THERAPEUTIC NUTRITION
THERAPEUTIC NUTRITION
Useful information about the needs of cats and dogs with nutritionally sensitive health conditions.
Gastrointestinal Disorders
Fiber-Responsive Colitis and Large Bowel Diarrhea in Dogs
Fiber-responsive diarrhea in dogs can be an inflammatory (e.g., colitis) or non-inflammatory (e.g., chronic idiopathic large bowel diarrhea) condition that primarily affects the colon and clinically improves after fiber is added to the diet.1─3 Both colitis and idiopathic large bowel diarrhea are characterized by soft-to-liquid stools often combined with excess mucus and/or fresh red blood, tenesmus, and increased defecation frequency and urgency.1─5 Colitis may be acute or chronic with intermittent or persistent diarrhea.
The goals of dietary intervention are to reduce or eliminate clinical signs while meeting a dog’s nutritional needs.
THERAPEUTIC NUTRITION
Approximately 95% to 99% of the short-chain fatty acids (SCFAs) produced by bacterial fermentation are rapidly absorbed in the large intestine, where colonocytes use them as an energy source.6 SCFAs also aid water and electrolyte absorption.7
Key Messages
- A key nutritional consideration for these cases is to increase dietary fiber, while still feeding a diet made with highly digestible protein, fat, and carbohydrate ingredients.
- Increased dietary fiber influences stool consistency, normalizes colon motility, and improves SCFA production.
- Highly digestible macronutrients help reduce colon irritation and prevent maldigestion.
- Most dogs with fiber-responsive colitis or large bowel diarrhea can benefit from a combination of soluble (fermentable) and insoluble (poorly fermentable) fibers.1─5,8
- Dietary fiber can be categorized by solubility and fermentability.7,9
- Soluble, gel-forming fiber adsorbs large amounts of water, which improves stool consistency and supports normal colon motility.
- Soluble fiber is metabolized by the microbiota, producing SCFAs that colonocytes use for energy while also reducing the pH of colon contents, decreasing toxin absorption, and potentially inhibiting the growth of pathogenic bacteria.
- Insoluble dietary fiber increases stool bulk, improving intestinal motility and normalizing transit time, while also binding water to form a firmer stool.
- Insoluble fiber binds unabsorbed bile acids and microbial toxins, which helps protect the colonic mucosa from injury.
- Another nutritional strategy that may benefit dogs with fiber-responsive diarrhea is the administration of prebiotics, probiotics or synbiotics.
- Prebiotics, specific soluble fibers that are fermented by bacteria in the colon, can help recover beneficial bacterial populations, restore short-chain fatty acid production and lower intestinal lumen pH.
- A probiotic supplement, particularly one with immune-modulating and anti-inflammatory effects, can positively influence the gut microbiome and intestinal health.
- Synbiotics, which blend probiotics and prebiotics, may provide complementary or synergistic benefits for gut health. In complementary combinations, the prebiotic and probiotic have independent mechanisms and benefits.10
- For dogs that do not respond to increased dietary fiber and/or probiotics, a hydrolyzed or novel protein diet should be considered.11
THERAPEUTIC NUTRITION
“Based on your dog’s evaluation, I suspect your dog may benefit from a change in [his/her] food. I recommend we start [dog’s name] on a therapeutic diet that contains more fiber to see if the additional fiber helps your pet. I am also recommending that [dog’s name] be given a [probiotic/synbiotic] to support [his/her] gut microbiome. We should see improvement within 2 weeks and, if not, we can discuss trying a hydrolyzed or novel protein diet, which can be helpful in some cases.”
Related Tools and Content:
Nutritional Assessment Is an Iterative Process: Extended Evaluation
An extended nutritional evaluation is important for pets at risk for nutrition-related problems.
Considerations When Choosing a Probiotic Supplement
Probiotics are a nutritional intervention that may help manage pet health issues from gastrointestinal tract and beyond.
Distinguishing Characteristics of Small and Large Bowel Diarrhea Chart
A practical, easy-to-use chart that helps localize diarrhea to the small or large intestine.
