intestinal malabsorption syndrome in dogs is one of the most complex clinical conditions to diagnose and treat in this species, and may have consequences fatal. In this way, it requires constant monitoring and timely treatment. Affected dogs often have chronic diarrhea and weight loss. The causes of malabsorption syndrome in dogs are diverse, although they are mainly due to intestinal problems, in which the dog has difficulty properly absorbing the nutrients from the food it eats.
What is malabsorption syndrome in dogs?
The malabsorption syndrome is not a diagnosis as such, but implies that there is an underlying intestinal or pancreatic problem that results in a malabsorption of nutrients from food, including protein, resulting in hypoproteinemia (low protein).
In most cases of malabsorption in dogs, the problem is in the intestine, which is the place where nutrients from food are absorbed, although there may also be a problem in the secretion of enzymes of the pancreas, which are necessary for a correct digestive process.
Some of the breeds most predisposed to suffering from it are the basenji, the lundehund, the soft-coated wheaten terrier, the yorkshire and the shar pei.
Causes of canine malabsorption syndrome
There is a wide variety of explanations for why your dog is suffering from malabsorption syndrome, all related to the functioning of the structures that involved in the digestive process, such as:
Inflammatory causes
In which the dog's immune system attacks its intestinal mucosa, as if it were a foreign factor external to the animal, in this way the intestinal inflammations can be:
- Lymphoplasmacytic enteritis: or accumulation of lymphocytes and plasma cells, which are the ones that produce antibodies.
- Eosinophilic enteritis: due to an accumulation of eosinophils, which are the white blood cells that rise when there is an allergy or parasites.
- Granulomatous enteritis: thickening and narrowing at the end of the intestine.
Lymphangiectasia
Malabsorption syndrome in dogs can also be caused by lymphangiectasia, which is where the lymphatic vessels meetdilated and fluid-filled in one or more layers of the intestine. It can be primary or secondary due to portal vein hypertension (due to liver or heart failure).
Intestinal tumors
O infiltration of tumor cells in the layers of the intestinal wall. It may be a lymphoma or lymphosarcoma, caused by an accumulation of neoplastic lymphocytes.
Infectious causes
Infectious agents are those that cause injury to the intestinal mucosa resulting in malabsorption of nutrients. They can produce it:
- Parvovirus.
- Salmonellosis.
- Parasites (Ancylostomas).
- Fungi (Histoplasmosis or Pytiosis).
Pancreatic insufficiency
Disease in which the pancreas does not produce pancreatic enzymes necessary for the proper functioning of the digestive process.
Removal of a segment of intestine
When a segment of the intestine is surgically removed, it leads to the rest of the intestine being forced to function, which can lead to intestinal paralysis with the consequent nutritional malabsorption.
Congenital intestinal villus atrophy
It is due to inadequate development of intestinal villi, which are the area of the intestine where nutrients are absorbed. It is the most common cause of malabsorption in German Shepherds.
Symptoms of malabsorption syndrome in dogs
The symptoms of canine malabsorption syndrome are very diverse, since our dog can present the following clinical signs:
- Weightloss.
- Chronic diarrhea.
- Yellowish vomit.
- Altered eating habits (eat feces, more or less appetite and sometimes eat things that are not food).
- Melena (presence of blood in the stool).
- Gut sounds.
- Reduced muscle mass.
- Ascites (accumulation of fluid in the abdomen due to the drop in the protein albumin, which prevents fluid from flowing out of the blood vessels into the cavities).
- Effusion of fluid from the pleura (membrane lining the lungs).
Diagnosis of malabsorption syndrome in dogs
To correctly diagnose canine malabsorption syndrome, the following techniques must be used:
Alterations in the blood test
In the hemogram and blood biochemistry of our dog, the following alterations indicative of a malabsorption syndrome may appear:
- Hypoproteinemia or decreased globulins and albumin.
- Hypocalcaemia or low calcium (may be an artifact, as 40% of calcium circulates in the blood together with albumin, with which the loss of this protein can cause a false decrease in the total amount of serum calcium or due to the decrease in its intestinal absorption).
