Emphysematous gastritis in a cat

Abstract

Objective -To describe the presentation, diagnosis, treatment, and outcome of a case of emphysematous gastritis (EG) in a cat. Case Series Summary -A 15-year-old female neutered domestic short-hair cat presented for a 4-month history of weight loss and intermittent vomiting. Clinicopathologic and imaging findings suggested an underlying primary gastrointestinal (GI) disease, as well as possible hepatobiliary disease. Two days following exploratory laparotomy to obtain GI and liver biopsies, the patient became septic and intracellular bacteria were present on cytology of peritoneal effusion. On radiographs, the stomach was markedly distended with fluid and contained a thin gas opacity surrounding the stomach wall. The patient was taken back to surgery to identify a source of sepsis. At surgery, the patient's stomach was firm and emphysematous on palpation but grossly appeared normal. There were no signs of dehiscence of the previous biopsy sites. Stomach biopsy confirmed the presence of intralesional Gram-positive rods, consistent with microbial EG, and a light growth of a Clostridium sp. was cultured from abdominal fluid, consistent with clostridial peritonitis. During a third surgery for suspected septic peritonitis, a jejunostomy tube was placed for postgastric enteral feeding. The patient ultimately survived to discharge and is clinically stable 10 months later. New/Unique Information Provided -EG is a rare but potentially fatal clinical entity in the human and veterinary literature with only 1 other case reported in cats. Though clostridial organisms have been reported in EG in people, this is the first implication of EG secondary to a Clostridium sp. in the cat. This is also the first report to document the use of a jejunostomy tube for postgastric enteral nutrition to treat EG in the veterinary literature. (J Vet Emerg Crit Care 2018; 28(6): 596-602)

Feline Emphysematous Gastritis in a Cat with Pancreatitis and Secondary Hepatic Lipidosis

“…Interestingly, pancreatitis was also present in a previous case of feline emphysematous gastritis as well as in the case of feline gastric emphysema. 8,11 In the current case, it is likely that the cause of emphysematous gastritis was multifactorial, but we hypothesize that regional peritonitis secondary to pancreatitis, hypotension, and local vascular events such as thromboembolism contributed to compromise of the gastric mucosa allowing colonization with bacteria. The use of omeprazole could have contributed to gastrointestinal dysbiosis, leading to the proliferation of noncommensal bacteria within the stomach.…”

“…There are four reports of emphysematous gastritis, two of which were associated with abdominal surgery; one cat underwent exploratory laparotomy to obtain biopsies (including gastric biopsy) and the other to remove foreign material from the gastrointestinal tract. 8,9 In a third case, FNAs were taken from a thickened portion of small intestine. 10 The fourth case occurred in a cat with concurrent hepatic portal venous gas; this cat had undergone endoscopy retrieval of gastric foreign material alongside endoscopic biopsies of the stomach and duodenum.…”

“…In the cat, there have been just seven reports of gastric pneumatosis and a single report of pneumatosis intestinalis. [8][9][10][11][12][13][14] The single reported predisposing factor in cats for the development of emphysematous gastritis is gastrointestinal surgery. 8 Canine gastric pneumatosis is also uncommon, and its occurrence is most often associated with the presence of gastric dilation and volvulus.…”

“…[8][9][10][11][12][13][14] The single reported predisposing factor in cats for the development of emphysematous gastritis is gastrointestinal surgery. 8 Canine gastric pneumatosis is also uncommon, and its occurrence is most often associated with the presence of gastric dilation and volvulus. 15 Here, we report a case of emphysematous gastritis in a cat who had been diagnosed with pancreatitis with secondary hepatic lipidosis; the cat was medically managed and had not undergone gastrointestinal surgery.…”

Nectarivorous Bird Emphysematous Ingluvitis (NBEI): A Novel Disease in Loriinae Birds Associated With Clostridium perfringens Infection

“…Emphysematous diseases are commonly associated with Clostridium spp. infection (15), most notably malignant edema in various species (15) and blackleg in cattle (16), with other sporadic reports including emphysematous gastritis in horses (17) and cats (18), and C. perfringens-associated cystitis in a dog (19).…”