What are Stomach and Intestinal Ulcers in Dogs?
Stomach and intestinal ulcers in dogs refer to erosions occurring in one or more layers of the stomach or small intestines. Gastric ulcers are the most prevalent, followed by those in the duodenum, the initial part of the small intestines.
During the process of digestion, the stomach produces potent gastric acids and enzymes to aid in breaking down food and extracting nutrients. To shield against the corrosive effects of these stomach juices, the stomach is lined with a protective mucosal barrier. If this barrier becomes compromised, the stomach lining can gradually deteriorate, leading to the formation of ulcers.
Ulcers can vary in severity. Some erosions may penetrate only a few layers (non-perforating ulcers), while others may create a hole through the stomach wall (perforating ulcers). Perforating ulcers pose the highest risk as they can allow the stomach’s contents to leak into the abdominal cavity. Ulcers can adversely affect both the gastrointestinal and cardiovascular systems, potentially leading to sepsis.
If you suspect your dog may have an ulcer, it is crucial to promptly contact your veterinarian for an examination and diagnostic testing.
Symptoms and Types
Symptoms of stomach and intestinal ulcers in dogs typically manifest in various ways. The primary indicator is vomiting, often accompanied by the presence of blood. Depending on factors such as the severity, location, and frequency of the ulcers, additional symptoms may include:
- Weight loss
- Dark, tarry stools (known as melena)
- Diarrhea
- Decreased appetite
- Excessive drooling
- Dehydration
- Abdominal pain, indicated by behaviors such as looking at the abdomen, crying when touched, or assuming a “praying” position
- Lethargy and weakness
- Fever
- Pale mucous membranes
If you notice any of these symptoms in your dog, it is important to seek veterinary care promptly for diagnosis and treatment.
Causes
The causes of stomach and intestinal ulcers in dogs encompass various conditions or circumstances. Some of these causes are more prevalent than others and include:
- Drugs, such as NSAIDs (non-steroidal anti-inflammatories like Rimadyl and Deramax) and steroids (such as prednisone and dexamethasone).
- Gastrointestinal diseases, including inflammatory bowel disease (IBD), ingestion of foreign materials, and an increase in gastric acid production.
- Infectious diseases, such as pythiosis (an infection transmitted through water) and bacterial infections caused by helicobacter.
- Metabolic diseases, which involve the liver, kidneys, and adrenal glands (such as Addison’s disease).
- Poisoning from heavy metals like arsenic, zinc, thallium, iron, and lead.
- Gastrointestinal tract cancers like carcinoma, lymphoma, leiomyoma, and GI stromal tumor.
- Stress can also contribute to ulcer development. Severe shock, low blood pressure (often due to trauma or surgery), heat stroke, sepsis, thermal burns, and intense exercise in extreme temperatures (hot or cold) are examples of stressors.
- Sled dogs and other elite canine athletes are particularly susceptible to developing stomach ulcers.
Understanding these potential causes can aid in identifying and addressing ulcers in dogs promptly and effectively.
Diagnosis
To diagnose stomach and intestinal ulcers in dogs, veterinarians typically require a biopsy. Biopsy samples are particularly valuable for determining the underlying cause of the ulcer, notably cancer or infections.
Before resorting to a biopsy, veterinarians may recommend several tests. A history of vomiting, especially with blood, can raise suspicion of an ulcer, particularly in dogs with a history of being prescribed ulcer-causing drugs like NSAIDs or steroids. Diagnostic tests may include:
- Complete blood count: This blood test helps identify anemia or a decreased red blood cell count. Details regarding the shape, size, and color of blood cells can assist veterinarians in determining whether ulcers are chronic.
- Biochemistry profile: This blood test helps identify other diseases that may contribute to ulceration.
- Fecal occult blood test: This test detects blood loss from the gastrointestinal tract in feces that appear normal.
- Radiographs: Although ulcers themselves are not visible on radiographs (X-rays), they are essential for ruling out other causes of vomiting and gastrointestinal symptoms. Contrast radiographs involve administering a special liquid called barium, which appears bright white on X-rays. This method may reveal barium filling in a defect at the ulcer site. Radiographs also help detect air in the abdomen, which may indicate a perforating ulcer.
- Ultrasonography: Ultrasound imaging can visualize and measure the thickness of the gastrointestinal tract walls, aiding in diagnosis.
These diagnostic measures help veterinarians accurately identify and address stomach and intestinal ulcers in dogs, leading to appropriate treatment and management strategies.
Treatment
Treatment of stomach and intestinal ulcers in dogs primarily focuses on addressing any underlying causes such as drugs, toxicities, or cancer. For dogs with stomach ulcers, hospitalization and supportive care may be necessary depending on the severity. Clinically ill dogs and those with perforated ulcers require intensive nursing care, which may include:
- Blood transfusions
- Intravenous fluid support
- Emergency surgery
- Administration of antibiotics and pain medications
Dogs with partial-thickness, non-perforating ulcers may be treated on an outpatient basis. They typically require a bland diet and gastroprotectant medications. Common gastrointestinal medications used include:
- Sucralfate, which coats the ulcer and promotes healing
- H2 receptor antagonists like Pepcid (famotidine), which block receptors in the stomach to reduce gastric acid secretion
- Proton pump inhibitors such as omeprazole, pantoprazole, lansoprazole, and esomeprazole, which are preferred for preventing ulcerations
- Prostaglandin E analogs like Misoprostol (Cytotec), which increase mucosal protection by reducing gastric acid secretion and may be used to prevent ulcers in dogs on chronic NSAID therapy
Long-term dietary changes may be necessary for some dogs. Common diet recommendations include products from the Purina EN Line, Royal Canin GI Line, and Hill’s i/d Line. In cases where an ulcer has perforated or cancer is present, surgical therapy may be considered.
By addressing the underlying causes and providing appropriate medical care, dogs with stomach and intestinal ulcers can often return to a normal quality of life.
Recovery and Management
The recovery and management of stomach and intestinal ulcers in dogs generally yield a good prognosis, contingent upon the underlying causes and response to treatment. Perforated ulcers present a more serious scenario, and the prognosis is cautiously optimistic. Less complex ulcers should exhibit signs of improvement within 5 to 7 days.
Depending on the root cause, certain dogs may be predisposed to future ulcerations. These dogs may be prescribed specialized gastrointestinal diets and could continue with ulcer-preventative medications. For dogs undergoing chronic NSAID therapy, administering the NSAID with food, along with preventative GI medications, may be beneficial.
By closely monitoring and addressing the underlying factors, dogs with gastrointestinal ulcers can often experience successful recovery and management, leading to an improved quality of life.
Stomach and Intestinal Ulcers in Dogs FAQs
What causes intestinal ulcers in dogs?
Ulcers in dogs can result from various factors, including common medications, internal organ dysfunction, chronic diseases, and cancer.
Can dogs survive a stomach ulcer?
Yes! The prognosis for certain types of ulcers in dogs is generally positive.
What are the symptoms of stomach ulcers in dogs?
The primary symptom of stomach ulcers in dogs is vomiting, often accompanied by blood or coffee-ground material.
How long does it take to heal an ulcer in a dog?
In most cases, ulcers in dogs respond to treatment within 5 to 7 days.