Inflammatory Bowel Disease
Courtesy of www.petjunction.co.za : www.petshealth.co.za
Inflammatory Bowel Disease … Can You Stomach It?
Idiopathic (i.e. of unknown origin) inflammatory bowel disease (IBD) is a syndrome where inflammatory cell infiltration in the walls of the intestine are present. IBD can occur in different locations in the bowel, and each form is classified according to where it occurs, and which cell type is involved. (Eosinophilic colitis indicates, for example, that eosinophile cells are involved, and the inflammation is taking place in the colon.) Some IBD forms occur in specific breeds. The Basenji and the Lundehund might get diarrhoeal syndromes, while German Shepherds may contract lymphocytic plasmacytic enteritis. Other animals that are predisposed to IBD are Yorkshire Terriers, Cocker Spaniels and purebred cats.
Dietary Considerations?
Dietary allergy seems to be an unlikely cause of IBD (except in eosinophilic gastroenteritis), it may contribute to increased permeability of the gut wall and sensitivity to various foods. Current research supports the likely involvement of hypersensitivity reactions to proteins (e.g. food, bacteria, mucus, epithelial cells) in the intestine. This reaction may result in the intestinal wall becoming inflamed. Persistent inflammation results in fibrosis and scarring of the intestine.
The Signs Of The Times …
The average age at which clinical disease develops is 6.3 years in dogs and 6.9 years in cats, but IBD has been documented in dogs less than 2 years of age. Clinical signs are often chronic and sometimes cyclic or intermittent. Vomiting, diarrhoea, changes in appetite, and weight loss may be seen. Intermittent vomiting may progress to more frequent vomiting. Bloody stool associated with vomiting and cranial abdominal pain are often seen with stomach and small intestinal ulceration and erosion. IBD in dogs may predispose animals to a condition called gastric dilatation-volvulus, where the stomach enlarges and inflates after having rotated out of position. Research has shown that may be an association between inflammatory liver disease, pancreatitis, and IBD in cats. Although as yet unproved, it has been suggested that severe IBD in cats may progress to lymphosarcoma, a form of cancer.
How IBD Is Diagnosed And Treated …
Diagnosis requires biopsy of the intestinal wall. Complimentary blood tests, X-rays and/or abdominal ultrasound examination may contribute significantly towards confirming the diagnosis. Biopsy must always be considered in relation to clinical signs, and the animal treated accordingly. The goals of therapy are to reduce diarrhoea, promote weight gain, and decrease intestinal inflammation. If a cause can be identified (e.g. dietary, parasitic, bacterial overgrowth, drug reaction, etc), it should be eliminated. Dietary manipulation by itself may be effective in some cases (e.g. in chronic colitis); in other cases, it can enhance the efficacy of concurrent medical therapy allowing for the drug dosage to be reduced or for drug therapy to be discontinued once clinical signs are in remission.
Changing The Diet
Dietary modification generally involves feeding a hypoallergenic or elimination diet, i.e. feeding a source of protein that the animal has not been previously exposed to. This diet should be the sole source of food for a minimum of 8 weeks, and no treats of any kind should be fed. Novel protein diets (ostrich meat or egg) alone are effective in controlling clinical signs in cats with IBD, but not in cats with food sensitivity or food allergy. Dogs with large-intestinal diarrhoea may benefit from diets high in insoluble fibre content. Supplementation of dietary fiber alone is rarely effective in severe cases.
Understanding The Prescription
Treatment will often involve medication that will manipulate the function of the immune system since IBD seems to be an immune-mediated disease. It is absolutely critical that pet owners understand what medication has been prescribed, why it has been prescribed, as well as know what the potential side effects may be. Once the treatment has proven to be effective, the pet owner and the vet in consultation with each other should then consider reducing the dosages of the medication, in an effort to find the lowest possible dose of each required medicine that will keep the affected animal comfortable, and ideally symptom free and healthy. IBD cure is not easily achieved and often means life-long treatment for the affected pet. Thus, every effort should be made to avoid any type of complication.
Quality Of Life … A Goal
The prognosis for feline IBD is good for adequate control but poor for cure. It has been reported that 79% of cats with IBD treated with a combination of diet and medication had a positive clinical response. A more guarded prognosis is reported in cases with severe internal pathology. Relapses occur and are most often precipitated by dietary indiscretion.
