Malabsorption is when a nutrient is not properly absorbed and results from the interference of the nutrient’s digestion or absorption, or both. Interference in the digestion of food is generally caused by a lack of certain enzymes from the pancreas. This is known as exocrine pancreatic insufficiency. Cases of absorption failure are usually caused by the small intestine.
The symptoms of malabsorption in dogs are long term diarrhea, changes in appetite, and weight loss. However, there may be no diarrhea even in severe cases, and there may be substantial weight loos even if the animal has a good appetite, although this can be characterized by the eating of feces. The signs are usually due to loss of nutrient in the feces and a lack of nutrient uptake. Dogs suffering from malabsorption can appear healthy in other respects, unless cancer or sever inflammation is also present. Symptoms that are not specific to malabsorption can include fluid retention, anemia, dehydration and dark blood in the stool. The veterinarian may be able to detect abdominal lymph node enlargement or thickened bowel loops.
It can be difficult to diagnose malabsorption as symptoms like weight loss and long term diarrhea are found in several diseases. It may take more than one visit to the veterinarian for an exact diagnosis. The dog will need to be thoroughly examined as the symptoms may be caused by an underlying generalized or metabolic condition. Tests may be undertaken to determine if the symptoms are related to other condition such as liver disease, inflammatory bowel disease or parasites. The history of the dog is very important as it may indicate if the dog has a food allergy, consumes inappropriate items, or other sensitivity. The weight loss may be due to malabsorption or a protein losing disease, but it may be due to vomiting, appetite loss or a disease that is not related to the digestive system. If it suspected that the large intestine is involved the a biopsy of the intestinal lining in the large intestine may be necessary. If the symptoms are accompanied with weight loss, or a large amount of feces, then it is likely that the small intestine is also involved.
The treatment of malabsorption can require changes to the diet, management of any and all complications and if a cause can be identified, it also needs to be treated. In malabsorption caused by exocrine pancreatic insufficiency, the treatment includes a low fiber diet with moderate fat levels or easily digestible fat, easily digestible carbohydrates and high quality protein. It is also necessary to supplement pancreatic extract so as to provide the missing enzymes. If the dog has a poor response to pancreatic replacement treatment, then there may also be a bacterial overgrowth in the small intestine. It may be necessary to administer antibiotics for around one month in order to reduce the overgrowth of bacteria. Effective treatment of disease in the small intestine is dependent on the nature of the disease. If a specific diagnosis can not be made then it may be necessary to administer treatments on a trial basis. The veterinarian may recommend an exclusion diet, feeding a single protein source which the animal has not eaten before as a test is food sensitivity is suspected. It is important that the owner follow the veterinarian’s instruction exactly as the dietary changes are a very important part of small intestinal disease management. The animal is unlikely to be allowed treats and the owner must not give any treats when instructed to withhold them. The animal can be reward with toys, praise or some other non food reward. The best reward may be a lot of attention. If the owner does not follow the instruction exactly, it can delay diagnosis and the appropriate treatment.