Canine IBD, UK
When a dog turns up in their consulting room with chronic diarrhoea, vomiting and weight loss, then it is quite likely that the vet will call it a case of inflammatory bowel disease. But that is probably the only thing that they can say with any confidence after identifying one of the most enigmatic and frustrating conditions seen in small animal practice.
The cause of the disease is uncertain, the best treatment is still a mystery and even in those patients that do appear to be getting better, then the owner must appreciate that their pet’s condition is only under temporary control, it is rarely ever cured. However, first opinion practitioners may have a better idea of the task awaiting them and improve the odds of a satisfactory response, after attending the session on the diagnosis and treatment of canine disease by Alex German at this year’s BVA Congress. His talk is part of the excellent clinical programme designed by BSAVA to offer a greater small animal science presence at BVA Congress, 22-24 September, London.
Dr German, holder of a European diploma in internal medicine and a lecturer at the Liverpool veterinary school, will explain that IBD is not a single condition but a group of similar disorders characterised by persistent or recurrent gastrointestinal signs, with histological evidence of intestinal inflammation.
In many respects canine IBD is very like the common human condition, though there are key differences in the underlying pathology, he says. The inflammatory process in the intestinal wall will be found on biopsy to be lymphocytic-plasmacytic in origin whereas the two main forms of human IBD are neutrophilic in ulcerative colitis and granulomatous in Crohn’s disease.
Yet in both species the condition is largely seen to be rooted in a defective immune response triggered by a range of infectious, environmental and genetic factors. The search for specific gene factors has so far proved fruitless but the apparently excessive numbers of cases from particular breeds, notably German shepherd dogs, shar peis and Norwegian lundehunds certainly points in that direction.Another breed which is overrepresented in the list of canine IBD cases in the boxer which has a granulamatous form of disease more closely allied with Crohn’s disease. It is a condition for which US researchers appear to have found a trigger in the form of invasive E coli bacteria infiltrating from the dog’s gut. Dr German says there is increasingly strong evidence to show that an abnormal response to the patient’s normal gut flora is a key feature of the disease in many of its different forms.
Once established there does appear to be mainly an immunological problem and steroid therapy will usually be the mainstay of any successful therapy. But antimicrobial treatment can often be helpful in getting the condition under control, and dietary management particularly with low allergenic hydrolised protein may help to keep it that way. The use of probiotics is favoured by some clinicians but there is no convincing evidence that they can provide significant benefits other than as an adjunct therapy in already well controlled cases.
However, achieving the goal of controlling the symptoms of canine IBD is no easy task and the dog’s owner will have to accept a certain amount of trial and error in the treatment until the specific trigger factors can be identified in that individual animal. But once the particular features of the disease have been found then there is every chance that it can go on to enjoy a good quality of life.
1. Alex German BVSc(Hons), PhD, CertSAM, DipECVIM-CA, MRCVS is a graduate of Bristol University, and received his PhD from the same institution in 2000. He is currently Royal Canin Senior Lecturer in Small Animal Medicine’ at the University of Liverpool. His research interests include small animal gastroenterology and obesity biology.
2. Session title: Diagnosis and treatment of inflammatory bowel disease in the dog, 9.45am Saturday 24 September
3. BVA Congress, in association with BSAVA, will be held in London on 22-24 September 2011 under the theme ‘Vets in a Changing World’.
British Veterinary Association