Purina Fecal Scoring Chart
The Purina Fecal Scoring Chart is a practical, easy-to-use tool that can help clients describe their pets’ stools.
To Share With Pet Owner:
Managing the Gut Microbiome
Diet, a controllable factor that influences the gut microbiome, offers a daily opportunity to contribute to gut health.
Intestinal Dysbiosis in Dogs and Cats
Diet modification is a key component of therapeutic plans for managing dogs and cats with intestinal dysbiosis.
Fiber in Pet Food
High fiber diets are often recommended for people to support a healthy digestion. What is the role of fiber in pet foods?
Prebiotics
Purina was the first to use prebiotics in pet food and is a leader in the field. What are the benefits of prebiotics to pets?
Probiotics
Probiotics offer many benefits, but with so many options available, pet owners may not know how to select the best quality and most appropriate one for their pet's needs
References
- Leib, M. S. (2016). Fiber-responsive large bowel diarrhea. In L. P. Tilley & F. W. K. Smith, Jr. (Eds.), Blackwell’s five-minute veterinary consult: Canine and feline (6th ed., p. 514). Wiley-Blackwell.
- Leib, M. (2000). Treatment of chronic idiopathic large bowel diarrhea in dogs with a highly digestible diet and soluble fiber: A retrospective review of 37 cases. Journal of Veterinary Internal Medicine, 14(1), 27─32. doi: 10.1111/j.1939-1676.2000.tb01495.x
- Marks, S. L. (2016). Colitis and proctitis. In L. P. Tilley & F. W. K. Smith, Jr. (Eds.), Blackwell’s five-minute veterinary consult: Canine and feline (6th ed., pp. 293─295). Wiley-Blackwell.
- Zoran, D. (2010). Large bowel diarrhea–canine. In Nestlé Purina PetCare handbook of canine and feline clinical nutrition (pp. 46─47). Nestlé Purina PetCare Company.
- Campbell, S. (2010). Colitis–canine. In Nestlé Purina PetCare handbook of canine and feline clinical nutrition (pp. 52─53). Nestlé Purina PetCare Company.
- Von Engelhardt, W., Rönnau, K., Rechkemmer, G., & Sakata, T. (1989). Absorption of short-chain fatty acids and their role in the hindgut of monogastric animals. Animal Feed Science and Technology, 23(1─3), 43─53. doi: 10.1016/0377-8401(89)90088-6
- Gross, K. L., Yamka, R. M., Khoo, C., Friesen, K. G., Jewell, D. E., Schoenherr, W. D., Debraekeleer, J., & Zicker, S. C. (2010). Macronutrients. In M. S. Hand, C. D. Thatcher, R. L. Remillard, P. Roudebush, & B. J. Novotny (Eds.), Small animal clinical nutrition (5th ed., pp. 49─105). Mark Morris Institute.
- Lenox, C. (2021). Nutritional management for dogs and cats with gastrointestinal diseases. Veterinary Clinics of North America: Small Animal Practice, 51(3), 669─684. doi: 10.1016/j.cvsm.2021.01.006
- Cave, N. (2012). Nutritional management of gastrointestinal diseases. In A. J. Fascetti & S. J. Delaney (Eds.), Applied veterinary clinical nutrition (pp. 175─219). Wiley-Blackwell.
- Cunningham, M., Azcarate-Peril, M. A., Barnard, A., Benoit, V., Grimaldi, R., Guyonnet, D., Holscher, H. D., Hunter, K., Manurung, S., Obis, D., Petrova, M. I., Steinert, R. E., Swanson, K. S., van Sinderen, D., Vulevic, J., & Gibson, G. R. (2021). Shaping the future of probiotics and prebiotics. Trends in Microbiology, 29(8), 667─685. doi: 10.1016/j.tim.2021.01.003
- Allenspach, K., Wieland, B., Gröne, A., & Gaschen, F. (2007). Chronic enteropathies in dogs: Evaluation of risk factors for negative outcome. Journal of Veterinary Internal Medicine, 21(4), 700─708. doi: 10.1111/j.1939-1676.2007.tb03011.x