Inflammatory Bowel Disease (IBD)

What is inflammatory bowel disease (IBD)?

IBD results from an inappropriate response of the immune system to substances presented to the gastrointestinal tract. These substances might include proteins, carbohydrates, food preservatives or bacteria in the stomach or intestinal tract. For some unknown reason, the immune system begins to recognize one or more of these substances as foreign and reacts by trying to rid them from the body. The white blood cells of the immune system leave the blood stream and migrate into the walls of the gastrointestinal tract. This causes the walls to become thickened and decreases the ability of the stomach and intestine to properly digest and absorb nutrients from the ingested food. Any region of the gastrointestinal tract from the stomach through the large intestine can be affected, and different regions may be affected to varying degrees. For example, there may be mild inflammation in the stomach, but severe inflammation in the small or large intestine. Severe cases of IBD, particularly in cats, can progress to a cancer called lymphosarcoma.

What are the clinical signs of IBD?

The clinical signs seen with IBD vary, but most commonly, the pet suffers from one or more of the following clinical signs. These include decreased appetite, nausea, vomiting, diarrhea or weight loss. The pet may have any one of these clinical signs alone, or all of them depending on the region of the gastrointestinal tract affected and the severity of inflammation.  The frequency of vomiting or diarrhea can vary from multiple times daily to intermittent episodes. Some pets will begin to lose weight, despite having a reasonable appetite. The clinical signs may not be severe, and might be written off to the pet having a “sensitive stomach”. Many pets have had intermittent episodes of vomiting or diarrhea for months to years before seeking medical attention. 

Can I test my pet for IBD?

here are dozens of causes for vomiting, diarrhea, inappetence and weight loss in cats and dogs. Before pursuing a diagnosis of IBD it is important to rule out other causes of the clinical signs by performing less invasive tests first. These screening tests might include fecal examination, routine or more specialized blood tests and urinalysis to screen for metabolic causes of the clinical signs, such as liver, kidney, thyroid or pancreatic disease and viral testing in cats. Radiographs and ultrasound may also be recommended to evaluate organ size and texture and to look for evidence of masses. Ultrasound can also look at the thickness and layering of the gastrointestinal tract. If after these screening tests, it is still indicated, your veterinarian may recommend endoscopy. This procedure requires the pet to be put under general anesthesia. A long, flexible scope with a camera in the end is inserted into the stomach and upper small intestine, where any gross abnormalities can be visualized. If large bowel diarrhea is perceived to be a problem, the colon and possibly the lower small intestine may also be evaluated. Small pinch biopsies are taken from each region and submitted to a pathologist. The pathologist is able to assess the tissues on a cellular level and look for abnormal accumulations of white blood cells in the stomach or intestinal walls. Endoscopic or surgical biopsy of the affected tissues is the only reliable method of diagnosing IBD. 

How do you treat IBD?

Treatment is tailored to each individual pet and depends on the severity of the inflammation and the clinical signs. Some pets will respond to a hypoallergenic diet if the inflammation is triggered by a component of the diet. Some pets require antibiotic therapy, as the compromised stomach and intestine are more prone to overgrowth of certain types of bacteria. Treatment of most pets is centered around suppressing the abnormal immune response by using medications such as corticosteroids. The goal is to use the lowest dosage of medication possible that prevents the clinical signs of IBD from re-surfacing, yet minimizes the side effects of the medications. 

Can IBD be cured?

There is no cure for IBD, however approximately 80% of pets can be controlled with diet change and medications that help to alleviate their clinical signs. The remaining 20% may range from having recurrent flare-ups of their clinical signs to not responding to medications at all. Although the majority of patients will require some form of life-long medication, the odds are in our favor that the pet’s IBD can be controlled with the pet leading a normal, quality life.


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