Fibrosing gastrointestinal leiomyositis as a cause of chronic intestinal pseudo-obstruction in an 8-month-old dog

An 8-month-old, female, mixed-breed dog presented to the Iowa State University Veterinary Teaching Hospital with a 1-month history of vomiting and diarrhea. An exploratory laparotomy was performed revealing markedly distended and fluid-filled small and large intestines that were not obstructed. The clinical condition of the dog did not improve subsequent to exploratory surgery, and it was euthanized. At necropsy, both the small and large intestines were distended (approximately 4 cm in diameter) and fluid-filled, and the wall was thin. The abdominal cavity contained approximately 500 ml of a brownish clear fluid. Microscopic lesions of the intestines were confined to the intestinal tunica muscularis and muscularis mucosae and consisted of locally extensive-to-diffuse replacement of the smooth muscle by fibrous tissue and multifocal infiltration by a moderately dense mononuclear inflammatory infiltrate. A unique finding was the presence of similar microscopic lesions in the tunica muscularis of the urinary bladder and stomach.     

Small intestinal segmental volvulus in horses after gastroscopy: Four cases (2011–2012)

Gastroscopy is the most common technique used in veterinary medicine to evaluate the stomach in horses and to date, no complications have been described associated with the procedure. This paper reports 4 cases developing a nonstrangulating segmental volvulus of the small intestine after gastroscopy at 3 referral institutions over a 2 year period. After performing diagnostic gastroscopy, all horses developed acute and severe clinical signs of colic unresponsive to medical management. Time range between gastroscopy and onset of colic signs varied from 10 min to 3 h. An exploratory laparotomy revealed a nonstrangulating segmental volvulus of the small intestine that was manually corrected without need for resection in all horses. In all cases, affected small intestine was severely gas distended. Three of those horses survived to discharge and were alive at follow‐up. One horse was subjected to euthanasia 2 days after surgery due to diffuse intestinal lymphoma.     

Equine Large Intestinal Volvulus A Review of 124 Cases

The average age of 122 horses with ascending colon volvulus was 6.6 +/- 0.4 years. Gastric reflux was a presenting sign in 35% of the cases. Peritoneal fluid protein levels had a mean of 2.54 +/- 0.14 g/dl and 20 horses had grossly normal peritoneal fluid at the time of presentation. Ascending colon volvulus was most commonly found at the level of the cecocolic fold with the initial ventral colon movement in a dorsomedial direction about the ascending mesocolic axis. The overall survival rate was 34.7% with a recurrence rate of only 4.9%.     

Intestinal volvulus and stricture associated with a leiomyoma in a green turtle (Chelonia mydas).

A previously stranded 30-kg female green turtle (Chelonia mydas) was referred to the Veterinary Medical Teaching Hospital at the University of Florida following a 2-mo history of anorexia, intermittent regurgitation, decreased fecal production, and positive buoyancy of the right side. Radiographs confirmed gaseous distension of bowel loops suggestive of intestinal obstruction. The coelom was surgically approached through a plastron osteotomy, and a 540 degrees volvulus of the small intestine was identified and derotated. An intestinal stricture was present at the site of the volvulus, and segments of bowel orad to the stricture were greatly distended. Following resection of abnormal bowel, the osteotomy was stabilized using self-tapping screws and figure-eight wire, and the defect was sealed with fiberglass cloth and fast-drying epoxy resin. A leiomyoma associated with the focal stricture was identified by histology. Appetite and defecation returned to normal. Six months after surgery, the turtle had regained normal buoyancy and showed no further clinical signs of gastrointestinal obstruction.     

Poult malabsorption syndrome. I. Malabsorption in poult enteritis.

One-day-old poults were placed on littler on which poults had previously developed diarrhea, increased mortality, and stunting. Small intestines, pancreas, and liver were evaluated histologically. Morphometric evaluations were conducted to determine villous length and crypt depth. Poults were evaluated for malabsorption utilizing D-xylose and lipid absorption tests. Compared with controls, the gastrointestinal tract of affected birds was grossly distended, was fluid-filled, and had thin, flaccid walls on days 5 and 8. Ceca were distended with brown watery fluid and gas on days 5, 8, and 12. No histologic lesions were present in the liver, pancreas, or pancreatic ducts, and only mild inflammatory changes were present in the small intestine. Villous atrophy and crypt hypertrophy were present in the small intestine on days 5, 8, 12, 16, and 21. Morphometry revealed significant decreases in villous lengths and increases in crypt depth throughout the trial. D-Xylose and lipid absorption were significantly decreased on days 8 and 11. Intestinal epithelial damage by infectious agents with subsequent villous atrophy is postulated to have produced malabsorptive diarrhea.     

