It’s easy to think of a disease as a THING: it’s Salmonella; it’s food poisoning; it’s indigestion… but thinking this way overlooks what’s really going on inside your sick pet. Disease isn’t a noun, it’s a verb: a process of dysfunction and degeneration that must be stopped before the patient can return to health. Let’s take a look at a simple and common disease process and see how it works.
I’d like to introduce you to enterocolitis, or maybe gastroenteritis, or maybe even gastro-enterocolitis. Would a rose by any other name… not cause vomiting and diarrhea? It begins with an initiating factor. Perhaps your dog Schmoopy (dogs are especially good at this) ate something he shouldn’t have: a dead sea gull perhaps, or the neighbor’s garbage, or box full of Cat Box Roca, or maybe Schmoopy got too much of something too rich for him. Whatever. We call this initiating factor an insult.
Now, having been insulted, Schmoopy’s bowel is not happy and the unhappy portion gives the disease a name: gastritis for stomach, with lots of immediate vomiting; enteritis for small intestine, with delayed vomiting and high volume diarrhea; and colitis for colon, with infrequent vomiting and frequent, low volume diarrhea. There are combinations, of course, and sometimes more colorful names are used: “garbage gut” is popular, but “dietary indiscretion” sounds more professional. There are special case names, too, like “hemorrhagic enterocolitis,” when the insulted bowel passes material that looks like raspberry jam. Whatever you call it, it isn’t pretty, and Schmoopy is not fun to be around.
But what does the insult actually DO? Given some of the things we’ve seen dogs eat, and enjoy, it is a wonder that anything ever bothers them. Gut insults that cause self-sustaining problems usually do so by changing the normal bacterial population of the intestine. Normally, the surface of the intestine is Macy’s parking lot on Christmas Eve: No matter what unsavory character cruises through, there’s no place to park. Gut bacteria populations change rapidly in response to an insult, leaving billions of empty parking spots and allowing pathogenic bacteria to move in. These pathogens secrete toxins which create inflammation, modify the motility of the bowel, change the acidity of the fluids, and promote secretion of fluids. The bacteria do this to make Schmoopy’s insides a nicer place for them to live.
This doesn’t really work for Schmoopy, who experiences the increased motility as cramping, vomiting, and diarrhea. After consulting his built-in Doggie Medical Book, Schmoopy rushes outside to eat a huge pile of grass, but that only serves to irritate the bowel further and give him more stuff to throw up. As the bowel becomes more irritated, the initial increase in motility gives way to a loss of motility, and his intestine goes stagnant.
Now Schmoopy IS in trouble. Any food or medication he takes sits in his immobile stomach. He can’t absorb food or drugs, so the stuff just ferments inside him until he throws it up. If he throws up too many times, Schmoopy will lose excessive amounts of hydrochloric acid from his stomach. He can replace the acid, but the chloride can only be obtained from food, and when Schmoopy eats, he vomits, so his problem just gets worse. At some point, Schmoopy’s chloride level gets so low that he will vomit anything he swallows, including water. He is dehydrated, hypochloremic, has an acid/base imbalance, is stressed, immunosuppressed, toxic, and malnourished.
It’s a hot mess - literally. At this point, The Schmoopmeister requires IV fluids to replace his water and electrolyte losses. He can be medicated only by injection. His stagnant bowel is absorbing toxin like crazy, and the cells lining his intestines are dying from lack of nutrients and oxygen. His intoxicated capillary cells are separating, allowing fluid and blood cells to literally walk through the blood vessels and into his intestine, where they serve as nutrients for the very bacteria that created the problem, and let them produce even more toxin. As the intestinal wall deteriorates, bacteria cross into the bloodstream to invade the liver, kidneys, and other organs. If this continues, Schmoopy will soon be driving a dirt bus back to Schmoopistan.
Quite a process, huh? The exact nature of the insult doesn’t really matter. Once started, the enteritis process will advance, racing the immune system to determine whether Schmoopy, or the pathogens, will survive.
Early on, this process is easy to stop, but it gets increasingly difficult as time passes. Save your money. Get Schmoopy to the veterinarian early.