Inflammatory bowel disease (IBD) is a chronic condition (greater than three weeks) caused by inflammation in the gastrointestinal tract. Middle aged dogs of both sexes are equally affected. 

Clinical signs

Signs may vary and be intermittent and may include:

• Weight loss
• Vomiting
• Diarrhea
• Flatulence
• Decreased or increased appetite

Cause

The cause of IBD is unknown but is believed to be a combination of factors which may include:

• Genetic predisposition
• Abnormal immune response to food components (dietary antigens)
• Alterations in gut flora (dysbiosis)

Breed predisposition

• Basenji
• Soft-coated Wheaten Terrier
• Boxer
• French Bulldog
• Doberman Pinscher
• Mastiff
• Alaskan Malamute
• Others

Diagnosis

IBD is often a diagnosis of exclusion after other causes for the clinical signs have been ruled-out.

Tests may include:

• Routine blood work and urinalysis
• Fecal testing for parasites
• A GI panel to measure vitamin B12 and folate levels as well as to screen for pancreatic inflammation or insufficiency.
• Abdominal x-rays
• Abdominal ultrasonography to examine and measure the layers of the stomach and intestinal walls.
• Biopsy of the GI tract can be considered for dogs that fail to respond to antibiotics and food trials. Biopsies can also distinguish between the various forms of inflammation as well as lymphoma. Biopsy samples can be obtained through an exploratory surgery or through endoscopy.

Treatment

• Empirical treatment for parasites (e.g. fenbendazole)
• Diet trials: easily digestible GI diets, novel protein diets, or hydrolyzed diets, home-prepared diets. 
• Probiotics
• Vitamin B12 supplementation as needed
• Antibiotic therapy (e.g. metronidazole, tylosin, enrofloxacin)
• Gastroprotectants, antiemetics
• Immunosuppressant therapy:

1. Corticosteroids: prednisone or prednisolone are most commonly used.
2. In more severe cases, other medications such as azathioprine, cyclosporine, or chlorambucil may be included.
3. Duration of therapy may range from months to long-term.

Outcomes

The success of treatment varies depending on the severity of disease.  Dogs with certain laboratory findings have a poorer prognosis. Dogs with mild to moderate IBD that respond to diet therapy with or without antibiotics have a good prognosis. Dogs with more severe disease that do not respond to diet therapy and antibiotics will require immunosuppressive therapy that may be long-term.