Inflammatory Bowel Disease (IBD)
An invasive intestinal disease found in both dogs and cats that results in loosing a significant amount of protein is an inflammatory bowel disease called lymphocytic-plasmacytic gastroenteritis. The normal digestion of food, including protein, takes place in the small intestines. The absorption of these products into the bloodstream cannot occur adequately due to the large number of lymphocytes and/or plasmacytes that are present in the intestinal wall that blocks this process. The end result is that the level of protein in the bloodstream begins to drop as the condition progresses.
Clinically, the pet may begin to have symptoms such as vomiting and/or diarrhea. Due to the insidious nature of this condition it is difficult to make a diagnosis early in the disease process. As this condition worsens with time the frequency and severity of gastrointestinal symptoms increases as well. In extreme cases, the protein level in the bloodstream can drop so low as to result in free fluid accumulation within the abdominal cavity called ascites.
The current understanding as to the cause of this inflammatory bowel disease (IBD) is that it is the result of an allergy to either an ingredient in the food or the type of bacteria that is present in the intestines or a combination of both. Thus, a diagnosis of IBD is suspected when all other causes of gastroenteritis have been eliminated by either treatment or by tests. Taking a biopsy of the intestinal wall and demonstrating the presence of a large number of lymphocytes and plasmacytes makes the confirmation of IBD.
Treatment consists of changing the bacteria flora by using a medication such as metronidazole (Flagyl®). In addition, prednisone is often used to reduce the inflammation and thus clears away the allergy cells that are present in the lining of the stomach and intestines. It is also necessary to change the ingredients in the diet completely. An example of a hypoallergenic diet is the Hills product called Z/D®. As this condition probably took many weeks to months to develop, it may take equally as long to resolve. Once the condition is under control often the medication can be reduced if not completely eliminated with time.
It is not well understood as to why the immune system develops sensitivity to certain ingredients within the food that your pet has been eating right along. It does seem to me that we veterinarians are seeing more and more of this inflammatory bowel disease condition in dogs and cats than we have ever seen before. We are getting better at diagnosing and managing the IBD condition.