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Steroids and Diet Best For Treating Canine IBD

Find out a possible treatment plan for inflammatory bowel disease in dogs.

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Inflammatory bowel disease in dogs continues to be one of the most challenging conditions for veterinarians to treat. The cure for this painful, chronic gastrointestinal condition remains elusive, but a treatment plan that combines the synthetic steroid budesonide with a novel protein or hydrolyzed diet is generating support among leading veterinary specialists in the internal and nutritional fields.

Dogs suffering from IBD may demonstrate such signs as chronic or recurring vomiting, loose stools, loss of appetite, lethargy, low-grade fever, poor-quality hair coat and weight loss—signs that can be present in other medical conditions, making diagnosing IBD trickier. These dogs typically have inflammation of the stomach lining, colon and small intestine. Their immune systems are waging war on the invasion of bacterial, food or parasitic antigens. They are miserable and in pain, and their owners are often frustrated by the lack of a quick diagnosis and recovery.

"We still don’t know much about this condition, but we’re finding better ways to treat it,” says Joseph Wakshlag, DVM, Ph.D, associate professor of clinical nutrition at the Cornell University College of Veterinary Medicine in Ithaca, N.Y.  "We tend to identify IBD by ruling out other possible causes, such as parasites and cancers. We back our way into diagnosing IBD.”

The primary types of IBD affecting dogs include:
Lymphocytic-plasmacytic enterocolitis. Considered the most common type of IBD, it is identified through a biopsy that confirms excessive numbers of lymphocytes and plasma cells on the colon wall or small intestine.

Eosinophilic enterocolitis: This challenging type of IBD is identified by the presence of eosinophils (small, rod-shaped white blood cells in bone marrow that control allergic and inflammatory responses) present in a dog’s colon, small intestine or stomach.

Granulomatous enteritis: A biopsy is needed to identify this rare type of IBD and rule out other possible medical conditions, such as histoplasmosis or fungal disease. This type is characterized by inflammation that triggers a narrowing of the small bowel.

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Frederick Drazner, DVM, Dipl. ACVIM, co-chief of Wright Animal Hospital/Animal Specialty Services of Cook County in Des Plaines, Ill., says it is vital for veterinarians to confirm IBD by taking a detailed medical history.

"A detailed history is imperative to find out the frequency, consistency and character of the bowel movement,” he says. "Ask the client, ‘How long have the symptoms been going on? What therapeutic/dietary measures have been used in the past? What does the dog eat?’”

Pinpointing IBD as the cause also requires performing an extensive physical examination and conducting a series of diagnostic tests that may include:
* A fecal exam for the possible presence of a parasitic or bacterial agent
* Abdominal X-rays and possibly, an ultrasound
* A complete blood cell count
*  Serum chemistry screen

But his favorite diagnostic tool is the endoscope.

Dr. Drazner has performed more than 800 endoscopic procedures on animals under general anesthesia. The scope, connected to a light source, camera and computer monitor, permits a veterinarian to collect biopsy samples and examine the condition of a dog’s colon, stomach or small intestine to detect any swelling, bleeding or presence of ulcers or foreign bodies.

"My advice is to practice, practice, practice performing fiber optic examinations,” Drazner says. "The endoscopic equipment has vastly improved in recent years. Gastroscopic, endoscopic and colonoscopic investigation by an experienced, skilled operator can yield invaluable histopathologic information with minimal stress to the patient.”

Once IBD has been diagnosed, Wakshlag favors gradually switching a dog’s diet, if the main proteins have been common ones such as beef, chicken or lamb. The dog would be then fed a novel protein or hydrolyzed diet. The veterinarian works with the client to introduce a specific protein the dog has never consumed, such as bison, kangaroo or rabbit.

Breeds at Risk for IBD
Any dog of any age can develop inflammatory bowel disease; however, certain breeds are at a greater risk, with the Norwegian Lundehunds especially vulnerable, according to Joseph Wakshlag, DVM, Ph.D., assistant professor of clinical nutrition at Cornell University’s College of Veterinary Medicine.
Also on the at-risk list are:
* Basenjis
* Boxers
* English bulldogs
* German shepherds
* Irish setters
* Rottweilers
* Shar-Peis
* Wheaten terriers

Change of Diet

A second option is to go with a hydrolyzed protein diet. These are marketed directly to veterinarians and consist of minuscule protein particles that are too small to be detected—or to generate response from a dog’s immune system.

