Is it an Upset Stomach or IBD?
A Case Study by Internal Medicine Specialist Lawren Durocher,MS, DVM, DACVIM, SAIM
There are many causes of vomiting and diarrhea in dogs, from getting into the garbage to food allergies, inflammatory bowel disease and cancer. Board-certified Internist Lawren Durocher takes a look at the case of Emmie, a 5-year-old female spayed Lab mix, who came to us for the evaluation of chronic and unresolved stomach issues.
Emmie’s owners reported that she had been vomiting and having diarrhea for the past two weeks. Her appetite had decreased and she had lost ½ pound. Her owners brought Emmie to their general practitioner for initial evaluation, and a complete examination and blood work were done. Everything came back normal. She was treated with a bland diet and anti-nausea medications, but she continued to vomit, so Emmie was referred by her doctor to Crown for further testing and evaluation.
We met Emmie with her owners and discussed her history. Emmie had been having episodes of gastrointestinal (GI) upset about every six months. She usually improved with a bland diet. On examination, Emmie was bright and playful but slightly thin. We discussed possible causes of the vomiting and diarrhea with her owners – everything from food allergies to inflammatory bowel disease to pancreatitis and cancer.
We then proceeded with further diagnostic testing, including abdominal ultrasound (looking for tumors or masses), blood work to check her Vitamin B levels, and an endoscopy under general anesthesia. Other than slightly thickened intestinal walls, the ultrasound was normal. The blood work showed that her B12 levels were slightly low. The endoscopy showed that her stomach and small intestine were slightly roughened and irregular. Biopsies showed that Emmie had inflammatory bowel disease (IBS). Emmie was treated with steroids (prednisone) and a change of diet. Also, we started supplementing her with weekly B12 injections under the skin.
Inflammatory bowel disease is a condition in which the body’s immune system attacks the intestines, causing inflammation. The cause of IBD is unknown. It can affect any portion of the gastrointestinal tract, from the stomach to the colon. Signs of inflammatory bowel disease range in severity and can include decreased appetite, vomiting, diarrhea, weight loss, and bloody stools. It is diagnosed via biopsies of the gastrointestinal tract, which can be done endoscopically or surgically. There are different types of inflammatory bowel disease and they are classified based on where they are occurring in the GI tract, as well as what type of white blood cells are present (eosinophils, neutrophils, lymphocytes, etc.).
Most dogs respond very well to treatment with diet change and steroids, but some dogs do require other medications as well, including supplementation with B12 injections. Our goal is to manage this disease, not cure it. Quality of life is very good and most dogs will have a normal life span with this condition. Most dogs will adjust and be able to come off of the steroids, needing them only during flare-ups. Some dogs, however, remain on low doses of steroids for life. We were able to wean Emmie off the steroids completely in three months and she is still going strong. She only vomits occasionally (mostly when she gets into something outside), is back to a healthy weight, and enjoying life.
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