By Dr. Becker
The term irritable bowel syndrome (IBS) is often used interchangeably with inflammatory bowel disease (IBD), but they are actually somewhat different conditions. However, left untreated, I believe IBS can progress to full-blown IBD in dogs.
In IBD, there is chronic inflammation of the bowels. However, dogs with IBS usually have what I call “consistently intermittent” inflammation, meaning it comes and goes, but does so dependably. Irritable bowel syndrome, also often called “sensitive stomach,” is actually less common in dogs than other GI diseases, but it may not seem so, because when a dog’s digestive issues aren’t accurately or thoroughly diagnosed, they’re often assumed to be IBS.
Potential Causes and Symptoms of IBS in Dogs
There are a handful of suspected causes of “true” IBS, including:
- Abnormal colonic myoelectrical activity and motility
- Changes in neural or neurochemical regulation of colonic function
- Dietary intolerances
- Lack of dietary fiber
The most common symptoms of irritable bowel syndrome involve intermittent-but-consistent bouts of diarrhea, frequent attempts to pass small amounts of poop and mucus and constipation. Some dogs also suffer from abdominal pain, bloating, nausea and vomiting.
Diagnosing Irritable Bowel Syndrome
IBS is a diagnosis of exclusion, meaning it’s the diagnosis we arrive at after every other condition with similar symptoms is ruled out. Most gastrointestinal (GI) disorders share a long list of symptoms, so there’s a lot to rule out before deciding on a diagnosis of canine IBS. Some of the conditions that may need to be ruled out include:
- Intestinal worms (e.g., whipworms) or parasites (e.g., giardia, coccidia)
- Inflammatory colitis
- A bacterial, fungal or other type of infection
- Tumors of the colon
- Abnormal turning of the intestine (cecal inversion)
Since inflammatory bowel disease is a very common cause of GI issues in dogs, and since diarrhea is a symptom of both IBS and IBD, I almost always check for IBD in dogs with GI issues.
Lack of healthy digestion is a common cause of secondary infections. Since over half your pet's immune function is located in her GI tract, compromised intestines lead to a compromised immune system. Secondary organ failure is common in IBD patients. Nutritional deficiencies are also a significant risk because GI inflammation greatly interferes with your dog’s ability to process and absorb nutrients from her diet.
To check for IBD, functional GI testing is required, at a minimum. These blood tests provide information on how well your dog is absorbing folate (a water-soluble B vitamin) and cobalamin, another B vitamin that binds to protein.
A low folate level indicates one of two things — either the dog's ability to absorb nutrients is compromised, or there is disease of the small intestine. If the folate level is too high, it can indicate another problem known as SIBO — Small Intestinal Bacterial Overgrowth. If the cobalamin level is low, it's another indicator that all is not well with the small intestine. Cobalamin levels are a measure of digestion. I also run two more functional tests — TLI and PLI — that assess pancreatic function.
There is another test known as the "confirming" test for IBD, which involves a biopsy to look for changes in the architecture of the GI tract characteristic of the condition. This isn't my first choice because it's invasive, expensive and involves anesthesia, but it’s the only option to differentiate lymphoma from IBD.
Dietary Recommendations for Dogs With IBS
If your dog is diagnosed with irritable bowel syndrome, I recommend you work with an integrative vet to create a comprehensive protocol to address dietary issues and appropriate supplements, including a high-quality pet probiotic to heal and reseed the gut with healthy bacteria.
The entire length of your pet's digestive tract, when healthy, is coated with a good balance of bacteria that protects against foreign invaders, undigested food particles, toxins and parasites. Friendly gut bacteria serve as a natural antibiotic and also contain antifungal and antiviral properties. It also promotes appropriate immune response to invaders.
When gut bacteria (your dog’s microbiome) are out of whack, the intestine walls are essentially unprotected and undernourished. A healthy balance of bacteria provides a rich source of energy and nourishment for the lining of the GI tract. Microbiome restorative therapy can also be an inexpensive and profoundly effective tool at rebalancing your pet’s internal terrain.
Depending on your dog’s symptoms, your veterinarian may recommend a bland diet. The bland diet I prefer is a grain-free menu of cooked ground turkey and canned pumpkin (pure pumpkin, not the filling used in pies) or cooked sweet potato. Make sure to eliminate all grocery store treats at the same time.
When it's safe for your dog to transition away from the bland diet, I recommend working with your integrative vet to create a novel protein diet. This will give the GI tract and immune system a good rest.
Novel protein diets are made with foods your dog hasn’t consumed before. I also recommend giving IBS dogs a break from all sources of food contaminants, including high heat processing that creates AGEs, foods that have been genetically modified, added colors and flavors and synthetic vitamins. After three months on a novel protein diet, you should be able to gradually transition your dog to a balanced, species-appropriate, fresh food diet, including healthy treats.
You and your veterinarian should also discuss appropriate supplements in addition to a high-quality pet probiotic, for example, digestive enzymes. There are also numerous homeopathics and nutraceuticals that can be very beneficial in helping to reduce GI inflammation and IBS symptoms. I absolutely do not recommend that pets with IBS stay on steroids as the only treatment plan, which is currently how most of these cases are managed.
Also make sure your dog has a continuous supply of fresh filtered water, free from fluoride and chorine. I also recommend you stop using chemical-based household cleaning supplies, as well as room sprays, plug-ins and fabric deodorizers.
