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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
Signs of the Aging
Dog and Cat
Part 9:
Organs of the Abdomen: The Stomach and Small Intestine
by Kathleen M. Carson, D.V.M
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This month I’m moving on to the organs of the abdomen. The abdomen contains organs of the digestive system, the urinary system, and the reproductive system. I’ll discuss the digestive system first.
Digestion is a very complex process, and, because of this, there are several organs involved: the stomach, small and large intestines, the pancreas, and the liver and gallbladder.
Within the digestive system, this month’s subject is the stomach and small intestine.
When your dog or cat eats, the food is broken up in his/her mouth by the teeth. Cats’ and dogs’ teeth aren’t made to chew food in the way human teeth are. Their teeth more or less slash the food into chunks. These chunks are mixed with saliva, which contains the enzyme amylase, which breaks down carbohydrates, and mucin, which softens and lubricates the food chunks for easier swallowing. When your animal swallows, the food chunks enter the esophagus, a muscular tube which moves them down through the chest and through the diaphragm, the dome-shaped muscle which divides the chest from the abdomen. Right after the esophagus enters the abdomen, it connects with the stomach through the cardiac sphincter, a valve-like opening at the top of the stomach.
The stomach contains hydrochloric acid, which mixes with the food chunks and helps to further break them down. After the food has been in the stomach for a while, it leaves the stomach through the pyloric sphincter and enters the small intestine.
The small intestine is divided into three parts. The first part is called the duodenum, the middle part is called the jejunum, and the last part is called the ileum.
In the duodenum the ingesta (ingested food) is broken down even further with the aid of two organs: the gall bladder and the pancreas.
The liver, which we’ll discuss in greater detail in a future column, makes bile and stores it in the gall bladder. When food enters the duodenum, bile is released from the gall bladder and flows into the duodenum through the common bile duct. Bile helps emulsify (break into smaller parts) fat and fat-soluble nutrients so they can be absorbed into the body.
The pancreas, which we’ll also discuss in greater detail in a future column, produces enzymes which break down carbohydrates (amylase), proteins (trypsin), and fats (lipase). These enzymes are released from the pancreas when food enters the duodenum; they flow down to the small intestine through a tube called the pancreatic duct. This pancreatic duct joins the common bile duct right before the latter enters the duodenum.
After the bile and the pancreatic enzymes have worked on the ingesta in the duodenum, it enters the jejunum and ileum, where absorption of the nutrients of the ingesta begins to take place.
If there is a problem with your animal’s stomach, his/her appetite will decrease or disappear because of nausea. Sometimes a nauseous animal will drool and/or “smack” or lick his/her lips, but some nauseous animals show no signs at all except the decreased appetite. Nausea is often followed by vomiting, the main symptom associated with stomach upsets. In vomiting, the food reverses its direction, hurling back up out of the stomach, through the esophagus, then through and out the mouth.
Problems with your animal’s small intestine show up as diarrhea, ie, his/her stool will be less formed because there will be more liquid in it. Diarrhea occurs when the bowel moves the food along faster than it normally goes, not allowing for the full absorption of water (and nutrients) from the digesting food. Sometimes, even more liquid is poured into the irritated/diseased intestines from the body, leading to a very watery stool.
Diarrhea from small intestinal disease results in stools that are large in volume; these large volume, loose stools are passed more frequently than normal stools are, but usually not more than 2-3 times per day.
Problems with the upper small intestine sometimes causes vomiting, not diarrhea. In this case, bile is vomited, either alone (causing bright yellow vomitus), or mixed with food.
Conditions causing vomiting and/or diarrhea in your geriatric dog or cat which primarily involve the stomach and/or upper small intestines include: food allergies/sensitivities, autoimmune diseases such as Inflammatory Bowel Disease (IBD), hairballs, and, unfortunately, cancer.
As with other conditions discussed in this column, not all the illnesses which cause these symptoms in the older dog or cat are exclusively illnesses of the geriatric patient. Some of them can show up first in earlier years and worsen with time.
An example of this is food allergies or sensitivities. Your animal can start developing allergies or sensitivities to various ingredients in his/her diet early in life. By the time your animal is in his/her geriatric years, the allergic reaction to a given ingredient has intensified, and he/she has probably developed multiple dietary allergies/sensitivities.
If your animal has a severe enough problem with food allergies, it may turn into a disease called lymphoplasmacytic gastritis or gastroenteritis (gastritis = inflammation of the stomach; gastroenteritis = inflammation of the stomach and intestines). It is commonly called Inflammatory Bowel Disease, or IBD. It is one of a family of diseases called autoimmune disease. In autoimmune disease the body starts attacking parts of itself as if they were foreign. In the case of IBD, the parts attacked are the stomach and/or intestines. Food allergies are a major trigger of IBD, but there are genetic and other factors involved as well.
