Gastrointestinal System
 
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NJ Veterinary Medical Association
390 Amwell Road, Suite 402
Hillsborough, NJ 08844
info@njvma.org
Phone:  908-281-0918
Fax:  908-450-1286
 

Health Concerns: Gastrointestinal System

Dear Veterinarian:
My dog sometimes sits on her fanny and pushes herself around the room. While it looks rather funny, it results in a horrible odor. She has also been licking herself a lot underneath her tail. Why does she do this?

Dear Pet Owner:
The problem your dog is having is with her anal sac glands. This is usually a small dog problem but sometimes large dogs will scoot as well. The anal sac glands are modified scent glands that are located on either side of the dog or cats' anus or rectum. Usually the dog expresses them each time he defecates. Most of our dogs don't have firm enough bowel movements that force the anal sac glands to empty each time. If your dog is scooting on his fanny but isn't crying in pain, it's probably a simple anal sac gland impaction. If your dog is expressing pain, lift her tail and look for feces that may be stuck to the fur as well as for bleeding, sores, or protrusions. Sometimes the anal sac glands become infected and rupture. This can make her feel pretty sick. The area around the anus is also a place where tumors can be present. Another problem found in the perineum that can look like simple scooting is a perineal hernia. It's important to have your veterinarian examine your dog when scooting becomes a problem. Most of the time, it's easy to correct, but once in a while scooting can be the sign of a more serious condition.

 


Dear Veterinarian:
I like to sew and my three-year-old cat, Fluffy, likes to watch. Sometimes he grabs the end of the thread and bats around the spool. I think this makes a great toy but I worry that he may swallow some while he plays. Is this safe?

Dear Pet Owner:
No! Thread is a very dangerous to a cat. Eventually he will gulp a ball of it and problems will develop. Sometimes the middle of the strand gets caught under the tongue and the loose ends travel down the digestive tract, but the section anchored in the mouth prevents the thread from advancing, as waves of intestinal contractions work to move the material along. This causes the intestines to bunch like raising window blinds. Your cat will act sick. He won't eat and he may vomit. If you're lucky, your veterinarian will be able to see the thin filament under the tongue. Sometimes it digs into the flesh and becomes virtually invisible. Other times the thread clumps in the stomach instead of the mouth. This condition can be difficult to diagnose early. As times passes, the damage to the intestines may become more visible on x-rays, but by then, it is more likely the thin sharp string has cut through the bowel, causing even more serious harm.

Surgery by your veterinarian would be necessary to save your pet. Multiple incisions are made into the gastrointestinal tract to remove the offending material and repair any tears. This can be a dangerous and complicated operation. It's important to keep thread and string away from your cat. Other dangerous objects include plastic bad ties, rubber bands, Christmas tree tinsel, plastic Easter basket grass, and any other similar or small indigestible objects that your cat may ingest.

Your cat certainly needs to play. Safe toys can be purchased at pet stores. Cats often like to chase flashlight beams, bat dangling bathrobe belts, or hide in paper grocery bags. As you can see, it's important to cat-proof your house to provide a safe playful environment for your pet.

 


Dear Veterinarian:
My pet has had diarrhea for quite sometime and is very hungry. Despite his voracious appetite and intake of food, he is losing weight. His laboratory blood work and fecal sample checks did not reveal any abnormalities. However, my veterinarian would like to do a blood test for pancreatic insufficiency. What is that?

Dear Pet Owner:
The pancreas is an organ near the stomach and small intestine. It has 2 main functions: producing insulin to regulate blood sugar and producing enzymes to help digest food. If the endocrine cells of the pancreas malfunction, diabetes mellitus can ensue. If the exocrine cells malfunction, the pet is diagnosed with exocrine pancreatic insufficiency or EPI. EPI is what your veterinarian wants to test for in your dog's case.

The most common form of EPI in dogs is called idiopathic, which means we do not know exactly what caused it. If a pet has had severe trauma, infections, or tumors of the pancreas, this may cause irreversible damage to the tissue and cause it to stop making enzymes. Rarely, young dogs may have been born with very little pancreatic tissue and thus develop congenital diabetes mellitus and EPI. And certain breeds of dogs such as the German Shepherd and the rough coated Collie are at risk for inheriting EPI. Most of the time, dogs with EPI are not diabetic.

Dogs with EPI usually have a history of weight loss despite a ravenous appetite. Many pets may also have diarrhea or produce large volumes of semiformed feces. Some pets may vomit, or have a noisy, gurgling stomach, or have abdominal cramps as well as flatulence. The dog is often thin and has a poor hair coat. Many of the routine laboratory tests are normal. However, if your veterinarian suspects EPI, she can submit a blood test called a TLI, or trypsin-like immunoreactivity. This test measures the level of an enzyme that is leaked directly into the blood from he pancreas. If the test comes back low, it means the pancreas is not producing enough digestive enzymes. It is important, however, that your pet is fasted from food for 12 hours prior to the test to give an accurate reading.

