Category Archives: Gastroenterology

All things “gut” canine and feline gastroenterology covers diseases of the bowel, microbiota, FMT, diarrhea and more.

AMAZING: FOS Fructo-Oligo-Saccharides Chicory Root Soluble Fiber

What is FOS and Why Should I Care?

FOS stands for “Fructo-Oligo-Saccharides” and it’s pure “inulin”  – (not insulin lol)

Inulin is the ‘active ingredient” in all the cholesterol-lowering-good-gut-germ-growing-probiotics in the plant kingdom. Black beans, canned pumpkin, sweet potato, etc.

It turns out, to maintain a decent quality poop for most indoor dogs, “FOS” is great.

Gluten free and powerfully bio active in the gut, FOS slows an irritable bowel, and activates a stale one.

activity of soluble fiber for dogs

Question: Is FOS better than ‘canned pumpkin’?

Answer: Not really better than canned pumpkin, but FOS powder is less bulky and it’s easier. Also more economical.

Question: What is FOS Made of?

Answer: When FOS appeared on the market it was made with Chicory Root. It’s still made with Chicory Root but quite often, it also comes from “Jerusalem Artichoke” and tbh you couldn’t tell the difference because it’s both a white powder that looks like coffee creamer and has a very faint, slightly sweet taste.

Question: How do you use FOS in canine feeds?

Answer:  I use 1 tsp per 15 pounds of dog sprinkled in each feeding. IF the dog gets really gassy, or somehow (improbable) ends up with a loose(ish) stool, you’re giving too much. If the dog isn’t gassy at all and the stools are “better than ever” then you’re doing it right.

FOS is cheap.

FOS Chicory rooth soluble fiber for dogs

FOS in dogs

Be extra nice to your gastrointestinal germs

It turns out your gastrointestinal germs have many more functions then they ever knew. Shouldn’t come as a surprise, considering we have lived with these beneficial germs for literally millions of years. Handed down from generation to generation, even.
Well, one of the metabolic processes driven by the germs in your intestine, happens to be anti-cancer. Have a listen.
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Pancreatitis Case Communication

When bloodwork reveals pancreatitis.

That’s serious inflammation (sometimes even infection) of the dog or cat’s pancreas. It can be life threatening if it drags on or becomes chronic. The pancreas can lose enough integrity to result in diabetes and exocrine pancreatic insufficiency. If the inflammation is serious enough, the belly may even suffer peritonitis.

In some cases, infection is suspected when a pet is anemic. (Low iron, lacking red cells) or the white cells are elevated.

Pancreatitis is painful and “Tramadol” pain reliever is a “good idea”.

Management of Pancreatitis

The KEY element in pancreatitis is LOW or NO FAT in the diet from here on out.

Starting now:

  1. No food for 48 hours.
  2. Only water, not even broth.
  3. After 48 hours — Fat free or VERY low fat food(s)

Rice is fat free.

A diet of eggs, and non-starch vegetables works.
So you can consider: (Low starch low fat home cooking)

Or, you can use Hill’s Low Fat ‘i/D’ diet which is super digestible and very low fat. We have excellent luck resolving pancreatitis with that. I’d go through a 30 pound bag and then MAYBE consider going back to another low fat brand.

pancreatitis

If a dog or cat with pancreatitis gets a piece of pizza, they will go RIGHT back to “square one” with the pancreatitis.

If the pet is diagnosed with pancreatitis and the hematocrit is low, or the white cells are high, vets may be a little worried that a dog or cat may have blood in the abdomen from the pancreas. A tap would tell.

But what would we do with that information BESIDES:

  1. Low fat feeding
  2. after a 48 hour fast
  3. Tramadol
  4. Antibiotics

Inflammatory Bowel Disease IBD in Cats & Dogs

Inflammatory Bowel Disease ( IBD ) – Feline

This is in my Vet Notes section as more of a library entry

Inflammatory Bowel Disease is common, and I think more common in cats than dogs tbh.

Recommendations: Metronidazole, steroids, fiber diet, B12, and probiotics.