- Hypocholesterolemia or low amount of cholesterol in the blood (due to fat malabsorption due to intestinal lumen and/or liver disease).
- Lymphopenia or reduced blood lymphocyte count.
- Anemia due to chronic disease in some cases.
- Neutrophilia or increased neutrophils from a stress leukogram, due to chronic inflammation.
- Low platelets if blood thrombosis (clotting) occurs by reducing antithrombin due to its loss in the intestine (which is involved in breaking down the blood clots).
Supplementary Analysis
Other determinations can be made to guide the diagnosis of canine malabsorption syndrome:
- Alpha-1 proteinase inhibitor: commercial test that confirms the loss of protein through the stool, being sensitive to detect the early disease, although suspicion of protein loss appears after ruling out protein loss at the kidney level and excluding liver disease.
- Folate and vitamin B12 levels:since their reduction indicates a possible intestinal problem.
- Coagulation: Coagulation parameters (D-dimers, antithrombin) can also be analyzed to assess the risk of thrombosis.
Abdominal ultrasound
Imaging test with which you can see the appearance of the intestine (inflammation, masses…) and the rest of the organs and detect fluid in the abdominal cavity. It is also useful to guide the taking of samples by biopsy to send to the laboratory and obtain a comprehensive diagnosis.
Biopsy for histopathological analysis
The definitive diagnosis of diseases that can cause malabsorption syndrome in dogs is performed by laboratory histopathology from an intestinal biopsy (sample of tissue from the intestine).
The taking of biopsies can be done through endoscopy or laparotomy (surgical operation that consists of opening the abdomen and taking samples directly, taking the opportunity to assess the state of the rest of the organs). The sample will be better if it is obtained in the latter way, but due to the low albumin and the state in which dogs are sometimes found, endoscopy is generally chosen, with its limitations in the diagnosis of tumors or lymphangiectasia.
Treatment of malabsorption syndrome in dogs
To cure malabsorption syndrome in dogs, we will opt for the following:
Support treatment
Support or symptomatic treatments will have the purpose of relieving our dog's symptoms, such as:
- Thoracocentesis: or fluid-releasing puncture. It will be used if there is respiratory difficulty due to the presence of fluid in the pulmonary pleura.
- Diuretics: loop diuretics, such as furosemide, are useful for eliminating ascites, but assessing the state of hydration of the animal and potassium concentrations. To prevent low potassium, it can be combined with a potassium-sparing diuretic such as spironolactone.
- Fluidotherapy: only if the animal is dehydrated due to vomiting or diarrhea.
- Anticoagulants: such as aspirin or clopidrogel to prevent thrombus formation.
- Vitamin B12 or folate supplementation: if there are deficiencies.
- Changes in diet: In cases of inflammatory bowel disease or lymphectasia secondary to it, a hypoallergenic diet with hydrolyzed protein and fat restriction.
Specific treatment
To treat conditions that can cause intestinal malabsorption in dogs, your vet may prescribe the following treatments
- Treatment of inflammatory or immune-mediated diseases: usually includes therapy with immunosuppressive drugs, such as the corticosteroid prednisolone. In cases in which there is no improvement with this, a second immunosuppressant such as cyclosporine or azathioprine is usually necessary. In animals for which corticosteroids are contraindicated due to their side effects, the use of budesonide has been described as a substitute for them.
- Treatment of infectious diseases: antibiotics in bacterial cases, antiparasitics if caused by parasites and antifungals if caused by fungi.
- Treatment of diseases of tumor origin: in these cases, chemotherapy protocols must be administered.
- Treatment of pancreatic insufficiency: administration of pancreatic enzymes.
The prognosis of a dog with malabsorption will depend on the state of its organs, the evolution of the disease and its origin, with infectious cases being the easiest to treat and tumor cases the most complicated and with worse prognosis. So if your dog is unexplainably losing weight or has any of the symptoms we've discussed, you should take him to the vet to have him diagnosed. problem and give you the proper treatment to restore your he alth and especially that of your intestine as soon as possible.