If your pet is diagnosed with EPI, pancreatic enzyme supplement powder will be prescribed to compensate for the deficiency. The powder is mixed into the food for each meal. It is also recommended to feed a highly digestible, caloric food twice daily to promote weight gain and satisfy the appetite. Most pets respond to therapy within a week with fecal consistency and appetite returning to normal, and weight gain. Once the body condition normalizes, the amount of enzyme replacement can be gradually reduced to a daily dosage that maintains healthy body weight. Although EPI is irreversible, most pets have a good prognosis with appropriate enzyme therapy and dietary management.

 


Dear Veterinarian:
My golden retriever loves to play with sticks out in our yard. But in addition to playing with them, he chews and swallows them. Hours later he will vomit the pieces. Can eating sticks be dangerous to his system?

Dear Pet Owner:
Yes, it can be dangerous. One common problem occurs when a dog bites on a stick and it breaks off on each end with the remainder of the stick being firmly wedged between the two rows of upper teeth across the roof of the mouth. The dog is unable to dislodge it, yet will make repeated attempts to do so by constantly pawing at the mouth and acting distressed. Sometimes the stick can be removed by your veterinarian with forceps while your pet is awake, but more often than not, general anesthesia is required.

Also, there is always the danger of an intestinal obstruction, which is a blockage to the normal flow of ingested material through the intestines. Symptoms of a GI obstruction would be severe and continuous vomiting with some of the vomiting projectile in nature. Sometimes, the only sign is that the dog stops eating. A veterinarian can diagnose the problem, and provide prompt surgical intervention to correct the problem.

A problem could arise if sharp pieces of stick perforate the lining of the stomach or the small intestines resulting in peritonitis. Peritonitis is a serious and possibly fatal infection of the abdominal cavity requiring prompt and vigorous treatment with surgical intervention and intensive antibiotic therapy to save the animal's life.

A rare but serious scenario occurs if the sticks lacerate the lining of the esophagus causing scar tissue to form and leads to a narrowing of the esophagus. This could be a major problem over a period of time.

The best prevention is to try and minimize your dog's access to sticks. There are many safe play toys and chew toys that your veterinarian can recommend.

 


Dear Veterinarian:
I have a friend who has a cat that died of a “fatty liver”. My friend says that her cat got the disease because she did not eat. My cat Fluff sometimes will not eat for a day or so. I'm worried that Fluff will get “fatty liver”. What do can I do to prevent this?

Dear Pet Owner:
Hepatic lipidosis or fatty liver is a syndrome that is commonly seen in cats. It is most commonly seen in obese cats that have anorexia for at least two weeks. Fat accumulates in the liver and causes damage to the liver. Sometimes there is a second disease that predisposes the cat to developing hepatic lipidosis. These include diabetes mellitus, cancer, pancreatitis and other liver diseases. Stressful situations such as introduction of new pets or people into the household, boarding and dietary changes are also associated with anorexia and the development of hepatic lipidosis. In 50% of the cases of hepatic lipidosis no predisposing disease or factor is identified.

The most common clinical signs seen in this syndrome are anorexia, weight loss, vomiting, and icterus (yellow color to skin and mucous membranes). Less often, behavioral changes such as drooling, blindness, coma, and seizures may be seen.

Suspicion of hepatic lipidosis is based on history, physical exam findings and supportive laboratory work. Radiographs (x-rays) and ultrasound help to define the appearance of the liver and rule out other disease states. Definitive diagnosis requires identification of fat globules in liver cells. The liver cells may be obtained by liver biopsy or fine needle aspiration.

Once hepatic lipidosis develops, treatment depends on the severity of the disease and the presence of other diseases. Treatment requires aggressive nutritional support. Force feeding is usually not adequate and may cause the cat to develop an aversion to the food being offered. Placement of a feeding tube into the esophagus or the stomach for long-term nutritional support has reduced the mortality in this disease from over 90% to 30%. Often the tube must be used for several weeks.

Obviously, despite aggressive therapy, many cats will succumb to this disease. Therefore, prevention is essential. Any anorexic cat should be evaluated by a veterinarian. Therapy for prevention may include use of appetite stimulants and offering tempting foods, as well as elimination of predisposing factors if possible.

 


Dear Veterinarian:
Are rawhides safe for my dog to eat? Other than worrying about him choking, he seems to really enjoy them.

