Short bowel syndrome
Short bowel syndrome occurs when more than two thirds of the entire length of the small intestine have been surgically removed. The clinical hallmark is intractable small intestinal diarrhea resulting from severe malabsorption due to the massively reduced mucosal surface area.
If the ileum had to be resected as well, malabsorption of bile salts and cobalamin can occur.76 If the ileocolic valve has been resected, antibiotic treatment is necessary because of bacterial overgrowth of the small intestine. Tylosin (25 mg/kg PO q 12 h) or metronidazole (10 mg/kg PO q 12 h) can be used in these cases. Fluid and electrolyte replacement is important in the immediate post-operative period, but oral feeding should be continued as well to prevent starvation of the remaining mucosal epithelial cells. A fat-restricted oligomeric liquid diet should be fed at first, with gradual transition to more solid food. If the ileum has been removed, the patient should also receive cobalamin supplementation as cobalamin is exclusively absorbed in this region of the bowel. The prognosis depends on the patient’s response to therapy. Some animals will have life-long intractable diarrhea.5.3.7
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