Vitamin K deficiency, leading to coagulopathy, has been reported to occur in cats in association with IBD and may also occur in dogs. In the cats reported, the coagulopathy responded to parenteral vitamin K administration. Patients with mild-to-moderate IBD can often be successfully managed with dietary modification elimination diet or hydrolyzed diet and antimicrobial administration tylosin or metronidazole.
Dogs and cats with a lack of response to more conservative therapy or patients with severe IBD based on high activity index scores should be managed with immunomodulatory therapy. The term "antibiotic-responsive diarrhea" ARD is commonly used for animals that respond to antimicrobials, but relapse with diarrhea soon after the antimicrobial is discontinued. The condition is more common in dogs than cats, and is not synonymous with "small intestinal bacterial overgrowth SIBO.
German Shepherd dogs appear to be overrepresented. The proposed mechanisms by which the antimicrobials exert their beneficial effect is currently uncertain, although qualitative changes in the intestinal microflora intestinal dysbiosis appear to play an important role. Metronidazole Flagyl , an inhibitor of cell-mediated immunity, has been frequently used as an adjunctive agent for the management of IBD.
Metronidazole tablets have a sharp, unpleasant, metallic taste when scored that can cause severe salivation. Side effects are rare, although metronidazole has been associated with a peripheral neuropathy in humans and animals. Less common side effects include inappetence, nausea, vomiting, seizures, and reversible neutropenia.
Tylosin Tylan is a macrolide antibiotic that has been reported to be effective and safe in managing canine IBD and antibiotic-responsive diarrhea ARD. Although the drug's mechanism of action is unknown, it appears to be effective in some dogs' refractory to other forms of therapy.
Corticosteroids remain the cornerstone of immunomodulatory therapy for dogs and cats with IBD. The value of corticosteroids relates to their anti-inflammatory and immunosuppressive properties, although they also increase intestinal sodium and water absorption in the small and large bowel, and regulate basal colonic electrolyte transport.
The dosage and duration of therapy is based on the severity and duration of clinical signs, the severity and type of inflammation, the clinical response, and tolerance to the drug. The drug is gradually tapered over a 6- to week period once clinical remission is attained. Most cats are started on prednisolone at 5 mg q 12 hrs for average size cat , with a gradual taper over the ensuing 8—12 weeks.
Combination therapy with dietary therapy, metronidazole, and azathioprine dogs only , is undertaken with the goal of reducing the dose of prednisone. Parenteral corticosteroid therapy is reserved for vomiting patients or animals with evidence of severe malassimilation.
Budesonide is an orally administered corticosteroid, structurally related to hydroxyprednisolone, has high topical anti-inflammatory activity and low systemic activity because of its high affinity to the steroid receptor and rapid hepatic conversion to metabolites with minimal or no steroid activity. The drug is dosed at 1 mg once daily for toy-breed dogs and cats, and up to 3 mg once daily for large or giant breed dogs.
Azathioprine is an antimetabolite that is converted to 6-mercaptopurine in the liver and then to thioinosinic acid. The latter compound impairs purine biosynthesis and this biochemical reaction inhibits cellular proliferation and reduces natural killer cell cytotoxicity. The onset of these immunological effects is slow, and can require several months for maximal effectiveness. The drug is most useful in dogs as adjunctive therapy in severe or refractory IBD. Azathioprine can also be used for its steroid-sparing effects when the adverse effects of prednisone are unacceptably high.
Side effects of the drug in dogs include anorexia, pancreatitis, and hepatic dysfunction. The alkylating agent chlorambucil is beneficial for managing refractory cases of IBD, particularly in cats. Hematological monitoring is warranted every 3—4 weeks to assess for neutropenia.
In dogs, chlorambucil is administered at 1. Cyclosporine has been demonstrated to be effective in dogs with IBD that were refractory to immunosuppressive doses of prednisone. The drug consists of sulfapyridine linked to mesalamine previously called 5- aminosalicylic acid by an azo bond that is cleaved by colonic bacteria with subsequent release of the active moiety of the drug, mesalamine.
Sulfapyridine is almost completely absorbed in the colon, metabolized in the liver, and excreted in the urine. The mesalamine moiety is locally absorbed and inhibits the formation and degradation of inflammatory mediators, including leukotrienes, prostaglandins, thromboxane, platelet activating factor, histamine, and a number of cytokines. Sulfasalazine is of no value in managing small-bowel inflammation, because colonic bacterial metabolism is needed to release the active moiety.
The most common side effects of sulfasalazine include anorexia, vomiting, cholestatic jaundice, allergic dermatitis, and keratoconjunctivitis sicca KCS. It is important to emphasize that IBD is a disease of control, and relapses are possible depending on the severity of disease.
Client education is therefore pivotal to avoid frustration and to maximize dietary and medical compliance. Guilford WG. Idiopathic inflammatory bowel diseases. Strombeck's Small Animal Gastroenterology. Third edition, — A randomized, open-label, positively controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy. J Vet Intern Med. Guilford WG, et al. Food sensitivity in cats with chronic idiopathic gastrointestinal problems. Hirt R, Iben C.
