Intestinal pseudo‐obstruction, lymphocytic leiomyositis and atrophy of the muscularis externa in a dog

Couraud, L; Jermyn, Kieri; Yam, P.S.; Ramsey, Ian; Philbey, Adrian

doi:10.1136/vr.159.3.86

Cited by 14 publications

(23 citation statements)

References 9 publications

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“…It has been reported that in patients with CIIP a barium contrast may take from 10 days (Johnson et al, 2007) to 3 weeks (Couraud et al, 2006) to move from the stomach to the small intestine. Endoscopy could be used for exclusion of mechanical obstruction, however superficial endoscopic biopsies would not help diagnosis due to the deeper level of the lesion (Schuffler, 1981).…”

Section: Discussionmentioning

confidence: 99%

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Chronic intestinal pseudo-obstruction in a dog: case report

Bicalho

Silva

Paixão

et al. 2011

Arq. Bras. Med. Vet. Zootec.

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Intestinal pseudo-obstruction is a rare disorder that affects gastrointestinal propulsion. It may be secondary to several pathological conditions or it may develop without a known cause. A 1.2 year-old intact Pug bitch had a history of vomiting and constipation, which were followed by diarrhea and distended abdomen. Hypomotility and dilation of the small intestine, which was filled with gas, were observed during laparotomy. Histologically, full thickness biopsy specimens demonstrated a severe loss and degeneration of leiomyocytes in the inner and outer muscular layers of the intestinal wall, whereas there was a marked hypertrophy and hyperplasia of smooth muscle cells in the lamina propria, and extremely thickened muscularis mucosae arranged in bundles oriented in different directions with marked hypertrophy and hyperplasia of leiomyocytes. Distribution of leiomyocytes was further characterized by immunohistochemistry. These findings support the diagnosis of intestinal pseudo-obstruction in a Pug, associated with degeneration and loss of leiomyocytes in the muscular layer. Keywords: dog, pseudo-obstruction, intestine RESUMO

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Section: Discussionmentioning

confidence: 99%

“…This syndrome may develop as a secondary event to several pathological conditions, including hypokalaemia, myocardial infarction, spinal or pelvic trauma, abdominal surgery, and retroperitoneal hemorrhage (De Giorgio et al, 2001) or it may be idiopathic. Furthermore, it may have an acute or a chronic clinical course.…”

Section: Introductionmentioning

confidence: 99%

Chronic intestinal pseudo-obstruction in a dog: case report

Bicalho

Silva

Paixão

et al. 2011

Arq. Bras. Med. Vet. Zootec.

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“…Leiomyositis affects contractility of the enteric smooth muscle cells because of infiltration of lymphocytes between functional myocytes, causing subsequent ileus . Affected humans and dogs present with marked gastric and small intestinal dilatation with severe hypomotility, resulting in clinical signs of abdominal discomfort, vomiting, regurgitation, diarrhea, anorexia, and weight loss of variable onset . The syndrome has been poorly defined in dogs to date, and all but 1 of the publications in the peer‐reviewed veterinary literature are single‐case reports .…”

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confidence: 99%

“…Affected humans and dogs present with marked gastric and small intestinal dilatation with severe hypomotility, resulting in clinical signs of abdominal discomfort, vomiting, regurgitation, diarrhea, anorexia, and weight loss of variable onset . The syndrome has been poorly defined in dogs to date, and all but 1 of the publications in the peer‐reviewed veterinary literature are single‐case reports . The prognosis of dogs with intestinal leiomyositis generally is poor with survival times ranging from 10 days to 5 weeks after diagnosis .…”

