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Non-Neoplastic Infiltrative Bowel Diseases

29 14:18:34

Non-neoplastic (noncancerous) infiltrative bowel diseases are a
group of disorders that cause infiltration of the
gastrointestinal tract with inflammatory cells. Broadly
speaking, there are two major causes: inflammatory bowel disease
and fungal or algal infections. The significance of these
disorders is that they cause chronic debilitating disease, and
they are reliably diagnosed only by gastrointestinal tract
biopsy. The cause(s) and therapy of these disorders are widely
divergent.

Inflammatory bowel disease is the most common cause of
intractable vomiting and diarrhea in dogs and cats. Although the
exact cause of inflammatory bowel disease is unknown,
inflammatory cells probably infiltrate the gut in response to
dietary or bacterial challenges. The inflammatory bowel disease
disorders may strike anywhere in the gastrointestinal tract, but
the small intestine and large intestine are primarily affected.
Middle-aged pets are most often diagnosed with this disease.

The most common symptoms include vomiting, diarrhea, loss of
appetite, and weight loss, but symptoms may vary depending on
the severity of inflammation and the extent of gut involvement.
A diagnosis of inflammatory bowel disease is one of exclusion
(everything else is ruled out, leaving only this diagnosis) and
requires ruling out many other diseases that may cause
intestinal inflammation.

Baseline diagnostic tests that may be recommended by your
veterinarian include multiple fecal examinations, routine blood
work (to test the kidneys, liver, etc.), urinalysis,
radiographic imaging procedures, thyroid testing (in cats), and
tests for feline viral diseases (e.g., feline leukemia virus,
feline immunodeficiency virus).

Surgical or endoscopic biopsy of the intestine is required to
confirm the presence of inflammatory cells and to exclude other
diseases that mimic inflammatory bowel disease. Therapy for
inflammatory bowel disease includes the use of anti-inflammatory
drugs to combat gut inflammation and use of a hypoallergenic
diet to reduce the workload on the gut.

Your pet is likely to require several weeks to months of drug
and/or dietary therapy and to require a hypoallergenic diet
indefinitely. Most animals with inflammatory bowel disease
respond favorably to therapy; however, relapses should be
expected.

Fungal or algal infections are caused by various organisms that
are introduced into the gastrointestinal tract, inciting an
inflammatory response to their presence. Histoplasmosis is the
most frequently diagnosed fungal infection affecting the
gastrointestinal tract of animals (primarily dogs). Infection
with the fungus generally causes intractable diarrhea. Other
symptoms may include loss of appetite, weight loss, fever,
labored breathing, and enlargement of the lymph nodes.

Diagnosis requires detecting the organisms (contained within
inflammatory cells) in rectal scrapings or in surgical or
endoscopic biopsy specimens of the intestines. Current blood
tests for histoplasmosis are unreliable. Therapy usually
consists of antifungal drugs given over several months. The
prognosis varies with the extent of disease activity. Animals
with severe symptoms or widespread disease generally fail to
respond to therapy.

Pythiosis and protothecosis are rare fungal and algal infections
that cause infiltrative gastrointestinal disease in animals.
Both diseases are most common in dogs, and both preferentially
affect the large intestine, causing diarrhea, weight loss, and
generalized debilitation. Diagnosis is made only by
demonstrating the organisms in affected gastrointestinal tract
tissues. Surgical removal of all infected tissue, if possible,
is the preferred treatment for pythiosis. There is presently no
effective therapy for protothecosis.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.