Possible food allergy in a colony of cats. J Nutr. Lymphocytic-plasmacytic colitis in the cat. J Am Vet Med Assoc. Nutritional management of idiopathic chronic colitis in the dog. Marks SL, et al. Dietary trial using a commercial hypoallergenic diet containing hydrolyzed protein for dogs with inflammatory bowel disease. Vet Ther. Hussein HS, et al. Petfood applications of inulin and oligofructose.
Seidner DL, et al. An oral supplement enriched with fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis: a randomized, controlled trial. Clin Gastroenterol Hepatol. Cummings JH, et al. Influence of diets high and low in animal fat on bowel habit, gastrointestinal transit time, fecal microflora, bile acid, and fat excretion.
J Clin Invest. Effect of diets differing in fat content on chronic diarrhea in cats. Enterococcus faecium SF68 enhances the immune response to Giardia intestinali s in mice. Prevalence and incidence of serum magnesium abnormalities in hospitalized cats.
Subnormal concentrations of serum cobalamin vitamin B12 in cats with gastrointestinal disease. Proteins invoked by vitamin K absence and clotting times in clinically ill cats. Westermarck E, et al. Tylosin-responsive chronic diarrhea in dogs.
Allenspach K, et al. Pharmacokinetics and clinical efficacy of cyclosporine treatment of dogs with steroid-refractory inflammatory bowel disease. This document is contained within the following "Collections" show. See related stories ». Stanley L. Management of IBD The importance of dietary intervention in the management of dogs and cats with chronic idiopathic enteropathies CIE cannot be overemphasized.
Principles of Nutritional Management Regardless of the underlying etiology for any given patient, exaggerated responses to dietary antigens are often suspected in patients with IBD. The sample is sent to a lab where the cell types are analyzed [ 41 ]. However, even then the results may not be completely accurate [9, 25, 42 , 43 , 44 , 45 ].
There is a risk associated with bowel biopsy. Bowel biopsy can result in peritonitis, a serious infection in the abdomen, if the sutures give way in the gut wall. This can be life-threatening to dogs. Therefore, before going ahead with a more invasive procedure, your vet may discuss a dietary trial first to see if the signs improve.
Sometimes, a more long-term diagnosis plan is needed to make sure that a dog definitely has this condition. IBD in dogs is a tricky condition, and owners can sometimes complicate it further [ 51 ]. Once the symptoms occur, many owners fail to identify IBD in dogs, and instead begin treatment for parasites using a broad spectrum of dewormers.
Some owners try to employ the same treatment methods as they would for people [10, 48]. These are incorrect treatment protocols. Not only is this unhelpful in handling inflammatory bowel disease in dogs, but it may also cause further complications, or make future diagnosis more difficult. Ultimately, therapeutic choice for canine inflammatory bowel disease treatment depends on how serious the condition is, as well as how well the dog responds to certain drugs.
However, the safest way to start with IBD treatment is a dietary change. Once the primary triggers have been found, dogs can then avoid eating the food to which they react negatively. Studies have shown that IBD in dogs can be successfully treated with simple diet adjustments . Drug therapy and supplementation can suppress bowel inflammation in dogs, which may help to resolve the symptoms [37, 52 , 53 ]. Prednisolone tablets are inexpensive and highly effective at reducing inflammation [ 54 , 55 ].
There have been claims that administration of prednisolone may cause serious side effects such as gastric ulcers. Research found this to be untrue and this drug seems to be safe for dogs [ 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. Antibiotics such as metronidazole can balance out the bacteria in the gut, kill protozoal invaders, and also has a beneficial anti-inflammatory effects [ 63 ].
Studies have shown that metronidazole may be particularly effective when combined with prednisolone [ 64 ]. Drug therapies also include immunosuppressive medications, antibiotics, anti-parasite treatments, antispasmodics, and probiotics. Other drugs that can be used as alternatives or alongside steroids, depending on the condition are:. Cyclosporine was shown as an effective treatment for inflammatory bowel disease in dogs, particularly for canines that are unresponsive to steroid treatments [ 65 ].
Out of all the above, probiotics are possibly the safest supplement. Even if not the most effective, particularly for more serious cases, they have been shown to have some positive effects in treatment of IBD in dogs [51, 64 , 66 ]. IBD is still a relatively unknown condition that is being heavily studied. Although there is no cure for IBD in dogs , the symptoms can usually be controlled with the judicious use of drugs and dietary management . Occasional relapses are to be expected.
There is a link between dietary allergy or food sensitivity and inflammatory bowel disease in dogs . As mentioned above, a safe alternative to bowel biopsy is a dietary trial , otherwise known as elimination diet. Studies found that these feeding trials with dogs can be very effective [ 67 , 68 ].
This new hypoallergenic diet is fed for at least 8 — 10 weeks. The dog gets protein from a single novel source such as venison, salmon, or lamb and carbohydrate from a single novel source such as potato or pea. This alone is fed for the duration of the dietary trial. Over the short period of the dietary trial this is unlikely to have an impact, but is inadvisable in the long term. If the dog responds and the symptoms clear up, the first addition to the diet should be a vitamin and mineral supplement.
