By Dr. Becker
An ulcer of the stomach or the intestine, called gastroduodenal ulcer disease, refers to one or more ulcers found in a dog's or cat's stomach and/or duodenum. The duodenum is the first section of the small intestine. Ulcers are more common in dogs than cats, but kitties do get them as well.
Your pet's stomach acid is highly acidic, with a pH range of 1 to 2.5. This is a deliberate design of nature, because cats and especially dogs, are scavengers.
Nothing much can survive the acidic environment of their stomach, which keeps your carnivorous companion safe from potentially contaminated raw meat, pathogenic bacteria, and other "consumables" like poop that pets occasionally snack on.
Other species are not able to eat all those things without suffering the consequences, but dogs and cats are equipped to handle raw meat-based diets thanks to their highly acidic stomach pH.
The stomach plays an important initial role in helping your pet digest food through its mixing actions and by secreting gastric acid and pepsin, which activates key digestive enzymes.
The gastric tissues are able to withstand a high acidic environment because they are equipped with a number of protective forces, including mucosal cells, tight junctions, and a thick layer of mucus that prevents acid-induced injury.
There is also a high level of blood flow to the area, which promotes cellular metabolism and rapid renewal of injured cells.
Causes of Gastric Ulcers
The GI tract is quite resilient and heals quickly, however, if gastric acid secretion increases to the point that the protective forces are overwhelmed in some way, a gastric ulcer is often the result. There are several potential triggers for GI ulcers:
• Diseases that are known to increase gastric acid production include acute or chronic kidney failure, tumors of the pancreas or duodenum, and mast cell tumors.
• Gastric ulcers also develop when protective forces are inhibited or break down. A change in mucosal blood flow is a risk factor for gastric ulcers, and can result from the administration of non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids (for example, prednisone).
• Hypovolemia, which is a decreased volume of blood circulating in the body, severe trauma, vascular thrombosis, and gastric dilatation volvulus (GDV) can also result in mucosal ulceration of the GI tract.
• Other conditions linked to the formation of gastric ulcers include gastric tumors; inflammatory stomach disease; liver disease; hypoadrenocorticism (Addison's disease); hyperacidity of the stomach; GI parasites; bacterial, fungal, and viral infections; pythiosis (a rare condition caused by water mold); and a helicobacter infection.
• Dogs that engage in extreme exercise, for example, sled dog racing, and dogs dealing with a substantial amount of stress are also at risk for gastric ulcers.
• Accidental poisoning is one of the leading causes of GI ulcer disease. This can be from plants (for example, toxic mushrooms, castor beans, or sago palm), pesticide or rodenticide toxicity, chemical poisoning (often with ethylene glycol or phenol), or heavy metal poisoning involving zinc, iron, or arsenic.
• Gastroduodenal ulcers are common in German Shepherds receiving high doses of ibuprofen, an NSAID that I don't recommend giving to dogs on a routine basis. Rottweilers also have an increased incidence of stomach perforation and ulcers from NSAIDs.
It's important to note that in veterinary medicine ibuprofen is rarely used. However, there are many drugs in the NSAID category we use instead, and they create the same types of GI side effects as ibuprofen and other human NSAIDs.
Symptoms of Gastroduodenal Ulcer Disease
Gastroduodenal ulcers can cause a number of symptoms, which unfortunately often go undetected until the condition becomes severe. Some of the more common symptoms include:
✓ Vomiting blood
✓ Black tarry stool (a sign of digested blood)
✓ Loss of appetite, weight loss
✓ Abdominal pain
✓ Rapid heart rate
✓ Nausea (watch for lip licking or drooling)
Cats with GI ulceration rarely show specific symptoms, such as blood in the stool or vomiting, and as a result, they often go undiagnosed. Unfortunately, kitties are more likely to show signs of life-threatening hemorrhaging, so cats often present with acute crisis symptoms, but can also have the above symptoms as well.
Diagnosing Gastric Ulcer Disease
Your veterinarian can take a complete history and conduct a physical exam. He or she will also run diagnostics, including a complete blood count (CBC), biochemistry profile, a stool sample, and urinalysis.
Blood test in animals with GI ulcers may reveal anemia. If the bleeding is chronic, iron deficiency anemia may be evident. Other bloodwork abnormalities may be a decreased number of platelets (the cells that support blood clotting), and a higher than normal white blood cell count. Feces will be tested for the presence of blood.
A definitive diagnosis of gastric ulcers is typically made using endoscopy, a procedure that allows your veterinarian to look directly into your pet's stomach and duodenum with a small camera. The endoscopy will also allow the vet to remove any foreign bodies that might be present, and take samples of abnormal-looking tissue for biopsy.
The ultimate goal in treating gastroduodenal ulcers is to relieve the animal's symptoms while identifying and treating the underlying cause. However, since GI ulcers can be accompanied by severe symptoms like hemorrhage, shock, or serious abdominal infection, often intensive care is required to stabilize the patient.
Intravenous (IV) fluids are given to maintain body fluid levels, and in some pets, blood transfusions may also be required. Patients will be administered GI protectants and medications to reduce acid secretion while the GI tract is healing.
Preventing Gastric Ulcers in Your Pet
In my experience, the two most common reasons for GI ulcers are overuse of steroids or NSAIDs (or both), and helicobacter infection secondary to an unhealthy GI tract. Steroids and NSAIDs are used to control inflammation in the body. Some pets are very sensitive to even a few doses of these drugs. Many animals, however, can tolerate short-term use.
