How to Help a Dog With Inflammatory Bowel Disease (IBD)

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It’s the kind of ailment that can sometimes take years (and multiple vet visits) to diagnose. It can cause serious discomfort for your dog and, often, lots of clean-ups for you. And these days, it goes by a new name. What’s a loving dog person to do when their best friend has chronic inflammatory enteropathy (CIE), formerly known as Inflammatory Bowel Disease (IBD)? 

Chronic inflammatory enteropathy is an umbrella term for various gastrointestinal ailments that stick around for three weeks or more. They tend to arise when diet, illness, and other factors compromise your dog’s intestinal lining. According to Christina Marino, DVM, Diplomate of the American College of Veterinary Internal Medicine (Small Animal), a veterinarian and owner of Small Animal Veterinary Specialists and Small Animal Veterinary Care, many vets still call chronic enteropathy “IBD” for short “because that rolls off the tongue better.”

Depending on how your dog’s chronic enteropathy responds to treatment, it will fall into one of these categories: 

  • Food-responsive enteropathy (meaning the issues subside with a change in diet)
  • Antibiotic-responsive enteropathy (requires antibiotics in order to treat)
  • Immunosuppressive-responsive enteropathy (requires immunosuppressive medications)
  • Non-responsive enteropathy (does not respond to diet or medical intervention)

If you suspect your dog is dealing with chronic enteropathy, here’s a preview of the path ahead.

What are the symptoms of chronic inflammatory enteropathy in dogs?

With chronic enteropathy, it’s important to focus on the word “chronic”—meaning that it keeps happening. This isn’t a case of “the dog ate something weird and got sick.” Often, Dr. Marino said, “these are dogs that have had these signs for a while that just continue to happen over and over.” 

If you suspect your dog has chronic enteropathy, look for patterns like:

  • Vomiting and progressive vomiting
  • Regurgitation
  • Reflux
  • Diarrhea
  • Blood in stool
  • Excess gas 
  • Nausea
  • Lack of appetite
  • Lethargy
A tired brown dog lying down on a carpet.

How do I know if my dog has inflammatory bowel disease/chronic enteropathy?

As scary as five-syllable health terms like “enteropathy” might sound, CIE can be relatively simple to treat: Dr. Marino said that 75% of patients respond well to dietary changes alone. Still, it’s important to rule out other potential causes. Per Dr. Marino, chronic enteropathy is usually a diagnosis of exclusion—meaning that veterinarians diagnose it by eliminating other possible explanations for a dog’s signs of illness.

Ruling out secondary illness

Early on during the diagnostic process, your vet will want to confirm whether your dog’s illness stems directly from their GI system, or if it’s actually starting somewhere else. Dr. Stuart Walton, Diplomate of the American College of Veterinary Internal Medicine (Small Animal), Clinical Assistant Professor of Small Animal Internal Medicine at University of Florida, said that bloodwork is often the first step. That helps weed out concerns like liver, kidney, or pancreatic disease. Your vet might also check or treat for parasites, run a GI panel, and/or run an infectious disease workup.

Trying a new diet

Technically, Dr. Marino said, a formal diagnosis requires a biopsy. But these days, many vets try dietary modifications first to avoid the cost and hassle of general anesthesia—especially given how often it does the trick on its own. See the treatment section below for details on the dietary changes a vet might try.

If the new food is going to work, Dr. Walton said, symptoms usually begin shifting within one to two weeks. “It doesn’t have to completely resolve,” he said, “but we should see improvement in those patients during that period of time.”

Screening for other diseases

If new eating habits don’t move the needle, it’s time to look for more serious illnesses. This is usually when Dr. Walton uses an ultrasound to check the abdomen for masses, enlarged lymph nodes, and other abnormalities. He also runs an adrenocorticotropic hormone (ACTH) stimulation test to check for an adrenal deficiency called Addison’s disease. Dogs whose tests come back clean might then need a biopsy, either surgical or endoscopic, to check for inflammation or cancer in the intestines. 

A worried-looking Rottweiler.

What does treatment for chronic enteropathy look like?

