Short Bowel Syndrome

Signalment

Description

Short bowel syndrome occurs when greater than two-thirds of small intestine is absent. This may be the result from surgical resection or congenital anomaly. Consequently, the absoptive capacity of the small intestine greatly reduced, with inadequate absoption of nutrients and electrolytes, leading to diarrhoea. However, this may be only be transient as the remaining of the intestine can undergo adaptive hyperplasia.

Diagnosis

Clinical Signs

Small intestinal diarrhoea
Weight loss

In cases which occur after surgical bowel resection, the presenting clinical signs is sufficient to make a diagnosis. In cases of congenital origin, a plain or contrast radiography is required.

Treatment

Dietary modification

Highly digestible, low fat diet is recommended.
Vitamin supplementation may be required.

Antimicrobials

A secondary antibiotic responsive diarrhoea may result if the ileocaecal valve is removed.
Metronicazole or tylosin can be given in these cases.

Antisecretory agents & antacids

These may be needed in cases which are poorly responsive.
Antisecretory agents such as loperamide, diphenoxylate.
Antacids such as ranitidine, famotidine

Nutritional support

Total or partial parenteral nutrition may be required in some cases to provide adequate nutrition until adaptive hyperplasia takes place.

Prognosis

This is dependent on the length of the small intestine that remains. If adequate adaptive hyperplasia takes place, the patient may respond well. However, there will always be a limitation in the absoptive capacity of these animals. Some cases may respond poorly to treatment.

References

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA
Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.