Veterinary Guide to Canine Ileus 2025 🩺🐶

By Dr. Duncan Houston BVSc

🧬 What Is Ileus?

Ileus is a disruption in gastrointestinal (GI) motility resulting in stasis of intestinal content. It may be functional (loss of motility without obstruction) or mechanical (physical blockage like foreign bodies, tumors, intussusception).

👥 Who’s at Risk & Causes?

• Functional ileus: hospitalized, post-op GI, metabolic (electrolyte/pain), peritonitis, pancreatitis.
• Mechanical ileus: foreign bodies, intussusception, neoplasia, strictures, hernias, volvulus.
• Rare pseudo-obstruction causes: e.g., intestinal leiomyositis.
• Breeds: no breed predisposition, but all dogs recovering from GI surgery or handling ingests are potential candidates.

⚠️ Clinical Signs

• Persistent vomiting, nausea, anorexia, reluctance to eat 🔄
• Abdominal pain, distension, and gas accumulation.
• Absent or altered bowel sounds; constipation or straining.
• Lethargy, dehydration, electrolyte imbalance, and systemic illness brunt.

🔍 Diagnostic Approach

1. History & exam: surgery, foreign body risk, metabolic disease, medication history.
2. Abdominal auscultation: hypomotility or silence. Useful for functional ileus monitoring.
3. Radiography: survey films reveal multiple gas/fluid‑filled, dilated loops; measure diameter L5 vertebra guidelines (>1.6× height).
4. Ultrasound: distinguishes obstruction from functional ileus, visualizes masses, intussusception, and peristalsis.
5. Endoscopy: direct visualization and possible foreign object removal.
6. Exploratory surgery if imaging is inconclusive, but the condition deteriorates.
7. Bloodwork & electrolytes: address imbalances contributing to ileus.

🛠️ Treatment & Management

1. Supportive Care

• IV fluids: correct dehydration, electrolytes, and acid-base status.
• Anti-emetics & pain control to reduce vomiting and stress.
• Early enteral nutrition: gentle small meals or feeding tubes encourage motility.

2. Address the Underlying Cause

• Functional ileus: treat underlying sepsis, peritonitis, pancreatitis, and metabolic imbalance.
• Mechanical ileus: surgical removal of obstruction, resection, and anastomosis if necrotic bowel is present.

3. Prokinetics

• Cisapride: enhances gastric and colonic motility—used for hypomotility.
• Metoclopramide: promotes gastric emptying, weak intestinal action.
• Others: Erythromycin (low-dose), lidocaine CRI post-op.

4. Surgery

• Exploratory laparotomy for mechanical obstruction—remove foreign bodies, correct intussusception, resect diseased bowel.
• Biopsy for suspected neoplasia or pseudo-obstruction.

📈 Prognosis & Monitoring

• Functional ileus: often excellent if the underlying cause managed early.
• Mechanical ileus: prognosis dependent on cause, surgery success, bowel viability—prompt treatment improves outcome.
• Frequent rechecks—exams, hydration status, abdominal auscultation.
• Follow-up imaging if motility doesn't return or signs recur.

🏡 Home Care & Prevention

• Prevent foreign body ingestion—supervision, safe toys, secure environment.
• After GI surgery: strict rest, slow feeding, meds adherence.
• Maintain hydration and monitor for vomiting or distension.
• Manage chronic diseases (pancreatitis, infections) to reduce ileus risk.

📱 Ask A Vet Telehealth Support

• 📸 Upload images or videos showing abdominal swelling or vomiting for triage.
• 🔔 Scheduled reminders for fluids, medications, nutritional support.
• 🧾 Virtual auscultation tutorials—help owners identify changes in gut sounds

🎓 Case Spotlight: “Rosie” the Labrador

Rosie, a 5‑year‑old Labrador recovering from GDV surgery, developed abdominal distension and intermittent vomiting on day 3 post-op. Radiographs showed multiple dilated loops without focal obstruction. IV fluids, cisapride, lidocaine CRI, and early feeding resulted in the return of bowel sounds and appetite within 48 hours. She went home on oral cisapride and a low-fat diet, with Ask A Vet remote check-ins and medication reminders. Recovery was smooth with no recurrence 🌟.

🔚 Key Takeaways

1. Ileus—functional or mechanical—is a loss of GI propulsion; early detection is critical.
2. Signs include vomiting, pain, distension, decreased gut sounds, and immobility of GI contents.
3. Diagnosis relies on imaging (X-ray/US), auscultation, bloodwork, and sometimes endoscopy or surgery.
4. Treatment includes fluids, pain control, prokinetics, and surgery if obstruction is present.
5. Ask A Vet telehealth supports through monitoring, medication reminders, remote exams, and nutritional guidance 🐾📲

Dr Duncan Houston BVSc, founder of Ask A Vet. Download the Ask A Vet app today to support your dog during ileus diagnosis, treatment, and recovery—from remote monitoring to medication delivery and nutrition planning 🐶📲