Dear Pet Owner:
Rawhides come in a variety of shapes and sizes. They can also come in many different “flavors." You may hear different opinions on whether or not a dog should eat rawhides. Dogs like to chew to help keep their teeth clean and it also help to prevent boredom. Chewing on a toy or a rawhide is one way that dogs pass the time. The problem with rawhides is that dogs can break off pieces small enough to swallow but are too large to digest quickly. This piece of chewed off rawhide can obstruct their gastrointestinal tract, which can cause vomiting. Some dogs can get a piece of rawhide stuck in between their teeth, in the roof of their mouth, or even partially in their throat. Some rawhides are sprayed with different flavorings or may have preservative chemical residue that can make allergic dogs sick. Having said all this, it depends upon your dog and how he or she handles this dried piece of skin. If your dog seems to enjoy rawhide and has no problems, it is probably OK to keep giving it to him. Be aware, however, that even if your dog is alright eating a rawhide now, there is no guarantee in the future that there will be no problems. You should always monitor your dog in case any problems occur.

 


Dear Veterinarian:
My dog Ralph has been vomiting foam. I took him to my veterinarian and he took x-rays and said that Ralph has an enlarged esophagus. He recommended doing a lot of testing to try to find out why this is happening. Ralph doesn't seem to be having other problems at this time so I am not certain about what I should do. What do you think?

Dear Pet Owner:
The esophagus connects the pharynx or back of the mouth to the stomach. It transports food and water to the stomach. Usually the esophagus contracts to move substances to the stomach. In megaesophagus (enlarged esophagus) the esophagus dilates and becomes weak and unable to propel food or water to the stomach.

Animals with megaesophagus will regurgitate food or water. This process involves food or water coming out from the esophagus or back of the mouth and is often confused with vomiting.

Vomiting occurs when food or water comes from the stomach or duodenum. Other signs include weight loss, but the most life threatening side effect of the syndrome is leakage of food or water from the esophagus into the trachea (windpipe) and the lungs. This leakage into the lungs is called aspiration and results in pneumonia (infection in the lungs). Sometimes signs of aspiration pneumonia including fever, cough, and labored breathing occur without regurgitation being observed. Some animals die suddenly if large amounts of material are aspirated.

Diagnosis of megaesophagus is made by taking radiographs (x-rays) of the chest, sometimes with administration of a contrast agent. Radiographs are important to take because there are other problems that can cause similar signs, but require different therapy.

Megaesophagus has devastating effects. Clinical signs usually are progressive and most animals die of aspiration pneumonia. Since there are many recognized causes of megaesophagus a search for the underlying cause is recommended. Unfortunately, an underlying cause is found in only about 25% of cases. When no underlying cause is found the syndrome is called idiopathic megaesophagus. In cases of idiopathic megaesophagus therapy is symptomatic and management is aimed at preventing side effects such as aspiration pneumonia. In cases in which an underlying cause is found, the underlying cause is treated and the megaesophagus may be reversed.

Medical management of megaesophagus consists of trying to assist food and fluid flow into the stomach. Feeding the animal in an upright position and maintaining that position for 5 to 10 minutes after feeding is helpful in some cases. Feeding a gruel may allow the food to flow more easily into the stomach. Other animals tolerate solid food better than gruels. Small feedings several times a day are also recommended.

Sometimes a gastrostomy tube (stomach tube) may be placed for feeding. This allows food and water to be given directly to the stomach. Although this decreases the risk of aspiration from feeding, it does not entirely remove the risk of aspiration since the animal will still swallow saliva.

 


Dear Veterinarian:
Every week, my eight-year-old Persian cat, Fluffy, makes a gurgh-gurgh-gurgh noise and spits up a wet tube of clumped hair and food. Why does he do this?

Dear Pet Owner:
It sounds like Fluffy is vomiting hairballs. You cat is naturally very clean and spends many hours grooming himself. He possesses a rough tongue that pulls dirt and loose hair from his coat. Fluffy may pack too much hair into his digestive tract during grooming and eventually vomits it out.

Certain conditions may increase Fluffy's hairball episodes. Stress may trigger shedding or overgrooming behavior. Allergies or flea infestation can lead to more licking and hair ingestion. Stomach or intestinal inflammations can make the digestive system more sensitive to a usually acceptable volume of hair. See you veterinarian to help you sort out possible underlying health problems.

Once illness has been ruled out, there are several steps you can take to alleviate your cat's discomfort. Tasty hairball pastes can be purchased. They contain flavored white petroleum jelly. When your cat licks this lubricant, the hairy lump will more easily slide through the digestive system. Frequent brushing or bathing will remove loose fur, leaving less for your fastidious feline to groom. Cat foods containing fiber are now on the market that help break apart the obstructive blocks of hair so they are deposited in the litter pan where they belong rather than regurgitated on the kitchen floor.

