Promising New Test for Elusive Bowel Disease

Analysis by Dr. Karen Shaw Becker

inflammatory bowel disease (IBD)

Story at-a-glance -

  • A newly developed simple blood test to diagnose inflammatory bowel disease (IBD) in dogs is on its way to market
  • Hopefully, the new test will make this challenging disease easier to detect, and even replace the need for expensive, invasive biopsies
  • Analysis of gut microbes also shows promise as an IBD diagnostic tool
  • Treating canine IBD requires a multi-pronged approach that starts with a bland diet
  • Additional treatment recommendations include microbiome restorative therapy and appropriate supplements

Digestive problems plague so many dogs (and cats) today that I don’t think it’s an exaggeration to call it an epidemic. And among the variety of things that can go haywire in your pet’s gut, inflammatory bowel disease (IBD) — also known as canine chronic enteropathy (CCE) — is one of the most difficult, time consuming and costly to accurately diagnose.

Thankfully, this could be changing with the news from Antech Diagnostics that the first simple blood test to diagnose canine IBD will be available in the very near future.1

Diagnosing IBD in Dogs Can Be Challenging

Historically, there have been two diagnostic tests veterinarians rely on to detect IBD. One is known as the “confirming test,” a biopsy, which is a small piece of tissue removed during an endoscopy procedure and sent to a pathology lab for analysis. The pathologist assesses the characteristics common in the gastrointestinal (GI) tracts of animals with inflammatory bowel disease.

Like most veterinarians, a biopsy is almost never my first choice, because it’s expensive, invasive, and involves putting the patient under anesthesia, so having additional noninvasive diagnostics is a breath of fresh air for vets around the world.

When I see a dog with possible IBD, my preference is to order functional gastrointestinal testing using blood and fecal samples. What I look for in the blood sample results are absorption levels of the B vitamins folate and cobalamin.

Folate is water-soluble and not easily absorbed in the small intestine unless it’s deconjugated there. If your dog’s small intestine can’t deconjugate folate, meaning it can’t break it down into an absorbable form, he can develop a folate deficiency.

If this is the case, his blood test will show low levels of folate. This tells me either the body’s ability to assimilate and absorb nutrients is poor, or the small intestine is unable to efficiently deconjugate nutrients, indicating a disease or disorder of that organ. On the other hand, if the blood folate level is abnormally high, it signals a condition known as small intestinal bacterial overgrowth (SIBO).

Cobalamin, the other B vitamin I check for, binds to protein and is released through a complex series of events that starts in the stomach and finishes in the small intestine. If cobalamin levels are low, we can assume this complex process is not working as it should. Cobalamin levels are a measure of digestion.

Maldigestion can sometimes also involve the pancreas in a condition called exocrine pancreatic insufficiency (EPI). EPI can be diagnosed using a blood test called a TLI (trypsin-like immunoreactivity). I also like to do a pancreatic lipase immunoreactivity (PLI) test to assess pancreatic function, because secondary pancreatitis is very common in IBD patients.

Completing a dysbiosis test2 and a microbiome analysis also provides information about the health or disease status of the GI tract and allows for the formulation of a specific recovery plan (often involving microbiome restorative therapy).

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Gut Microbes Can Also Help Detect Canine IBD

The bacteria that live in our digestive tracts, known as the gut microbiome, is thought to play a role in IBD. Since both dogs and humans suffer from IBD, researchers at the University of California San Diego School of Medicine set out to see what they could learn about the disease by examining canine gut bacteria.

For the study, which was published in 2016 in the journal Nature Microbiology,3 the researchers collected feces samples from 65 dogs with chronic GI symptoms and inflammation, and 85 healthy dogs. They used a special sequencing technique to identify the microbial species present in each sample, then used the sequencing data to look for similarities and differences in the bacterial species found in IBD and non-IBD dogs.

The differences were significant enough that the researchers could determine with a high degree of accuracy (over 90%) which dogs had IBD and which did not. Unfortunately, they also learned that the gut microbiomes of dogs and humans aren’t similar enough to apply their findings to people with IBD.

Treating Your Dog’s IBD

I believe 100% of pets with IBD also have dysbiosis, which thankfully can now be evaluated with a microbiome analysis. Most veterinarians agree that addressing a dysbiotic microbiome and the profound inflammatory response is the key to healing many chronic enteropathies.

However, I don’t agree with the conventional veterinary community that offering a feed-grade, ultra-processed “prescription” kibble containing hydrolyzed protein is the best approach to achieve improved gut health in dogs with inflammatory bowel disease. Although rendered, feed-grade pet food may improve GI symptoms in some pets, it isn’t a long-term solution.

Researchers are beginning to identify potential systemic consequences, including chronic inflammatory responses, from consuming exclusively ultra-processed diets (kibble and canned food), including the consumption of advanced glycation end products found in high-heat processed pet food which may explain why many pets don’t improve after switching from one brand of kibble to another.

The traditional dietary recommendation for dogs with IBD, especially those with vomiting or diarrhea, is to first find out if they need to avoid any specific foods. This can be done with a high degree of accuracy with a simple saliva test.

Once you have these test results, I recommend initially feeding a homemade, bland diet of one veggie and one meat from the “approved foods” list until symptoms improve, along with medications or nutraceuticals to manage the vomiting and diarrhea, if needed.

If your dog has been diagnosed with IBD and you’re feeding a bland diet, I recommend working with an integrative veterinarian, because after the bland diet, you’ll need to choose a novel, nutritionally balanced, low residue, preferably fresh food diet. A novel (new) diet will give your dog’s GI tract and immune system a much-needed rest, and the anti-inflammatory nature of the diet will support healing.

I also recommend asking your functional medicine veterinarian about microbiome restorative therapy, which is nontoxic, resonates with the body, and can have a profoundly positive effect on your dog’s health — not just GI health, but also organ function, immune system function and even behavior.

You and your veterinarian should also discuss appropriate supplements, including specific protocols to balance the microbiome and reseed the gut with healthy bacteria. In addition, there are numerous herbs and nutraceuticals that are excellent in helping to improve digestion and absorption and reduce GI inflammation.

Whether these supplements are introduced before, during, or after a dietary change depends on your dog’s individual situation. Transitioning too soon or incorrectly can actually lead to a worsening of symptoms, which is why I strongly encourage you to get professional guidance from an integrative veterinarian well-versed in gut health.

Other environmental and lifestyle factors you should address include future unnecessary vaccines (which I don’t automatically recommend unless warranted by titer testing) and other veterinary drugs (including the prescribing of steroids without fully explaining the next course of action), as well as any potential toxins in your pet’s environment or lifestyle that could be contributing to unaddressed inflammation.