Inflammatory Bowel Disease _Feline_ Cornell University College of Veterinary Medicine

Medical Treatment
Metronidazole may be recommended along with dietary modification as the first medical therapy. Metronidazole has antibiotic, anti-inflammatory, and antiprotozoal properties, and is usually fairly well tolerated, although some cats may lose their appetite when given this drug.

If dietary modification or metronidazole are not effective, corticosteroids, which are potent anti-inflammatory and immune-suppressing agents, may be recommended, either alone or in combination with metronidazole. Cats should be monitored closely while they are on corticosteroids, as diabetes and immune suppression are among their potential side effects. Nonetheless, cats tend to tolerate these drugs well as long as they receive them at an appropriate dose.

Inflammatory Bowel Disease ( IBD ) - Feline
Inflammatory Bowel Disease ( IBD ) – Feline

Cats usually take corticosteroids orally, starting with a higher dose that is gradually reduced over several weeks. In cats that won’t take medication orally, or in cases in which vomiting is severe, your veterinarian may give the medications as an injection.

If none of these medications successfully controls the symptoms of IBD, more potent immunosuppressive drugs, such as chlorambucil or azathioprine, may be necessary. These drugs can suppress production of white blood cells, red blood cells, and, less commonly, platelets, in the bone marrow. A veterinarian must carefully monitor cats taking these drugs.

Inflammatory Bowel Disease ( IBD ) – Feline

As GI bacteria may play a role in the development of IBD, newer therapies include prebiotics, which are substances that promote certain bacterial populations, and probiotics, which are bacterial strains that promote GI health. The addition of soluble fiber, such as psyllium, to the diets of cats with inflammatory colitis may be helpful, and supplementation with folate or vitamin B12 should be provided if an affected cat is deficient in these B vitamins.

I’ve always liked Sulfasalazine for IBD in the past, wondered about its use in cats: Found this quality literature.

You have to scroll past the cut and paste Bull that the online pharmacies trot out as “fact” – which is often paraphrased by non-English speakers.

 

Sulfasalazine (Azulfidine) – Veterinary Partner – VIN

IBD_dog_cat_hoskens

Sulfasalazine is considered by many veterinarians to be the preferred drug in dogs for treatment of colitis. The recommended oral dosage in dogs is 12.5 mg/kg q8h up to a maximum of one gram q8h in refractory dogs or those having severe IBD. It is important to continue initial therapy with sulfasalazine for a minimum of four weeks before modifying drug dosage. With resolution of signs, sulfasalazine dosage is gradually decreased by 25 percent at two-week intervals and eventually discontinued while maintaining the dietary management. Caution is advised in using sulfasalazine in cats because of their sensitivity to salicylates. Other oral medications of potential use in dogs include olsalazine and mesa-lamine. Olsalazine (Dipentum) consists of two molecules of mesalamine linked by an azo bond. The enteric-coated products of mesalamine (Pentasa and Asacol) release the active drug in the distal small intestine and colon, respectively. The use of olsalazine or mesalamine for treatment of IBD in dogs and cats has not been critically evaluated, but there are substantial anecdotal reports of their efficacy. The proposed dosage is about one-half that of sulfasalazine.

  • 25 – 50 mg every 12 hours = Cat dose up to 12-14 pounds.
  • Cat dose also provided at 5-10 mg/lb PO SID
  • It’s provided in 500mg tablets
  • 4 weeks to tell if it works.

Typical cat dosing:  500mg Sulfasalazine, 1/8th tablet every day. 4 weeks.

 

 

 

How and When to Induce Vomiting: Hydrogen Peroxide for Poisoning

Sometimes the dog will eat something it shouldn’t. Sometimes it’s not a poisoning, it’s annoying, like a cake, or a pile of chicken skin and you know it’s going to cause diarrhea, BAD.

Other times it’s medicine or some other toxic molecule or poisoning substance.

How and When to Induce Vomiting: Use Hydrogen Peroxide for Poisoning

In any event, TWO HOURS is an important parameter to recall, because stomach-emptying occurs within two hours, so if your dog JUST ATE that bunch of grapes 5 minutes ago, it’s fine. Induce vomiting. Good-t0-go.