Idiopathic (i.e. of unknown origin) inflammatory bowel disease (IBD) is a syndrome where inflammatory cell infiltration in the walls of the intestine are present. IBD can occur in different locations in the bowel, and each form is classified according to where it occurs, and which cell type is involved. (Eosinophilic colitis indicates, for example, that eosinophile cells are involved, and the inflammation is taking place in the colon.) Some IBD forms occur in specific breeds. The Basenji and the Lundehund might get diarrhoeal syndromes, while German Shepherds may contract lymphocytic plasmacytic enteritis. Other animals that are predisposed to IBD are Yorkshire Terriers, Cocker Spaniels and purebred cats.
Dietary Considerations?
Dietary allergy seems to be an unlikely cause of IBD (except in eosinophilic gastroenteritis), it may contribute to increased permeability of the gut wall and sensitivity to various foods. Current research supports the likely involvement of hypersensitivity reactions to proteins (e.g. food, bacteria, mucus, epithelial cells) in the intestine. This reaction may result in the intestinal wall becoming inflamed. Persistent inflammation results in fibrosis and scarring of the intestine.
The Signs Of The Times …
The average age at which clinical disease develops is 6.3 years in dogs and 6.9 years in cats, but IBD has been documented in dogs less than 2 years of age. Clinical signs are often chronic and sometimes cyclic or intermittent. Vomiting, diarrhoea, changes in appetite, and weight loss may be seen. Intermittent vomiting may progress to more frequent vomiting. Bloody stool associated with vomiting and cranial abdominal pain are often seen with stomach and small intestinal ulceration and erosion. IBD in dogs may predispose animals to a condition called gastric dilatation-volvulus, where the stomach enlarges and inflates after having rotated out of position. Research has shown that may be an association between inflammatory liver disease, pancreatitis, and IBD in cats. Although as yet unproved, it has been suggested that severe IBD in cats may progress to lymphosarcoma, a form of cancer.
How IBD Is Diagnosed And Treated …
Diagnosis requires biopsy of the intestinal wall. Complimentary blood tests, X-rays and/or abdominal ultrasound examination may contribute significantly towards confirming the diagnosis. Biopsy must always be considered in relation to clinical signs, and the animal treated accordingly. The goals of therapy are to reduce diarrhoea, promote weight gain, and decrease intestinal inflammation. If a cause can be identified (e.g. dietary, parasitic, bacterial overgrowth, drug reaction, etc), it should be eliminated. Dietary manipulation by itself may be effective in some cases (e.g. in chronic colitis); in other cases, it can enhance the efficacy of concurrent medical therapy allowing for the drug dosage to be reduced or for drug therapy to be discontinued once clinical signs are in remission.
Changing The Diet
Dietary modification generally involves feeding a hypoallergenic or elimination diet, i.e. feeding a source of protein that the animal has not been previously exposed to. This diet should be the sole source of food for a minimum of 8 weeks, and no treats of any kind should be fed. Novel protein diets (ostrich meat or egg) alone are effective in controlling clinical signs in cats with IBD, but not in cats with food sensitivity or food allergy. Dogs with large-intestinal diarrhoea may benefit from diets high in insoluble fibre content. Supplementation of dietary fiber alone is rarely effective in severe cases.
Understanding The Prescription
Treatment will often involve medication that will manipulate the function of the immune system since IBD seems to be an immune-mediated disease. It is absolutely critical that pet owners understand what medication has been prescribed, why it has been prescribed, as well as know what the potential side effects may be. Once the treatment has proven to be effective, the pet owner and the vet in consultation with each other should then consider reducing the dosages of the medication, in an effort to find the lowest possible dose of each required medicine that will keep the affected animal comfortable, and ideally symptom free and healthy. IBD cure is not easily achieved and often means life-long treatment for the affected pet. Thus, every effort should be made to avoid any type of complication.
Quality Of Life … A Goal
The prognosis for feline IBD is good for adequate control but poor for cure. It has been reported that 79% of cats with IBD treated with a combination of diet and medication had a positive clinical response. A more guarded prognosis is reported in cases with severe internal pathology. Relapses occur and are most often precipitated by dietary indiscretion.
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