Inflammatory bowel disease

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Emaciated Boxer with ulcerative colitis, resulting in inflammatory bowel disease[1]

Inflammatory bowel disease (IBD) is a collective term for chronic gastroenteritis and protein-losing enteropathy characterized by vomiting, diarrhea and weight loss.

It is thought that an hypersensitivity type I reactions is involved in the pathogenesis of this disease[2].

This disease, especially in large-breed dogs, may predispose to gastric dilatation-volvulus[3].

A number of common causes include:

Many of these diseases present with similar clinical symptoms including chronic weight loss, intermittent anorexia, vomiting and diarrhea[4].

Blood tests may reveal eosinophilia, hypoalbuminemia and folate deficiency[5]

Diagnosis is based on ruling out diseases that may cause intestinal inflammation along with imaging studies such as ultrasonography or barium meal radiography.

A definitive diagnosis requires histological evidence of inflammatory infiltration into the intestinal mucosa[6].

A differential diagnosis would include other intestinal lymphoma, leiomyoma, leiomyosarcoma, gastrointestinal stromal tumor and gastrointestinal parasites such as Giardia spp[7].

Treatment is usually symptomatic with antidiarrheal medication, dietary modification (low fat diet), prednisolone[8], metronidazole, metoclopramide, omeprazole and anthelmintic therapy[9].

Treatment is directed at addressing the underlying cause.

Dogs with low grade IBD benefit from low-fat hypoallergenic diet, whereas dogs with high grade IBD benefit from immunosuppressive therapy with drugs such as prednisolone[10].

In most dogs, this will result in resolution of clinical symptoms, although intestinal pathology may well persist for life[11]. This is reflected histopathologically, where clinical improvement is not always followed by significant improvement of the histopathologic lesions[5][12].

The effect of antibiotic treatment is questionable.

References

  1. Cornell Vet
  2. Kleinschmidt S et al (2007) Characterization of mast cell numbers and subtypes in biopsies from the gastrointestinal tract of dogs with lymphocytic-plasmacytic or eosinophilic gastroenterocolitis. Vet Immunol Immunopathol 120(3-4):80-92
  3. Braun L et al (1996) Gastric dilatation-volvulus in the dog with histological evidence of preexisting inflammatory bowel disease: a retrospective study of 23 cases. J Am Anim Hosp Assoc 32(4):287-290
  4. Tams TR (2003) Handbook of Small Animal Gastroenterology. 2nd ed. Philadelphia: Saunders. pp:211–250
  5. 5.0 5.1 Allenspach K et al (2007) Chronic enteropathies in dogs: evaluation of risk factors for negative outcome. J Vet Intern Med 21:700-708
  6. Hall EJ & German AJ (2005) Diseases of the small intestine. In: Ettinger SJ, Feldman EC, editors. Textbook of Veterinary Internal Medicine: Diseases of the Dog and the Cat. St. Louis: Saunders. pp:1332–1378
  7. Willard MD (2012) Alimentary neoplasia in geriatric dogs and cats. Vet Clin North Am Small Anim Pract 42(4):693-706
  8. Steiner JM (2004) Protein-losing enteropathy. In: Tilley LP, Smith FWK, eds. The 5-Minute Veterinary Consult Canine and Feline, 3rd ed. Philadelphia: Lippincott Williams & Wilkins. pp:1070–1071
  9. García-Sancho M et al (2007) Evaluation of clinical, macroscopic, and histopathologic response to treatment in nonhypoproteinemic dogs with lymphocytic-plasmacytic enteritis. J Vet Intern Med 21(1):11-17
  10. Münster M et al (2006) Assessment of disease severity and outcome of dietary, antibiotic, and immunosuppressive interventions by use of the canine IBD activity index in 21 dogs with chronic inflammatory bowel disease. Berl Munch Tierarztl Wochenschr 119(11-12):493-505
  11. García-Sancho M et al (2007) Evaluation of clinical, macroscopic, and histopathologic response to treatment in nonhypoproteinemic dogs with lymphocytic-plasmacytic enteritis. J Vet Intern Med 21(1):11-17
  12. Craven M et al (2004) Canine inflammatory bowel disease: retrospective analysis of diagnosis and outcome in 80 cases (1995-2002). J Small Anim Pract 45(7):336-342