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190 Colitis, Chronic

of defecation, mucoid feces, and fresh (red) of Clostridia) or increased numbers of fecal be avoided in animals with small-bowel–type
blood leukocytes indicative of acute mucosal diarrhea.
VetBooks.ir PHYSICAL EXAM FINDINGS Advanced or Confirmatory Testing Recommended Monitoring
inflammation.
Have clients communicate their pet’s progress
Generally well fleshed without systemic signs
(e.g., unthriftiness or weight loss) of illness.
to respond to empirical therapy (see below)
Rectal examination fails to reveal significant Generally not indicated. Animals that fail after 48-72 hours of therapy.
abnormalities except the character of feces. require confirmatory testing (e.g., fecal cultures, PROGNOSIS & OUTCOME
polymerase chain reaction [PCR], other assays)
Etiology and Pathophysiology for suspected bacterial or protozoal pathogens. Generally excellent for full recovery
• Parasites: helminth and protozoa
• Dietary causes: gluttony, spoiled food, dietary TREATMENT PEARLS & CONSIDERATIONS
indiscretion with ingestion of foreign or
abrasive materials (e.g., cat litter, rocks, Treatment Overview Comments
indigestible materials such as hair in long- Initial management of animals with acute colitis In general practice, acute colitis is a common
haired cats) is nonspecific and supportive. In most instances, complaint that is very responsive to supportive
• Specific bacterial pathogens may cause colonic signs are self-limited and/or respond readily to therapy. Elimination of infectious and parasitic
inflammation by invasion or enterotoxin empirical therapy. causes is the key to treating acute colitis.
production.
Acute General Treatment Prevention
DIAGNOSIS • Treat for suspected nematode and protozoan • Prophylactic deworming
parasites using appropriate broad-spectrum • Avoid dietary indiscretion.
Diagnostic Overview anthelmintics or antiprotozoal medications • Avoid allowing pets to roam freely.
Acute colitis rarely requires extensive diagnostic (e.g., fenbendazole 50 mg/kg PO q 24h for • In cats with recurrent colitis due to hair,
evaluation. A thorough history, physical exami- 3 days). frequent brushing, administration of hairball
nation, routine fecal examination for nematode • Avoid the use of antibiotics in animals, except laxatives, or removing excess hair (shaving)
or protozoal parasites, and fecal/rectal smears those with confirmed bacterial causes of their may be indicated to control signs.
for cytologic evaluation are indicated. gastrointestinal signs. Empirical use of com-
mercial probiotics (FortiFlora, Prostora Max) Technician Tips
Differential Diagnosis for 3-5 days may facilitate clinical recovery, Always perform multiple fecal examinations to
Other causes of diarrhea (p. 1213) although clinical trial data supporting their exclude parasitism as a cause of colitis.
use are limited.
Initial Database Client Education
• Physical examination: abdominal palpation Nutrition/Diet Monitor for failure to respond to empirical
and digital rectal examination with collection • Feed a bland or mixed-fiber diet (commercial treatments.
of feces or homemade), giving small volumes at
• Fecal examination for nematode and proto- increasingly frequent intervals for 3-5 days. SUGGESTED READING
zoal parasites. Both fecal flotations and direct • Avoid all treats and dietary supplements Bybee SN, et al: Effect of the probiotic Enterococcus
fecal smears should be performed. Multiple (except probiotics) during the dietary trial faecium SF68 on presence of diarrhea in cats and
(three) zinc sulfate flotation tests using fresh period. dogs housed in an animal shelter. J Vet Intern
feces may be required for identification of • If using a bland diet, add fiber (small amounts Med 25:856, 2011.
Giardia spp trophozoites. of soluble fiber such as psyllium mucilloid, AUTHOR: Albert E. Jergens, DVM, MS, PhD, DACVIM
• Commercial ELISA kits are sensitive for the 1 teaspoon/10 kg at each feeding) to the EDITOR: Rance K. Sellon, DVM, PhD, DACVIM
detection of Giardia antigen. diet to reduce tenesmus and facilitate colonic
• Rectal cytology (p. 1157) may show evidence epithelial repair. Fiber supplements should
of bacterial pathogens (e.g., vegetative spores

Colitis, Chronic Bonus Material Client Education
Online
Sheet

BASIC INFORMATION Epidemiology GENETICS, BREED PREDISPOSITION
Definition SPECIES, AGE, SEX Boxers, French bulldogs, and possibly German
A common cause of persistent (>3 weeks’ More common in middle-aged and older shepherds are predisposed to granulomatous
duration) signs of colonic inflammation dogs and cats as a consequence of infiltrative colitis (GC [p. 395]). German shepherds
characterized by large-bowel diarrhea with mucosal disorders (e.g., inflammatory bowel and purebred cats are at increased risk for
tenesmus, dyschezia, and increased frequency disease [IBD], neoplasia). Infectious disor- lymphocytic-plasmacytic enterocolitis.
of defecation. Feces often contain mucus and/ ders (e.g., Trichuris vulpis, gastrointestinal
or fresh blood. Systemic signs attributable to [GI] histoplasmosis, Tritrichomonas foetus) CONTAGION AND ZOONOSIS
nutrient malabsorption (e.g., weight loss) are may be seen in younger animals (less Some bacterial enteropathogens (e.g., Clos-
uncommon. common). tridium perfringens, potentially contagious)

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