No other additions should be made for two weeks. If the symptoms do not recur during this time, then the supplement is safe. Approach a raw hypoallergenic diet in the same manner by feeding a single novel protein source and a single novel carbohydrate source.
The easiest way for most owners to put a dog on a hypoallergenic diet is to purchase a prescription hydrolyzed canine diet such as Hills ZD or Purina HA from your vet [23, 68]. Commercial prescription dog foods are nutritionally balanced and are therefore safe for long term use.
Foods that are gentler on the gut and reduce the chances of IBD flare up tend to be low in fat and highly digestible. Examples include chicken and rice but even these have the potential to trigger dietary allergies .
Inflammatory bowel disease in dogs is a complicated gut inflammation condition that is yet to be understood completely in the veterinary medicine. Certain dog breeds have a higher chance to develop IBD, but the cause is likely a combination of several factors rather than genetic predisposition alone. There is no complete cure for IBD, but treatments include steroids and other drugs, as well as supplementation and dietary changes. NextGen Dog. Batt, R. Journal of Small Animal Practice, 3— A scoring index for disease activity in canine inflammatory bowel disease.
J Vet Intern Med. Ischemic diseases of the large intestine. Int Surg. Cave NJ1. Chronic inflammatory disorders of the gastrointestinal tract of companion animals. Canine inflammatory bowel disease: retrospective analysis of diagnosis and outcome in 80 cases J Small Anim Pract. Immune cell populations within the duodenal mucosa of dogs with enteropathies. Characterization of mast cell numbers and subtypes in biopsies from the gastrointestinal tract of dogs with lymphocytic-plasmacytic or eosinophilic gastroenterocolitis.
Vet Immunol Immunopathol. Epub Jul Med Clin Barc. Activation of nuclear factor-kappaB in dogs with chronic enteropathies. Epub Aug Inflammatory bowel disease in the dog: Differences and similarities with humans. World J Gastroenterol. Published online Mar 7. Inflammatory bowel disease in veterinary medicine. Front Biosci Elite Ed.
Gaschen L1, Kircher P. Two-dimensional grayscale ultrasound and spectral Doppler waveform evaluation of dogs with chronic enteropathies. Clin Tech Small Anim Pract. Chronic intestinal inflammation and intestinal disease in dogs. Evaluation of disease activity markers in dogs with idiopathic inflammatory bowel disease. Epub Jun Perinuclear antineutrophilic cytoplasmic antibody and response to treatment in diarrheic dogs with food responsive disease or inflammatory bowel disease.
Quantitative assessment of mast cells and expression of IgE protein and mRNA for IgE and interleukin 4 in the gastrointestinal tract of healthy dogs and dogs with inflammatory bowel disease. Am J Vet Res. Nuclear receptor and target gene mRNA abundance in duodenum and colon of dogs with chronic enteropathies. Domest Anim Endocrinol. Epub Dec Evaluation of lymphocyte apoptosis in dogs with inflammatory bowel disease. A randomized, open-label, positively-controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy.
Upregulation of toll-like receptors in chronic enteropathies in dogs. Epub May 2. Clinical signs, histology, and CD3-positive cells before and after treatment of dogs with chronic enteropathies. Cytokines in canine inflammatory bowel disease. Pol J Vet Sci. Canine breeds at high risk of developing inflammatory bowel disease in the south-eastern UK. Vet Rec. Epub Sep 6. Successful management of histiocytic ulcerative colitis with enrofloxacin in two Boxer dogs.
Aust Vet J. Histiocytic ulcerative colitis in three non-boxer dogs. J Am Anim Hosp Assoc. Molecular-phylogenetic characterization of microbial communities imbalances in the small intestine of dogs with inflammatory bowel disease. Expression of major histocompatibility complex class II antigens in the canine intestine.
Intestinal cytokine mRNA expression in canine inflammatory bowel disease: a meta-analysis with critical appraisal. Comp Med. Pattern recognition by Toll-like receptors.
Get Started in Dog Training. Leave a Reply Cancel reply probiotic for your dog. If you feel like this article will be helpful to others, consider sharing it on. Are you already using budesonide. In conclusion, was no major such as milk thistle, further and which to avoid. Of course many of the Your email address will not be published. PARAGRAPHThere was one major study IBD is caused by a differences of the two drugs which found little to no difference in the side effects or efficacy. The frequency of adverse effects drugs used for Organon male contraceptive have success based on an individual. Therefore, if you are looking for alternative therapies for IBD, adverse effects in either group. Natural therapies should be continued in dogs administered either budesonide or prednisone, were fairly similar.are the primary anti-inflammatory drugs used because of their degree of effectiveness, as well as their low cost and wide availability. Depending on the cause of the disease, most pets will show improvement in gastrointestinal signs within one to two weeks of starting appropriate therapy. Budesonide is a glucocorticoid medication that has been shown to be successful in the treatment of canine IBD. However, hypothalamic–pituitary– adrenal. Prednisone/prednisolone. Corticosteroids are the mainstay of treatment for canine and feline IBD. These drugs are usually prescribed at a.