Common Disorders of the Digestive System In Small Animal Medicine

Most Common Disorders Bloat and Gastric Dilation Volvulus (GDV) Pancreatitis Colitis Food Allergies Foreign Body Inflammatory Bowel Disease

Bloat and GDV Bloat: build up of air and gas in the stomach and intestinal tract ◦ More common in large breed deep chested dogs but can happen in any size dog ◦ Also occurs in ruminants ◦ Bloated animals are to be considered an emergency ◦ Bloat can progress to gastric dilation volvulus GDV: build up of gas causes stomach to flip or twist. This cuts off blood supply. This is an emergency, animal must be seen by vet immediately!!!

Bloat and GDV Signs & Symptoms Retching with nothing coming up or out Distended abdomen Painful abdomen Standing or pacing, unable to lay down and get comfortable Lethargy Shock

Bloat and GDV Cause May ingest food or water too quickly Ingesting large amounts of food or water Physically active after a meal Eating foods they are not accustomed to eating (getting in trash)

Bloat and GDV Diagnosis & Treatment Diagnosis ◦ Radiographs ◦ Physical Exam Treatment ◦ Decompress gas with stomach tube ◦ Monitor heart (pressure from distended stomach) ◦ IV fluids for shock ◦ Surgery to relieve pressure, untwist stomach and tack stomach to abdominal wall  May be irreversible damage to stomach and spleen, necrotic parts must be removed  Critical condition after surgery

Bloat and GDV Prevention Small meals ◦ Objects like kong toys can be placed in food or water bowl to slow down consumption No exercise after meals or large water consumption Raised bowls to decrease air swallowed Dogs at high risk can have stomach pexy done at time of spay/neuter

Pancreatitis Inflammation of the pancreas Digestive enzymes which are normally safely stored are prematurely released causing many metabolic problems Can occur in cats and dogs Miniature Schnauzers are predisposed due to altered fat metabolism Can lead to diabetes mellitus if significant damage occurs to the pancreas

Pancreatitis Signs & Symptoms Mild to severe vomiting Diarrhea Decreased appetite Fever Painful abdomen

Pancreatitis Cause Most times cause is unknown ◦ Contents of duodenum go through pancreatic duct ◦ Trauma ◦ Use of certain drugs ◦ Exposure to organophosphate insecticides ◦ Tumor ◦ Hormonal imbalances  Diabetes  Hypothyroidism  Hypercalcemia ◦ In dogs may be high fat diet/consumption ◦ In cats may be secondary to Inflammatory Bowel Disease ◦ In cats an active feline distemper infection

Pancreatitis Diagnosis & Treatment Diagnosis ◦ Idexx snap test (Specific Canine Pancreatic Lipase) ◦ Idexx Lab (Specific Feline Pancreatic Lipase) ◦ Ultrasound Treatment ◦ NPO for 2-3 days ◦ IV fluid therapy ◦ Pain medication ◦ Anti-nausea medication

Pancreatitis Prevention Dogs that suffer from pancreatitis must be put on a low fat diet usually for life If a dog is suspected to have consumed large amounts of fat, treat them as an emergency Cats diagnosed with inflammatory bowel disease should be monitored for pancreatitis

Colitis Inflammation of the colon Can occur in dogs and cats Acute Colitis ◦ Usually stress related ◦ Overgrowth of clostridium ◦ Can be caused from parasite infestation ◦ Change in diet ◦ Inappropriate foods for animals Chronic Colitis ◦ Persistent parasite infestation ◦ Secondary to other diseases ◦ Food allergy

Colitis Signs & Symptoms Diarrhea of the large intestine ◦ Blood in stool ◦ Mucous in stool ◦ Stool that starts normal and finishes loose ◦ Straining to defecate or sudden urgency ◦ More gooey or slimy than watery

Colitis Diagnosis & Treatment Diagnosis ◦ Fecal examination ◦ Detailed information from client  New diet  Stress in household  Human foods Treatment ◦ High fiber diet ◦ Antibiotics that target GI tract ◦ Medication to kill parasites if they are the cause ◦ Probiotics to rebalance “helpful” bacteria count ◦ Treatment of underlying disease causing colitis ◦ Elimination Diet (if allergy is suspected)

Food Allergy Intolerance from dyes, preservatives, contaminants or protein source Can occur in dogs and cats Difficult to diagnose Sometimes allergy can be from bowl not food ◦ Usually reaction occurs right around mouth ◦ Try using stainless steel bowls, less reactive than plastic

Food Allergy Signs & Symptoms In dogs ◦ Itchy feet, face and belly ◦ Chronic ear infections In cats ◦ Itchy around face and neck Watch for signs of itching not just act of itching ◦ Scabs ◦ Alopecia ◦ Licking

Food Allergy Diagnosis & Treatment Diagnosis ◦ Diet Elimination or Food Trial  Change to hypoallergenic diet for at least 4 weeks  Change protein source Treatment ◦ Remain on new diet for life

Foreign Body Pica: eating inappropriate objects When inappropriate object becomes lodged in intestinal tract it is called a foreign body Can occur in cats and dogs String or string-like material is the most dangerous - cuts the intestines ◦ NEVER pull string that is coming from mouth or anus!

Foreign Body Signs & Symptoms Vomiting ◦ Undigested food vs. bile  Helps determine location of foreign body Anorexia Lethargy Dehydration Shock

Foreign Body Diagnosis & Treatment Diagnosis ◦ Radiographs  Barium study may be needed Treatment ◦ If still in esophagus or stomach an endoscope can retrieve it (rare) ◦ If in intestinal tract surgery is required (more common) ◦ Fatal without treatment

Inflammatory Bowel Disease (IBD) Inflammatory cells line the intestine and cause thickness which interferes with absorption and motility Different than Irritable Bowel Syndrome (IBS) More of a symptom than a disease but difficult to determine disease causing agent, may be… ◦ Persistent parasites infestation ◦ Allergy against food protein ◦ Bacteria producing inflammatories ◦ Compromised immune system ◦ Combination of the above Can occur in dogs and cats

IBD Signs & Symptoms Chronic problem with vomiting, diarrhea and weight loss Chronic vomiting ◦ If in stomach or upper small intestine Watery diarrhea with weight loss ◦ If in lower small intestine A mucous diarrhea with fresh blood ◦ If in large intestine May be problem in all three areas

IBD Diagnosis & Treatment Diagnosis ◦ Endoscopy and biopsy ◦ Baseline workup  Radiographs  Bloodwork  Urinalysis  Fecal Analysis Treatment ◦ Steroids to treat inflammation ◦ High fiber diet