit of relaxing the dog and therefore easing pain. ü For diarrhea lomotil was our drug of choice. Imodium AD works well for many IBD dogs. Do not use them together. Pepto bismol and kaopectate may not work at all. ü Green tea (decaf) is very soothing and was the first thing offered after bouts of vomiting. Ginger is also great for an upset tummy. ü Adding rice or cooked oatmeal to the dog’s diet prior to an expected change in routine may help curtail diarrhea. ü Many IBD dogs appear to have a food sensitivity component. Some are helped by introducing proteins that they’ve not experienced before, such as salmon or rabbit. However, these sources of protein may be too rich for your dog. If diarrhea continues, or increases, consider another type of protein. IKE did well on cottage cheese, although some IBD dogs cannot tolerate dairy foods. ü IKE often had excessive stomach acid and giving Pepcid AC brought relief from its pain. Check with your vet before using this or any over the counter antacid for any length of time as serious side effects may result. ü Small feedings throughout the day will often stop dogs from vomiting bile. Going from 2 feedings to 3, plus nutritious treats, really helped IKE. ü IBD dogs, like EPI dogs, often have episodes of bacterial overgrowth. These episodes may mimic an IBD attack. Antibiotics are the appropriate treatment for this overgrowth; adjusting herbs and supplements may not help. When IKE had bacterial overgrowth, his stools had a very characteristic odor, which helped me understand what was taking place. Be sure to discuss how you may recognize this complication. How long does IBD last? IBD, like high blood pressure or diabetes, cannot be cured. It is a condition that is, however, able to be controlled in most dogs. If your protocol appears to be failing - - try another. I found it wise to only change one element of my protocol at a time. That way, using my daily diary, I could easily see which variable was responsible for either improving or worsening IKE’s condition. Each IBD episode may be different in your dog - - or, each may run the same course. Some may last only a few days and others may last much longer. Remember: just because the symptoms are better you may not be able to stop all prescription medications. This is certainly true with antibiotics; and, some steroids must be discontinued over a period of time. Be certain to understand your vet’s game plan and check-in before stopping any prescription drug. In Conclusion Be mindful of your IBD dog. Watch body posture, observe their eyes, be aware of the number of daily stools and the consistency. Jot down ideas to run by your vet and print out articles you come across. Share those, too. Keep the lines of communication open with your veterinarian and his/her staff. Don’t be afraid to ask questions or make suggestions. Multiple opinions, points of view and input from a variety of disciplines (acupuncture, massage therapists, etc.) all serve to make you a more informed caregiver. Your IBD dog is depending upon you to provide the best quality of life for many, many years to come. This article has been reviewed for medical content by Gary Yochum, DVM. This article has been previously published and used here with author’s permission. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
