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Digestive System
Problems related to the digestive system represent the most common medical problem seen by veterinarians. The digestive system begins at the mouth.
Food enters the mouth; chewing action from the teeth breaks food down to allow digestive enzymes in the mouth to begin the digestive process. From the oral cavity, food begins the long journey towards digestion and absorption. The road to digestion begins in the esophagus, a long tube that connects the mouth with the stomach. Once in the stomach, secretion of acids causes food constituents to separate. As food material enters the small intestine, secretions from the pancreas and gall bladder allow nutrients to be absorbed by the intestine. Beyond the small intestines lies the large intestine, which absorbs needed water for the body.
Indications of problems within the digestive system include: vomiting, diarrhea, lack of an appetite, weight loss, voracious appetite with weight loss, and lethargy.
Disease within the oral cavity is an ever growing concern for your pet’s overall health. Periodontal disease affects more than 85% of all pets over 4 years of age. Pets may not show overt signs of oral disease; the only indication of poor oral health may be foul smelling breath. Contrary to popular myth, the inside of your pet’s mouth is not clean. Germs and infection can spread from the oral cavity and lead to disease in other organ systems.
The majority of digestive problems result from dietary indiscretions and sudden dietary changes. Other digestive conditions include: intestinal parasites, ingestion of foreign bodies, toxin ingestion, intestinal inflammation, medications, hormonal and
metabolic imbalances, and cancer.
Anal Sac
Anal Sac
The anal sacs (also known as anal glands) rest on either side of the anus in the 4 and 8 o’clock positions. All dogs and cats have these scent glands that normally empty their secretions during defecation. Anal sac disease develops when the sacs cannot empty normally, such as with obesity, skin inflammation from allergies, loose stools/diarrhea, and tumors. Symptoms of anal sac disease (ASD) include scooting, excessive licking, pain, swelling, and/or foul-smelling discharge from the anal sacs.
Anal Sac Disease
The anal sacs rest on either side of the anus in the 4 and 8 o’clock positions. All dogs and cats have these scent glands that normally empty their secretions during defecation. Symptoms of anal sac disease (ASD) include scooting, excessive licking, pain, swelling, and/or foul-smelling discharge from the anal sacs. Anal sac disease develops when the sacs cannot empty normally, such as with obesity, skin inflammation from allergies, loose stools/diarrhea, and tumors. The degree of ASD varies from mild impaction with thickened secretions to severe infections that breakthrough the skin around the anus. To treat ASD, the sacs are manually expressed followed by flushing of the sacs to clear excess debris and infection. Some pets may benefit from dietary changes, antibiotics, and anti-inflammatories. Investigating and treating for an underlying cause limits the recurrence of ASD. In pets with chronic inflammation or tumors, surgery may be necessary to remove the anal sacs.
Colon
Colon
The large intestine, named for its large diameter, is shorter in length: about 10-20% of the length of the small intestine. Functions of the large intestine include:
- Water and electrolyte absorption
- Fecal storage
- Fermentation of ingested food fibers by beneficial bacteria
Inflammation of the large intestine, termed colitis, causes: straining to defecate and soft stool that may contain fresh blood and/or mucus. Dogs with colitis alone do not act sick beyond the soft stool. The most common causes of colitis in dogs include dietary indiscretion/intolerance and parasites.
Colitis
Patients with colitis (inflammation of the colon/large intestine) strain to defecate and may have mucus and/or small amounts of fresh blood. Pets with colitis should still have a good appetite and energy level. If your pet is lethargic, not wanting to eat, or the stools are of a watery consistency, your veterinarian should be contacted immediately. Common causes of colitis are dietary intolerance (e.g.: new treats or type of food) and parasitic infections. Other causes include: infections (e.g.: bacteria, protozoa), inflammation (e.g.: inflammatory bowel disease, foreign bodies), and tumors. Diagnosis of colitis is based on symptoms. After examining your pet, your veterinarian will begin by testing your pet’s feces for intestinal parasites. Cases of chronic colitis may require further diagnostic testing such as blood work, fecal testing, and imaging (x-rays and abdominal ultrasound). Treatment for colitis includes identifying the underlying cause and treating specifically if possible. If a specific underlying cause is not found, pets may be treated with an antibiotic, a deworming treatment, and/or nutritional support to promote intestinal health and hasten the recovery process.
