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 Colitis refers to inflammation of the colon, or large intestine. It may be acute or, if signs have been present for over 2-3 weeks, chronic.
Since inflammation of the colon interferes with its normal function, diarrhoea is the result. Faeces are passed frequently, accompanied by straining (tenesmus), and there may be mucous and blood in the stools. Sometimes vomiting, weight loss, inappetance, and lethargy are seen.
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What causes colitis?
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There are many causes of colitis, most of which are unknown. Inflammatory Bowel Disease (IBD) refers to a group of chronic inflammatory diseases of the gastrointestinal tract that have no identifiable cause. It can be classified according to the type of inflammation present e.g. Eosinophilic Colitis or Lymphocytic-Plasmacytic Colitis. The cause(s) of IBD are unknown but is believed to be a hypersensitivity (allergic) reaction within the intestinal lining and the resultant inflammation interferes with food digestion and absorption. The hypersensitivity has been hypothesized to be due to dietary factors, parasites, infections, and drug reactions, among others.
Identifiable causes of colitis include infectious agents such as viruses, bacteria, fungi, and parasites (including intestinal worms). Food intolerance, indiscretion or allergy, cancer, intussusception (where the bowel telescopes into itself), and trauma are some other causes.
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How is cause of the problem determined?
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The veterinarian will obtain a complete history of relevant facts, and perform a physical examination. Faecal examination may indicate the likely cause of the colitis, although blood tests, X-rays, and/or ultrasound may be required. If IBD is suspected, a sample of the lining of the colon is taken by colonoscopy and examined by a pathologist.
The diagnosis of IBD is reached once all known causes of gastrointestinal disease in dogs and cats are ruled out.
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What is the treatment?
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Treatment depends on the underlying cause. If a specific diagnosis can be made, treatment is directed at the identified cause. Therapies include antibiotics, dietary modification, fibre supplementation, anti-inflammatories, and motility modifiers.
Dietary therapy for acute colitis usually consists of fasting for at least 24 hours followed by feeding an intestinal medical diet, or a homemade low fat, highly digestible diet.
The management of IBD includes dietary modification, antibiotics for secondary bowel bacterial overgrowth, and anti-inflammatories. Each animal is different and requires a different, individually tailored approach to treatment.
The diet chosen for IBD is a hypoallergenic medical diet that is highly digestible, gluten-free, and low in lactose and fat. Commercial diets are available although a homemade diet may be used. If a homemade diet is fed, it is advisable to change the protein source after 6 weeks in case the animal develops an allergy to the new food while the gut is still inflamed. Use of the new hypoallergenic diets such as Hill’s Science Diet Z/D Ultra avoids this complication.
Anti-inflammatories such as cortisone are often used in a tapering dose, and more potent immunosuppressive drugs are indicated for severe cases of IBD.
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What is the prognosis?
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The prognosis for colitis depends on the cause. It is usually good for infectious causes. For dogs with IBD, the prognosis is good once the appropriate management regime has been identified. However, in some cases the condition becomes intractable and resistant to treatment.
It is important for owners to feed the prescribed diet exclusively, and to give all medications as recommended in order to achieve the optimal result. IBD can be a frustrating disease to diagnose and treat and requires good communication between the client and the veterinarian, and a great deal of persistence and effort on the owner’s part.
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Dr Rebecca Bragg BVSc MACVS
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