It is normal for cats to vomit an occasional hairball. If bouts occur several times a week or more often than usual, seek help from your veterinarian. Neither you nor your pet need to tolerate this unpleasantness.

 


Dear Veterinarian:
My dog loves to eat grass. Every once in a while, he'll insist on eating it but then vomits it a few minutes later? Why does he do this?

Dear Pet Owner:
There are a number of different theories about why dogs eat grass. One theory is that dogs eat grass to empty out their stomachs and make themselves feel better just as an antacid can help humans feel better after they eat something that disagrees with them. Dogs typically can eat many different things that would get a human sick immediately. Their gastrointestinal system is usually strong enough to handle most abnormal foods or objects. Occasionally, however, something could upset a dog's stomach. Their system allows them to vomit easily to get rid of any potential food or object that could make them sick. Therefore a dog can vomit and not be “sick”. This is nature's way of easily ridding a dog's body of inedible material. The grass can naturally induce vomiting since it is not easily digestible and is one way for a dog empty his stomach.

Another theory is that dogs like the taste of grass and just eat it for the sake of eating it. Not all dogs vomit upon eating grass though. As long as the vomiting is short-lived and does not persist, eating a little grass now and then should not be of great concern. Speak with your veterinarian if this vomiting continues.

 


Dear Veterinarian:
I recently adopted a Great Dane and understand that large breeds like this are prone to a condition called bloat. Can you tell me more about it and how to prevent it?

Dear Pet Owner:
Bloat or Gastric Dilatation-Volvulus (GDV) tends to predominantly occur in large, deep-chested breeds such as your Great Dane, Shepherds, Retrievers, etc. However, it can occur in any dog regardless of size or breed. The classic, acute GDV syndrome happens when the stomach can not empty properly and consequentially becomes enlarged with gas, food or fluid or all three. This expansion can proceed (like a balloon being inflated) to cause the stomach to rotate, which further worsens the situation. The dog will go into a systemic shock and twenty to forty percent of treated animals die. The cause is unknown as to why the stomach cannot empty in the first place. Nothing can be done to prevent bloat per se, however some recommendations can be made.

The type of food does not seem to matter. But you may try to feed several small meals a day rather than one large one. If your dog tends to eat very quickly, offer him smaller portions over a few minutes time. Have feeding times be quiet and stress free. Restrict exercise before and after eating. Keep the food bowls flat on the floor and not elevated. Never breed dogs that have had this condition. Speak to your veterinarian about performing a prophylactic stomach tacking surgery, where the stomach is stitched to the inner body wall to prevent the stomach from twisting. And of course, seek immediate veterinary attention if your dog seems to gag and nothing comes out or if he is pacing and seems uncomfortable and you notice his abdomen starting to expand. The faster this gets treated the better your odds are that your dog will live.

 


Dear Veterinarian:
My dog has had recurrent episodes of diarrhea with blood in it. This is getting to be a problem for me, as well as my dog. I have heard the term colitis used to describe his episodes. Could you explain this to me?

Dear Pet Owner:
Colitis refers to a condition related to inflammation in the lower intestinal tract. There are several causes of colitis. The first is parasites that live in the intestine, such as whipworms. That is why it is important to check a stool sample to check for worms. It is the microscopic egg shed by the adult worm that is seen in the sample. If your dog tests positive for an intestinal parasite, medication can be dispensed to eliminate them. Sometimes in chronic cases of colitis, a prophylactic deworming is done, even if no parasites have been found. It could be that the eggs are not showing up on the fecal test, so the deworming is done as a precaution. Deworming medications could be a liquid, powder, or pill. Heartworm medications are now available which also control certain intestinal parasites, such as roundworms, hookworms and whipworms, so it is important to give your dog this medication, generally on a monthly basis.

A second cause of colitis is diet. Some dogs may have allergies or sensitivities to certain foods, and when ingested, cause the diarrhea to start. Beef is one of the most common causes of this. A low fat, highly digestible food is recommended for colitis. Your veterinarian may recommend a prescription diet trial to see if the colitis responds to changing the food. Sometimes a hypoallergenic diet may be tried-this is a diet that contains a protein that the animal has never been exposed to in the past-such as fish or duck.

Lastly, some dogs may have colitis as a primary disease. There may be inflammatory cells in the tissue lining the colon that cause the diarrhea. A biopsy obtained with a proctoscope may be needed to get a definite diagnosis. Before this is done, medications and food can be tried. Some dogs require medication for some period of time.

Your veterinarian will know best how to treat your dog's colitis problem. It may take some time to get it under control, but he or she will be able to make your dog "regular" again.

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