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Krzysztof Kubiak, Marcin Jankowski, Jolanta Spuzak, Kamila Glinska-Suchocka, Vasyl Vlizlo*, Jakub Nicpon**, Maciej Grzegory ©
Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, University of Environmental and Life Sciences, pl. Grunwaldzki
47, 50-366 Wroclaw, Poland *Institute of the Animal Biology of UAAS, Lviv, Ukraine **Department and Clinic of Veterinary Surgery, Faculty of Veterinary Medicine, University of Environmental and Life Sciences, pl. Grunwaldzki 51, 50-366 Wroclaw,
Poland
THE DIAGNOSIS AND TREATMENT OF IBD IN DOGS - THE OWN
EXPERIENCE
Key words: dog, IBD, endoscopy
Introduction
Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract disorder of unknown etiology and pathogenesis. Although the etiology is unclear, the scientists suggest that these diseases caused by complex interactions between host susceptibility, mucosal immunity, and the enteric microflora. Depending on kind of cellular infiltration in dogs and cats, we distinguish 2 main IBD forms: lymphocytic-plasmacytic enteritis (LPE) and eosinophilic gastroenteritis (EGE). The most frequently observed clinical signs include: recurrent vomiting, anorexia, changeable appetite, chronic and recurrent diarrhea (large bowel and/or small bowel in origin) and loss of the body weight. The diagnosis of IBD should be based on: history, clinical examination, laboratory blood tests (hematological and biochemical), an X-ray examination, ultrasound examination and endoscopic examination. The differential diagnosis includes: granulomatous enteritis, other causes of malabsorption, protein-losing enteropathy and neoplasia (1, 2, 3, 4).
Task, the aim of the article
The purpose of the study was to present our own experience in diagnosis and treatment of IBD in dogs.
Material and methods
Cases, described in the article, included dogs wchich were referred to the endoscopic laboratory of the Departament of Internal Diseases with Clinic for Horses, Dogs and Cats with the symptoms of gastrointestinal disorders. The endoscopy was carried out under general anesthesia recommending 48 hours of fasting and a 6 - hour break in fluid administration immediately before endoscopy. The 2-3 warm-water enemas were performed before endoscopy. For premedication xylasin in dose 1-2 mg/kg b.w., and atropine in dose 0,05 mg/kg b.w. were administered in one intramuscular injection. For general anaesthesia thiopental (in initial dose 5 mg/kg
© Krzysztof Kubiak, Marcin Jankowski, Jolanta Spuzak, Kamila Glinska-Suchocka, Vasyl Vlizlo, Jakub Nicpon, Maciej Grzegory, 2009
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b.w., next according to effects) was administered intravenously. The endoscopy of the alimentary tract was carried out using pediatric fiberoscope Olympus GIF XQ 20. For histopathological examination bioptates were taken by endoscopic forceps: Olympus FB25 K-1 and Olympus FB24 KR-1.
Results of researches
Case I - dog, male, 5 years old, fila brasileiro.
History and clinical examination - vomiting, changeable appetite, diarrhea with fresh blood, slighty body weight loss.
Laboratory tests - hematological examination: RBC - 7.32 T/l, HCT - 0.512 l/l, HGB - 10.9 mmol/l, WBC - 20.1 G/l (|), PLT - 206 G/l, MCV - 70 fl, MCH -1.48 f/mol, MCHC - 21.2 mmol/l, leucogram: lymphocytes - 15.4 % (3,0 G/l), monocytes - 4 % (0,8 G/l), granulocytes - 80.6 % (16,3 G/l); biochemical examination: ALT - 30 U/l, AST - 34 U/l, ALP - 31 U/l, urea - 5,40 mmol/l, creatinine - 132 ^mol/l, amylase - 1073 U/l, lipase - 691 U/l, total protein - 59 g/l, albumine - 28 G/l, Na+- 144 mmol/l, K+- 4,14 mmol/l, Cl- - 113 mmol/l.
Ultrasound examination - increase the diameter of colon and rectum wall.
Endoscopy examination - oedema and reddening mucosa membrane of colon and rectum, visible erosiones and ulcers, large amount of mucus.
Histopathological examination - colitis chronica activa magni gradus sine neoplasmate.
