2013年9月20日星期五

INFLAMMATORY BOWEL DISEASE - (IBD)

The German Shepherd Dog is prone to gastro intestinal diseases. Why this is, no one knows for sure. Among some of the diseases that this breed can have is a condition called Inflammatory Bowel Disease or IBD.


IBD is a when one or more sections of the gastrointestinal tract have been invaded with inflammatory cells. Left untreated, this inflammation can cause the intestinal tract to become less efficient at absorbing nutrients from their food. The result can be a dog that loses weight, vomits and has diarrhea. Many times this condition develops slowly and can go on for several months or even years before a real problem presents itself.


There are several types of IBD. These different types affect different parts of the gastro intestinal tract and the different cells that are affecting it. Because there are many different things that can inflame the dog’s intestinal tract, other diseases must be ruled out before a true diagnosis of IBD can be confirmed.


The four different types of IBD are: The most common type is Lympho plasmacytic. The second most common type is Eosinophilic which is also the most severe form of IBD. Food allergy and parasites must be ruled out for the inflammation before a diagnosis of IBD is made. Then there is the rarer form of IBD known as Neutrophilic. Bacterial infection must be ruled out for a proper diagnosis. And lastly another rare form of IBD is Granulomatous. Foreign bodies and fungal infection must be ruled out for this diagnosis.


The cause of IBD is not truly known although genetics, intestinal infections, food and abnormalities of the dog’s immune system can all play a role. The intestines produce a large amount of food and bacterial particles called antigens. It is these antigens that can cause an allergic immune type response. Bottom line, when these inflammatory cells invade the intestines, it interferes with the body’s ability to absorb and digest nutrients.


Some common antigens are proteins and preservatives from the dog’s food, parasites, virus’s and bacteria, and ingested foreign materials (garbage, toys, etc.). These things can start the abnormal immune response and even when the antigen is no longer present, the inflammation continues. When an exact reason cannot be found for the inflammation, this is call idiopathic, or true IBD.


The most common signs to look for are vomiting and diarrhea. Putting the dog on antibiotics and changing his food may help for a short time, but eventually the symptoms return. Usually the signs will slowly progress and then can become severe and sudden as the disease progresses. With IBD, the stomach, colon and small intestines may be involved.


When a dog has stomach inflammation, this is called gastritis. Typical of this condition is loss of appetite and vomiting. The dog may vomit undigested food, partially digested food, a clear or brownish liquid and sometimes a small amount of blood.


When the inflammation is in the small intestines, this is called enteritis. This can cause vomiting, weight loss and diarrhea. The dog may be lethargic and doesn’t look like he’s thriving very well. The diarrhea is usually a large amount and can happen one to three times a day.


When the colon is inflamed, it’s called colitis. This condition causes diarrhea in smaller amounts, but can happen up to ten times a day. The dog many times will strain while defecating and have blood or mucus in his stools. These dogs usually remain active, eat well and don’t lose weight.


Many conditions can cause a dog to vomit and have diarrhea and this can be the most difficult part in diagnosing IBD. After all testing is done which may include, a complete blood count, chemistry panel, urinalysis, fecal examination and culture, ex-rays of the chest and abdomen and sometimes an ultrasound, intestinal parasites, bacterial, viral and fungal infections, dietary allergies, foreign bodies and cancer. To determine intestinal malabsorption, specialized blood tests such as colbalamine and folate are often recommended to determine the severity.


If all tests fail to reveal another disease that’s causing the intestinal malabsorption, then IBD is suspected and a biopsy of the intestines is required to make a definite diagnoses. Once the biopsies are performed, then they are sent to a lab for a microscopic examination. A diagnosis will confirm if the IBD is mild, moderate or severe. This will help your veterinarian determine the best treatment for your dog.


Most dogs will require medication and dietary management to treat their IBD. Highly digestible diets are usually recommended for these types of dogs because nutrients are more easily digested and will reduce the amount of diarrhea. Usually it will take 8 – 12 weeks to see a positive change in the dog. If the dog’ colon is inflamed, then the vet may advise the dog get more fiber in his food.


The medicines that are usually used to treat this condition are: Corticosteroids (steroids, cortisone, and prednisone). These medications help reduce the inflammatory process and inflammation in the intestines. Since steroids can have potentially serious side effects, your vet will usually start at a lower dose until the dog can be helped by dietary measures alone. Another medicine that sometimes can be used is called Metronidazole which is an antibiotic that helps restore the normal balance of intestinal bacteria and has anti-inflammatory properties. Sometimes dogs with more severe IBD may be treated with Azathioprine, chlorambucil and cyclosporine that reduce inflammation by suppressing the immune system. Sometimes your vet will recommend treating the dog that vomits and has diarrhea with an antacid, anti-nausea, and anti-diarrhea medicine.


Although dogs with IBD can be treated and controlled, it is a condition that can not be cured. These dogs will require a strict diet and anti-inflammatory medicines to manage their disease. Unfortunately some dogs will not respond to dietary changes or medications. These severe cases can sometimes lead to intestinal cancer.


If a dog is diagnosed with IBD, it is wise to have your veterinarian check him over a few times a year to make sure the disease has not progressed to a worse condition.


My rating: early diagnosis of symptoms: (4), importance of dietary changes; (4), medical attention: (4)


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