IMAGING DIAGNOSIS—MUSCULAR HYPERTROPHY OF THE SMALL INTESTINE AND PSEUDODIVERTICULA IN A HORSE

A 14‐year‐old Thoroughbred gelding was presented for chronic colic and weight loss. Transcutaneous and transrectal abdominal ultrasonography revealed distended, thickened small intestine with primary thickening of the muscularis and a focally more thickened loop with an echoic structure crossing the wall from the mucosa to the serosa. Visualization of diffuse thickening of the muscularis (muscular hypertrophy of the small intestine) and a focal lesion (pseudodiverticulum) helped clinicians make informed decisions. This case illustrates the importance of transabdominal and transrectal ultrasonography in horses with chronic colic and the relevance of considering the abnormalities in layering pattern of the intestinal wall.     

Parvoviral enteritis and salmonellosis in raccoons with sudden death

Eight of 9 juvenile raccoons at a rehabilitation center died without obvious prior clinical signs. Gross changes were unremarkable except for mildly distended intestines. Microscopically, crypt loss, distension, necrosis, and regeneration with intranuclear viral inclusions were observed in the small intestine, with marked lymphoid depletion and necrosis in Peyer patches and mesenteric lymph nodes. Immunohistochemistry with a canine parvovirus antibody showed intensive signals of parvoviral antigens in the crypts and lymphoid germinal centers. Metagenomic sequencing allowed assembly of a complete parvoviral genome with >99% identity to canine parvovirus 2a, as well as Salmonella enterica subsp. enterica. Also, S. enterica subsp. enterica serovar Thompson with multiple antimicrobial resistance was isolated from the intestinal contents. Concurrent infection with parvovirus and Salmonella should be included as a differential diagnosis in raccoons with sudden death.     

Intestinal cryptosporidiosis and reovirus isolation from bobwhite quail (Colinus virginianus) with enteritis

An acute enteric disease of young pen-raised bobwhite quails was studied. Affected quails had white, watery diarrhea accompanied by dehydration and subsequent death. Mortality from hatch to 17 days of age ranged from 30 to 45% in the three flocks examined. Small intestines were thin-walled and distended with fluid and gas. Microscopic lesions in the intestinal tract consisted of villus atrophy, villus fusion, and sloughing of cells at the tip of the villi in duodenum, jejunum, and ileum. Cryptosporidium sp. and reovirus were identified in affected quails.     

MESENTERIC ROOT AND CECAL TORSION IN A DOMESTIC RABBIT (ORYCTOLAGUS CUNICULUS)

A 4.5-year-old female spayed Rex rabbit (Oryctolagus cuniculus) was presented as an emergency case for hyporexia, pigmenturia, and abnormal feces. The rabbit had been treated for intermittent hyporexia with outpatient medical management and over the next 2 months demonstrated intermittent signs of gastrointestinal stasis, which were only partially responsive to aggressive medical management. Serial radiographs demonstrated persistent gas within the cecum as well as left-sided, cranial displacement of the cecum. A partial cecal obstruction or volvulus was suspected but could not be confirmed, as advanced imaging and exploratory laparotomy were declined. Two months following its initial presentation, the rabbit developed acute signs of shock and colic, but arrested prior to emergency evaluation. Postmortem radiographs showed marked generalized gas dilation of the small intestines and cecum. Necropsy revealed a 360° mesenteric root torsion with devitalization of much of the small intestines, with an additional 180° rotation of the cecum. This case demonstrates that mesenteric root torsion occurs in rabbits and is an important consideration in rabbits presenting with acute shock or chronic, intractable gastrointestinal signs.     

Concurrent gall bladder,liver lobe torsion,and bile peritonitis in a German shepherd dog 2 months after gastric dilatation/volvulus gastropexy and splenectomy

Postmortem examination of a 7-year-old German shepherd dog which had gastric dilatation/volvulus and splenectomy 2 months earlier revealed that the right middle and quadrate liver lobes were diffusely congested and torsed. The gall bladder was grossly distended and torsed along its long axis and there was evidence of bile peritonitis.     