How and When to Induce Vomiting: Hydrogen Peroxide for Poisoning
How and When to Induce Vomiting: Hydrogen Peroxide for Poisoning

But if you discover a problem closer to, or AFTER the two hour window, it’s going to be a problem.

So, How and When to Induce Vomiting: Use Hydrogen Peroxide for Poisoning.

Probiotic Yogurt and Antibiotics

Why I recommend probiotic Yogurt for any dog or cat that I put on antibiotics. How yogurt cultures work, which yogurt is best and why.

I did a video that talks about antibiotics and some of their liabilities, as well as how to use Yogurt probiotic to prevent some of those problems.

Probiotic Yogurt and Antibiotics
Probiotic Yogurt and Antibiotics

Did you know that yogurt probiotic ‘germs’ aren’t ‘native’ to the gastrointestinal tract of the dog and cat? Nope, the germs just hold the place of some dead germs while the good germs repopulate after a round of antibiotics.

Probiotic Yogurt and Antibiotics

Probiotic Yogurt and Antibiotics

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Please Give Yogurt Whenever You Give An Antibiotic

Give Yogurt Whenever You Give An Antibiotic

In this audio recording, I would like to advise all of my clients who are instructed to give antibiotics to themselves or their pets to administer yogurt hopefully loaded with probiotics (beneficial bacteria) with each dose of the antibiotic and as indicated by the doctor.

There are certain antibiotics that are bound out by calcium (the quinolones and the ‘blank-a-cyclines’ are a specific example, so be careful). But even if you don’t take the yoogurt and the antibiotic  simultaneously it is beneficial to get yogurt prebiotic into the system that is also being exposed to antibiotics.

yogurt probiotic
Goodbelly is one of my favorites for pets because it’s lactose free.

This audio recording will use simple English to explain why the administration of yogurt is so important and exactly how that works. I will also identify two or three of the best yogurts to use while taking antibiotics. You will be smarter than everyone else at the office.

Give Yogurt Whenever You Give An Antibiotic

See also

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How To Unfeed and Then Feed a Dog With Diarrhea

Here’s how you’d feed, then wean-back,  a diarrhea-dog:

Download This Nice Printable Version

Phase A: First 12 – 24 hours:   Water, Ice-licks*, Broth, (fat free) and plain, canned Pumpkin 1/4c. per 15 pounds twice a day and some hard cheese.
How To Unfeed and Then Feed a Dog With Diarrhea
How To Unfeed and Then Feed a Dog With Diarrhea

Phase B: 24-48 hours: White rice or white bread and Campbell’s Chicken Noodle soup or Eggs any style and plain, canned Pumpkin 1/4c. per 15 pounds twice a day.

Phase C: 48-72 hours: Regular DRY food, except it’s waterlogged with water or fat free broth, plus plain, canned Pumpkin 1/4c. per 15 pounds once or twice a day. After the first 48 hours or so, you might do well to add a little low fat yogurt (Chobani) of the Blueberry persuasion to replace germs we’re killing with some of the diarrhea medications. That’d be a tablespoon of Blueberry yogurt per 20 pounds, twice a day.
It is PERFECTLY OKAY if the dog doesn’t want to eat anything. Their colon knows better than you, or I do, when it’s ready to accept food for processing.
*Ice-licks is a ‘technique’ –  it’s a towel in a bowl with ice on it. The towel wicks up ‘standing water” and the dog licks the ice for thirst. Thing is, they consider it such a pleasant novelty that they’ll “lick” much more water than they’d ever “drink”.

How To Unfeed and Then Feed a Dog With Diarrhea

Feed a Dog With Diarrhea
Feed a Dog With Diarrhea

Pumpkin For Diarrhea in Dogs and Cats

How Does Pumpkin Treat Diarrhea AND Constipation in Dogs and Cats?

Ehhhhhhhhh, so maybe the cats won’t take Pumpkin but dogs almost always will, as long as they’ll take ANYTHING. (Means that if your dog isn’t eating, he sure won’t eat Pumpkin.)

When soluble fiber hits the large intestine, the colon says “Oh! You feel nice! Let’s Dance!” And the bowel begins to work on the soluble fiber. It takes work, which makes the bowel move, but it also takes time, which slows the bowel down. This is how the Pumpkin can fix BOTH diarrhea *and* constipation.

