G.I. Tract

Inflammatory bowel disease (IBD) is a condition of inflammation of the intestines.

There are four common types of IBD, classified by what kind of white blood cells infiltrate the intestine: lymphocytes, plasmacytes, eosinophils and neutrophils. Without a doubt, the most common cause of IBD in pets is lymphocytic-plasmacytic enteritis, gastritis and colitis.

If your pet’s intestines are inflamed long enough, the situation can create a host of other debilitating health conditions.

IBD and Leaky Gut

Both cats and dogs get IBD. Both are susceptible to dysbiosis or ‘leaky gut,’ which means the balance of bad to good intestinal bacteria gets out of whack.

Leaky or permeable gut is a condition in which inflammation weakens the tight junctions of the cells of the GI tract, allowing partially digested proteins and potential allergens to escape into your pet’s bloodstream.

Allergens in the bloodstream trigger a systemic immune reaction – your pet’s body senses foreign invading substances and mounts a powerful defense. The result is allergies or worse – autoimmune or immune-mediated disease. A simple explanation for this condition is that your pet’s body is attacking itself.

IBD Leads to Secondary Infections, Organ Degeneration, Nutritional Deficiencies and Even Cancer

Secondary infections are very common in dogs and cats with inflammatory bowel disease. This is the result of not having a balanced, healthy digestive system.

Over half your pet’s immune function is located in his GI tract, so if the intestines are inflamed and compromised, the immune system is compromised right along with it.

Secondary organ degeneration is common with IBD, especially in the kidneys and liver.

Nutritional deficiencies are also typical in IBD pets because inflammation disrupts the normal absorption and processing of nutrients from food.

With kitties, there’s a correlation between GI cancer (lymphoma of the GI tract) and chronic IBD.

A Common Cause of IBD – GI Parasites

There are a few common causes of inflammatory bowel disease in dogs and cats.

One that is often overlooked is the presence of parasites.

My estimate is the vast majority of puppy mill pets and abandoned/rescued animals left at shelters are positive for parasites – roundworms, hookworms, tapeworms, coccidia, and Giardia. Parasites cause GI inflammation.

Another source for parasite infestation is in litters whose mothers were not tested or treated prior to being bred. Responsible breeders arrange for testing and deworming of females before they are bred, which insures litters will be parasite free.

Less responsible or unknowledgeable breeders don’t take the same precautions and end up selling litter after litter of puppies and kittens that have GI parasites.

The next problem arises at the veterinary clinic, where broad spectrum dewormers are given to infected animals at regular intervals until 16 weeks. At the end of the 16 weeks, the pets are re-checked to see if the parasites are gone.

But here’s the issue: if the specific parasite isn’t identified, it may not be killed by a broad spectrum dewormer. So pets wind up with several weeks of unnecessary medication that doesn’t even solve the problem.

Many dogs I see at my Natural Pet hospital have been dewormed three or four times but are still having problems. When I check fecal samples for these pups, I often find they are coccidia or Giardia-positive. Broad spectrum dewormers don’t take care of these particular parasites. Giardia, for example, causes intermittent diarrhea and chronic low-grade inflammation of the GI tract. It is not responsive to the dewormers most vets prescribe.

A saner, safer approach is for your vet to do at least three fecal analyses one month apart to determine the type of parasite and to confirm your pet is rid of them. Selecting the appropriate dewormer for the type of parasite, and treating the pet until the parasites are completely resolved is a crucial part of decreasing GI inflammation and preventing full-blown IBD.

By the time these unfortunate pups are seen at my practice, they are over 16 weeks old, with intermittent soft stools indicating GI inflammation, and they typically still have a parasite problem which requires treatment before any other symptoms can be resolved.

Another Root Cause – Antibiotics and Steroids

Another of my frustrations is that animals with low-grade GI inflammation are treated with antibiotics by the traditional veterinary community.

Antibiotics are a second common trigger for inflammatory bowel disease.

GI antibiotics kill the healthy bacteria right along with the bad guys. When all bacteria is obliterated from your pet’s gut, the regrowth often results in an imbalance featuring too many gram-negative, unhealthy bacteria or opportunistic yeast and not enough of the friendly variety. This is the definition of dysbiosis.

Now we have a 16+ week old puppy or kitten that has had several weeks of GI inflammation, ineffective deworming treatments, one or two rounds of antibiotics which have obliterated all the bacteria in his GI tract, and no re-seeding of bacteria with an appropriate probiotic to insure a healthy balance.

This little guy is well on his way to low-grade GI inflammation and IBD.

I’ve also seen dogs and cats that at six months of age are already on Prednisone therapy for GI inflammation. Prednisone is an immunosuppressive steroid, which turns the immune system down or completely off, wiping out troublesome symptoms and giving the appearance of a ‘cure.’ Unfortunately, this treatment doesn’t do a thing to uncover the root cause of the GI inflammation and ultimately postpones true healing.