Radiographic features of congenital segmental dilation of the intestine in a german shepherd dog

A 10‐week‐old spayed female German Shepherd Dog was presented for acute vomiting and diarrhea. There was no reported foreign body or toxin ingestion. Radiographs showed a severely (～11 × 7 cm), focally distended right abdominal intestinal segment containing gas and soft tissue material. Other small intestinal segments were segmentally gas distended. Celiotomy identified a ～9 cm focally dilated segment at the jejunoileal junction with no aborad luminal obstruction. Resection and anastomosis of the dilation was performed. Histopathology showed mild mucosal inflammation, but otherwise normal wall layering and autonomic ganglia. Radiographic and histopathologic findings were consistent with congenital segmental dilation of the intestine.     

Duodenal volvulus as a cause of gastric rupture in a 15‐year‐old Warmblood gelding

Duodenal volvulus is an unreported cause of colic in the horse. This case report describes a 15‐year‐old Warmblood gelding evaluated for acute abdominal discomfort. Exploratory celiotomy revealed duodenal volvulus and gastric rupture resulting in severe, acute, septic peritonitis. To the authors' knowledge, this is the first report of a volvulus of the equine duodenum.     

Canine Intestinal Volvulus A Report of Nine New Cases

The records of nine dogs with intestinal volvulus were reviewed. Most were young adult (median 2.6 years) males (6/9) of medium to large breeds. Vigorous activity, dietary indiscretion, or trauma preceded volvulus. Signs included a peracute to acute onset of vomiting, hematochezia, a moderately distended and often painful abdomen, and shock. Normal packed cell volume, altered white blood cell count, hypoproteinemia, hypoalbuminemia, hypokalemia, pathologic bowel dilatation, and serosanguineous abdominal fluid were common clinical findings. Jejunum was most often affected. One dog survived with surgical management.     

Jejunal hemorrhage syndrome in dairy and beef cattle: 11 cases (2001 to 2003)

The medical records of 11 cattle with jejunal hemorrhage syndrome were reviewed. Female and male, lactating and pregnant, dairy and beef cattle were affected. Decreased feed intake and milk production, reduced amounts of dark feces, and abdominal discomfort were common historical findings. Common clinical findings included depressed demeanor, a "ping" and fluid-splashing sounds over the right abdomen, melena, and distended loops of intestine on rectal palpation. Surgery was done on 7 cases, 10 cases were euthanized, and 1 died. Clostridium perfringens type A was isolated from the intestinal contents from 7 of 7 cases. At necropsy, the characteristic finding was a varying length of a dark purple-red distended jejunum with an intraluminal blood clot. Histologically, there was segmental necrosis, ulceration, and mucosal and transmural hemorrhage of the jejunum. This is a sporadic disease of adult cattle characterized by mechanical obstruction of the small intestines by a large blood clot with a case fatality of almost 100%.     

Ultrasonographic features of pedunculated lipomas in two horses

Small intestine strangulation by pedunculated lipomas is a common cause of acute colic in horses. However, diagnosis of this condition prior to surgery may be difficult due to the poor specificity of the clinical signs. We describe the ultrasonographic findings of 2 horses presented for acute colic with a diagnosis of strangulating lipoma confirmed in surgery. Lipomas were identified as rounded and well‐defined, homogeneous hyperechoic structures, surrounded by distended small intestine loops and peritoneal fluid. Ultrasonographic identification of lipomas should be attempted during an abdominal scan, especially in horses with evidence of small intestinal ileus and/or obstruction.     