Constipation
Constipation, retention of feces, affects cats more commonly than dogs. Constipation can be caused by dehydration, anal sac disease, foreign bodies trapped within the colon, spinal disease, obstructions or trauma within the pelvic canal, and idiopathic (unexplained) causes. Pets with constipation posture to defecate yet produce scant to no feces; they may have abdominal pain. Pets with marked constipation may vomit. Definitive diagnosis is made by physical examination and radiographs of the abdomen. Treatment for constipation includes rehydration, dietary modifications, stool softeners, and addressing the primary cause if possible (e.g.: foreign body or pelvic fracture).
Intestine
Intestine
The small intestine, named for its small diameter, roughly spans 3-4 times the length of your dog’s body. As food material exits the stomach, it enters the small intestine and mixes with pancreatic and gall bladder secretions. These secretions cause breakdown of food nutrients to allow absorption of proteins, sugars, and fats. Dogs with small intestinal disease do not feel well; they may have vomiting and/or voluminous, watery diarrhea. By far, the most common cause of small intestinal inflammation is dietary indiscretion-raiding the trash can or eating something rotten from the park. Other common causes of small intestinal disease include: foreign body ingestion (e.g.: corn cob, toys), dietary intolerance, parasites, and viral infections.
Coccidia
Pets affected by Coccidiosis are typically young, debilitated, and/or immunocompromised. Coccidia are protozoal organisms that are an important cause of diarrhea in young pets. Adult pets may be positive for Coccidia, yet do not show any symptoms. Pets with intestinal inflammation caused by Coccidia require antibiotic therapy to help resolve the infection. Easily digested foods and probiotic therapy help the intestinal tract heal more quickly. During treatment, it is important that your pet stays well hydrated; you can add water to their food. Most Coccidia organisms are not contagious to people, however, care should be taken to ensure good hygienic practices including hand washing and bathing your pet during treatment.
Foreign Body
Dogs, being indiscriminant eaters, commonly eat things that are not meant for ingestion. Surprisingly, many foreign objects travel through the gastrointestinal tract unnoticed. Occasionally, however, foreign objects enter the stomach and become lodged in the gastrointestinal tract as the lumen narrows down. Dogs with a foreign body causing an obstruction may be painful, lethargic, and vomit repeatedly. Prompt veterinary attention is necessary to prevent permanent damage to the intestinal tract. Diagnosis of foreign body ingestion requires a physical examination and imaging (e.g.: radiographs of the abdomen). If the foreign body is causing an obstruction or contains toxins, then prompt surgical removal is necessary. Some foreign bodies in the stomach may be removed with endoscopy, a flexible scope that can be manipulated through the upper portions of the gastro intestinal tract.
Giardia
Giardia is a protozoal organism that is an important cause diarrhea in pets. The organism commonly infects pets (and people) drinking from contaminated water sources. Pets with Giardia may be asymptomatic; younger and debilitated pets may have severe diarrhea and dehydration. Diagnosis of Giardia can be challenging as the organisms are not always shed into the feces to be detected. Multiple stool checks may be necessary before a definitive diagnosis can be made. Treatment for Giardia includes supportive care with fluids to rehydrate; bland, easily digested diets; and an oral medication to eliminate the infection. To prevent reinfection, 1) bathe your pet during treatment to remove any organisms attached to the fur, 2) treat all pets in the household, and 3) pick up feces as soon as possible to prevent environmental contamination. Some strains of Giardia can be transmitted from your pet to people. Contact your physician if you or a family member suspects a Giardia infection.