Treatment: sulphasalasine in dose 20 mg/kg b.w., p.o., BID. Because of not satisfacted results the prednisone prednisone in dose 1 mg/kg b.w., p.o., BID (for 4 weeks) was added to our thetapeutic management. Also the hypoallergenic diet was introduced. After that therapy modification we obtained significant improvement in health status.
After one year the patient came back to endoscopic laboratory with clinical signs of: fresh blood in feaces and loss of body weight.
The results of second endoscopic examination: slighty reddening mucosa membrane of colon and rectum and visible a few erosions.
Diagnosis of second histopathological examination: colitis chronica levis.
Treatment: mesalasine in dose 6.25 mg/kg b.w., p.o., BID (for 4 weeks), hypoallergenic diet.
Case II - dog, male, 13 years old, mixed breed.
History and clinical examination - for few monthes diarrhea, for 3 monthes diarrhea with fresh blood, changeable appetite.
Laboratory tests - hematological examination: RBC - 6.68 T/l, HCT - 0.449 l/l, HGB - 9.3 mmol/l, WBC - 11.1 G/l, PLT - 288 G/l, MCV - 69 fl, MCH - 1.43 f/mol, MCHC - 27.7 mmol/l, leucogram: lymphocytes - 11.2 % (1.3 G/l), monocytes - 6 % (0.7 G/l), granulocytes - 82.8 % (9.9 G/l); biochemical examination: ALT - 55 U/l, AST - 44 U/l, ALP - 103 U/l, urea - 12.96 mmol/l, creatinine - 128 ^mol/l, amylase - 781 U/l, total protein - 77 g/l, Ca++- 2.34 mmol/l.
Ultrasound examination - abdominal organs without visible pathological changes.
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Endoscopy examination - oedema and reddening mucosa membrane of colon and rectum, large amount of mucus.
Histopathological examination - colitis chronica medii gradus.
Treatment: sulphasalasine in dose 20 mg/kg b.w., p.o., BID (for 4 weeks) and hypoallergenic diet.
Not satisfed results was the resone to modify our treatment and we added prednisone in dose 1 mg/kg b.w., p.o., BID (for 4 weeks). After that management we observed the improvement in dog's condition and we decided to decrease the prednisone dose to 0.5 mg/kg b.w., p.o., BID for the next 6 weeks. Unfortunately after 3 weeks of those therapy the patient was worsen, so we should have introduced: mesalasine in dose 12.5 mg/dog, p.o., BID for 4 weeks. After that period we decided to decrease the prednisone dose to 0.5 mg/kg b.w., p.o., BID fot 4 weeks and next: 0.5 mg/kg b.w., p.o. every second day for 4 weeks. Nowadays mesalasine in dose 12.5 mg/dog p.o., BID and hypoallergenic diet is given to his dog.
Conclusions
The best diagnostic metod of IBD in dogs is endoskopy, completed by histopathological examination of taken samples of mucosa. Medicines recommended in IBD therapy in dogs are: sulphasalasine or mesalasine with prednisone and as a dietary management - hypoallergenic diet.
References
1. Allaspach K., Gaschen F.: Chronic intestinal diseases In the dog: a review.
Schweiz Arch Tierheilkd., 2003, 145, 209-219.
2. Jergens A. E.: Inflamatory bowel disease: current perspectives. Vet. Clin.
North. Am. Small Pract. 1999, 29, 501-521.
3. Jergens A. E.: Inflamatory bowel disease In the dog and cat. Proc. Word
Small Anim. Vet. Assos. 2002, 238-240.
4. Rychlik A., Nieradka R., Depta A., Paluszewski A., Sarti K.: Skutecznosc
roznych metod leczenia przewleklej zapalnej choroby jelit u psow. Medycyna
Wet., 2008, 64 (6), 796-799.
Summary
The purpose of the study was to present our own experience in diagnosis and treatment of IBD in dogs. Cases, described in the article, included dogs wchich were referred to the endoscopic laboratory of the Departament of Internal Diseases with Clinic for Horses, Dogs and Cats with the symptoms of gastrointestinal disorders. The best diagnostic metod of IBD in dogs is endoskopy, completed by histopathological examination of taken samples of mucosa. Medicines recommended in IBD therapy in dogs are: sulphasalasine or mesalasine with prednisone and as a dietary management - hypoallergenic diet.
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