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The goal with the nutritional approach is to calm the immune system that has been working overtime to combat allergens, and to give the inflamed, painful GI tract time to heal.

"People often try the novel food approach first because it is easy,” Wakshlag says. "If you put your dog on a novel protein or hydrolyzed diet and things get better, then the challenge is to gradually re-introduce the old foods, one at a time. When the diarrhea and vomiting return, you’ve figured out the problem.”

Cyclosporine

In some cases, cyclosporine, an immunosuppressant designed to reduce inflammation in the digestive tract, and azathioprine, a drug that suppresses lymphocytes invading the GI tract, are prescribed. Anti-nausea medications and antacids may also be warranted.

Wakshlag says prednisone has been the synthetic steroid of choice to protect a dog’s intestinal lining, ease digestive upset and restore a healthy appetite in affected dogs. It is relatively inexpensive, but he believes that Budesonide, given as a topical, yields fewer side effects.

"At Cornell, we often get the most severe cases of dogs with IBD,” he says. "We need to bring out aggressive doses of heavy-hitting drugs to combat IBD. Dogs with IBD feel miserable, but with the right treatment plan, most can experience a livable outcome.”

Moving Forward

In the future, Drazner believes that immunosuppressant agents such as CellCept will be more widely utilized to combat IBD in dogs.

"Gene therapy will be the future of handling a lot of chronic, auto-immune diseases like IBD, diabetes and arthritis,” Drazner says. "CellCept is the main drug used on human patients with organ transplants. I have used it on four dogs—a golden retriever, springer spaniel, Brittany spaniel and a Yorkshire terrier, and it has improved their quality of life.

"But one must be very careful in using CellCept because it is very potent. Some veterinarians are turning to CellCept for dogs with IBD who don’t respond to prednisone, azathioprine or cyclosporine.”

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30 thoughts on “Steroids and Diet Best For Treating Canine IBD

  1. My dog was diagnosed Aug 2016 with ibd . my question is can eating grass cause flare ups every April the flare up starts and by Oct its under control she is on a hydronized dog food.

      1. I seriously think that is what my mini dachshund/possible min pin mix suffers from. My niece bought him from a pet store and we took him in. We think he was probably a puppy mill dog 😞. But since we have had him, about 5 years now, he has suffered from intestinal issues. It is getting progressively worse. Ever other thing he is on antibiotics for pooping mucus and blood which the vet says there is an overgrowth of bad bacteria. His diet is now completely changed…raw goats milk, a little pumpkin and green beans, a little bit of bananna, and raw stella and chewy beef diet. He loves it and his poop is looking better. Also seems to be great while on antibiotics, but once off…the gassy noises, loose poop, wanting to eat grass returns. I am at a loss. Suggestions?

        1. It sounds like eating grass might be a sign of digestive upset or inflammation possibly caused by bacterial overgrowth in the gut. My German Shepherd had the same thing as your dog. Diarrhea with mucus. Started with small intestinal bacterial overgrowth, but hers was not treated in a timely manner and led to leaky gut, IBD and arthritis. All of these issues were cured. First I treated the gut imbalance using coconut oil, a natural antibiotic. Safe and recommended by my dog’s veterinary nutritionist. Incredibly important in helping my dog recover was veterinarian formulated food plan from the company Just Food for Dogs. My dog gets sushi rice, lamb, and cauliflower with vitamin powder added. Really important to add custom vitamins so it is nutritionally balanced. She is on Visbiome probiotics, as recommended by her veterinarian nutritionist.

        2. Dogs eat grass when they are nauseated. Please take your dog to an Internal Medicine Vet. They are very good at diagnosing and treating IBD.

          1. we have a 10 yr old jack russel that has bad stomach gurgling about every 2 -3 days, he will shake allot as well, he doesnt seem to be in pain but he also wont eat for 8-10 hrs or until it stops, been going on for about a year now, we have spent so much money on different foods none seem to work, also been giving daily probiotic which seems to do nothing, he will eat dirt and grass as well, is this similar to what your jack has ?
            Bill

          2. First my Jack was diagnosed with pancreatitis then after changing the diet to Science Diet ID low fat food he was better but still had flare ups. I researched high and low and talked to every vet I could and was given advice about the immumnosuppresives. When he started the Budesonide it was life changing for him. Ask your vet about trying 1mg Budesonide daily, I really think it will help. I also boil chicken breast and give my dog Frisbee boiled chicken with his Science Diet ID low fat food and we don’t have any episodes of bloody stool.

