Garbagitis, Garbage Gut, Non Specific GI Upset, & GI Discomfort
by Roger Ross, DVM
These terms are frequently used for any type of gastro-intestinal upset that we suspect is due to eating something inappropriate, rancid, or in excess.
Your pet may feel miserable and be suffering from any combination of gas, diarrhea, constipation, bloat, gastro intestinal cramps, and so forth.
Despite the awful feeling your pet may be experiencing, these cases are not usually serious.
However, every once in a while these cases can become critical quickly....leading to a twisted bowel, colic, and possible death.
Trust your vet and his or her instincts on whether or not to treat your case conservatively or aggressively.
Conservative treatment typically involves treating the symptoms to make the patient more comfortable and evacuating the bowel with laxatives and/or enemas.
Conservative treatment at our clinic would consist of:
A good exam and history: If the vital signs, gum color, pupil responses, and hydration are all normal, and the problem has only been going on for 1-2 days, then treating symptomatically and skipping a more expensive work up would be appropriate as long as someone is watching carefully to make sure the patient is improving quickly and not getting worse.
A typical case presentation would be a young dog that is somewhat tight and gassy on palpation of the abdomen and a history of "just isn't feeling well" and not eating much for a day or two. Sometimes the history includes "got into the garbage" or "yes, it eats everything including sticks, dirt, toys, etc" or "my husband feeds it food and snacks from the table".
Here's how I handle these less serious cases:
Unless the owner brought in a stool sample, I put a rectal probe up the anus to see what comes out. Is there mucus or blood indicating irritation? Is there diarrhea? Is there an odor typical of necrosis? Sometimes we have to be prepared to change our minds and say to ourselves.... "this might be more serious than I first thought"
If an adequate stool sample comes out with the probe, we'll do an inexpensive screening test for intestinal worms. Just because we suspect the problem is due to eating something inappropriate, there are several other possible causes of bowel distress and one of those causes are intestinal parasites. Tapeworms, round worms, hook worms, whip worms, coccidia and giardia are all persistant little creatures that cause a variety of intestinal symptoms.
For most cases I give a combination injection of antibiotics, short acting steroids, atropine, and B-12 to reduce gas, inflammation, as a prophylaxis against infection, and to make the patient feel better.
Then we try to get everything out of the bowel whether it be a physical object such as plastic wrap, fermented hair, chewed up wood ... or whether it be just rancid food, gastric acid etc.
Whatever it is... our goal is to get it out of there. We do this with some combination of mineral oil based laxatives and/or enemas. This will seem counter intuitive, but depending on how the abdomen feels on palpation, I evacuate the bowels even if the patient has diarrhea.
And finally, we wait and watch. If the bowel evacuation works and lots of foul looking stool or crud comes out and this results in a patient that is much perkier and eating our job is pretty much done.
If, on the other hand, the vital signs are alarming, the gums aren't a healthy pink, there's clinical dehydration, or the abdomen is especially hard or painful on palpation ... or we've already tried conservative, symptomatic treatment and it didn't work ... It's time to switch our approach and get more aggressive. Like appendicitis in humans, intestinal cases that you think are just a bad case of indigestion, can become deadly serious quickly. Clinical experience, judgement, and monitoring for changes are critical when it comes to recognizing the difference between mild, moderate, and serious cases. This judgement that comes from extensive training and seeing so many patients is yet another reason to take your pet to the vet when it's sick... and not to dink around with home treatments for extended periods.
Here's how we handle such cases more aggressively:
Diagnostics: if we think the case merits a closer look we will recommend blood work to check for pancreatitis, liver disease, dehydration status, electrolye balance, acidosis, ketones, and lipidosis. We will be especially interested in the white blood cell profile and looking for bacteremia.
We will take radiographs and/or ultra sound images to check for foreign bodies, blockages, excessive stomach or bowel distenstions, tumors, herniations, twists and flips, abdominal fluid, and a very serious condition called an intussusception in which a part of the intestine has invaginated into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another.
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Hospitalization: For cases where our training and experience make us suspect the patient has more than just "bad indigestion", we will hospitalize and in addition to the symptomatic treatment will start IV fluids and antibiotics as needed.
Surgery is NOT needed in most cases but sometimes it is and sometimes on an emergency basis. Neither dogs nor cats are prone to appendicitis, but they are prone to perforations, torsions, foreign bodies, and intussceptions all of which need quick surgical intervention.
Endoscopy: If your vet thinks your pet would benefit from a closer look at the inside of your pet's stomach or intestinal system, a lot of vets now have endoscopes in their practice. And any vet can refer you to a specialty practice for endoscopy which is used to explore, take biopsies, to remove objects, or even perform minor surgery.