Inflammatory Bowel Disease (IBD)

Overview

Inflammatory bowel disease (IBD) is one of the most common causes of chronic vomiting and diarrhea in cats and dogs. In most pets the ‘trigger’ of the reaction within the intestinal tract (gut) is due to:

Bacteria
A food type or ingredient
An inappropriate immune reaction by the pet’s own body

This reaction by the intestinal tract (gut) causes inflammation and leads to worsening of clinical signs such as vomiting, diarrhea or poor appetite.

Importantly, IBD is sometimes confused with irritable bowel syndrome (IBS), however these are two very different diseases, and are require different treatments.

Signs & Symptoms

Signs of IBD include gastrointestinal (GI) signs and others such as:

Vomiting
Diarrhea
Change in appetite (eating less, ‘picky’ appetite, rarely eating more)
Change in the pet’s attitude or energy level (quiet, sleepy, dull)
Weight loss may also occur

Diagnosis

Unlike other causes of these GI signs in dogs and cats, IBD doesn’t get better or resolve on its own. It lasts for more than 3 weeks (making it a chronic disease), and may not respond completely to medicines or a change in the pet’s diet.

Tests your veterinarian may use to diagnose IBD include:

Blood and urine tests to determine how severely the pet is affected, evaluate for concurrent disease, and help plan treatment strategies
Feces testing or a deworming trial to ensure parasites are not involved
Imaging like ultrasound and X-rays to look for other causes of disease and assess the appearance of the stomach and intestines
Specialized blood tests to investigate non-GI causes of your pet’s signs like pancreatitis and hormonal disease, as well as measurement of B vitamins
Biopsy of the intestinal tract – either surgical or endoscopic biopsies to characterize the disease, plan and evaluate response to treatment

Treatment & Aftercare

Initial treatment usually consists of diet change (specific veterinary novel protein or hydrolyzed protein diet, and/or low fat diet) to assess for the possibility of food intolerance as a reason for your pet’s clinical signs. Antibiotics may be part of the treatment for some patients. If your pet does not respond to either of these treatments and biopsies confirm the diagnosis of IBD, medication to reduce inflammation and the immune response might be required (eg. prednisone/prednisolone, or other immunosuppressive drugs).

The goals of IBD treatment are:

Improve quality of life for the pet and pet’s family
Decrease the inflammation in the intestinal tract
Allow the pet’s normal intestinal bacteria to come back

Prognosis

IBD is rarely cured but can be well managed and controlled with both dietary and medical therapy. In most pets, the prognosis with medical and dietary management is excellent, and there is no impact to their expected lifespan.

In some pets, side effects from immune suppressive medications can occur. As uncomfortable as these may be (for the pet and the household), it is important to realize that these effects are typically short-term. Side effects will improve as the medication’s dose is decreased, therapy changes, and as the pet improves.

A relapse or worsening of symptoms in pets with IBD is most commonly due to:

Lack of strict diet management (giving treats or using different foods)
Incorrect diagnosis (ie. if biopsies are not obtained to confirm clinical suspicion)
Tapering or stopping medications too quickly

Don’t hesitate to ask your veterinarian any questions you have about IBD or its treatment. Your veterinary specialist will want to work with you as a team since you are the one who knows and understands your pet the best.