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Questions for Dr. Shawn - GI Diseases, Irritable Bowel Disease (IBS), Probiotics, Stomach

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"Dear Dr. Shawn:
"I know in people that probiotics can be used to treat diarrhea. Do these also work in pets?"

Answer:
"Absolutely. Probiotics are beneficial (friendly) bacteria and yeasts that are important for normal health of the intestinal system. When acute diarrhea occurs, these healthy bacteria are decreased which can allow overgrowth of more harmful bacteria and yeasts. By giving probiotics to the pet, the balance is restored and the diarrhea resolves. There are no side effects to treating diarrhea with probiotics. Common organisms that are included in probiotic preparations include various species of Lactobacillus, Acidophilus, Bacillus, Bifidobacterium, Streptococcus, Saccharomyces, and Enterococcus.

In addition to probiotics, I use several supplements for pets with acute diarrhea including the amino acid glutamine which helps to heal the damaged intestinal cells. I like to check the pet over to make sure causes of diarrhea such as parasites or clostridial overgrowth are not present, as these conditions will require additional appropriate therapy. Dietary therapy, usually fasting for 12-24 hours followed by a bland diet for 2-3 days with a gradual reintroduction of the regular diet. Probiotics are also very helpful to minimize side effects from chemotherapy, radiation, and chronic antibiotic usage as often occurs in pets with repeated skin infections."


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"Dear Dr. Shawn:
"I have a Papillon who suffers periodically with stomach issues. He has problems with spitting up a yellow substance. He is treated at the vet each time and is on a special food. He gets NO table food,only EN Dog Food, which is for his sensitive stomach. Is there any holistic advise that you can give to help me? My vet said if left untreated it could turn into pancreatitis which I know is deadly. Thanks for your help."

Answer:
”The yellow substance you see is bile; vomited material from pets with gastrointestinal problems often contain yellow, green, or brown bile fluid. For acute vomiting or diarrhea, often symptomatic treatment with medications (such as metoclopramide) and dietary supplements (such as glutamine, probiotics, marshmallow, and enzymes) usually resolves the problem within 24-48 hours. If your dog has a chronic problem, this indicates an underlying problem that should be properly diagnosed so the correct treatment can be prescribed.

I recommended several microscopic fecal examinations to check for parasites, bacteria, and yeasts. If none of these organisms are found, an endoscopic examination and biopsy might be needed to check for inflammatory bowel disease (IBD,) of which there are several causes. While pets with IBD usually require immunosuppressive drugs like prednisone, most of my patients can be gradually weaned off of these drugs by using various supplements (such as the ones mentioned above, plus homeopathic medications) and a low antigen diet. IBD can cause or be associated with pancreatitis, which can be life-threatening. Early diagnosis is needed to prevent secondary problems like pancreatitis and allow proper healing of the GI system.”


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"Dear Dr. Shawn:
"I suffer from a condition called irritable bowel disease (IBS.) My 3 year old poodle Amy seems to have the same problem. She has loose stool with a foul odor. My veterinarian has run several fecal tests to check for parasites but so far has not found anything. Is it possible Amy suffers from IBS too?"

Answer:
Irritable bowel disease (IBS) is very common in people, possibly afflicting up to 25% or more of the population. The cause is unknown, but dietary sensitivities and stress can certainly contribute to the cause and symptoms. Most of the time, people with IBS have GI cramping and various bouts of diarrhea or constipation. IBS is diagnosed in people based upon clinical signs and ruling out other problems like diverticulitis and Crohn’s disease. IBS can occur in pets but is very rare and difficult to diagnose. More than likely, Amy suffers from inflammatory bowel disease (IBD.) In this condition, clinical signs such as weight loss, vomiting, and/or diarrhea can occur.

As with IBS, the cause of IBD is not always known. Certainly various infections and cancer can cause IBD; more commonly, the pet’s body produces inflammation that attacks the intestines. As with IBS, diet can contribute to the cause. Even though fecal testing has not detected parasites, I still like to deworm dogs like Amy for whipworms as these are very difficult to diagnose, even on multiple fecal tests. Also make sure she has been treated for Giardia infection, which is also difficult to diagnose (a new fecal test your doctor can run in the office makes diagnosis easier.) Ultimately, Amy will probably need to see a specialist to have further testing (ultrasound, endoscopic biopsy) done to diagnose the problem. Fortunately, IBD responds very well in most pets to supplements, making long-term drug therapy not necessary. Good luck.”


