My Lab mix, Rio, has always had a bit of a sensitive stomach. But last fall when he vomited blood, we knew something serious was going on. After help from the emergency room at Wheat Ridge Animal Hospital in metro Denver, Colorado, we scheduled an appointment with the internal medicine department.
Biopsy results revealed Rio has inflammatory bowel disease (IBD). So far, we’ve been able to manage it with probiotics and a strict diet of hydrolyzed protein (kibble and wet food). He happily wolfs it down and has regained the weight he lost from months of diarrhea and vomiting.
It’s an immense relief to see him feeling so much better.
Ruchita Ahuja, a veterinarian who is residency trained in internal medicine, helped get Rio healthy again. She said IBD is surprisingly common, and the veterinary community has been learning more and more about the condition in the past 10 to 15 years.
“What we know is that IBD is a chronic inflammatory disease of the intestines,” she says. “Most commonly, it affects the small intestine, but it can definitely affect the small and the large intestines.”
Evidence suggests IBD results from a dysregulation in the immune system, though technically it doesn’t fit the criteria for an autoimmune disorder. Veterinarians are currently researching potential triggers that can predispose dogs to it later in life. There are some associations with dogs who got a lot of antibiotics as puppies, which can potentially disrupt the normal microbiome.
“If I get a puppy that’s been on antibiotics, say for pneumonia or something, a lot of times we’ll try our best to add in probiotics to help maintain that normal microbiome,” she says. “That whole bacteria population in the gut, it’s really intricate. There’s a specific balance for every patient between good bacteria, bad bacteria, and their roles and their responsibilities in nutrition and digestion.”
The most common symptoms of IBD include diarrhea, vomiting, weight loss, or appetite changes, though Dr. Ahuja notes there are cases of IBD without any signs.
When she suspects a dog has IBD, she recommends a hypoallergenic diet trial, to which about half of dogs respond within 10 to 14 days, and probiotics, which typically show results in four to eight weeks.
Blood tests to measure vitamin levels such as B12, absorbed through the intestines, can also help point toward IBD if levels are low, as well as GI (gastrointestinal) panels from fecal samples. But the only way to definitively diagnose IBD is to get biopsies with endoscopy. (Dr. Ahuja and her team scoped Rio from both ends, so to speak. He spent the night before his colonoscopy at the hospital because the prep – including cleaning out the stomach and intestinal tract – requires special care.)
Once IBD is diagnosed, if a dog doesn’t respond to a hydrolyzed protein diet, the veterinarian can prescribe immunosuppressive medications.
“A lot of times we’ll start with steroids because one, it’s going to help suppress that immune response, and two, it’s also anti-inflammatory, so it will help act faster to get rid of that inflammation and get a better response,” Dr. Ahuja said. “If it’s a big dog, or if it’s a dog that doesn’t respond to steroids alone, we’ll talk about using other immunosuppressives.”
If a dog responds well to treatment, the prognosis is generally good, though Dr. Ahuja notes that there’s no cure for IBD.
“It’s going to be lifelong management, and there’s always a lifelong risk of relapse,” she said, adding that some dogs can eventually be weaned off steroids and just maintain a strict diet.
I know how hard it can be to keep a food-motivated dog from gobbling up random things. During Rio’s food trial, he managed to snatch some sort of discarded salami from a gutter when I was distracted by traffic as we were preparing to cross a busy street.
It’s so challenging to resist his puppy-dog eyes when I’m cutting tomatoes or slicing cheese, and to avoid walking past his favorite pet stores with delicious cookies inside. “Tough love” doesn’t come easily to me.
But then I remember waking up to the sound of retching, or hearing Rio moan in pain, or seeing him look at me weakly, almost as if asking for help. There’s no question: tough love is a small price to pay for a healthy, happy dog.
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Award-winning journalist Jen Reeder is former president of the Dog Writers Association of America.
Published April 19, 2021