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Monday: 8:30 a.m.-7 p.m.
Tuesday: 8:30 a.m.-7 p.m.
Wednesday: 8:30 a.m.-5 p.m.
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Friday: 8:30 a.m.-7 p.m.
Saturday: 8:30 a.m.-2 p.m.
Sunday: 9:00 a.m-12 p.m.

Inflammatory bowel disease in pets can be difficult to diagnose

Inflammatory bowel disease, or IBD for short, is a severe form of irritable bowel syndrome found in pets. This disease affects cats more than dogs and can be difficult to diagnose. The actual trigger, or cause of disease, is poorly understood. This makes treating this disease difficult and leads to frustration amongst both pet owners and veterinarians because medications and special diets either work for a short time and fail or do not work at all. So, how do we diagnose this disease? How, then, do we treat it?

True IBD is an idiopathic disease. Idiopathic is a fancy term doctors use for "we don't know." Now, before you declare your veterinarian an idiot for using this term to try to confuse you, please understand that this term is used clear across the land from your veterinarian's general practice to the leading veterinary universities.

We veterinarians understand there is some mechanism to trigger this disease, however, definitive testing is unavailable at this time. To make things really confusing, the criteria for IBD differs between many top veterinary gastroenterologists. Sounds like trying to get agreement on capitol hill, yes? The good news is there are ways to get a definitive diagnosis and treatment.

Many times IBD is not IBD at all. Other diseases such as parasites, glandular diseases, etc. can mimic IBD. To rule these diseases out your veterinarian may suggest some screening tests such as a fecal parasite check, routine blood work, x-rays, and an abdominal ultrasound. These are non-invasive, relatively inexpensive tests that establish a baseline. If they come back with normal results please do not feel that you wasted your money, but rather that you were able to rule out certain diseases before considering more invasive testing.

Other times a food allergy can mimic IBD. If there are foods that cause us an upset stomach and we know what they are then it is easy to avoid them. In some cases you as the pet owner can try different brands or flavors of over-the-counter diets. If one particular diet is tolerated, then stick with it. Remember to be very strict with what your pet gets besides its diet so as not to cause a flare up.

If that doesn't work there are commercially made prescription diets available through your veterinarian's office. These diets are a little more expensive and not sold at your local supermarket or pet store, however, I have found that many pets respond so well that the extra cost and inconvenience is worth it.

If these simple tests are normal and your pet does not respond to a particular diet, then more invasive testing is warranted. Veterinarians may suggest a procedure called endoscopy, or passage of a flexible tube with a camera on the end of it down the esophagus into the stomach and duodenum (first section of small intestine). Instruments can be passed through the tube to obtain samples of tissue for testing (biopsy, culture, etc). Endoscopy does require anesthesia but uses natural openings so trauma is minimal.

Many of these patients can be released the same day of the procedure. Unfortunately, the flip side to that is endoscopy is not always definitive. Small samples of tissue from the surface of the stomach and duodenum may not always give the full picture of the disease. If the biopsies obtained by endoscopy are inconclusive, an exploratory laparotomy and full thickness samples are required.

An exploratory laparotomy refers to a full surgery where an incision is made to enter the abdominal cavity to basically look around and obtain samples of tissue. The advantage of this is that one can actually look and feel the tissue, as well as obtain larger samples of tissue. You can also biopsy more tissue (stomach, bowel, liver, spleen, kidneys, lymph nodes).

The disadvantage is that there is a longer recovery time and more in the way of potential post operative complications. In my experience, I have always gotten a definitive diagnosis from an exploratory laparotomy. However, there have been times that depending on age and physical condition of my patient that I have not even suggested this procedure.

I hope this sheds some light on a disease which is, to some extent, still very confusing to veterinarians. Have a great Halloween. Remember, no chocolate (for your pets — not you).

Dr. Kearns is a veterinarian with a special interest in emergency and critical care. He has been in practice for eight years. Dr. Kearns is pictured here with his son Matthew and his cat, The One Eyed Guy.

 

Author: 
Matthew Kearns, DVM