        3. My mini dachshund had these symptons and turns out had ulcerative collitus. We changed er diet to rice and chicken….very bland diet is needed and I would suggest water only as drink. They get dehydrated very quickly which is dangerous.

  2. Thus information about IBD has been very helpful and my dig Banbury suffers grim it regularly. But so far not bren given whst is suggested in eeb site. He is 13yrs okd and i love him so much and am always searching 4 treatment for him.

  3. My miniature Yorkshire terrier (8years) was diagnosed after a destended abdomen and diarrhea/vomiting led to a blood test revealing extremely low albumin levels (11). She also had siezures due to low electrolyte level. She has had ultrasound to rule out cancer but the albumin level was too low to have any form of biopsy. We tried a strict diet but that didn’t help and so now she is on steroids daily and a strict diet. Repeated blood tests show albumin levels between 11 and 28 and whilst the steroids are helping she is in a three week cycle of being really well then unwell for 2-3 days, everyone seems puzzled and of course I am worried. Any suggestions or advice greatly appreciated.

    1. Damion, my blue heeler has IBD. we are just starting the 3 week pretazone treatment. she is 17.8 lbs and should be 45 or more lbs. They have done surgery and took samples. Nothing is getting better. It seems she is getting worst. What food are you using for your pup? There is so many foods its insane.

      1. Hi Rainey
        My golden is 2 with IBD. She was responding very well to me cooking for her or eating freeze dried dog food. Now she is having issues with both of those so we just started a round of prednisone. She was never able to tolerate any brand of kibble or canned food, Hydrolyzed or not. Have you found anything to help?

    2. My Yorkshire terrier has gone through similar. Two years ago she was on death’s door, but after a last ditch endoscopy we discovered she not only had IBD but also a bacterial problem that was affecting her ability to absorb protein. After two years of phasing out the steroids she is now only on Chlorambucil. Most of the time she is fine, but we still have the occasional flare ups.

  4. The only thing that has helped my chi-mix girl is Prednisone. After trying unsuccessfully to wean her from it (she relapses), she takes Prednisone regularly. I give her the smallest dose that I know works for her. I give her one dose every other day, since Icannot wean her without her getting sick. She has been happy and healthy with this technique.

    1. How old is she? Our lab is 10 years old and just diagnosed a week ago. He is on Prednisone, but haven’t seen relief yet. I’m wondering if this will be going on for the rest of his life…..

    2. Makes my girl crazy! Really hate the prednisone…has created a crazy dog who eats and drinks like the world is ending tomorrow and then proceeds to pee and poop on the floor😒Love my girl (13 yr old Boston terrier). Feel so bad for her & losing my mind. Almost lost her last year to IBD and she is my bestie. $5,000 in vet bills after finally a diagnosis from a lifetime of gastro issues. Texas A&M emergency room because her doctor was ill equipped and lacked the expertise. They saved her life❤️ Looking for dietary fix. Steroids can’t be the answer.

      1. Ask your vet advice on a change to Budesonide 1 mg and Metroniazole. It has been a miracle for my dog Frisbee a Jack Russel.

  5. My 11 year old Lhasa poo, Bernie, was diagnosed last year with IBD resulting in PLE. He presenteded with weight loss, loss in appetite, lethargy, a distended abdomin and thinning fur coat. His Dr has had him on metronidazole, prednisone and atopica every day for the past 12 months. He’s also on the hills prescription low fat diet 3x daily, and we have been told he will be on both long term. He gets regular blood work done every 3 months now (at first it was much more frequent), his treatment plan saved his life. It was quite touch and go for 2-4 months, but at his last checkup his Dr actually reported he was actually on the chubby side!

  6. My 15yr old Sheltie cross has just been diagnosed with IBD . She is on a strict chicken and rice diet, and low dose Docycyclline antibiotics. She no longer has the diarrhoea but I’m struggling to get her to eat this bland diet… Any suggestions ?? She has to stay on this for a further 4 weeks to allow for the inflammation to settle before being reviewed.

