Colitis
Colitis
What Is Colitis?
What Are The Symptoms of Colitis??
- They are not associated with weight loss
- They are associated with straining and sense of sudden urgency
- They often involve fresh blood in the stool
- They often involve slime or mucus in the stool
- They often involve a stool that starts normal and finishes loose
- They involve stool quality that is more gooey or slimy than watery
A diagnosis of colitis is generally straight forward given the above classic findings though how one should proceed depends on the course of the signs. Is the problem acute (i.e., suddenly there) or chronic (been happening for several weeks regularly) or episodic (happens then goes away then happens again)?
In classifying diarrhea, it is important to determine whether the problem relates to the small intestine (diarrheas originating here are more serious) or large intestine. Diarrheas of the large intestine have the following common characteristics:
In brief, colitis is inflammation of the colon.
Sudden Colitis
A pet that has symptoms of colitis suddenly probably has a stress-related colitis (common after boarding, moving, severe weather or other change) or a dietary indiscretion related colitis (related to treats or raiding the garbage). These cases are generally minor and can be cleared with a short course of medication; metronidazole is commonly prescribed) and/or dietary therapy. Parasites can also cause colitis and may have to be ruled out as well.
Chronic or Episodic?
feline leukemia virus and feline immunodeficiency virus) confirmed. A test for pancreatic ability to produce digestive enzymes may also be in order. A fecal smear or cytology test where the bacteria of the stool sample (as opposed to worm content) is examined microscopically can help rule out pathogenic bacteria that can cause colitis (Clostridial organisms especially). inflammatory bowel disease for more information on specific therapy. It is very important to rule out irritable bowel syndrome at this point, which will mimic colitis but be related to psychological stress, and tissue sampling is the only way to do this. Metronidazole This medication has anti-inflammatory properties in the large intestine as well as ability to kill harmful organisms such as Clostridia and Giardia. For more information on this medication, see the link. amoxicillin, tylosin, metronidazole (which has other colitis-helping properties as well), and clindamycin. Prednisone is the cornerstone of treatment for inflammatory bowel disease and inflammatory bowel disease must be diagnosed by biopsy. Sometimes a trial course of this medication is suggested for colitis.
In dogs, whipworms are difficult to confirm by fecal test (the test detects worm eggs and whipworms only periodically release their eggs). It may be prudent to deworm the dog for whipworms and see if the problem resolves.
If response to a short course of simple treatment is short-lived and if blood testing, then colonoscopy with biopsies will probably be necessary to reach a diagnosis.
Please read the section on
Treating Clostridium:Clostridial organisms are a group of anaerobic bacteria responsible for such unpleasant conditions as tetanus, botulism, and gangrene. There are Clostridial organisms that normally live in the large intestine, but they do not cause any trouble unless some stressful event or diet change allows them to over grow. Once they are present in large numbers, the toxins that they produce become significant and can cause colitis. Colitis can result from a food intolerance (an example would be lactose intolerance from which numerous people suffer). Intolerances can result from dyes, preservatives, contaminants or even natural proteins in the food. Similarly, colitis can result from an actual food allergy. The solution for these intolerances is the feeding a pure diet, ideally a home cooked food made with carbohydrates and proteins that are novel or new to the patient. An 8 to 10 week diet course is typically needed and no other chews or treats can be offered during the time of the trial. Food allergy cannot be diagnosed by blood test or skin test. At this time, response to elimination diet is the only test for food allergy or intolerance. One of the prescription Iams diets as well as the Innovative Veterinary Hi Factor diet emphasizes the addition of FOS to its formulation. FOS’s are carbohydrates involving fructose (fruit sugar) units attached to glucose (starch sugar) units. Most carbohydrates are digested by the bacteria of the small intestine FOSs are not fibers but they are digested in the large intestine (not the small intestine) in the same way that fibers are yielding the same biochemicals that fibers do. Why is this good? Tests in healthy cats indicate that this will help remove pathogenic bacteria from the large intestine and promote the growth of helpful bacteria. Diets that contain FOS’s may be helpful in the management of colitis. The role of fiber in colitis is confusing as there are an assortment of fiber preparations (soluble fibers, insoluble fibers, and mixtures). In general, colitis is felt to be a fiber-responsive disease. Fibers are broken down into nutrients for colon cells and also for food for beneficial colon bacteria. This medication consists of a sulfa antibiotic bound to a salicylate anti-inflammatory. The sulfa bond protects the anti-inflammatory medication until it gets to the large intestine thus saving the anti-inflammatory effect for the disease of the large intestine. This is an effective medication but is typically given 3 times a day, which is an inconvenience. Cats are sensitive to salicylates, thus this medication is primarily used in dogs.
The diagnosis of Clostridial disease is complicated. A fecal smear may show the presence of Clostridial organisms but that does not mean they are producing toxin. Further tests (the reverse passive latex antigen test and the ELISA test) may be needed but the accuracy of these tests is in dispute. Often a course of a Clostridium-killing antibiotic is used as a test. Such antibiotics include:
Colitis is best managed when its cause is known and specific therapy can be instituted. When this is not possible, symptomatic management is often attempted. The following are therapeutic medications and strategies that can be helpful in the treatment of colitis.
If your pet has had symptoms of colitis for one month or more, a search for the actual cause of the colitis should be sought. Your first move is to run a basic database. This should include blood chemistry, a white and red cell profile (a CBC), and at least one fecal test for parasites. Cats should have their viral status (