Digestive disorders common among dogs
Jilly the terrier stood on the consulting table and looked glumly at me. I could tell just by looking at her that she was not feeling well: she was normally a bouncy, happy, enthusiastic dog. Her owner explained what had happened.
'She brought up her dinner overnight, she didn't want to touch her breakfast this morning, and she had the squits when I took her for a walk. What could be wrong with her?'
When I examined Jilly, there were a few key findings. Her gums were dry and tacky to touch: she was dehydrated. Her abdomen was tender - she tensed up when I palpated her - and loud gurgling noises could be heard with my stethoscope. Jilly was suffering from some type of gastroenteritis, which is one of the most common reasons for pets being taken to the vet.
The term 'gastroenteritis' is self-explanatory. It means 'inflammation of the stomach and intestines'. The best way to imagine inflammation is to think about what happens to your thumb if you accidentally hit it with a hammer. Inflammation describes the way the body reacts to irritation of any kind, and the result is redness, heat, pain, swelling, lack of normal function. There are many different causes of inflammation, but the end result is the same.
So what can cause the stomach and intestines to become inflamed in gastroenteritis? There is a long list of possibilities, and most often, the cause is said to be "ideopathic". While this may sound impressive, it simply means "the cause is unknown". In other words, in most cases of pets with gastroenteritis, the precise reason remains a mystery. This doesn't usually matter, because with simple treatment, most cases of gastroenteritis make a full recovery over a few days.
There is a long list of possible causes of gastroenteritis: these include toxins and irritants (e.g. eating certain garden plants), food allergies and dietary sensitivities. These cause the initial irritation of the lining of the stomach and intestines, producing the end result of gastroenteritis. By the time the investigating vet comes along, the original cause has often long gone, leaving no trace, which is why it's so often impossible to say what started it.
There are, of course, some cases where the inciting cause of gastroenteritis is still present and active: viruses, bacteria, parasites and physical causes like swallowed objects. Vets will routinely check for these causes, and if they are suspected, specific tests can be done to be certain. This may mean faecal tests to rule out specific viruses, faecal culture to look for bacteria, microscopic examination to search for parasites and imaging (such as x-rays and ultrasound) to identify any physical causes. Vets don't tend to do this type of work up with every case; only when one of these more complex causes seems likely after checking an animal over, or if a case does not respond to standard treatment.
In most cases, treatment for gastroenteritis is very simple: rehydration and rest.
Rehydration is essential. If an animal is vomiting, they lose fluid out the front end. If they have diarrhoea, they lose fluid from the rear end. The net result is the same: dehydration. This makes animals - like Gilly - feel dull and depressed. If they could talk, they'd tell us they had a headache and they feel wiped out.
In simple cases, oral rehydration is possible, by giving affected animals a solution of sugars and salts in water. Many pets will willingly lap this up instead of food. In more severe cases, they may refuse to do this, or they may regurgitate the solution, or pass more diarrhoea than the fluid they are drinking. These animals need a more intensive approach at the vet, with an intravenous drip pumping the much needed fluid directly into their blood stream.
Resting the digestive system is the second part of treatment. A short period of fasting is easy to do: most sick pets don't want to eat anyway - and then bland, low fat, easily digestible food is recommended for a day or two. The easiest option is commercial diets designed for pets recovering from a digestive upset, although home cooked diets such as cooked chicken and boiled white rice are also possible. Once the pet can cope with this easily digested food, their standard diet can gradually be reintroduced, initially by mixing it half on half with the bland diet. Sometimes medication is given to ease the irritated digestive tract, with various products to lessen the irritation of the lining of the bowel, but these aren't always needed from your vet.
As long as the patient remains reasonably bright and active, the simple approach of rest and rehydration is often enough. There are many times when more intensive veterinary intervention is needed: if the signs of vomiting and diarrhoea continue unabated, if an animal becomes dull and depressed or if blood is passed at either end. Such cases should be regarded as emergencies, and life-saving treatment is urgently needed.
Gilly was lucky: she was an uncomplicated case, responding to simple oral rehydration fluids and bland food. When she came in for a check up the next day, she was already back to her normal self, jumping up and down like a jack in the box, and refusing to sit still on the table.