Inflammatory Bowel Disease

What is inflammatory bowel disease?

IBD is a result of long-term irritation of the intestinal tract. Dogs who appear otherwise normal will usually suffer from poor appetite, chronic vomiting and diarrhoea. IBD is a group of symptoms which means it is actually a syndrome rather than a disease.

What causes it?

Several factors are involved with IBD and the exact cause is not yet identified, but ultimately the lining of the intestine is compromised by invading inflammatory cells. This disrupts the digestion and absorption of nutrients and an allergic-type response then occurs within the intestinal tract.

Possible causes include a pet’s reaction to a specific protein in their diet and/or a parasitic/bacterial infection such as Salmonella, E. coli, or Giardia.

What are the clinical signs?

Although IBD can involve any part of the digestive tract the most commonly affected areas are the stomach and/or the intestines. Stomach problems will cause the dog to experience chronic vomiting, intestinal difficulties will manifest as diarrhoea and both of these can occur simultaneously. Poor appetite and subsequent weight loss are noticeable consequences of this although some dogs will start to eat excessively due to the resulting inability to absorb nutrients from their food.

How is IBD diagnosed?

If other conditions have been ruled out and the signs of IBD are present then the condition may be presumed, but a conclusive diagnosis can be formed by tests such as:

• Faecal examinations looking for infections

• Blood tests to determine vitamin B12/folate levels

• X-ray or ultrasound scans of the intestines

What is the treatment?

No permanent cure exists but - depending on the dog - the condition can be managed with the following:

• Diet: If recommended, specific meal plans are used as a therapeutic trial. These diets must be fed exclusively for six to twelve weeks and must be strictly adhered to (no treats!). This may involve high-fibre options, home-cooked exclusion diets and hypoallergenic or low-residue foods. Other nutrient adjustments are important in supporting pets with IBD. You can read more about this below.*

• Medication: If required these may be antibiotics or probiotic supplements to calm inflammation and restore the bacterial balance of the digestive system. A vet should always be consulted before giving these to your dog.

• Deworming: This is recommended for pets with IBD because faecal tests are not always representative of the parasites in the GI tract and parasite burden worsens the signs of IBD.

• B Vitamin Supplementation - An injection or oral supplement of B12 will likely be given to dogs with IBD as most will show low levels.

*Nutritional Management of IBD - Specific Points

As discussed above, one of the common initial steps in the nutritional management of IBD is to use a limited-ingredient elimination diet. Other aspects of feeding can also have a positive impact on the syndrome:

• Zinc - Zinc levels may drop in pets with IBD due to poor absorption or as the result of certain medications (e.g. antacids) so providing higher levels of zinc is important. It helps to improve the quality of the gut surface and speeds gut healing. One of the earliest signs of zinc deficiency is a poor coat, so it is important to consider zinc supplementation in pets who have developed brittle, dry or itchy coats. The VetChef IBD supplement provides higher-than-usual levels of zinc in a highly bioavailable natural protein-bound form to support gut function and all balanced VetChef IBD recipes are formulated to ensure total zinc intake is in line with clinical guidelines for IBD.

• Digestibility - Providing diets that are highly digestible is important for pets with digestive disorders of any kind. Freshly cooked foods have the highest digestibility and the use of home-cooked diets containing easily absorbed protein and carbohydrate sources can be helpful. If you are using kibble or canned diets you should ideally choose products with known high digestibility. Usually these are prescription diets intended for gastrointestinal disorders.

• Fat Level - Many pets with IBD cope best on diets that are moderate to low in fat. Ideally we aim for a level of 10-15% by Dry Matter although the specific tolerated level will vary between individual pets.

• Protein Level - It is important to provide enough protein for pets where absorption is hindered and appetite is not as good as usual. Protein levels should be at least 25% Dry Matter (you can read more about Dry Matter here).

• Omega 3 - These fatty acids (especially EPA/DHA) have an anti-inflammatory effect on pets with IBD. It can take some months for the effect to be optimal but it is important to include higher levels in the diet.

• Fibre - The fibre level required by dogs with IBD can vary. Some pets will respond to high levels whilst others will be better on very low levels (these are often referred to as low-residue diets in humans). It is not always easy to predict this and so it may be beneficial to gradually adjust fibre in pets with IBD under the supervision of your vet or nutritionist.

• Potassium - Potassium levels in pets with IBD often drop too low as a result of diarrhoea. This can cause secondary issues such as weakness, muscle wastage, vomiting or nausea. VetChef recipes for IBD (in combination with the VetChef IBD Supplement) are designed to provide higher than usual levels of potassium. Green vegetables, potatoes and whole grains are all good sources.

• Other B Vitamins - Pets with IBD have often been tested for B12 and Folate deficiency and are supplemented accordingly but other B vitamins are often low due to poor food intakes and reduced gut absorption. Deficiencies in other water-soluble B vitamins (e.g. Thiamine) can affect appetite and reduce food intakes further, thereby exacerbating weight loss and deterioration. For this reason it is important to provide higher levels of all water-soluble B vitamins. All balanced VetChef recipes intended for IBD account for this.

Nutrient Summary - IBD

High-Digestibility Ingredients only Protein: >25%DM

Fat: 12-15%DM

Fibre: Adjust to effect

Zinc: 2-3 x Recommended Allowance

Potassium: 0.8-1.1%DM

Omega 3: EPA+DHA - Total >50mg/kg

B12 and Folate supplemented to correct blood levels

Other B Vitamins: Supplemented to higher than minimum level

What is the prognosis?

Once the diagnosis is confirmed and treatment instigated, some pets will be easier to manage than others. Some will remain on the appropriate diet or drugs for life, although alterations may be made over time. A challenging condition may require frequent alterations to medication or diet as the syndrome changes or progresses. Sometimes a dog will be able to stop drugs completely if the dietary management is effective enough.

More about IBD: If your vet has suggested that you try an elimination (exclusion) diet with your dog, you can read more about how to do this here.