Unfortunately, many conventional veterinarians rely heavily or entirely on these drugs to control chronic conditions like arthritis or allergies. They put patients on steroids or NSAIDs (or both) for an indefinite period of time, which very often results in significant GI issues.
If your pet absolutely must be put on a steroid like prednisone for a life-threatening condition, insist on concurrent GI protectants from your veterinarian. If his or her only suggestion for pain, stiffness, or age-related issues is NSAIDs, I recommend finding a different veterinarian.
It's not that these drugs are all terrible short-term, it's that there are many other effective treatment options that are non-toxic for the long-term. If your vet is simply handing out drugs without offering additional supportive, rehabilitative, proactive solutions, I'm concerned you're not partnering with someone who is making the best decisions regarding the health of your furry family member.
About Helicobacter Infections
Conventional veterinarians typically prescribe antibiotics to treat opportunistic helicobacter bacteria. Holistic veterinarians do not (including me).
The presence of a helicobacter infection means an animal's innate GI defenses have been lost and local bacteria have taken advantage of the situation. It could be that too many antacids or H2 blockers were given. It could be your pet's GI immune system has been compromised as the result of a biologically incorrect diet. Or perhaps too many veterinary drugs have been prescribed.
Holistic/integrative veterinarians understand that helicobacter is nothing to fear, and is actually a fairly accurate measure of the health of your pet's innate GI defenses and systemic immune system.
Understanding Potential Triggers for a Helicobacter Infection
It's important to understand why the helicobacter infection occurred. Was the pet recently adopted from a shelter? Everything that happens in the life of a homeless pet causes tremendous stress, so it's not surprising that opportunistic bacteria are able to colonize the GI tract.
Does your dog sit in a crate all day while you're at work? Or is a hyperactive dog in the household constantly harassing your cat? These types of situations are emotional stressors, and over time are enough to suppress your pet's natural immune and GI defenses.
Evaluating what has gone on with your dog or cat, or what's currently stressful in his environment, is a very important step in identifying the root cause of a helicobacter infection. Another very important consideration is your pet's nutritional status. If you're feeding a highly processed diet day in and day out, you're creating nutritional stress in your pet.
Consider taking steps to improve your pet's diet. Take a look at my video and article "From Best to Worst — My NEW Rankings of 13 Pet Foods." Figure out where your pet's food is in the ranking and work to move up the list to decrease the amount of nutritional stress your dog or cat is experiencing.
Foods that contain pesticide residues, most notably glyphosate, which is found in almost every conventionally grown fruit, vegetable, meat, and grain, are exposing your pet to chemical toxins. These toxins alter GI defenses. Factory-farmed animals are fed vast amounts of antibiotics that end up in the meat we eat and feed to our pets. Try to feed free-range, ethically raised meat to your dog or cat to minimize exposure to antibiotics and the potential for antibiotic resistance.
Another consideration is environmental stressors around your home, for example PBDEs, which are flame-retardant chemicals sprayed on dog and cat beds. Or it could be household chemical cleaners, or lawn and garden pesticides, herbicides, and fertilizers.
Any chemical in or around your home has the potential to end up in your pet's mouth, because your dog or kitty will walk through it or get it on their fur, and then ingest it while grooming. Going green around your home and yard will not only improve your health, but the health of your animal companion as well.
And while you're at it, ditch those plastic food and water bowls and replace them with stainless steel bowls. And make sure you're providing filtered drinking water for your pet.
Is Your Veterinarian Part of the Solution — Or Part of the Problem?
Is it possible your veterinarian is stressing your pet out? Conventional vets perform a number of routine procedures that are surprisingly taxing to your pet's immune and GI health, including way too many vaccines, as well as unnecessary antibiotics and dewormers.
For example, because pets are out and about and may eat a bit of poo now and then, many vets automatically give dewormers instead of checking a dog's or cat's poop for parasites. These drugs negatively alter your pet's microbiome, or gut bacteria balance.
Pairing with an integrative or holistic vet who weighs the use chemicals against the overall well-being of your dog or cat is a really important step for your pet's long-term health. Fortunately, there are lots of effective natural helicobacter treatments. In fact, I haven't had a single case of helicobacter not respond to a natural approach. A holistic vet may, for example, suggest berberine or grape root for a pet with GI ulcers.
Other options include bismuth, deglycyrrhizinated licorice (DGL), specific forms of aloe, certain strains of probiotics, mastic gum, and a whole host of homeopathic and traditional Chinese medicine (TCM) remedies. Complete resolution of GI ulcer disease depends on the underlying cause, the extent of the problem, and the treatment provided. Regular monitoring and repeat follow up examination is necessary until the ulcers are completely gone.
Preventing GI ulcers usually means preventing the underlying cause, however, not every trigger is within your control. But to recap, steps you can take as your pet's guardian include:
- Feeding a balanced species-appropriate, organic, non-GMO, and fresh food diet
- Remaining vigilant in keeping your pet away from situations where he could be inadvertently poisoned or consume a caustic substance
- Ensuring every veterinary medication is given in the lowest effective therapeutic dose, and insisting on titering in place of automatic re-vaccination
- Taking your pet for regular wellness visits to monitor his overall heath and check for the presence of hidden parasitic, bacterial, or fungal diseases
- Providing a low-stress environment and lifestyle for your pet that includes adequate but not extreme forms of exercise