A Third Culprit: Food Intolerance

In my practice I see many pets brought in for intermittent soft-to-watery stools, a situation many pet parents dub ‘sensitive stomach.’

Typically, this ‘sensitive stomach’ means the dog or cat cannot undergo any sort of dietary change without major GI consequences. This isn’t what nature had in mind when it built your favorite furry friend.

Just as you are designed to eat different foods at every meal without GI disturbance, pets with healthy, resilient GI tracts should be able to tolerate changes in the food they eat without negative consequences.

Probably more than half the pet owners I talk to assume it’s normal for their dog or cat to have GI sensitivity to changes in diet. But what’s really going on is the animal’s gut is in some way compromised and therefore cannot withstand dietary variety. It could be a low-grade inflammation that has been present for weeks, months or even years by that time.

Food intolerance or sensitivity can begin with a poor quality, non-species appropriate diet – one that is high in unnecessary carbohydrates. Processed pet food containing a lot of corn, wheat or rice can create inflammation in the gut of your carnivorous dog or cat, designed to digest meat – not grains.

I also have clients that feed a raw, species-appropriate diet without carbohydrates, which is wonderful, except they feed the same protein source for weeks, months or years.

Many animals (including humans) develop hypersensitivity to a food they eat over and over again. Inflammation is the result and can lead to IBD.

So overfeeding too much of even the right foods can lead to problems in the digestive tract.

Testing for IBD

There are two different diagnostic tests that are commonly done to detect IBD.

One test is what is known as a ‘confirming’ test, in which a biopsy is taken to assess morphologic characteristics common in the GI tracts of animals with inflammatory bowel disease. This is not my first choice because it’s expensive, invasive and involves anesthesia and the inherent risks that come with it.

The other test, which I use often in my practice, is a functional gastrointestinal test using a blood sample.

What we’re looking for with this test is two types of B vitamin absorption, the first of which is folate. Folate is a water-soluble B vitamin that is not easily absorbed in the small intestine unless it is deconjugated there.

If your pet’s small intestine can’t deconjugate folate, meaning it can’t break it down into an absorbable form, she can end up folate-deficient, in which case her blood test will show low or suboptimal levels of folate.

A low folate level means either your pet’s assimilation and absorption of nutrients is poor, or her body is challenged by the deconjugation process, indicating a disease or disorder of the small intestine.

If your pet’s folate is high rather than low, it indicates another type of problem. Your pet’s small intestine contains a small amount of bacteria critical for the production and assimilation of certain B vitamins. If this bacteria blooms into an overgrowth, your pet can wind up with high folate levels and a condition known as SIBO – Small Intestinal Bacterial Overgrowth.

The second blood test I use to assess GI function involves another B vitamin called cobalamin, which is bound to protein.

Cobalamin is released from protein through a complex series of events that starts in the stomach and finishes in the small intestine.

If cobalamin levels are low, we can assume this complex process is not occurring optimally. Cobalamin levels are a measure of digestion. This condition of maldigestion can sometimes also involve the pancreas. The disorder is called EPI – Exocrine Pancreatic Insufficiency and can be diagnosed via another GI blood test called a TLI (Trypsin-like Immunoreactivity).

If you suspect your pet has IBD but you’re not interested in doing a biopsy at this point, ask your vet to perform functional GI testing to determine a diagnosis.

In my practice, I also do two additional functional tests, TLI and PLI, which assess pancreatic function. Secondary pancreatitis is a very common condition in IBD patients, so assessing your dog’s or cat’s pancreatic function is also important.

These functional GI tests are available through the gastrointestinal lab at Texas A&M University.

Dietary Recommendations for IBD

Upon diagnosis, your veterinarian will probably tell you to feed a bland diet if your pet is symptomatic with vomiting, diarrhea or soft stool with mucus and/or blood.

My idea of a bland diet is different from a traditional veterinarian’s. I recommend ground cooked turkey and canned pumpkin or cooked sweet potato. I don’t recommend the traditional beef and rice. Beef is high in fat, which can exacerbate GI inflammation and pancreatitis.

Rice is a complex carb which can be fermented in the GI tract, causing gas, which can lead to additional digestive upset.

I recommend a grain-free, bland diet because in my experience it’s more suitable to pets with active symptoms of IBD.

While feeding your dog or cat a bland diet, you should be thinking about what’s next for her in terms of nutritional requirements. Bland is fine for a short time, but balance in the diet is crucial

I recommend you work with an integrative veterinarian to select a novel protein source -- one your pet has either never consumed or hasn’t for a long while. This will give the GI tract and your pet’s immune system a good rest.

You’ll also want to select a novel vegetable or fiber source as well, to create an anti-inflammatory menu that will facilitate healing within both the large and small intestine.

An integrative vet can help you build a comprehensive protocol for your pet that addresses not only dietary issues, but also vaccinations, the use of drug therapy, and any potential toxins in your pet’s environment or lifestyle that could be contributing to unaddressed inflammation.