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confidence: 99%

Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs

Zacuto

Hill

McAlister³

et al. 2015

Veterinary Internal Medicne

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BackgroundIntestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo‐obstruction in humans and animals.ObjectiveTo characterize the clinical presentation, histopathologic features, and outcome of dogs with intestinal leiomyositis in an effort to optimize treatment and prognosis.AnimalsSix client‐owned dogs.MethodsRetrospective case series. Medical records were reviewed to describe signalment, clinicopathologic and imaging findings, histopathologic diagnoses, treatment, and outcome. All biopsy specimens were reviewed by a board‐certified pathologist.ResultsMedian age of dogs was 5.4 years (range, 15 months–9 years). Consistent clinical signs included vomiting (6/6), regurgitation (2/6), and small bowel diarrhea (3/6). Median duration of clinical signs before presentation was 13 days (range, 5–150 days). Diagnostic imaging showed marked gastric distension with dilated small intestines in 4/6 dogs. Full‐thickness intestinal biopsies were obtained in all dogs by laparotomy. Histopathology of the stomach and intestines disclosed mononuclear inflammation, myofiber degeneration and necrosis, and fibrosis centered within the region of myofiber loss in the intestinal muscularis propria. All dogs received various combinations of immunomodulatory and prokinetic treatment, antimicrobial agents, antiemetics, and IV fluids, but none of the dogs showed a clinically relevant improvement with treatment. Median survival was 19 days after diagnosis (range, 3–270 days).Conclusions and Clinical ImportanceIntestinal leiomyositis is a cause of intestinal pseudo‐obstruction and must be diagnosed by full‐thickness intestinal biopsy. This disease should be considered in dogs with acute and chronic vomiting, regurgitation, and small bowel diarrhea.

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“…Most often, they are fibrosis and inflammatory infiltration of the tunica muscularis. 6–12,15,16 Some other cases described an autonomous nervous system ganglioneuritis with inflammatory parietal lesions in a dog and two horses. 13,18,19 In the canine cases diagnosed with visceral myopathy, 6,8,9,11,12 leiomyositis 7,10,15,16 or sclerosing enteropathy, 14 the myenteric plexi were either normal 6,7,9,12,14 or exhibited some degree of lymphocytic inflammation, 8,10,15 considered less significant than the other lesions.…”

Section: Discussionmentioning

confidence: 99%

Chronic intestinal pseudo-obstruction associated with enteric ganglionitis in a Persian cat

Mortier

Elissalt

Palierne

et al. 2016

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 7-year-old neutered male Persian cat was presented for acute vomiting and inappetence. Physical examination revealed severe abdominal distension. Radiographs demonstrated pneumoperitoneum, megaoesophagus and generalised gaseous distension of the digestive tract. Exploratory coeliotomy was performed, revealing markedly distended and thickened small and large intestines with no observable peristalsis. No intestinal perforation was present. Bacteriological and cytological analysis of abdominal fluid revealed a septic peritonitis involving Pasteurella multocida. Full-thickness intestinal biopsies demonstrated lymphocytic ganglioneuritis localised to the enteric nervous system, in association with glandular atrophy and muscular layer hypertrophy. Amoxicillin-clavulanate and analgesics were given. The cat’s general condition gradually improved after the addition of pyridostigmine bromide (0.5 mg/kg q12h PO), initiated 3 days postsurgery. Vomiting resolved and did not recur. Follow-up radiographs at 15 days, and 1 and 6 months showed persistent intestinal ileus, milder than on the pretreatment radiographs. Thirty months after presentation the cat is still alive, without clinical signs, and receives 1 mg/kg q12h pyridostigmine.Relevance and novel information To our knowledge, this is the first case of ganglioneuritis of the myenteric plexus described in cats, as well as the first one successfully treated with pyridostigmine. Chronic intestinal pseudo-obstruction is a very rare condition in cats but should be included in the differential diagnosis of generalised gastrointestinal ileus.

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Intestinal pseudo‐obstruction, lymphocytic leiomyositis and atrophy of the muscularis externa in a dog

Cited by 14 publications

References 9 publications

Chronic intestinal pseudo-obstruction in a dog: case report

Chronic intestinal pseudo-obstruction in a dog: case report

Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs

Chronic intestinal pseudo-obstruction associated with enteric ganglionitis in a Persian cat

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