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Colitis

Maltese Colitis

Overview

Colitis refers to the inflammation or irritation of a dog's colon, which is also referred to as the large intestine. 

Colitis is not a disease itself, but rather describes a disruption of the normal digestive process when related to the colon/large intestine. 

Certain triggers cause an irritation of the colon, disrupting its normal functions due in part to inflammation of the lining. 

Two notable disruptions which manifest as common symptoms are that mucus and other substances shed from the lining; this is seen as slimy or mucus-filled stools. And water is not absorbed from digesting food as it normally would otherwise, which causes diarrhea. 

Types

There are two types of colitis:

Acute: This is a short-lived episode lasting 1 to 3 days. It resolves on its own and often does not require intervention other than what is normally done at home for diarrhea (more ahead).

Chronic: These are reoccurring episodes that last over a long period of time which can be months or even years. The condition may worsen as it progresses. 

Signs and Symptoms

Because this is an irritation of the large intestine which is the body's last stop in the digestive system tract, symptoms of colitis with Maltese and other canines are related to bowel movements. 

The most common signs include:
  • Diarrhea - This is the #1 sign of colitis. This may range from watery diarrhea to very loose stools with or without blood (which presents as red flecks).
  • Expelled mucus. Stools may be covered with slime presenting as a clear to white film and/or there may be bits of mucus in the stools.
  • Flatulence
  • Discomfort - Gas, burning from diarrhea, and/or stomach cramping can cause a dog to feel pain ranging from minor to quite severe. This may occur only when a Maltese goes to the bathroom, or may plague him in between as well. 
  • Nausea and/or vomiting which is seen secondary to the diarrhea
  • Inflamed, red, or otherwise irritated skin around the anus

Causes

There are quite a few causes of colitis, some more common than others. This includes:
  • Stress - This may include moving to a new home, the addition of a new household member, or a Maltese suddenly needing to cope being home alone and having intense separation anxiety.
  • Intestinal parasites - This includes all worms common to dogs such as hookworms, roundworms, and whipworms and the parasitic infection of giardia.
  • Reaction to medications - Most commonly this is a reaction to an antibiotic. 
  • Ingesting an irritating food or element - This includes ingesting something off-limits such as certain dairy products, grass, cat food, or people food (typically that which is fatty or greasy).
  • Dietary intolerance or food allergy.
  • IBD (inflammatory bowel disease), which itself has several causes. IBD can affect both the large and small intestines and/or the stomach. Signs often include both dirrhea and vomiting. 
  • Viral infections including parvovirus
  • Bacterial infections including salmonella, campylobacter, E. coli, and clostridium.
  • Fungal infections including histoplasma
  • Ingestion of toxins
  • Bowel cancer - Seen most often with senior dogs
  • Pancreatitis
  • Blockage - Most often caused by ingestion of a foreign object. 

Diagnosis

When a Maltese has chronic colitis, if the trigger is not clear, tests will be run to diagnose the cause. This may include:
  • Rectal exam
  • CBC (complete blood count) which includes checking for electrolyte disturbance and pancreatic enzymes.
  • Chemistry testing to check levels of the kidney, liver, and pancreas, and blood sugar levels
  • X-rays of the abdomen to rule out blockage, tumors, fecal impaction, and other abnormalites. 
  • Ultrasound to examine the digestive tract and surrounding organs
  • Upper endoscopy (checking the stomach and small intestines) and/or colonoscopy (checking the colon and rectum)
  • Fecal tests - including a PCR panel which screens for campylobacter, canine parvovirus, giardia, cryptosporidium, clostridium, lawsonia intracellularis, salmonella, and canine enteric coronavirus
  • If pancreatitis is suspected, fine needle aspiration of the pancreas may be performed
  • Biopsy of the colon lining

Treatment

Symptomatic treatment: This sort of treatment is to offer relief from the diarrhea, cramping, and other symptoms while the underlying condition is being diagnosed. 

1. Bland diet. The idea is to offer a Maltese relief and allow his digestive system to rest. Most Maltese do not complain about this part, since appetite can already be low due to feeling unwell.
  
You'll want to prepare meals with as few ingredients as possible. Typically one protein (white-meat, boneless, skinless turkey or chicken or low-fat beef) is mixed with one starch (rice, sweet potato, or canned pumpkin - use 100% pure pumpkin puree and not the pie filling). 

Do not add any seasoning, butter, oil, or other additions. Mix well and serve warm. 

2. Topical treatment for irritated  an anus area. An topical antibiotics may be given and/or topical creams to sooth red, sore skin. 

Other treatment: Medications including Flagyl (metronidazole) which fights bacterial infections and/or antibiotics may be given.

With such a wide range of possible causes, additional treatment will vary depending on the underlying conditions. 
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