Small intestinal volvulus in 115 horses: 1988-2000

OBJECTIVE: To evaluate the historical data, signalment, clinical signs, results of laboratory analyses, treatment, and outcome of horses with small intestinal (SI) volvulus. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred and fifteen client-owned horses, aged 1 month to 21 years. METHODS: Clinical signs, laboratory data, surgical or necropsy findings, and outcome for horses with SI volvulus were obtained from medical records, identified by computer search and manual review. RESULTS: There was no statistical difference in signalment between cases and the hospital population. Seventy-four percent of horses were >/=3 years. There were considerable variations in clinical signs on admission; high heart rate and signs of severe pain were not consistent features. Examination per rectum identified distended small intestine in only 69% of horses. One hundred horses had surgery, and small intestine resection was performed in 25. Eighty-four horses were recovered from surgery, and 67 horses survived to hospital discharge (80% of horses recovered from surgery, 58% of 115 horses). Forty-eight percent that were ultimately discharged had a post-operative complication and these horses had a longer average stay than horses with no complication (11 days versus 8.9 days). CONCLUSIONS: We identified 115 horses with primary SI volvulus over a 12-year period. We found that the population of horses with this lesion was older than has previously been reported and that the prognosis for post-operative survival to hospital discharge is good (80%). Post-operative complications were common, and affected approximately half the horses that were ultimately discharged from the hospital. CLINICAL RELEVANCE: This information may aid diagnosis and prognosis and guide decision making for horses with this condition.     

Multiple drug-resistant Salmonella typhimurium DT104 and DT104b isolated in bobwhite quail (Colinus virginianus)

Multiple drug-resistant Salmonella typhimurium, definitive type (DT) 104 and DT104b, were isolated in three separate hunting preserve bobwhite quail (Colinus virginianus) outbreaks. The cases involved 4-day-old and 3-wk-old quail with increased mortality of 5%-8.6%, respectively. Postmortem lesions included emaciation, distended abdomens, and dark colon contents, which were gaseous and fluid in consistency. Salmonella typhimurium isolated from the intestines and/or livers was resistant to ampicillin, chloramphenicol, sulfonamides, and tetracycline. The isolate involving the 3-wk-old quail was phage typed as S. typhimurium DT104. The isolates involving the two cases of 4-day-old quail were phage typed as S. typhimurium DT104b.     

Infection with Photobacterium damselae subspecies damselae and Vibrio harveyi in snapper, Pagrus auratus with bloat

OBJECTIVE: To diagnose the cause of chronic, low mortality associated with bloat in tanks of snapper at an aquaculture facility. DESIGN: A clinical, pathological and microbiological investigation into the cause of a low number of ongoing mortalities associated with bloat in snapper at an aquaculture facility is outlined. Necropsy, histology, microbiology and a comparison of haematology and water analysis from affected and unaffected fish and holding tanks, respectively were conducted. RESULTS: Affected moribund fish were found in lateral or dorsal recumbency floating on the water surface within 24 hours of death. Photobacterium damselae subspecies damselae was isolated from intestinal contents and Vibrio harveyi from the blood of affected fish and both were isolated from culture water. Both V harveyi and P damselae subspecies damselae isolates were sensitive to tetracycline, ciprofloxacin and sulphamethoxazole plus trimethoprim. Environmental parameters such as pH and dissolved oxygen were similar in tanks of affected and unaffected fish. Affected fish had gas distended swimbladders, anaemia, and the intestines were diffusely distended with a clear, pale yellowish fluid. Livers were mottled tan and green in a zonal pattern. Histologically the intestines of fish from tanks suffering mortality had a moderate granulocytic enteritis with oedema and infiltrations with eosinophilic granule cells that were also present as an infiltrate in the gills. There were elevated numbers of melanomacrophage centres and haemosiderin deposits in the spleen, kidney and liver of affected fish. CONCLUSION: Vibrio harveyi and Photobacterium damselae subspecies damselae infection should be recognised as potential pathogens of snapper held in water of less than optimal quality.     

Volvulus of the large colon in a neonatal foal

A one‐day‐old Thoroughbred colt foal was presented for assessment of abdominal pain and reduced urine output. Physical examination of the foal revealed marked abdominal distension, mild tachycardia, tachypnoea and congested mucous membranes. A marked anechoic peritoneal effusion, intestinal hypomotility and mural thickening of the large colon were detected sonographically. Serosanguinous fluid was obtained by abdominocentesis. After haemodynamic stabilisation, the foal underwent general anaesthesia and exploratory laparotomy and a 720° volvulus of the large colon at the sternal and diaphragmatic flexures was identified. After correction of the volvulus, the intraoperative findings were consistent with nonviability of the affected portion of the colon. The owner declined partial colon resection and elected for euthanasia of the foal. Although rare in neonatal foals, large colon volvulus should be considered in foals with signs of abdominal pain, abdominal distension and ultrasonographic findings of colonic mural thickening and luminal distension.