As stated above, IBD usually doesn’t wait to show up until the geriatric years, but, certainly by that time, the symptoms have progressed from occasional vomiting and/or diarrhea to more frequent/severe vomiting and/or diarrhea. This is often accompanied by reduced appetite and weight loss.
Interestingly, the tendency in some cats to vomit hairballs is associated with IBD. It isn’t known if irritation from the hairballs is one of the factors which triggers IBD, or whether animals with IBD are more likely to form hairballs.
Your older dog or cat may also vomit and/or have diarrhea from diseases of the pancreas, liver, and/or kidneys. Diseases of these organs in geriatric animals will be discussed in future columns.
One other thing tends to cause these symptoms in the geriatric patient, and this is reactions to medications. Geriatric animals are more likely to be taking a drug, often several drugs. One of the more common types of drugs which a geriatric dog or cat is on are non-steroidal anti-inflammatory drugs (NSAIDs), usually prescribed to help with such orthopedic diseases as arthritis and spondylosis. NSAIDs’ most common side effect is gastrointestinal (GI) upsets, and, sometimes, GI bleeding.
Antibiotics also are often needed in geriatric patients to treat the infections (e.g., those in the mouth, skin, ears, urinary tract, etc.) that they are prone to since their immune systems are not so efficient as those of younger animals. A common side effect of antibiotics is GI upset.
Because they’re often on multiple medications, there is an increased chance that the combination of drugs will lead to vomiting and/or diarrhea. If you notice these symptoms soon after your animal has been started on a new medication, notify your veterinarian.
Lastly, cancer of the stomach and/or intestines can cause decreased appetite, vomiting and/or diarrhea. If cancer is involved, the symptoms will usually be more severe, and the weight loss more pronounced.
Lymphosarcoma (LSA), one of the two common GI cancers, can be a sequella (a result of) chronic or severe IBD, though this is not always the case. The causes of the other common type of GI cancer, carcinoma, are less clear.
Not all instances of decreased appetite, vomiting or diarrhea are causes for worry in older dogs and cats. However, if these symptoms become pronounced or frequent, especially if accompanied by significant weight loss, consult your veterinarian.
Depending on your animal’s history and the doctor’s clinical findings, one or more types of diagnostic testing will probably be utilized to reach a diagnosis. These would include one or more of the following: blood and urine tests, X-rays (including possibly a Barium series, in which a radio-opaque dye is given to your animal and then followed in multiple, successive X-rays as it passes down the GI tract), and ultrasound.
If these tests don’t reveal a clear diagnosis, then endoscopy, a procedure in which an endoscopic instrument is inserted under anesthesia down your animal’s throat and esophagus into his/her stomach and upper small intestine may be necessary. This instrument allows your veterinarian (or a veterinary specialist) to view the inside of these organs to see if any abnormalities can be visualized. Pieces of tissue from various areas will also be taken so they can be examined later under the microscope (histopathology) to see if the tissue samples are normal or abnormal.
Lastly, exploratory surgery of your animal’s abdomen may be necessary to get a diagnosis. Again, organs are visually examined (this time from the outside) for any obvious pathology, and tissue samples for histopathology will be collected.
Treatment of diseases in your animal’s stomach and/or small intestine will depend on the diagnosis and the severity of symptoms. If food allergies/sensitivities are diagnosed, then food trials will be run to determine which dietary ingredients your animal can’t tolerate and a special diet of non-allergenic foods will be prescribed. In the meantime, drugs to help reduce/stop the vomiting/diarrhea may be necessary.
If your animal is found to have IBD, in addition to food trials, a conventional veterinarian will prescribe anti-inflammatory/immunosuppressive drugs to stop his/her immune system from attacking his/her stomach and/or intestine.
If your veterinarian is holistic, and if the IBD is mild, the treatments may start out with dietary changes and soothing herbs (such as Slippery Elm Bark), and other treatments and supplements for healing the GI tract. If the IBD is more severe, then drugs will be added to this regimen.
GI LSA is more responsive to chemotherapy than GI carcinomas. Even with LSA, chemotherapy doesn’t cure (rid the body of the cancer entirely and forever), but it does have a greater chance to reduce the number of cancer cells, slow growth and metastasis, and relieve symptoms. If your vet is holistic, he/she will probably also prescribe treatments/herbs/supplements to soothe your animal’s GI tract, reduce any side effects of chemotherapy, and to enhance your animal’s immune system.
Next month I’ll discuss the diseases of the large intestine in geriatric dogs and cats. |
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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