Is Diarrhea Common For Your Dog? It Could Be IBD 

As the name suggests, inflammatory bowel disease, or IBD, causes inflammation along the gastrointestinal tract. How does this happen? The exact cause is unknown. Inflammatory cells migrate to the GI tract and trigger an allergic-type reaction which causes inflammation (1).  When this happens, a dog will start experiencing clinical signs of IBD. 

What are the signs? 

The portion of the GI tract that is affected will determine some of the clinical signs. For example, if the upper small intestinal region is affected, vomiting may be a clinical sign due to the inflammation. This also impacts nutrient absorption. Other common clinical signs associated with IBD include chronic diarrhea and poor appetite. There may or may not be some weight loss depending on the severity. 

So, how is it diagnosed?

When presented with a patient that may have IBD, a clinician will typically order several tests. First, a fecal analysis will be performed to rule out any potential intestinal parasites. Routine bloodwork is recommended to assess overall health and organ function. A GI panel is generally performed to assess pancreatic and small intestine function. Imaging such as an abdominal ultrasound may also be ordered. An abdominal ultrasound can reveal signs of thickening intestinal walls and local lymph node enlargement. This can make a clinician speculate a diagnosis of IBD, however, the only way to definitively diagnose IBD is through surgical or endoscopic biopsy of the intestines. 

A variety of factors such as genetics, environmental factors, microbial factors, and immune responses, can contribute to the development of IBD, though the exact mechanism is unknown. (2) Treatment of IBD is aimed at reducing inflammation throughout the gastrointestinal tract and suppressing an immunologic component.

Treatment Options

A variety of factors such as genetics, environment, microbes, and immune responses, can contribute to the development of IBD (2). 

• Prebiotics and Probiotics: Because IBD can often have associated dysbiosis, prebiotics and probiotics may be beneficial as these supplements are used to support and restore normal gastrointestinal health. Dysbiosis is a condition where gut bacteria become imbalanced and can cause shifts within the microbiome which can affect microbial populations and diversity. Some studies have shown that the use of probiotics in the cases of IBD may help mucosal homeostasis and provide anti-inflammatory effects (3).
• Antibiotics: Because dysbiosis affects the microbial community and diversity, some cases of diarrhea are classified as antibiotic responsive diarrhea. In these cases, antibiotics such as metronidazole or tylosin may be used.   
• Steroids and Immunosuppressive Medications: For cases that do not respond to the above therapies, steroid use is often implemented to help reduce inflammation and alleviate the clinical signs associated with IBD. If the steroids are not effective or produce too many unwanted side effects, additional immunosuppressive drugs may be used.  
• Vitamin B12 Supplementation: Patients with IBD have difficulty absorbing nutrients and vitamins. The majority of vitamin B12, also known as cobalamin, is absorbed in the gastrointestinal tract. It is essential for overall health and function. For patients severely affected by IBD, supplementation with an injectable form of B12 is recommended as it will help with nutrient absorption and appetite.

IBD can be such a frustrating disease for our canine companions and their owners. There are a variety of approaches to the management of IBD in dogs and sometimes it takes a little trial and error to determine the best treatment course for the individual patient. As the research in the microbiome field continues to expand, we will gain a little more insight into this complicated disease and its management.