Adding Fiber to Your Dog’s Diet
Irritable bowel syndrome can cause either diarrhea or constipation, and supplemental fiber can address both symptoms. If your dog lived in the wild, his natural prey would provide ample fiber in the form of fur, feathers and predigested gut contents. Since domesticated dogs don’t get prey animal fiber in their meals, it can be beneficial to add fiber to an IBS dog’s diet to help keep things moving smoothly through the digestive tract — not too fast, and not too slow. Good options include:
Psyllium husk powder: 1/2 teaspoon per 10 pounds of body weight one to two times daily on food
Ground dark green leafy veggies: 1 teaspoon per 10 pounds of body weight one to two times daily with food
Coconut oil: 1/2 teaspoon per 10 pounds of body weight one to two times daily
Canned 100 percent pumpkin: 1 teaspoon per 10 pounds of body weight one to two times daily on food
Organic apple cider vinegar (ACV), raw and unfiltered: 1/8 teaspoon per 10 pounds of body weight added to food one to two times daily
Aloe juice (not the topical gel): 1/4 teaspoon per 10 pounds of body weight one to two times daily on food
Acacia fiber: 1/8 teaspoon per 10 pounds of body weight one to two times daily as prebiotic fiber
Again, it’s very important that dogs with IBS stay well hydrated, so make sure your pet has access to clean, fresh, filtered drinking water at all times. Place a few bowls around the house. You might also want to consider a pet water fountain to encourage your dog to drink more. Also consider adding bone broth to his food.
Managing Stress in Dogs With Irritable Bowel Syndrome
Since stress is a particular problem for dogs with IBS, one of the best ways to help a pet with irritable bowel syndrome is to take steps to manage her stress. It’s important to keep in mind that canine stressors are very different from human stressors, and research shows that stress can affect a dog's health and longevity. The 10 most common stressors in dogs:1
1. Novelty — exposure to new items, new people, new animals, etc.
2. Loud noises — fireworks, thunderstorms, etc.
3. Changes in housing — moving to a new home, boarding, etc.
4. Changes in household members — new baby, new pet, loss of pet or human, houseguests, etc.
5. Changes in household routine — new job schedule, kids returning to school, holidays, etc.
6. Punitive training methods — shock collars, yelling, hitting, etc.
7. Invasion of personal space — disruption when resting, hugging, kissing, forcibly restraining, etc.
8. Lack of outlets for normal breed behaviors — herding, running, retrieving, etc.
9. Separation from human family members — separation anxiety, etc.
10. Poor (strained) relationships with other household members (pets or humans), etc.
When your dog is under stress, his body releases an excessive amount of norepinephrine, the fight or flight hormone, which can alter gut bacteria and interfere with GI tract motility, which is obviously problematic for a pet with IBS. Fortunately, there are many things you can do to minimize stress in your dog’s life.
17 Tips to Reduce Your Dog’s Stress
1. Replace punitive training with positive reinforcement behavior training.
2. Make sure everyone in the household understands and respects your dog’s need for uninterrupted sleep and appropriate canine-friendly handling.
3. Most dogs, especially working and sporting breeds, need much more exercise than they get, so a great place to start in reducing your pet’s stress is to increase her daily physical activity level.
4. Dogs are social creatures who get lonely and bored when forced to stay alone for long stretches. If there’s no one home during the day to keep your dog company, I recommend recruiting a friend or neighbor or hiring a dog walker to take him for a stroll around the block, at a minimum. An alternative is doggy daycare.
5. Leave your dog with an article of clothing or blanket with your scent on it.
6. Leave a treat-release toy for your dog to focus on in your absence. Place small treats around the house for her to discover, along with her favorite toys.
7. Add a flower essence blend like Separation Anxiety from to her drinking water and put on some soothing doggy music before you leave.
8. Invest in an Adaptil collar or diffuser for your dog. These products release a pheromone that’s designed to have a calming effect on dogs.
9. Make sure your dog gets plenty of exercise, playtime, mental stimulation and TLC. The more full her life is when you're around, the calmer she'll be when you're not.
10. Play calm, soothing music before a possible stressor occurs. This may relax your dog and have the added bonus of drowning out distressing noises.
11. If your dog seems to respond well to pressure applied to her body, there are wraps available (e.g., Thundershirt, TTouch anxiety wrap) that many pet owners and veterinarians find extremely helpful.
12. TTouch is a specific massage technique that can help anxious pets.
13. Consult your holistic vet about homeopathic, TCM (traditional Chinese medicine), Rescue Remedy, as well as other specific Bach flower remedies that could be helpful in alleviating your dog's stress. Products I use, always in conjunction with behavior modification, include homeopathic aconitum (or whatever remedy fits the symptoms best), Hyland's Calms Forte or calming milk proteins (variety of brands).
14. Calming nutraceuticals and herbs that can be of benefit include holy basil, l-theanine, rhodiola, ashwagandha, GABA, 5-HTP and chamomile. Consult your holistic vet about which makes sense for your pet.
15. The essential oil of lavender has also been proven to reduce a dog's stress response. I recommend placing a few drops on your dog's collar or bedding before a stressor occurs, if possible, or diffuse the oil around your house for an overall calming effect.
16. If you’ve adopted a dog who may have had a rocky start in life, I also highly recommend a program called A Sound Beginning, which is designed to help rescue dogs and adoptive guardians learn to communicate effectively and form an unbreakable bond.
17. If your dog’s stress seems to be getting worse instead of better, consider an individualized approach to managing her anxiety by allowing her to choose what best soothes her via applied zoopharmacognosy (self-healing techniques offered through a trained professional).