Inflammatory bowel disease and adverse reaction to food in a dog

26 Inflammatory bowel disease and adverse reaction to food in a dog




Initial presentation


Six months of soft to watery diarrhoea and weight loss and episodes of vomiting


Signalment: 4-year-old entire male Sharpei, body weight 15.5 kg



Case history


The dog presented with a chronic, 6-month history of diarrhoea and weight loss. He was producing large volumes of soft faeces, with no increase in frequency of defecation, no blood or mucus in the faeces and no tenesmus while defecating. There had been episodes of vomiting occurring nearly every day. The dog usually vomited digested food and bile and this often occurred soon after eating. The owner reported that the dog had become quieter than he had been previously.



Clinical tip


The presence of weight loss, large volumes of faeces and lack of tenesmus, mucus or haematochezia indicate diarrhoea of small intestinal origin. Localizing the source of the diarrhoea aids the clinician in making a differential diagnoses list and deciding upon diagnostic techniques.



Clinical tip


The presence of digested food and bile in the vomited material indicates that it is likely to be true vomiting rather than regurgitation. The length of time after eating that an event takes place does not necessarily indicate whether it is vomiting or regurgitation.


The dog had been fed a variety of diets in an attempt to control the gastrointestinal signs, including a highly digestible diet for gastrointestinal disorders and a premium dry dog food.


The current diet being fed was a commercial dry diet based on lamb and rice. The dog had a good appetite while on this food, but there was no improvement in the diarrhoea or vomiting. In addition to eating dog food, the dog also scavenged from rubbish and was fed treats of human food.


His vaccinations were upto date and he had been treated for parasites 6 months prior to presentation. He had not travelled outside of the UK.


The diagnostic tests and treatments from the previous veterinary surgeon included:


• Faecal examination for parasites: negative

• Treatment with sulfasalazine and metronidazole for 1 week (doses not reported)

• Dietary therapy: a dry veterinary diet designed for intestinal disease for 2 weeks, then a dry commercial premium dog food for 2 weeks

There had been an initial improvement on these treatments and then the diarrhoea reoccurred 2 months later. He was treated again with sulfasalazine, metronidazole (doses not reported) and prednisolone at 0.6 mg/kg, with no improvement.



Clinical tip


Sulfasalazine is used for large intestinal diarrhoea so would not be expected to improve the signs in this dog. Metronidazole does help in some cases of diarrhoea. Prednisolone should probably not be used without a confirmed diagnosis; if it was being used for presumptive inflammatory bowel disease, the dose was too low as it is between the physiological dose for dogs (0.15–0.25 mg/kg/day) and the anti-inflammatory dose for dogs (0.5–1 mg/kg/day).



Clinical tip


While the diets that were used in this case are highly digestible they do include several protein sources and are not appropriate as elimination diets. The first ingredient in the lamb and rice diet was wheat, showing that it is necessary to read the labels. The diets at the time of this case contained the following main ingredients:


a Veterinary intestinal diet: maize, gluten meal, chicken and turkey meal

b Premium dry diet: chicken, rice, maize, poultry meal, gluten meal, wheat, fish oil, egg

c Lamb and rice based diet: wheat, lamb, rice, bran

On physical examination the dog was quiet and alert and his hydration was adequate. His body condition score was 3/9, with evidence of muscle loss. His mucous membranes were pink and capillary refill time was <2.5 seconds. His temperature, pulse and respiration parameters were within normal limits, thoracic auscultation was unremarkable and lymph nodes were within normal limits. On abdominal palpation there were thickened loops of small intestines which felt fluid filled. He had a dry dull hair coat.



Problem list and discussion of problems



• Chronic small intestinal diarrhoea

• Weight loss with good appetite

• Occasional vomiting


Differential diagnosis



Chronic small intestinal diarrhoea



• Dietary
• gluttony – the dog did have a good appetite but this is unlikely to cause chronic diarrhoea

• changes of diet – possible with scavenging and snacks

• adverse reaction to food: intolerance or allergy

• Gastric disorders
• rapid gastric emptying

• Small intestinal disease
• infectious, e.g. bacterial, viral, fungal

• gastrointestinal parasites

• inflammatory bowel disease

• infiltrative neoplasia, e.g. lymphoma, mastocytosis

• partial obstruction, e.g. intussusception, foreign body

• brush border defects

• lymphangiectasia

• Pancreatic disease
• chronic pancreatitis

• exocrine pancreatic insufficiency

• pancreatic neoplasia

• Liver disease
• bile duct obstruction

• liver failure

• Kidney disease – unlikely as he did not have polyuria/polydipsia (pu/pd), although glomerular disorders may present without pu/pd

• Miscellaneous
• congestive heart failure – no signs consistent with this

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Sep 22, 2016 | Posted by in SMALL ANIMAL | Comments Off on Inflammatory bowel disease and adverse reaction to food in a dog

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