Diagnostic utility of abdominal ultrasound for detecting non‐perforated gastroduodenal ulcers in dogs

Abstract

Background Abdominal ultrasound is frequently used to detect non‐perforated gastroduodenal ulcers in dogs. Studies assessing the diagnostic utility of abdominal ultrasound for the detection of non‐perforated gastroduodenal ulcers have yielded mixed results. No studies to date have investigated the effects of patient bodyweight, breed, sex, age, ulcer aetiology (neoplastic or inflammatory) or location on the diagnostic accuracy of abdominal ultrasound. Methods Retrospective, multicentre study to evaluate the diagnostic utility of abdominal ultrasonography for the diagnosis of non‐perforated gastroduodenal ulceration in dogs. Results Sixty‐one dogs met the inclusion criteria. Ulcers were detected during ultrasound examination in 18 of 61 dogs, yielding a sensitivity of 29.5% (95% confidence interval 18.8%–42.7%). Ulcers in the pyloric region were detected more frequently than those in the duodenum; however, location was not significantly associated with the ability of ultrasound to detect lesions (p = 0.41). No associations were identified between the ability of ultrasound to detect an ulcer and patient bodyweight (p = 0.45), breed (p = 0.98), sex (p = 0.90), age (p = 0.94), and neoplastic versus inflammatory nature of ulcerative lesions (p = 0.93). Conclusion The diagnostic utility of ultrasound as the sole modality for the detection of non‐perforated gastroduodenal mucosal ulceration is poor. The authors therefore recommend the use of additional modalities when ulcerative lesions are suspected.

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

“…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 In the present study population, abdominal ultrasound findings regarding duodenal ulcers were not consistently reliable, with a 55% incidence of non-specific increased duodenal wall thickness in the affected patients. The latter was not entirely surprising, as several studies have reported a low sensitivity of abdominal ultrasound examination for the detection of nonperforated gastroduodenal ulcers in dogs (Fitzgerald et al, 2017;O'Kell et al, 2022;Weston et al, 2022). Conversely, as previously reported by Saravanan et al (2012), the endoscopic approach seemed to be the most accurate technique for the early diagnosis of duodenal mucosal ulcers, useful both in defining the extent of the lesion, and for selecting the appropriate treatment.…”

“…In the present study population, abdominal ultrasound findings regarding duodenal ulcers were not consistently reliable, with a 55% incidence of non‐specific increased duodenal wall thickness in the affected patients. The latter was not entirely surprising, as several studies have reported a low sensitivity of abdominal ultrasound examination for the detection of non‐perforated gastroduodenal ulcers in dogs (Fitzgerald et al ., 2017; O'Kell et al ., 2022; Weston et al ., 2022). Conversely, as previously reported by Saravanan et al .…”

Gastroduodenal ulceration in dogs with liver disease

“…In our study population, clinical signs, laboratory findings, and abdominal ultrasound findings were not consistently indicative of GDU. The latter is not totally surprising because studies have reported sensitivities of abdominal ultrasound examination for nonperforated GDU in dogs ranging from 30‐65% 15,18 . Because not all of the dogs in our study had ultrasound examination immediately before endoscopy, it is also possible that ulcers detected at endoscopy were not present at the time of the ultrasound examination.…”

“…The latter is not totally surprising because studies have reported sensitivities of abdominal ultrasound examination for nonperforated GDU in dogs ranging from 30-65%. 15,18 Because not all of the dogs in our study had ultrasound examination immediately before endoscopy, it is also possible that ulcers detected at endoscopy were not present at the time of the ultrasound examination. The exclusion of dogs receiving acid suppressant medication may have biased our study population toward dogs without clinical signs or laboratory abnormalities suggestive of GDU.…”