It’s NOT ROUGHAGE and there’s a huge difference. Roughage is indigestible, fibrous material which is bulky and cannot be dissolved. For the most part, “roughage” is not a “food” for beneficial bacteria in the Colon, either.

Soluble fiber on the other hand IS digestible, (can be dissolved) and the “inulin” that is so rich in soluble fiber is a DIRECT “food” for beneficial bacteria.

While “roughage” is a call for a bulky state of emergency in the GI tract and causes forward motility (laxative) effect, the difference with soluble fiber is:

  1. It grows beneficial bacteria
  2. It makes a hyperactive, diarrheic bowel SLOW DOWN to process the fiber / inulin.
  3. It makes a stopped or constipated bowel REACTIVATE to process the fiber / inulin.

The net effect of pumpkin is to make an irregular bowel work at the PROPER speed, neither too fast, or too slow.

Other things that work SIMILARLY are FOS (chicory root, better than pumpkin) and Sweet Potato (not as good as pumpkin)

At left you see the FOS I buy for myself and for Ajax’s food when he needs a little help with a loose stool. It’s the best price on a couple pounds of high quality FOS. They sell 2.2 pounds for what most companies are selling 8 ounces for.

The net effect of pumpkin is to make an irregular bowel work at the PROPER speed, neither too fast, or too slow.

Pumpkin is given with the food as you may see in the picture above. Ajax waits patiently for his “I’ve got diarrhea” breakfast. I don’t know what he got into but it had his poop pretty loose.

What follows is dosing information on Libby’s Canned Pumpkin. These amounts are conservative by some author’s recommendations but in my hands, is “enough to do the trick” whether you’re keeping an old dog intestinally “limber” or trying to form up some diarrhea.

For dogs that are heavier than this chart, I’m sorry but you have to do math. I doubt I’d give ANY dog more than 1 cup of Pumpkin, frankly I’d defy any dog to need that much.

How Often to Give Pumpkin?

Answer: With each feeding or twice a day

Will Pumpkin aggravate pancreatitis, weight loss diets, food allergies or other gastrointestinal “issues” my pet may be having?

Answer: Yes and No. If your vet has prohibited ANYTHING be given by mouth (pancreatitis acute phase) then you can’t use Pumpkin until your vet says so. After that, since it’s fat free, it will NOT trigger pancreatitis. It will not cause water retention and will not impact cardiac cases, nor liver issues. It’s also low in sugar and will not bump your diabetics. Pumpkin is not a unique nor antigenic protein and has not been associated with adverse or allergic food reactions. Pumpkin is RECOMMENDED for the long term management of Post-HGE, inflammatory bowel disease or other serious diarrheic / immune mediated bowel issues.

Should I use Pumpkin in each feeding all the time?

Answer: You can. I recommend it if you’re feeding raw diets, because meat has no soluble fiber, and the bowel benefits from some “inulin” which is NOT sugar nor “carbohydrate” of metabolic consequence.  I also recommend Pumpkin be incorporated into any ‘home cooked’ diet because diets based on “chicken and rice” also lack calcium, soluble, fiber, water soluble vitamins and carotenoids. Pumpkin rounds those refined diets out.

MOST dog food manufacturers are already ‘sneaking’ pumpkin into their diets. You may see it added in a powdered form to a lot of diets without fanfare. It’s not a “buzz word” yet, so they’re not wasting ad space on the front of the bag, but they ALREADY KNOW that bowels are better and stools are regular and well formed (their customers love that) when they add a little pumpkin to their diet formulations.

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Chronic Diarrhea in Dogs and Cats

What to Do About Chronic Diarrhea

The following document is presented to clients whose pets have been experiencing chronic diarrhea and we’re working through an algorithm that takes us from common problems like worms, across the board to some inflammatory bowel diseases or other rarer pathology. Sometimes it takes a while to figure out the more obscure cases without performing a pinch-biopsy and you can’t just treat literally everything all at once like you can in veterinary dermatology.

https://drjohnson.com/wp-content/uploads/2019/09/Chronic-Diarrhea-Colitis-1.pdf