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"Dear Dr. Shawn:
"I have a cat who frequently has diarrhea. This has been going on for almost a year and it’s getting worse. My doctor has tested this kitty for internal parasites with negative results. He prescribed Flagyl and Imodium. I realize it could be related to her diet and am currently trying to determine that. However, I really want to get this diarrhea under control fast! Is there anything natural I can use to manage this?"

Answer:
”I’m not a big fan of Imodium for pets in most instances, although Flagyl can help control some parasites and bacteria. While I appreciate you wanting to get her diarrhea under control quickly, I’m more concerned about a chronic problem that has not yet been diagnosed or properly treated. There’s no reason for not having the correct diagnosis and treatment at this point, since your doctor has had a year to help here.

Here are some things that can help to decrease the diarrhea in the short-term while we’re trying to get a diagnosis. First, withhold food for 12-24 hours (water is OK.) Try then feeding a bland diet (your doctor can prescribe one.) I also use enzymes, probiotics, glutamine, and a homeopathic product called DiarHeel. These therapies usually work. Long-term, other testing must be done to rule out problems like inflammatory bowel disease (IBD.) This means an endoscopic exam and biopsy must be done. I’ve had great success treating IBD naturally; in most pets medications such as corticosteroids (like prednisone) or chemotherapy drugs are not needed for long term control and cure. I encourage you to followup with your doctor, as undiagnosed IBD can be fatal.”


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"Dear Dr. Shawn:
"My 2 year old dog started to throw up yellow fluid in the mornings. We visited the vet only 2 months ago and his lab tests were perfect. I am wondering if he’s cold at nights in the living room. Do you think that might be the reason?"

Answer:
No, it’s probably not due to colds. If it only occurs in the morning, your dog likely has a weak lower esophageal sphincter, a normally tight connection between the espophagus (the food tube from the mouth) and the stomach. Dogs with this condition usually respond to a medication (metoclopramide) given the night before as a single, oral dose. Talk with your doctor about this. I would also recommend a supplement (such as Vim & Vigor by PetCentrx) that helps maintain a normal gastrointestinal environment.


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"Dear Dr. Shawn:
"Our boston terrier has a sensitive stomach. She also gets a lot of sores on her body; our veterinarian says the sores are caused by her pink skin because she has very little hair cover. What can we give her to eliminate the infections that caused the sores, and what food would you recommend?"

Answer:
”I often consult with owners who tell me their prior veterinarians diagnosed their pets with a “sensitive stomach.” I never really know what to make of this “diagnosis,” as it really seems inadequate. It kind of reminds me of my first job here in Dallas. My first employer used to say that any dog or cat with a neurological problem “had a stroke.” This misdiagnosis resulted in many pets being treated improperly, and I suspect, based upon my experience, the same thing happens to pets with the “sensitive stomach” diagnosis. I suspect that your pet may have a food insensitivity or allergy, especially if she has intestinal and skin problems. Once again, simply saying she has sores on her skin because her skin is pink is copping out and not helping solve your pet’s true issues.

There are many things that can be done for your pet, but a proper diagnosis is essential. I would suggest a visit with another veterinarian, or even a referral to a specialist. Diagnostic testing that may help can include a food trial to see if food is in fact a problem, allergy testing, blood testing to check for other problems (like thyroid disease,) and even a trial of various therapies (detoxification therapies, bowel support, etc.) Once a diagnosis is made, my guess is that you will need to find a high quality natural diet to minimize intestinal and skin reactions.

Supplements that can help and might be prescribed include probiotics, colostrum, glutamine, antioxidants, omega-3 fatty acids, slippery elm, and marshmallow. Liver support and detoxification (with various homeopathics, nutritional supplements like choline, and herbs such as milk thistle) can also be helpful. Most cases like these are easily managed once properly diagnosed. I’ve had a lot of success with therapies like those I’ve mentioned, but be patient. Pets that have had chronic illness usually take a few months to heal and adapt to the new diet and supplements.”

 

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