Hookworms
Hookworms are small blood sucking parasites that live, feed, and reproduce within the small intestines. Puppies and kittens are most commonly affected; they acquire the infections 1) from an environment contaminated with hookworm larvae, 2) through the placenta (before birth), or 3) through the mother’s milk. Hookworms may be found incidentally on routine fecal exams; your pet may show no obvious signs of a problem. Large burdens of hookworms may cause anemia (due to the large amount of blood ingested by the worms), weight loss, and diarrhea. Pets in a heavily contaminated area may develop skin inflammation on the feet caused by the larvae burrowing into the body through the skin. Treatment of hookworm infections requires environmental clean-up and deworming medication. Environmental decontamination is particularly important to avoid transmission of this parasite to people. Regular deworming practices and testing of your pet’s feces help to ensure that your pet and your family are parasite free.
Intussuseption
Intussusception occurs when a portion of intestine slides inside an adjacent portion of intestine. This intestinal telescoping can occur following a bout of intestinal inflammation (e.g.: parvovirus infection in dogs) or other systemic illness; some intussusceptions have no known cause. The enfolding of the intestine narrows the passageway for flow of intestinal contents creating a partial or complete obstruction. Patients with intussusceptions present with lethargy, vomiting, diarrhea, pain, and/or inappetance. Diagnosis may be based on history of illness, physical examination findings (a firm cylindrical mass may be felt in the abdomen), and imaging (e.g.: x-rays, ultrasound). Intussusceptions rarely reverse themselves; treatment of choice for intussusceptions is surgical repair to restore bowel health and prevent recurrence.
Liver
Liver
A dog’s liver rests against the diaphragm, next to the stomach in the abdominal cavity. The liver performs many necessary functions to prevent illness:
- filters and detoxifies blood coming from the intestinal tract and other parts of the body
- aids in fat and sugar metabolism
- production of bile (to be later stored in the gall bladder), proteins, and vitamins
Young dogs with liver dysfunction often have abnormal blood flow through the liver (portosystemic shunts). Older dogs may develop inflammation, infections, cirrhosis (scarring of the liver) and cancer. Symptoms of liver disease may be obvious, such as jaundice (yellow tint to the skin); however, many liver diseases are insidious in onset and may be found incidentally with routine laboratory testing. Regular wellness testing allows early detection of liver disease to begin treatment before irreversible damage has been done to the liver.
End Stage Liver Disease
The liver rests in the abdomen just behind the diaphragm. The liver has many functions: protein, sugar, and fat metabolism, detoxification, and storage of vitamins and minerals. Because the liver receives, filters, and detoxifies a tremendous amount of blood continuously, it is susceptible to inflammation. While the liver has a tremendous capacity to repair itself, chronic undetected liver inflammation may eventually cause irreversible damage. Dogs with early stages of liver disease may not show obvious outward signs of a problem; the liver problem may be found incidentally on routine blood work. Dogs with end stage liver disease suffer symptoms related to the liver’s inability to perform its functions: vomiting, diarrhea, lethargy, weight loss, bleeding tendencies, jaundice (yellow color to skin and eyes), behavior changes, and in severe cases, seizures. End stage liver disease is diagnosed with blood work, abdominal ultrasound, and ultimately liver biopsies. At this final stage, it may not be possible to determine the inciting cause of the liver disease. Treatment of end stage liver disease includes symptomatic therapy with nutritional support, antioxidant therapy, anti-inflammatory and anticonvulsant medications, and/or fluid therapy. The key to better outcomes from liver disease is early detection. Breeds with a genetic predisposition (e.g.: Bedlington Terriers, West Highland White Terriers) to liver disease benefit from regular wellness testing with a complete blood count, chemistry profile, and urinalysis.
