Chronic Diarrhea in Intestinal Malabsorption in Dogs

Intestinal malabsorption in dogs is when a dog is experiencing a certain failure in digestion, due to exocrine pancreatic insufficiency or small intestine disease. This results in the malabsorption of nutrients from food, causing other health issues in our dog.

While some dogs may not exhibit symptoms, others will be suffering from weight less, chronic diarrhea and other symptoms we will list below. In both cases, the dog will be nutrient deficient and their health will begin declining if left untreated. Some of the breeds that are most prone to this health problem is the Basenji, Shar Pei and the Yorkshire Terrier.

The symptoms of canine intestinal malabsorption are very diverse, nevertheless, let's take a look at the main symptoms your dog may exhibit:

• Chronic diarrhea
• Weight loss
• Yellowish vomit
• Alteration in their eating habits
• Melena
• Bowel sounds
• Reduction of muscle mass
• Ascites (accumulation of fluid in the abdomen due to a decrease in the protein albumin, which prevents fluid from leaving the blood vessels into the cavities)
• Fluid effusion from the pleura (lining of the lungs)

If your dog is experiencing any of these symptoms or any other abnormal behaviour, it's very important to take them to the veterinarian as soon as possible to be properly diagnosed and treated.

There are many causes to intestinal malabsorption in dogs, they are the following:

• Exocrine pancreatic insufficiency
• Inflammatory bowel disease
• Small intestinal bacterial overgrowth
• Obstruction or blockages involving the lymphatic system of the gastrointestinal tract
• Idiopathic villous atrophy within the small intestine
• Infectious agents such as viral and fungal infections or parasites
• Bacterial overgrowth in the intestines such as SIBO
• Dietary causes such as wheat sensitivity

To correctly diagnose canine malabsorption syndrome, the following techniques must be used:

Blood test

In the hemogram blood test, the following alterations may appear, indicating that your dog is suffering from intestinal malabsorption:

• Hypoproteinemia or decreased globulins and albumin.
• Hypocalcaemia or low calcium (may be an artifact, since 40% of calcium circulates in the blood together with albumin, so the loss of this protein can cause a false decrease in the total amount of serum calcium or due to the decrease of its intestinal absorption).
• Hypocholesterolemia or low amount of cholesterol in the blood (due to fat malabsorption due to the intestinal lumen and / or liver disease).
• Lymphopenia or reduced lymphocyte count in the blood.
• Anemia from chronic disease in some cases.
• Neutrophilia, or increased neutrophils due to a stress leukogram, due to chronic inflammation.
• Low platelets if blood thrombosis (clotting) occurs by reducing antithrombin by its losses in the intestine (which is involved in breaking up blood clots).

Complementary analysis

Other determinations can be made to guide the diagnosis of a canine intestinal malabsorption:

• Inhibitor of alpha-1 proteinase: commercial test that allows confirming the loss of proteins through the stool, being sensitive to detect early disease, although the suspicion of protein loss appears after ruling out the loss of the same at the renal level and excluding liver disease.
• Folate and vitamin B12 levels: since their reduction indicates a possible intestinal problem.
• Coagulation: coagulation parameters (D-dimers, antithrombin) can also be analyzed to assess the risk of thrombosis.

Abdominal ultrasound

Imaging test with which you can see the appearance of the intestine (inflammations, masses ...) and the rest of the organs and detect fluid in the abdominal cavity. It is also useful to guide the collection of samples by biopsy to send to the laboratory and obtain a thorough diagnosis.

Biopsy for a histopathological analysis

The definitive diagnosis of diseases that can produce a malabsorption syndrome in dogs is done by a laboratory histopathology from an intestinal biopsy (sample of tissue from the intestine).

Biopsies can be performed by an endoscopy or a laparotomy (surgical operation that consists of opening the abdomen and taking samples directly, taking advantage of it to assess the state of the rest of the organs). The sample will be better if it is obtained through a laparotomy. However, due to low albumin and the state in which dogs are, sometimes endoscopy is chosen. This will depend on your veterinarian's decision.

Depending on your dog's condition and the cause of their intestinal malabsorption, your veterinarian will choose the correct treatment, this may include:

Supportive treatment

The supportive or symptomatic treatments will have the purpose of alleviating the symptoms of our dog, such as:

• Thoracentesis: or fluid-releasing puncture. It will be used if there is respiratory distress due to the presence of fluid in the lung pleura.
• Diuretics: loop drugs, such as furosemide, are useful to eliminate ascites, but assessing the hydration status of the animal and potassium concentrations. To avoid a low potassium, it can be combined with a potassium-sparing diuretic such as spironolactone.
• Fluid therapy: only if your dog is dehydrated due to vomiting or diarrhea.
• Anticoagulants: such as aspirin or clopidrogel to prevent the formation of thrombi.
• Vitamin B12 or folate supplementation: if there are deficiencies.
• Diet changes: in cases of inflammatory bowel disease or lymphaectasia secondary to it, a hypoallergenic diet with hydrolyzed protein and fat restriction is recommended.

Specific treatment

To treat diseases that can cause intestinal malabsorption in dogs, the veterinarian may prescribe the following treatments:

• Treatment of inflammatory or immune-mediated diseases: therapy with immunosuppressive drugs, such as the corticosteroid prednisolone, is generally included. In cases where there is no improvement with this, a second immunosuppressant such as cyclosporine or azathioprine is usually necessary. In animals where corticosteroids are contraindicated due to their side effects, the use of budesonide has been described as a substitute for them.
• Treatment of diseases of infectious origin: antibiotics in bacterial cases, antiparasitics if caused by parasites and antifungals if caused by fungi.
• Treatment of diseases of tumor origin: in these cases, chemotherapy protocols must be administered.
• Treatment of pancreatic insufficiency: administration of pancreatic enzymes.

The prognosis of a dog with intestinal malabsorption will depend on the state of their organs, the evolution of the disease and the origin, with infectious cases being the easiest to treat and tumor cases the most complicated and with the worst prognosis.

So if your dog is inexplicably losing weight or has any symptoms that we have discussed, you should take them to the veterinarian as soon as possible to diagnose the problem and give them the appropriate treatment to regain their health and especially that of their intestine as soon as possible.

This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.

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