  7. My 12 year old standard poodle was diagnosed last March with IBD. We tried several different diets and finally Royal Canin Hydrolyzed Protein for dogs. I buy the canned, kibble and treats. She enjoys them all, especially the treats. She is also treated with budesonide and cyclosporin

  8. Jake, My 2-year-old chiweenie, developed the odd habit of licking metal objects, such as the clasp on my other dog’s collar. I also noticed that he constantly chewed grass when he was outside. He chewed holes (lots of them) in blankets. When he started projectile vomiting horrible-looking brown stuff (undigested food for the most part), I took him to the vet, thinking he had eaten an inanimate object. On x-ray we saw a blob at the entrance of his stomach, and the vet performed surgery to remove it. As it turned out, that “blob” was inflamed tissue that prohibited Jake from digesting his food. His intestines were inflamed, and the vet diagnosed him with IBD, which a biopsy confirmed. Granted, the surgery was perhaps extreme, but it allowed for a quick diagnosis within a few weeks after the first sign that something was going on. For the most part, Jake never acted as if he was in pain. Several months prior to this, he developed a fever and had what we thought was a stomach bug. Antibiotics and hydrolyzed food cleared that up quickly. That was probably the first warning sign. The point I want to make is that pet owners should pay close attention to any unusual behaviors. Licking metal is not normal, but at first I just thought it was a quirky habit. I’m happy to report that hydrolyzed protein food and budesonide are working well for Jake. He has not vomited once since he started on this treatment. Prior to all of this, Jake often threw up a bit of white frothy stuff early in the morning before he ate. I figured he had a touch of GERD. In looking back, I think I should have put the pieces together sooner. At any rate, Jake is much improved. Two things that I think may have contributed to his IBD: he dug up my cat’s poop in the yard and ate it probably more than I know, and he got into discarded food that my next door neighbor threw out. No more running loose in the yard! I hope that reading Jake’s story will help someone else get the care their pets need.

  9. I have a 5 yr old yorkie who was diagnosed with IBD shortly after I rescued her. She stopped eating and would lie on the floor shaking. At first they thought it was addisons but after many dr visits and other workups and still refusing all food she underwent exploratory surgery and biopsies and that is what they discovered. She was then placed on a low dose, 1mg of budesonide daily and started Hills ZD dry and canned. She has recovered nicely amd we were able to cut her back on the budesonide to 1/4 tab every other day. So far so good but if we start allowing her snacks of table scraps she seems to slip backward! Also she has had some anal gland problems with them needing to be expressed lately. Wondering if it has to do with the canned food. Otherwise she seems much better. She has been in the diet for a year and a half. Her hair was falling out in the beginning but much better now that we cut her dose back. I am going to stsrt her on a probiotic. I think it might help with the gland.problem.

  10. Our Labrador Retriever was diagnosed a week ago. He has a significant case of IBD, diagnosed through endoscopy and biopsies. He has spots of hemorrhages in his small intestines. He has all the symptoms, but one that I have not found anyone talking about- he has severe abdominal cramping when he drinks water. He has even vomit up all his water. He has very loud abdominal noises following the cramping that last hours. Does anyone know of this happening with IBD? Or why?

    1. Yes, my ten your old Maltese cramps up from drinking too much water at a time and then gets sick and nauseous for a few hours or more afterwards. Now I will only allow her to drink smaller amounts at a time, never refusing her water, but smaller amounts at a time. Also I give her one half of the bowl with room temperature water, followed by the remainder of the bowl with cold. It works. No more cramping or nausea. She suffers from food allergies and mild IBS. I’m always trying to read up on what works best for other dogs with these issues. Hope this helped.

  11. I have an 8 year old Westie who is currently in the middle of another bad flare up. He was diagnosed with IBD last year by endoscopy and biopsies after loosing 2kg. He cannot eat dried food and did not tolerate a change in his wet food. Our vet is trying to avoid the use of steriods bit has him on a short course fot this flare up.

    He doesn’t have the usual sickness on this occasion but does have the stomach cramps and terrible trapped gas that the vet doesn’t know how to resolve. He is taking windeze but they do not appear to help… any suggestions?

    1. I think your dog needs to go on steroids long term to reduce flare ups. These are very uncomfortable for your dog. Also he may be B12 deficient . I don’t think the windeze would help and may hinder if they react with other meds . Would opiod pain relief help too ?

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