Case report: The first description of a Dieulafoy's lesion in the gastric mucosa of a dog

Abstract

An approximately 12-year-old, 31 kg, male neutered Labrador Retriever was presented to the referring hospital with an acute onset (less than 1 day) of hematemesis and melena. The dog was treated supportively for a presumptive gastric ulcer for 4 days with intravenous fluids, gastro protectants, such as pantoprazole, misoprostol, sucralfate, and barium, as well as an anti-emetic (maropitant) and analgesics (fentanyl, gabapentin, and tramadol). Throughout medical management, the dog continued to require blood transfusions approximately every 24 h. Given the poor medical response, the patient was subjected to an exploratory laparotomy. During surgery, a grossly raised, blister-like lesion on the mucosal surface of the stomach was appreciated on the lesser curvature of the stomach. A partial gastrectomy was performed, and the segment was submitted for histological evaluation. Histologically, there were multiple, tortuous, medium-caliber muscular arteries (>1.0 mm in diameter) in the submucosa. A single large-caliber artery (>0.75 mm in diameter) containing a partially occlusive thrombus extruded through the mucosa and projected on the ulcerated surface. The patient's signs were similar clinically and histopathologically to Dieulafoy's lesion in people. A Dieulafoy's lesion is a potentially life-threatening disorder that causes gastrointestinal (GI) hemorrhage. This lesion is characterized by a dilated, large-caliber, aberrant submucosal artery that erodes through the epithelium and ruptures, resulting in massive and potentially fatal hemorrhage. This lesion has never been documented previously in a dog.

Endoscopic and surgical treatment of non‐neoplastic proximal duodenal ulceration in dogs, and anatomical study of proximal duodenal vascularisation

“…The population in the present study had heterogeneous comorbidities; the limited number of patients examined did not allow the authors to statistically investigate their role. Furthermore, several vascular abnormalities which could be associated with gastrointestinal bleeding have been reported in humans (varices, haemorrhoids, vascular ectasia, angiodysplasias and Dieulafoy's lesions) (Xie et al ., 2022), while, in dogs, only one case of Dieulafoy's lesion has recently been described, characterised by dilated, large‐calibre, aberrant submucosal arteries eroding the epithelium, and causing massive and potentially fatal haemorrhage into the gastric lumen (Murillo et al ., 2022). The limited number of cases presented herein may justify the absence of hepatobiliary diseases as being among the causes of the ulceration; hepatobiliary diseases are often reported as being predisposing factors in the literature (Pavlova et al ., 2021).…”