Your vet will likely start by switching out your dog’s food—but, regardless of which direction treatment takes from there, get ready to hear the word “microbiome” a lot.

Changing diet

If you’re lucky, this step will do the trick all on its own. 

“Our ultimate aim, always, for [chronic inflammatory enteropathy] patients, is to try and control with diet and diet alone,” Dr. Walton said. “Plus or minus things like a probiotic.”  

What to feed a dog with IBD/CIE will depend on their specific needs. According to Dr. Marino, your vet might swap highly processed food for a fresh, minimally processed diet, a hypoallergenic diet with hydrolyzed or novel proteins, or a different regimen that targets other macronutrients like fat or fiber content. And, wherever they start, they’ll likely try a couple more if it doesn’t work.

Dr. Marino usually tests out at least three or four “very different diets” before moving on to other interventions like medication. “If they’re not having a good response to the diet in two weeks, that’s a short enough time for us to be able to say we need to switch it,” she said. Still, patience is also key: “We’re talking eight, 12 weeks sometimes for things to finally normalize,” Dr. Marino said. 

Balancing the microbiome

Just like people, dogs have a gut microbiome—a community of microorganisms that live in our GI tracts and shape our digestion, immune system, and other factors in our health. If your dog has ongoing digestive problems, chances are this delicate system is out of whack. Fortunately, Dr. Walton said, “There are a lot of ways you can manipulate the microbiome these days.” 

Researchers at Texas A&M have developed a dysbiosis index to determine exactly what’s wrong with your dog’s gut. “It’s not 100%,” Dr. Marino said, “…but it can help to guide you in what you need to do to fix that microbiome.” 

Depending on your dog’s specific gut problem, your vet might use probiotics (good bacteria), prebiotics (soluble fiber that feeds good bacteria), or postbiotics (substances left over after the probiotics feed on prebiotics) to restore balance. They might also recommend “fecal microbiota transplantation”—or, as Dr. Marino charmingly calls it, “a poop transplant.” (For those curious, this happens either through an enema or a pill.)

Medications

Not all dogs can heal through diet alone. For more severe disease, Dr. Walton will sometimes prescribe a steroid. If the patient doesn’t respond well, he might opt for a delayed-release steroid that doesn’t dissolve as quickly and may produce fewer side effects.

“If our patients are really not responding well to steroids or they’re having unwanted side effects, we will usually get there and pick a secondary agent, or we’ll try and transition [them] off steroids and put them on to an alternate medication,” Dr. Walton said. In these cases, he might move on to an immunosuppressive medication like chlorambucil or cyclosporine.

Because antibiotics can disrupt the microbiome, Dr. Walton and his team tend to avoid them when possible in these cases; as he points out, a five- or seven-day course of antibiotics can leave dogs with effects that last “well and truly beyond six to seven weeks.” Bacterial diversity can dwindle, and pathogenic bacteria (“bad” bacteria) can flourish, making the disease process even worse. At the same time, Dr. Marino said, “Sometimes you can’t avoid giving antibiotics if [the patient has] a systemic infection or a severe infection that is life threatening.” When they’re needed, antibiotics can save lives.

How to help your dog at home

When asked what owners can do at home to help their dogs heal alongside treatments from their vet, Dr. Walton suggested one thing not to do. If your dog has been diagnosed with food-responsive chronic enteropathy, it’s best not to break their diet—no matter how tempting it might be to give them a little treat. “That’s probably the hardest thing,” he said, but it’s incredibly important.  

Dr. Marino, meanwhile, urges owners to speak up if they believe their dog needs supportive medications. For example, she said, “If it’s a vomiting thing and they’re still vomiting while we’re trying to figure all this out, don’t be afraid to say, ‘Hey, I need some medications.’ … They’re not going to be used for the rest of the dog’s life.”

It can be tough to see your dog in distress, but most dogs with IBD/CIE who receive treatment have a good prognosis. The main thing is to pay close attention to any signs of illness and get them to the veterinarian for an exam and some advice.

The post How to Help a Dog With Inflammatory Bowel Disease (IBD) appeared first on The Farmer’s Dog - Digest.


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