Hepatic Neoplasia
The liver sits just behind the diaphragm within the abdominal cavity. The liver’s major functions are protein, fat, and sugar metabolism as well as blood detoxification. The liver receives a tremendous amount of blood from the abdominal organs to be filtered repeatedly each day. Due to the large blood supply the liver receives, the liver is susceptible to inflammation and tumor development. Two main types of cancer develop in the liver: 1) primary tumors and 2) metastatic tumors. Primary tumors begin their growth in the liver; the most common is hepatocellular carcinoma. Metastatic tumors are far more common. Blood flowing into the liver provides essential nutrients for the body, but it can also carry cancerous cells that have broken free from other places in the body. The cancerous cells attach to the liver tissue and begin to grow. Symptoms of liver cancer may be vague: general malaise, jaundice (yellow skin color), decreased appetite, and weight loss are common. Liver cancer may be suspected based on physical examination findings, blood work results, and abdominal ultrasound findings; a biopsy of the liver is necessary to confirm the diagnosis. Treatment depends on the type of tumor found. Primary liver tumors are often treated with surgical removal while metastatic tumors often require chemotherapy to slow down their growth.
Pancreas
Pancreas
The pancreas, while being a small organ, delivers a significant impact on digestion of food and blood sugar regulation. Functionally, the pancreas is divided into two sections: 1) the larger exocrine pancreas releases digestive enzymes to breakdown fats and proteins in the diet and 2) the smaller endocrine pancreas releases blood sugar regulating hormones. Abnormalities of the pancreas include:
- Inflammation, termed pancreatitis. Dogs may succumb to pancreatitis after ingesting a high fat meal, trauma, and certain drugs. Dogs with pancreatitis are ill, experiencing vomiting, anorexia, and abdominal pain.
- Failure to produce enzymes and/or hormones as in exocrine pancreatic insufficiency and diabetes mellitus respectively.
- Cancer
Acute Pancreatitis
The pancreas, while being a small organ, delivers a significant impact on digestion of food and blood sugar regulation. This key organ of digestion rests next to the small intestine as it exits from the stomach. Functionally, the pancreas is divided into two sections: 1) the larger exocrine pancreas releases digestive enzymes to breakdown fats, sugars, and proteins in the diet and 2) the smaller endocrine pancreas releases blood sugar regulating hormones. Inflammation of the pancreas causes unregulated release of digestive enzymes. The digestive enzymes begin to uncontrollably digest tissues surrounding the pancreas, creating tremendous inflammation. Dogs with pancreatitis present with vomiting, lethargy, anorexia, and abdominal pain. Common causes of pancreatitis include: high fat meals, concurrent diseases (e.g.: Cushing’s disease, hyperlipidemia), medications, abdominal trauma, and tumors. Diagnosis of pancreatitis involves a thorough history, physical examination, and specialized blood tests; an abdominal ultrasound may be needed to evaluate the area around the pancreas more closely. Treatment for this painful condition requires aggressive intravenous fluid therapy, medications to curtail vomiting, pain management, and withholding of food or water orally for 24-48 hours to rest the pancreas, and pain management.
Exocrine Insufficiency
The pancreas, residing next to the stomach and small intestine, allows digestion and absorption of nutrients from the diet. The pancreas can be divided into two major sections: 1) the exocrine pancreas that releases hormones to breakdown ingested fats, proteins, and sugars from the diet, and 2) the endocrine pancreas that releases hormones of sugar regulation, e.g.: insulin and glucagon (abnormalities in this section of the pancreas include Diabetes mellitus). Pets with exocrine pancreatic insufficiency (EPI) fail to release digestive enzymes and thus, suffer from malnutrition as food cannot be broken down for absorption. EPI can be congenital (born with condition) or acquired (caused by chronic pancreatic inflammation). Symptoms of exocrine pancreatic insufficiency (EPI) include diarrhea, a poor hair coat due to malnutrition, and a voracious appetite in the face of weight loss. Treatment for EPI requires lifelong oral supplementation with pancreatic enzymes to facilitate digestion and absorption of food.
Stomach
Stomach
After exiting the esophagus, food enters the stomach to begin the digestive process. The stomach mechanically and chemically separates food into smaller pieces prior to entry into the small intestine. Vomiting is a hallmark sign of stomach irritation. Dogs are best known for their indiscriminate eating, so it is not surprising that the most common causes of vomiting include foreign body ingestion (e.g.: rocks, toys), garbage ingestion, and parasites. Large breed dogs may also be at risk of a life threatening condition known as gastric-dilatation-volvulus (GDV). Recovery from GDV requires emergency treatment and surgery to correct the displaced stomach.
Gastric Dilitation Volvulus
Gastric Dilatation-Volvulus (GDV) is a life threatening condition typically seen in large, deep chested dogs (e.g.: Dobermans, German Shepherds, and Great Danes). The cause of this painful condition is a bit of a mystery, but it tends to happen after 2-3 hours after eating. GDV results from the stomach (Gastric) distending with gas (Dilatation) and subsequently twisting upon itself (Volvulus) and cutting off the blood supply. The distended stomach causes compression of the large blood vessels, impairing blood flow to other organs in the abdomen. Dogs suffering from GDV have non-productive retching and profound abdominal distension. Diagnosis of GDV is based upon history, physical examination, and abdominal x-rays. Patients with GDV must be treated aggressively for shock and require emergency surgery to decompress the stomach and return it to its normal position to restore blood flow to the organs in the abdomen. During surgery, the stomach is sutured to the body wall to prevent recurrences of GDV. The stomach tacking does not prevent the bloating, but prevents the life threatening volvulus.
Gastritis
Gastritis refers to inflammation of the lining of the stomach. The most common cause of gastritis is ingestion of something that should not be eaten (e.g.: spoiled food, trash). Other causes include: foreign body ingestion, parasites, medication intolerance (e.g.: antibiotics, anti-inflammatories, cardiac medications), toxins (e.g.: chocolate, plants, household chemicals), and organ inflammation (e.g.: kidney failure, hepatitis, pancreatitis). Diagnosis of gastritis is based on history, physical examination findings, lab work results, and radiographic findings. Your veterinarian may give your pet an injection to help stop the vomiting as well as administer fluids under the skin to help restore hydration. Pets with gastritis need to rest their stomachs to allow healing. Food and water should be withheld until the vomiting stops for 12-24 hours. If water is held down, then slow introduction of a bland diet can begin. A bland diet should be continued for 3-5 days with gradual reintroduction of the regular diet. Treatment of gastritis must also include treating the underlying cause if known (e.g.: deworming medication if parasites are involved; surgical removal of foreign bodies if causing obstruction).
Teeth
Teeth
Does your dog have bad breath? The odor you smell is caused by an infection in your dog’s mouth. The most common cause of infection in your dog’s mouth is periodontal disease, which affects over 75% of dogs over 2 years of age. Periodontal disease progresses without intervention. Unresolved periodontal disease can spread beyond the oral cavity to involve organs, such as the kidneys, liver, and heart. The goal of periodontal therapy is to restore oral health and stop the infection that causes pain, tooth and bone loss, and organ damage. Dogs need their teeth cleaned regularly just as people do. Home dental care and regular periodontal therapy help to maintain oral health to ensure a healthy, pain-free pet.
Periodontal Disease
The foul odor you smell coming from your dog’s mouth is caused by an infection around the teeth. The most common cause of the infection in your dog’s mouth is periodontal disease, which affects over 75% of dogs over 2 years of age. The inflammation begins when bacteria set up house in the gums surrounding your pet’s teeth. Without tooth brushing, these bacteria flourish and, in combination with food particles, cause calculus deposition on the teeth. The vicious cycle begins: bacteria grow, creating inflammation, calculus deposits on the teeth, more bacteria grow, while the inflammation and calculus deposition continues. Left untreated, this inflammation progresses to periodontal disease. Periodontal disease describes an irreversible loss of the support tissues of the teeth. Destruction of the support tissues surrounding the teeth causes pain, deeper infections, and tooth loss. Unresolved infections caused by periodontal disease can spread beyond the oral cavity to include distant organs, such as the kidneys, liver, and heart. The goal of periodontal therapy is to restore oral health by cleaning the teeth before irreversible damage occurs. Dogs need their teeth cleaned regularly just as people do. Home dental care and regular teeth cleanings help maintain oral health to ensure a healthy, pain-free pet.
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